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WCBCT 2013 Abstract Book

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World Congress of Behavioral and Cognitive Therapies 2013


ABSTRACT BOOK

Addictive Disorders/ Conductas Adictivas/ Comportamento viciante


Validao Psicomtrica do Cocaine Craving Questionnaire-Brief- Verso Brasileira
Adaptada para o Crack
Renata Araujo1, Rosemeri Pedroso2, Maria Castro3.
1. Hospital Psiquitrico So Pedro, Porto Alegre, Brazil, 2. Universidade Federal do Rio Grande
do Sul, Porto Alegre, Brazil, 3. CEFI, Porto Alegre, Brazil.
INTRODUO: O craving (ou fissura) um fator muito importante no tratamento da
dependncia de substncias psicotrpicas. OBJETIVO: Validar o Cocaine Craving
Questionnaire-Brief - Verso Brasileira Adaptada para o Crack. MTODO: O delineamento foi
experimental e seus participantes foram randomizados, em grupos: experimental para o qual foi
apresentado uma imagem de um indivduo consumindo crack (G1) e controle (G2) para o qual
no foi apresentada nenhuma imagem. A amostra foi composta por 109 sujeitos (G1=50 e
G2=59) do sexo masculino, internados devido dependncia do crack. Os instrumentos
utilizados foram: Entrevista Clnica com dados sociodemogrficos, CCQ-B- Verso Adaptada
para o Crack, Escala Analgico-Visual do Craving, Inventrios Beck de Ansiedade e de
Depresso e o Estmulo Visual indutor de craving para o G1. RESULTADOS: Na anlise
fatorial, foram encontrados dois fatores: o Fator 1 relacionado ao craving propriamente dito e o
Fator 2, percepo da falta de controle do uso do crack. Os dois Fatores apresentaram
varincia total de 68,84 % e a correlao entre os fatores foi significativa e de baixa intensidade
(r=0,204; p=0,041). O alfa de Cronbach do seu total de pontos foi 0,85. O instrumento no total
de pontos foi correlacionado com a Escala Analgico-Visual (r=0,515; p<0,01). CONCLUSO:
O CCQ-B Verso Brasileira Adaptada para o Crack demonstrou ser, psicometricamente,
satisfatrio para utilizao em pesquisas e em ambiente clnico.
Novas Abordagens em Terapia Cognitivo-Comportamental no Tratamento de
Dependentes de Crack
Renata Araujo1, Maria Castro3, Rosemeri Pedroso2.
1. Hospital Psiquitrico So Pedro, Porto Alegre, Brazil, 2. UFRGS, Porto Alegre, Brazil, 3.
CEFI, CEFI, Porto Alegre, Brazil.
A presente mesa pretende descrever novas abordagens da Terapia Cognitivo-Comportamental
(TCC) no tratamento de dependentes de crack, como Cue Exposure Treatment, o uso de um
jogo teraputico do tipo Role-Playing Game (RPG) para Treinamento de Habiidades e o uso da
TCC no tratamento de dependentes com comorbidades psiquitricas. Todas as abordagens
sero apresentadas havendo um direcionamento para dependentes de crack adultos e
adolescentes tratados em internao hospitalar ou em regime ambulatorial.
Brief Intervention for Marijuana Consumers: Factors Associated with the Dropout of
Therapy
Cesar Carrascoza1, Leticia Echeverra2.

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1. FES Iztacala, Universidad Nacional de Mxico, Ciudad de Mxico, Mexico, 2. Facultad de


Psicologa, Universidad Nacional de Mxico, Ciudad de Mxico, Mexico.
Abstract Central: The most widely used drug in the world is marijuana. In Mexico, marijuana is
also the most abused drug in the last survey (ENA 2011) and continues to be the most
significant as it represents 80% of total consumption of drugs, men have the highest figures, for
every woman 4.2 men consumed there. Marijuana use is a problem for its multiple health
effects, at family, social and its effect in scaling to other drugs. Many young people perceive it
as a little dangerous substance. The objective of this paper is to describe the implementation
and results of a brief intervention for marijuana users to achieve change in the consumers
behavior and maintain this change. The sample was integrated by 52 users of marijuana
consumers with an average age of 22 years, who came voluntarily to receive the intervention in
Addictions Care Center, Faculty of Psychology at the National University of Mexico. The design
used n = 1 with several replicas to ensure internal and external validity. A pre and post
assessment at six months after treatment ends was perform. The results show the effectiveness
of the operation and maintenance of change at 6 months were statistically significant differences
between the initial evaluation and follow-up at 6 months (F054.37, P <0.000). However, there is
a high dropout rate 69%, the higher data are between the first and second sessions. From these
results we analyze the reasons for the desertion, we compared the results of those who
completed treatment against those who dropout. You can see that the first and second sessions
(42.3%) were those that had the highest percentage of dropouts. Different variables are
analyzed to identify the variables that lead to this dropout: low risk perception by users,
affordability, anxiety and depression, as well as social acceptance of substance among young
people as natural without consequences. Alternatives are presented to generate greater
adherence to treatment, including strengthening the motivational interviewing .
Association Between Intensity of Depressive Symptoms and Hospitalization in Alcohol
Dependents
Fernanda Cerutti, Lauren Terroso, Marina Zanotto, Cristiane Esteves, Irani de Lima Argimon.
Pontifcia Universidade Catlica do Rio Grande do Sul - PUCRS, Porto Alegre, Brazil.
A existncia de uma associao entre sintomas depressivos e adio ao lcool encontra base
em subsdios tericos, clnicos e epidemiolgicos. Embora o apoio hiptese de que a
depresso leva ao alcoolismo seja incipiente, parece lgico pressupor que a co-ocorrncia de
sintomas depressivos e de dependncia do lcool acelere a trajetria para a hospitalizao.
Desta forma pretende-se examinar a associao entre a intensidade de sintomas depressivos e
a internao em dependentes de lcool. Para tanto, utilizou-se o Inventrio de Depresso de
Beck (BDI), que foi administrado em 239 dependentes do lcool, estando 110 em atendimento
ambulatorial e 129 internados, sendo estes ltimos testados aps sete dias de abstinncia. Foi
utilizada a anlise de qui-quadrado, considerando os nveis mnimo ou leve de depresso,
como baixa intensidade, e os nveis moderado e grave, como alta intensidade. Em relao ao
regime, as categorias foram internao-sim e internao-no. A segunda anlise foi feita
atravs da regresso logstica, levando em conta os quatro nveis de intensidade da depresso
e ponderando a internao (sim ou no) como varivel resposta. O resultado do qui-quadrado
foi significante (X2 = 5,82, p = 0,016), demonstrando a presena de associao entre as
variveis. A partir da tabela de contingencia, foi utilizada complementarmente a anlise de
correspondncia, verificando-se que a baixa intensidade est mais associada com internaono e alta intensidade, com internao-sim. O resultado da regresso logstica foi significante
(Wald = 9,77, p = 0,021), verificando-se que quem tem depresso grave (Wald = 8,75, p =
0,003) tem 5,38 mais chances de estar internado do que quem tem mnima.Os resultados

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sugerem a importncia da intensidade dos sintomas depressivos serem um foco teraputico no


tratamento de alcoolistas e reforam a hiptese de que a co-ocorrncia destes sintomas e de
dependncia acelera a trajetria para a internao, embora comprovem apenas um efeito
probabilstico para o fato do alcoolista estar internado, j que a prpria hospitalizao pode
agravar sintomas depressivos.
Programa de Interveno Comportamental Sobre o Comportamento de Fumar Cigarros:
Aplicao e Avaliao
Marco Antnio Chequer, Joao Carlos Martinelli, Cristiane Costa e Silva, Fabiana da Silva, Snia
da Silva Gonalves.
Psicologia, UNIVALE, Governador Valadares, Brazil.
Abstract Central: O presente trabalho objetivou avaliar a aplicabilidade e eficcia do
Programa de Interveno Comportamental Sobre o Comportamento de Fumar Cigarros:
Aplicao e Avaliao na modificao do comportamento de fumar cigarros, com a finalidade
de diminuir e/ou cessar o comportamento de fumar, tendo como base a abordagem
comportamental. Mtodo: Foram selecionados 11 voluntrios, com idade acima de 18 anos,
que sabiam ler e escrever, de ambos os sexos. Material/procedimento: Foram utilizados; Ficha
de Anamnese, Questionrio de Tolerncia a Nicotina de Fagerstrom 1991, Escala de AutoEficcia Geral Percepcionada, Auto-registro do consumo dirio de cigarros, Tcnicas de
controle de estmulos sobre as situaes nas quais se fuma, Grfico do consumo de cigarro,
Dicas para no sofrer a sndrome de abstinncia de nicotina, Questionrio de satisfao do
consumidor, Folha de presena, Atividades para desenvolver em casa, Bateria de Beck (escala
de depresso-BDI e escala de ansiedade-BAI), Contrato, Dinmicas e Tcnica de Relaxamento
Muscular Progressivo (Jacobson - 1974). O Programa foi dividido em 7 encontros, um a cada
semana, com durao aproximada de duas horas. Os temas trabalhados foram relacionados ao
comportamento de fumar cigarros, suas implicaes e modificao do comportamento de
fumar. Resultados: O programa mostrou-se eficaz em relao ao propsito de reduo do
consumo de cigarro. De acordo com 70% dos participantes a tcnica que mais os auxiliou no
processo de reduo, foi a Interao grupal atravs de dinmicas e atividades sobre o tabaco.
Terapia Cognitivo Comportamental para Familiares e Cuidadores de Dependentes
Qumicos
Nilse Chiapetti, Carmen Amorim-Gadncio, Andr Luiz Oliveira, Eronyce Rayka Carvalho,
Cyntia Ferreira.
Psicologia, Universidade Federal da Paraba, Joo Pessoa, Brazil.
As abordagens de base comportamental entendem a dependncia de drogas lcitas e ilcitas
como um comportamento aprendido, passvel de anlises e intervenes para uma postura
mais saudvel. primordial analisar os estmulos desencadeadores desse comportamento
(situao de risco), os fatores que contribuem para a manuteno (fatores reforadores) e a
funo das drogas na vida do indivduo (por exemplo: diminuio de ansiedade, presso ou
estresse no trabalho, facilitao de interao social etc.). A famlia figura como um elemento
essencial no apenas na histria de aprendizagem de comportamentos de risco para o uso e
abuso de drogas, mas principalmente pela participao no tratamento do indivduo dependente
qumico. A famlia exerce fundamental influencia no sucesso das intervenes. A Terapia
Cognitivo Comportamental (TCC) uma importante abordagem neste contexto. Apresentamse, aqui, os resultados de um programa de orientao e apoio, baseado na abordagem
cognitivo comportamental, oferecido a grupos de familiares ou cuidadores de dependentes

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qumicos. O projeto vem sendo aplicado h cerca de 2 anos, com duas sesses com durao
de 90 minutos cada, por semana. As sesses so abertas participao de novos
familiares/cuidadores, havendo grande circularidade na presena destes. Ainda assim, buscase estruturar as sesses mantendo uma certa sequencia nos temas e dificuldades trabalhadas.
Alm da psicoeducao, aborda-se o tema da codependncia e procura-se estimular a
identificao e modificao de crenas distorcidas a respeito de si mesmos e do seu papel no
surgimento e na manuteno do problema. Treinar o comportamento assertivo tambm um
foco do processo, pois os familiares e cuidadores frequentemente se encontram de tal forma
mergulhados no problema que encontram dificuldades para responder adequadamente s
demandas envolvidas nas interaes com o dependente. Os resultados so indicativos da
importncia em agregar ao tratamento da dependncia qumica o trabalho com familiares ou
cuidadores de dependentes de drogas como forma de ampliar a rede de apoio.
Moderating Effect of Depression on the Relationship Between Pre-Treatment Craving and
Post-Treatment Alcohol Use
Jennifer Connolly1, David Kavanagh1, Penny Davis2, Lake-Hui Quek1, 3.
1. Institute of Health and Biomedical Innovation, Queensland University of Technology,
Brisbane, QLD, Australia, 2. Griffith University, Brisbane, QLD, Australia, 3. The University of
Queensland, Brisbane, QLD, Australia.
Abstract Central: Alcohol is ranked as the third highest burden of disease worldwide and the
eighth highest leading cause of death. While treatments are effective in helping people to
achieve reductions, relapse rates are high. The ability to identify which treatment seekers may
be at greater risk for relapse would enable appropriate tailoring of interventions and planning of
aftercare. Craving has been widely studied as a potential predictor of relapse but has performed
inconsistently. The effect of comorbid depression on cravings predictive performance however,
has been largely neglected, despite demonstrated associations between negative affect and
craving, and between negative affect and substance use. This study explored the performance
of craving as a predictor of post-treatment alcohol use in the presence of comorbid depressed
mood, under the hypothesis that presence of negative affect would augment effects of craving,
strengthening its predictive power and increasing vulnerability to post-treatment relapse. Data
from 242 participants enrolled in a randomised controlled trial of CBT treatment for alcohol use
disorder were analysed. Craving and depression were measured prior to treatment using the
Obsessive Compulsive Drinking Scale, Alcohol Craving Experience questionnaire and
Depression, Anxiety and Stress Scale-21. Alcohol consumption was measured pre-treatment
and at 3 and 12 months post-baseline. Hierarchical linear regressions were performed, including
an interaction term between craving and depression. Neither craving or depression were
significant predictors of level of alcohol consumption post-treatment, however the interaction
term between craving and depression was significant in the prediction of 12-month drinking,
supporting a moderating effect of depression on the relationship between pre-treatment craving
and post-treatment alcohol use. Slope analysis revealed high depression as the source of the
interaction effect. The finding that craving was predictive of treatment outcomes in the presence
of elevated levels of depressed mood provides preliminary support for a moderating effect of
depression on the relationship between pre-treatment craving and post-treatment alcohol use.
Subscale results from the Alcohol Craving Experience questionnaire also suggest that risk from
craving may come from how alcohol thoughts are managed, rather than from the thoughts
themselves.
Innovations in addiction treatment: Translating therapy from the clinic to the real world

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Jennifer Connolly1, David Kavanagh1, Angela White2, Leanne Hides1, David Kavanagh1, Dian
Tjondronegoro1, Judy Drennan1, Desmond Koh1, Steven Edge1, Lake-Hui Quek1, 2, Jason
Connor2, Zachary Fitz-Walter1, Kate Witkiewitz3, Jennifer Connolly1, David Kavanagh1, Britt
Klein4, David Austin4, Judith Proudfoot4, Frances Kay-Lambkin5, 6, Jason Connor2, Ross Young1,
Angela White2, Lake-Hui Quek1, 2.
1. Institute of Health and Biomedical Innovation, Queensland University of Technology,
Brisbane, QLD, Australia, 2. The University of Queensland, Brisbane, QLD, Australia, 3.
University of New Mexico, Albuquerque, NM, USA, 4. Swinburne University of Technology,
Melbourne, VIC, Australia, 5. The University of New South Wales, Sydney, NSW, Australia, 6.
The University of Newcastle, Newcastle, NSW, Australia.
Substance use disorders are highly prevalent, with 15-25% lifetime incidence. Of all substances,
alcohol is the most widely used, with 84-90% of people with 12-month substance use disorder
having an alcohol use disorder. Hazardous alcohol consumption is especially rampant in young
adulthood, with close to 30% of 18-19 year olds and 22% of 20-29 year olds consuming alcohol
at high risk levels at least weekly, compared to only 13% of adults aged 30-39. Incidence of
alcohol use disorder is also higher in clinical populations than in the general population, with
close to 20% of people with a 12-month mental disorder also having a 12-month alcohol use
disorder, compared to 4% in the general population.
Substance misuse is associated with a range of negative physical, social and psychological
consequences, yet engagement with treatment services remains low. Up to 75% of people with
a 12-month alcohol use disorder do not seek any kind of mental health treatment. Barriers to
treatment access are numerous and include remote location, cost, convenience and stigma.
Treatment uptake is especially low in young adults, with only 11% of 16-24 year olds seeking
treatment for substance use disorder compared to 33% of 25-44 year olds. Innovative methods
for engaging substance users in treatment are required.
Technology overcomes many of the barriers that restrict access to traditional forms of treatment.
Web and mobile-delivered therapies can be accessed from any location with Internet access, at
times that are convenient to the client. Technology-based interventions can be offered to large
numbers of people at low or no cost, and the anonymity of use overcomes barriers related to
stigma.
The evidence supporting online interventions is rapidly growing. Efficacy has been
demonstrated for a range of mental disorders including alcohol misuse, depression and anxiety.
Fewer studies have examined the impact of online interventions for comorbid disorders, despite
the high prevalence of co-occurring mental health diagnoses. Mobile interventions are also on
the rise, with early data showing positive effects, but more research is needed in this expanding
area to determine most effective methods of delivery.
This symposium presents three papers that contribute new knowledge on the innovative
treatment of alcohol misuse using technology. The first paper reports on development of a
mobile application to help young people track and moderate their alcohol consumption. The
second paper presents findings of a brief mobile intervention study targeted to college students
who smoke and engage in heavy episodic drinking. The third and final paper presents results
from a randomised controlled trial investigating effectiveness of an Internet-based intervention
for comorbid alcohol misuse and depressed mood.
The next generation health intervention tool - Can smart phone applications help young
people track and moderate alcohol use and potential harms?
Whilst alcohol is a common feature of many social gatherings, there are numerous immediate
and long-term health and social harms associated with its abuse. Alcohol consumption is the
worlds third largest risk factor for disease and disability with almost 4% of all deaths worldwide
attributed to alcohol. Not surprisingly, alcohol use and binge drinking by young people is of

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particular concern with Australian data reporting that 39% of young people (18-19yrs) admitted
drinking at least weekly and 32% drank to levels that put them at risk of alcohol-related harm.
The growing market penetration and connectivity of smartphones may be an opportunities for
innovation in promoting health-related self-management of substance use. However, little is
known about how best to harness and optimise this technology for health-related intervention
and behaviour change.
This paper explores the utility and interface of smartphone technology as a health intervention
tool to monitor and moderate alcohol use. A review of the psychological health applications of
this technology will be presented along with the findings of a series of focus groups, surveys
and behavioural field trials of several drink-monitoring applications.
Qualitative and quantitative data will be presented on the perceptions, preferences and utility of
the design, usability and functionality of smartphone apps to monitoring and moderate alcohol
use. How these findings have shaped the development and evolution of the OnTrack app will be
specifically discussed, along with future directions and applications of this technology in health
intervention, prevention and promotion.
Development and evaluation of a Mobile intervention for heavy drinking and smoking
Nearly all college student smokers also drink alcohol, and smoking and heavy-episodic drinking
(HED) commonly co-occur. However, to date, no interventions have been developed that target
both HED and smoking in this population. The objective of the current study was to develop and
evaluate a brief mobile feedback intervention that targeted HED and smoking.
Data from our prior research on predictors of HED and smoking assessed in real-time using
mobile phones was used to develop and implement a mobile intervention that incorporated
components (called modules) administered up to 3 times per day in real-time. Each
intervention module was 1 to 3 pages (sized for a mobile phone screen) and targeted one of the
following topics: normative feedback, health information about alcohol or smoking, protective
behavioral strategies for drinking and smoking, urge surfing, or decisional balance for drinking
or smoking. Participant answers from the baseline assessment were incorporated into the
intervention in real-time to make the intervention more personalized to the individual user.
Participants (n = 94) were non-treatment seeking college students (mean age=20.5, SD=1.7)
who engaged in at least one episode of binge drinking in the past two weeks and reported
concurrent smoking and drinking at least once a week. Participants were randomized to either
receive the mobile intervention for 14 days (n=32), complete mobile assessments (n=33; without
intervention) for 14 days, or complete minimal assessments (n=29) without intervention or
mobile assessments). The mobile assessment and mobile intervention participants completed
2341 assessments over 14 days, including 664 occasions of drinking, 1199 occasions of
smoking, and 365 occasions of concurrent drinking and smoking. Individuals in the mobile
intervention condition received an average of 23.05 (SD = 6.78) modules over the 14 days.
At a 1-month follow-up, we observed significant reductions in smoking in both the mobile
intervention and mobile assessment conditions in comparison to the minimal assessment
condition. Among those who received the mobile intervention, receiving more modules of the
intervention was significantly associated with a lower likelihood of any drinking during the 14 day
assessment period and significant reductions in smoking at 1-month follow-up. The mobile
intervention did not predict reductions in HED or concurrent smoking and drinking. Future
research should continue to examine ways of using technology and the real-time environment to
improve interventions for HED and smoking.
Comparing brief, self-guided and therapist-assisted Internet CBT for co-occurring
alcohol misuse and depression: Outcomes to twelve months.
Research to date on Internet-based treatments for alcohol and other mental disorders has
focused primarily on single disorders of mild to moderate intensity. In practice however,

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disorders frequently co-occur. The Internet offers numerous advantages over face-to-face
therapy including high fidelity, accessibility and low cost. However, there remains scepticism on
whether remotely delivered therapies can address complex disorders, and whether therapist
support is needed.
Outcomes to 12 months from a randomised controlled trial comparing three Internet-based
treatments for comorbid alcohol and depression are presented. A brief motivational program
was compared against comprehensive CBT-based self- or therapist-guided treatments. Impacts
on alcohol consumption and depression are reported, and predictors examined.
Participants were recruited predominantly via media advertising and social marketing. Current
high-risk alcohol use and depressive symptoms were required for inclusion. After baseline
assessment, eligible participants were randomly allocated to one of the 3 treatments. Those
receiving the therapist-guided version of the full CBT-based program received 12 personalised
emails encouraging continued engagement and guiding program use. Assessments were
completed online and by phone at baseline, 3, 6, 9, and 12 months.
Eighty-nine percent of the 327 participants fulfilled criteria for current alcohol dependence, and
45% had a major depressive episode. Those receiving therapist assistance completed more of
the program and had better outcomes at 3-months, although group effects were not maintained
at later assessments. Predictors of superior outcomes are reported.
The results are highly consistent with those on Internet treatment of single disorders, and
demonstrate that Internet-based treatment is also suitable for more complex presentations.
Therapist assistance results in faster responses, but self-guided programs have similar longterm impact.
When Do Attitudes Predict Alcohol Use?: Attitude Accessibility as a Moderator
Mathilde Descheemaeker1, Adriaan Spruyt2, Dirk Hermans1.
1. University of Leuven, Leuven, Belgium, 2. Ghent University, Ghent, Belgium.
Insight in the processes underlying alcohol use could help to improve the understanding and
treatment of alcohol dependence. One potentially relevant factor is the attitude one has towards
alcohol. However, evidence for the relationship between attitude measures and behavior is
mixed. A possible moderator of this relationship is attitude accessibility, i.e. the ease with which
an attitude can be retrieved from memory. In behavioral domains other than alcohol use,
research has already shown self-reported attitudes to be more consistent with behavior when
they are more accessible. The current studies investigated whether attitude accessibility
moderated the ability of a direct attitude measure (rating scales) to predict alcohol use in a
student population. In the first study (N = 46), the accessibility of the attitude towards beer was
increased in the experimental group through repeated evaluation of beer stimuli. In the second
study (N = 59), we measured the pre-existing accessibility of the attitude towards beer by
means of a speeded evaluative categorization task (the faster an attitude object is evaluated,
the more accessible the attitude towards it is) and performed a tertile split to create a high and a
low accessible group. Dependent variables were the amount of beer relative to water poured
and drunk during a bogus taste test and the choice for beer versus water. Both studies provided
evidence for the moderating role of accessibility when predicting behavior during the taste test.
In the first study, the direct attitude measure was predictive only after accessibility had been
experimentally increased. In the second study, this attitude was predictive in the high but not in
the low accessible group. There was no evidence that accessibility influenced the prediction of
choice behavior, possibly because this behavior is less spontaneous.
Using Attitudes to Predict Relapse Following Treatment for Alcohol Dependence: Does
Attitude Accessibility Matter?

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Mathilde Descheemaeker1, Adriaan Spruyt2, Hendrik Peuskens3, Dirk Hermans1.


1. University of Leuven, Leuven, Belgium, 2. Ghent University, Ghent, Belgium, 3. Alexian
Brothers Psychiatric Hospital, Tienen, Belgium.
Alcohol dependence is an important public health problem that is characterized by high rates of
relapse. Identifying processes that contribute to relapse can help to develop more effective
treatments. One potentially relevant factor is the attitude one has towards alcohol. This attitude
can be measured directly (self-report) or indirectly (inferred from other behavior, such as
reaction speed). However, in the domain of alcohol use as well as in other behavioral domains,
evidence for the predictive validity of direct and indirect attitude measures is mixed. A possible
moderator of this relationship is attitude accessibility, i.e. the ease with which an attitude can be
retrieved from memory. Research has shown self-reported attitudes to be more consistent with
behavior when they are more accessible. It remains largely unexplored whether this is also the
case for indirectly measured attitudes. The current study (N = 36) investigated whether attitude
accessibility moderated the ability of direct and indirect attitude measures to predict relapse
after residential treatment for alcohol dependence. Shortly after admission to the treatment
centre, the valence of participants attitude towards alcohol was measured directly (rating
scales) and indirectly (Affective Priming Task). We also measured the accessibility of the
attitude towards alcohol by means of a speeded evaluative categorization task (the faster an
attitude object is evaluated, the more accessible the attitude towards it is) and used a median
split to create a high and a low accessible group. The follow-up questionnaires were
administered eight months after discharge. In line with our hypotheses, there was evidence that
the direct and the indirect attitude measure predicted whether participants had relapsed and the
severity of alcohol use at follow-up in the high but not in the low accessible group.
Cost Effectiveness of Brief Interventions to Address Addiction in the Early Stages
Leticia Echeverra.
Facultad de Psicologa, Universidad Nacional de Mexico, Mexico City, Mexico.
Abstract Central: The health and social problems resulting from alcohol and drugs use,
generate high costs that are absorbed by the country's health system. However, the use of
these substances while generating high economic and social costs, it is important to note that
this is a public health problem with a high recovery rate, both the health of the individual
concerned and in money spent on programs aimed at reducing the impact of the phenomenon.
Brief interventions are strategies internationally identified as effective in reducing harm from
substance use. These interventions require a few sessions, are provided in outpatient settings
and seen immediate results that endure over time, characteristics that make them inexpensive
alternatives. The aim of the study was to obtain the cost-effectiveness of brief interventions for
people in early stages of harmful use of alcohol and other illegal drugs. Methods: Users treated
in Addictions Care Center of the National University of Mexico formed the intervention and
comparison groups, made up of 129 individuals and a group of 119 members who refused
treatment but completed the initial and follow up assessment. Both groups were contacted one
year later for the follow up assessment. The results showed that brief interventions are able to
reduce substance use (p = 0.05), this reduction was reflected in a decrease in the use of health
services 86% (p = 0.08), and a reduction in days missed from school or work (p = 0.05).
Conclusions: brief interventions is considered a therapy with better cost-effectiveness option
compared with no treatment.

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Eficacia de las Tcnicas de Autocontrol y Saciacin de Estmulos en la Extincin de la


Conducta de Fumar
F, Robert Ferrel Ortega.
Psicologa, Universidad Cooperativa de Colombia, seccional Santa Marta, Santa Marta,
Colombia.
Abstract Central: El tabaquismo es la segunda causa principal de muerte en el mundo con
casi cinco millones de defunciones anuales y se estima que para el ao 2020 causar el doble
de defunciones (OMS, 2009), lo que evidencia un grave problema de salud pblica que
demanda tratamientos eficaces. Colombia, se considera como un pas intermedio en el
consumo en Suramrica, con una tasa del 19% (26% en hombres y 12% en mujeres). En esta
investigacin de tipo experimental, con diseo intra-sujeto (AB-AB) de caso nico, se tuvo
como objetivo evaluar la eficacia de la aplicacin combinada de dos tcnicas conductuales
(control estimular y saciacin de estmulos) en la extincin de la conducta de fumar, en cuatro
sujetos adultos adictos al consumo de cigarrillos con filtro. Se aplicaron tres instrumentos
previos: Historia Clnica y Tabquica (Solano y Jimnez, 2000), Test de Fagerstrm
(Fagerstrm y Schneider, 1989) y Test de Glover-Nilsson (2005); y, una ficha de autorregistro
de consumo, diseada por los autores. Se hall una correlacin lineal positiva entre la
aplicacin de las tcnicas y la probabilidad de extincin de la conducta de fumar; por lo que tres
de los sujetos lograron dejar de fumar en el tiempo establecido, 36 das despus de
comenzado el tratamiento, y uno redujo significativamente su consumo de 13.7 a un promedio
final de 5.1. Adems, se favoreci el control de la abstinencia, con probabilidad de un
abandono definitivo del consumo, sin temor a recadas futuras. Estos resultados confirman los
hallados por otros estudios, por lo que se sugiere establecer y generalizar la aplicacin
conjunta de estas tcnicas para la extincin del hbito de fumar. Palabras clave: hbito de
fumar, tcnicas de modificacin de conducta, saciacin de estmulos, autocontrol, extincin.
Desenvolvendo Habilidades Sociais em Adolescentes em Cumprimento de Medidas
Socioeducativas: Uma Proposta de Interveno em Grupo
Cristiane Fonseca.
1. Universidade Ceuma, So Lus, Brazil, 2. Ncleo Maranhense de Anlise do
Comportamento, So Lus, Brazil.
Abstract Central: O presente estudo apresenta a descrio de uma proposta de interveno
em grupo para adolescentes em cumprimento de medidas socioeducativas, com o objetivo de
desenvolver habilidades sociais. A justificativa para o concepo do programa foi amparada em
pesquisas nacionais e internacionais que apontam a existncia de dficits no repertrio
comportamental desses jovens, principalmente quanto dificuldade em resistir s drogas e
dizer no. Sendo assim, acredita-se que a construo de habilidades de resistncia ao
oferecimento de drogas, a autoeficcia e o estmulo capacidade de tomada de decises
podem reduzir o uso de substncias psicoativas, bem como favorecer uma melhor eficcia no
processo de ressocializao. Para tanto, foi desenvolvido um programa teraputico composto
por trs fases. Para a primeira fase foi utilizado como recurso instrucional, uma adaptao do
sistema multimdia de habilidades sociais para crianas (SMHSC-Del-Prette). Na primeira fase
do programa sero apresentadas 14 (quatorze) situaes do cotidiano dos adolescentes, nas
quais os mesmos (provavelmente) apresentam dificuldades em comportar-se habilidosamente,
seguidas de trs alternativas de reao: (a) assertiva; (b) passiva; (c) agressiva. Os
adolescentes devero avaliar cada uma das opes e responder com que frequncia se
comportam de forma semelhante a cada reao, a adequao que atribui a elas e a dificuldade
que encontra para se comportar em cada uma das propostas. Na segunda fase, cada

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adolescente dever apresentar ao grupo uma situao de difcil manejo e em seguida ser
estimulada uma discusso, onde o grupo dever sugerir alternativas para lidar com o problema,
alm de apresentar exemplos de reaes passivas, agressivas e assertivas. A terceira e ltima
fase do programa consiste em um momento de discusso de experincias reais dos
adolescentes, seguida de uma avaliao com o grupo sobre formas de lidar com cada uma das
situaes, fazendo uma anlise de perdas e ganhos. As situaes apresentadas na primeira
fase envolvero as tarefas descritas a seguir: Recusar pedido de colega; Expressar desagrado;
Pedir ajuda a colega; Pedir mudana de comportamento; Pedir desculpas; Demonstrar esprito
esportivo; Mediar conflitos; Negociar com colega, convencer; Questionar comportamento do
outro; Responder pergunta da professora; Fazer pergunta para a professora, Aceitar gozaes;
Resistir presso do grupo e Defender-se de acusao injusta. Esta proposta de interveno
ainda no foi testada na ntegra, entretanto, um estudo piloto, com cinco participantes do sexo
masculino, com idades entre 15 e 19 anos, foi aplicado em uma instituio que atua na
ressocializao de adolescentes em cumprimento de medidas socioeducativas. Os resultados
observados mostraram que todos os participantes conseguiram apresentar nas fases 2 e 3 do
programa, descries de reaes habilidosas, bem como fazer diferenciaes corretas dos
diferentes padres de comportamento (assertivo, passivo e agressivo). Na fase 3, dois dos trs
participantes, apresentaram relatos de situaes reais, onde conseguiram comportar-se de
forma assertiva. A partir desta primeira experincia, o programa foi aprimorado, com vistas a
sua continuidade.
Terapia Cognitivo Comportamental em Dependentes de Cocana e Crack: Melhora da
Adeso ao Tratamento com a Administrao de Biperideno
Iracema Frade, Luiz Henrique Dieckmann, Eroy Silva, Altay Souza, Jos Carlos Galduroz.
Psicobiologia - UDED, Universidade Federal de So Paulo - UNIFESP, So Paulo, Brazil.
Introduo: Vrios estudos tm mostrado que a adeso de pacientes dependentes de drogas
muito baixa. Isto especialmente observado em dependentes de cocana ou crack. Nos ltimos
anos temos desenvolvido alguns estudos no sentido de diminuir a compulso pelo uso destas
drogas. A mais promissora dessas substncias o biperideno, que um anticolinrgico usado
nas fases iniciais no tratamento da doena de Parkinson e para diminuir os efeitos
extrapiramidais de neurolpticos. O constructo terico que o bloqueio do sistema colinrgico
provoca aumento da dopamina, tornando seu nvel constante e, portanto, diminuio da
compulso pela cocana. Objetivo: Avaliar a adeso de pacientes dependentes de cocana e/ou
crack, Terapia Cognitivo Comportamental (TCC), entre aqueles que receberam biperideno ou
apenas TCC (juntamente com placebo). Mtodos: Foram avaliados Introduo: Vrios estudos
tm mostrado que a adeso de pacientes dependentes de drogas muito baixa. Isto
especialmente observado em dependentes de cocana ou crack. Nos ltimos anos temos
desenvolvido alguns estudos no sentido de diminuir a compulso pelo uso destas drogas. A
mais promissora dessas substncias o biperideno, que um anticolinrgico usado nas fases
iniciais no tratamento da doena de Parkinson e para diminuir os efeitos extrapiramidais de
neurolpticos. O constructo terico que o bloqueio do sistema colinrgico provoca aumento
da dopamina, tornando seu nvel constante e, portanto, diminuio da compulso pela cocana.
Objetivo: Avaliar a adeso de pacientes dependentes de cocana e/ou crack, Terapia
Cognitivo Comportamental (TCC), entre aqueles que receberam biperideno ou apenas TCC
(juntamente com placebo). Mtodos: Foram avaliados 104 pacientes dependentes de cocana
e/ou crack, distribudos em dois grupos aleatoriamente: 54 pacientes no grupo Experimental (2
mg de biperideno, duas vezes ao dia), enquanto frequentavam s sesses de Terapia
Cognitivo Comportamental e 53 pacientes no grupo Controle (apenas TCC, fazendo uso de 1
cpsula de placebo, duas vezes ao dia). As sesses de terapia foram em grupo e semanais,

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num total de 8 sesses. As consultas para avaliar efeitos colaterais e entregar as cpsulas de
placebo ou biperideno eram quinzenais. Tanto os terapeutas quanto os pacientes estiveram
cegos em relao medicao durante todo o estudo e as cpsulas tinham aspectos idnticos.
Resultados: No pr-tratamento no foram observadas diferenas significativas nas seguintes
variveis: faixa etria, estado civil, religio, grau de escolaridade, idade de incio e tempo de
uso entre os dois grupos (Experimental e Controle). A comparao dos escores de estresse foi
realizada atravs da Escala de Estresse Percebido (PSS14) e de ansiedade pelo Inventrio de
Ansiedade de Beck entre o incio e o trmino do tratamento (3 meses), no apresentaram
diferenas significativas nos dois grupos estudados. Foi feito um modelo de regresso linear
mltipla para avaliar os preditores de presena nas sesses de TCC. O modelo apresentou
efeito positivo do uso de biperideno no aumento do nmero de sesses frequentadas, sendo
que o grupo Experimental frequentou em mdia 4 sesses a mais de TCC que o controle
(p<0.005). Concluso: Os resultados sugerem que a administrao do biperideno ajudou no
engajamento psicoterpico, provavelmente por diminuir a compulso pela cocana e/ou crack,
facilitando a adeso ao tratamento.
Anlise do Comportamento de Fumar Cigarros
Ana Cristina Gameiro1, 2, Maria Luiza Marinho-Casanova1, Cristiane Oliveira3, 2.
1. Universidade Estadual de Londrina- PR, So Jos do Rio Preto, Brazil, 2. Centro Regional
de Ateno aos Maus Tratos na Infncia - CRAMI, So Jos do Rio Preto, Brazil, 3.
Universidade Paulista UNIP, So Jos do Rio Preto, Brazil.
Abstract Central: As drogas, sejam elas legais ou ilegais, acarretam problemas de grande
relevncia, tanto na esfera individual, como na sanitria e social, passando pela familiar,
pblica, econmica, entre outras. Os problemas acarretados pelo tabaco, do ponto de vista da
sade pblica, so superiores aos produzidos por drogas ilegais (Becoa, 1998), estando entre
as principais causas evitveis de mortes prematuras em todo o mundo (Ferreira, 2000). H
muitos componentes nocivos que se desprendem da combusto do tabaco. Mais de 4 mil
substncias qumicas j foram encontradas, entre elas esto o alcatro, o monxido de
carbono (CO) e a nicotina. A Anlise do Comportamento, que se apia nos pressupostos
filosficos e epistemolgicos do Behaviorismo Radical, no considera uma explicao orgnica
ou fsica da dependncia do tabaco separada da explicao psicolgica, visto que no acredita
no dualismo mente-corpo. Por essa viso monista do behaviorismo radical, o organismo
compreendido como um todo e a dependncia do tabaco vista de forma integral. Esta
pesquisa no pretendeu explicar minuciosamente como se d o efeito da nicotina no crebro,
mas focou nas variveis ambientais, ao identificar alguns princpios e conceitos tericos da
Anlise do Comportamento, como Condicionamento respondente, Comportamento Operante,
Estmulos Discriminativos, Operaes Estabelecedoras, Comportamento governado por regras
e modelado pelas contingncias, Autocontrole e Influncia do Grupo, que auxiliam na
explanao do comportamento de fumar. O objetivo principal desta pesquisa foi analisar, sob o
enfoque da Anlise do Comportamento, verbalizaes de trs tabagistas participantes em um
programa de tratamento para parar de fumar. Os principais reforadores do comportamento de
fumar encontrados foram: aumento de concentrao nas atividades, sensaes de bem-estar,
fuga de sentimentos e pensamentos desagradveis e dos sintomas de abstinncia e evitar
ganhar peso. Apesar das muitas conseqncias reforadoras, o fumar tambm possui
conseqncias punitivas como a desaprovao de pessoas prximas, o mau cheiro acarretado
pela fumaa e reaes orgnicas do fumar como falta de ar. Tambm foram analisadas as
regras e os estmulos discriminativos como importantes estmulos que sinalizavam que o fumar
seria reforado. A privao da nicotina e de reforadores alternativos ao fumar funcionam como
operaes estabalecedoras que aumentam o valor reforador de tal comportamento.

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Nuevas Aproximaciones en el Tratamiento del Tabaquismo


Olaya Garca-Rodrguez1, Irene Pericot-Valverde1, Sara Weidberg-Lpez1, Jos GutirrezMaldonado2.
1. Department of Psychology, University of Oviedo, Oviedo, Spain, 2. University of Barcelona,
Barcelona, Spain.
Abstract Central: En la adiccin al tabaco, el craving es un sntoma comn durante periodos
de abstinencia (Ferguson & Shiffman, 2009) y una de las principales causas de recada
(Piasecki, 2006). Las tcnicas de exposicin tienen como objetivo reducir el craving a travs de
la exposicin controlada y repetida a estmulos asociados al uso de la sustancia. Un mtodo de
exposicin que est recibiendo atencin en los ltimos aos se basa en el uso de Realidad
Virtual (RV). Las tcnicas de exposicin mediante RV permiten un elevado grado de control
sobre los parmetros de la exposicin con un alto nivel de precisin que no es posible en
situaciones reales. Ya que la RV ha mostrado su utilidad como tcnica de exposicin (LaRowe,
Saladin, Carpenter, & Upadhyaya, 2007) y presenta ventajas sobre los mtodos tradicionales
de exposicin, se propone su empleo para la mejora del tratamiento del tabaquismo. El objetivo
de esta investigacin fue desarrollar un protocolo de tratamiento para dejar de fumar validado
empricamente que combine un programa multicomponente (Becoa, 2007) junto con un nuevo
componente de exposicin mediante RV. Esta investigacin se desarroll en 3 etapas. Etapa 1:
Seleccin de los entornos virtuales. Se administr un cuestionario a 154 fumadores en el que
se pregunt el nivel de deseo de consumo de tabaco en 12 situaciones cotidianas, as como los
estmulos concretos presentes en dichas situaciones. Con los resultados, se desarrollaron 8
entornos virtuales que simulaban diferentes situaciones estrechamente relacionadas con el
consumo de tabaco. Etapa 2: Validacin de los entornos. Se evalu la capacidad de los
entornos virtuales para producir craving en 46 fumadores, registrando el deseo generado
durante la exposicin a los entornos virtuales. Etapa 3: Utilizacin de los entornos virtuales
como tcnica de exposicin junto a un programa multicomponente para el tratamiento del
tabaquismo. Los resultados disponibles de las etapas 1 y 2 de la investigacin muestran como
la RV es til para simular situaciones cotidianas asociadas al consumo de tabaco. Adems, la
exposicin a dichas situaciones a travs de entornos virtuales es capaz de producir craving en
fumadores (Garca-Rodrguez, Pericot-Valverde, Gutirrez-Maldonado, Ferrer-Garca, &
Secades-Villa, 2012). Los primeros datos del ensayo clnico muestran como la RV puede
contribuir a la mejora de los tratamientos para el tabaquismo. Referencias Becoa, E. (2007).
Programa para dejar de fumar. Vigo: Nova Galicia Edicins. Ferguson, S., & Shiffman, S.
(2009). Cue-induced cravings for cigarettes. Current Cardiovascular Risk Reports, 3(6), 385390. Garca-Rodrguez, O., Pericot-Valverde, I., Gutirrez-Maldonado, J., Ferrer-Garca, M., &
Secades-Villa, R. (2012). Validation of smoking-related virtual environments for cue exposure
therapy. Addictive Behaviors, 37(6), 703-708. LaRowe, S. D., Saladin, M. E., Carpenter, M. J., &
Upadhyaya, H. P. (2007). Reactivity to nicotine cues over repeated cue reactivity sessions.
Addictive behaviors, 32(12), 2888-2899. Piasecki, T. M. (2006). Relapse to smoking. Clinical
psychology review, 26, 196-215.
El rol de las creencias en las drogodependencias, las conductas adictivas, el abuso de
drogas y alcohol en jvenes. Aspectos y derivaciones asistenciales y preventivas
Raul Gomez1, Leticia Luque1, Patricia Del Zotto Libonatti3, Mariano Carrizo2, Guillermo Lloret2.
1. Unidad De Estudios Epidemiolgicas en Salud Mental. Facultad de Psicologa. Universidad
Nacional de Crdoba, Crdoba, Argentina, 2. Programa El Sol., Crdoba, Argentina, 3. Area de
abordaje de conductas adictivas: Sub-Secretara de Abordaje de las Conductas Prevencin de

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las Adicciones, Ministerio de Desarrollo Social, SENAF. Gobierno de la Provincia de Crdoba.


Argenti, Crdoba, Argentina.
El problema del uso de drogas y alcohol no es algo actual, dado que su historia se remonta a la
propia historia de la humanidad. Distintas sociedades han conocido y usado, para distintos
fines, individuales o colectivos, diferentes productos qumicos a fin de alterar sus estados de
nimos, estimularse, sedarse, modificar su percepcin y diversos procesos cognitivos. En el
ltimo siglo se produce un incremento del uso de drogas, asintiendo a problemas derivados y
generados principalmente por el abuso de bebidas alcohlicas, tabaco, medicamentos y las
adicciones sin sustancias o adiciones psicolgicas. La historia se agrava con la aparicin y
extensin de nuevas sustancias (derivados del cannabis, coca y opiceos bsicamente) que
viene acompaado de cambios en las modalidades y patrones de uso de drogas tradicionales.
Recientemente se ha sealado la aparicin de nuevas modalidades y patrones de consumo.
Estos fenmenos abarcan las adiciones sin sustancias y la modificacin de los patrones de
consumo de alcohol (Binge o atracn) por parte de las nuevas generaciones Los distintos
modelos tericos de abordaje de la drogodependencia se han centrado bsicamente en
analizar distintas variables, bien parcialmente o de modo comprehensivo, para intentar
entender por qu unas personas consumen drogas y otras no. Con dicho conocimiento se
estima que es posible aplicar estrategias preventivas y/o intervenciones adecuadas para que el
consumo no se produzca o se detenga. Los tericos cognitivos plantean que las personas
reaccionan ante su entorno segn la percepcin singular que tienen de ste. La forma de
valorar los acontecimientos es lo que determina el comportamiento. En este caso la conducta
adictiva. En las adicciones, sean comportamentales o qumicas, los sujetos presentan un
conjunto de creencias distorsionadas que les permiten justificar (para s mismos y con los
dems) su comportamiento hacia el objeto adictivo. Desde la teora de Beck, estas se
denominan creencias adictivas. Las creencias adictivas contribuyen a mantener las adiccines
o el consumo problemtico y proporcionan el trasfondo para las recadas. Las creencias son
estructuras cognitivas relativamente rgidas y duraderas, que no son fciles de modificar por la
experiencia. Las creencias adictivas son consideradas como un conjunto de ideas centradas
alrededor de la bsqueda de placer, resolucin de problemas, alivio y escape. El objetivo de
este panel es discutir las implicancias que las creencias tienen en relacin a la variedad y
complejidad de la problemtica adictiva. Se comunicarn resultados de investigaciones que han
indagan el rol de las creencias en las denominadas adicciones sin sustancias, el consumo de
alcohol en atracn y el desarrollo de proceso adictivo. Adicionalmente, se comentarn
intervenciones preventivas y asistenciales que se sustentan en los presupuestos tericos de la
perspectiva cognitivo-comportamental, especficamente las creencias, que son utilizadas en
nuestro medio. Finalmente se postular la importancia de estas herramientas tericas en el
diseo, implementacin y evaluacin de los abordajes preventivos y asistenciales de las
drogodependencias, las conductas adictivas y el abuso de drogas y alcohol en jvenes.
Taller de Prevencin Universal para el Consumo de Alcohol
Thania Gonzalez.
UNAM, Mxico city, Mexico.
RESUMEN El presente estudio busca sumarse a este esfuerzo mediante la realizacin y
evaluacin de una intervencin de prevencin, un taller de habilidades para la vida que tiene la
finalidad de dotar a chicos de preparatoria de ciertas habilidades que les sirvan para rechazar
el uso y el consumo de sustancias psicoactivas. Segn la teora de la Conducta Planificada, el
uso experimental de sustancias estara directamente relacionado con la intencin de
consumirlas, la cual integrara tres componentes: a) la actitud del individuo ante el uso de

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drogas, que comporta un conjunto de creencias relevantes sobre las consecuencias del
consumo y el valor afectivo que el individuo le atribuye a tales consecuencias, b) sus creencias
normativas al respecto (norma subjetiva) es decir la percepcin de que otras personas
significativas aprueban o desaprueban la conducta en cuestin y el grado de motivacin para
ajustarse a tales expectativas, y c) el control conductual percibido, esto es, la percepcin del
individuo de s mismo como capaz o no de usar drogas o, en su caso, de enfrentar la presin
social para hacerlo. El objetivo de este trabajo fue el de Brindar un taller de prevencin
universal para el consumo de alcohol, basado en ciertas habilidades sociales, cognitivas y para
el manejo de las emociones, sustentada en el modelo de la Conducta Planificada, de Ajzen y
Fishbein, que incorpora factores cognitivos y actitudinales relacionados directamente con el
inicio del uso de drogas. MTODO:Esta evaluacin se bas en un diseo experimental con
prueba- postprueba y grupo control. PARTICIPANTES: El programa se hizo para aplicarse a
estudiantes de educacin media superior. Este programa se aplic en una escuela urbana de
alto riesgo para el consumo. Asimismo, se dise para ser aplicado, de preferencia, en grupos
no mayores de 15 alumnos, con una duracin y frecuencia de cuatro sesiones de 90 minutos.
El programa se aplic en la preparatoria #2 que se encuentra en una zona de alto riesgo para
el consumo de drogas de la Ciudad de Mxico. La muestra total de alumnos participantes en
este estudio fue de 17 Para los anlisis estadsticos slo se consider a aquellos jvenes que
participaron en al menos 3 de las cuatro sesiones y que estuvieron presentes los dos das en
que se aplic evaluacin tanto de la pre-prueba como de la post-prueba y que adems
proporcionaron informacin completa en todos los rubros solicitados de ah que la muestra final
quedara conformada por 12 jvenes. INSTRUMENTOS:Se utiliz un cuestionario de evolucin
situacional pre y post. Se utiliz un cuestionario elaborado a partir de la adaptacin de los
elementos de actitud ante el consumo de drogas y de norma subjetiva. Para este estudio se
dise una escala con algunas habilidades para la vida que la literatura reporta como
relacionadas con la prevencin del consumo de drogas. Dependiendo del dficit general que
tuvieron los jvenes con respecto a este cuestionario, fue que se diseo el taller de habilidades
para la vida que quedo constituido por las habilidades de comunicacin asertiva, solucin de
problemas y toma de decisiones, y control emocional. RESULTADOS: Los resultados muestran
diferencias en la intencin de usar drogas antes y despus de la aplicacin del programa.
Tolerancia Asociativa al Etanol: Aportes del Laboratorio Experimental para Mejorar la
Terapia de Exposicin a las Claves
Valeria Gonzlez1, Mara Paz Contreras1, Vctor Navarro1, Margarita Borquez1, Vanetza
Quezada1, 2, Mario Laborda1, Ronald Betancourt1.
1. Universidad de Chile, Santiago, Chile, 2. Universidad Catlica de Chile, Santiago, Chile.
El condicionamiento Pavloviano tiene un rol importante en la mantencin de conductas
adictivas, especialmente de la tolerancia a las drogas. En esta, claves pre-droga (estmulos
condicionados, EC) se asocian con los efectos de la misma (estmulo incondicionado, EI), y
luego llegan a evocar respuestas condicionadas que compensan los efectos de la droga
produciendo as la tolerancia (una disminucin de los efectos de una droga tras varias
administraciones de una misma dosis de esta). Varios estudios experimentales han encontrado
que diversos fenmenos Pavlovianos estn involucrados en la tolerancia a drogas. A
continuacin se presentan resultados de cuatro estudios, donde utilizando una preparacin
experimental con ratas, se estudian efectos Pavlovianos en la tolerancia al etanol que pueden
ser tiles en la prctica clnica. Los estudios reportados aqu tienen una fase de adquisicin
donde las ratas reciben inyecciones intraperitoneales de etanol en presencia de las claves en
estudio, luego las ratas son puestas en un plano de deslizamiento donde se mide la respuesta
atxica, siendo el aumento del ngulo de inclinacin en que la rata comienza a deslizarse en el

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plano un ndice de la respuesta de tolerancia. En algunos casos las claves pre-droga fueron
posteriormente sometidas a extincin al presentarse en la ausencia de los efectos del etanol. El
Experimento 1 evalu la interaccin entre claves interoceptivas (internas al organismo) y
exteroceptivas (externas al organismo) asociadas a la administracin de etanol. Obteniendo
como resultado que ambas claves logran una respuesta de tolerancia de intensidad
comparable. El Experimento 2 evalu el rol de los contextos como moduladores de la respuesta
atxica (claves que no necesariamente se asocian directamente con el EI, sino que con la
relacin EC-EI). Se obtuvo un rol modulatorio de los contextos sobre la respuesta de tolerancia,
modulacin que fue efectivamente extinguida. El Experimento 3 evalu acaso la extincin en
mltiples contextos podra prevenir la renovacin de la respuesta de tolerancia, entendida esta
como la recuperacin de respuestas extinguidas al reintroducir a los sujetos al contexto de
adquisicin, habiendo ocurrido la extincin en un contexto diferente. Se evidenci la
renovacin, pero la extincin en mltiples contextos no la atenu. El Experimento 4 evalu si el
reforzamiento parcial durante la extincin (i.e., donde algunas de las presentaciones del EC
durante la extincin son seguidas del EI) disminuye la readquisicin de la respuesta de
tolerancia. Se observ que dicha manipulacin provoc una readquisicin ms lenta de la
respuesta de tolerancia que los sujetos sometidos a extincin sin ensayos reforzados. Los
Experimentos 1 y 2 aportan evidencia sobre elementos necesarios de incorporar en el
tratamiento basado en la exposicin para tratar adicciones, el primero sealando la importancia
comparable de claves internas y externas al consumo de etanol, y el segundo agregando el rol
modulatorio del contexto. Los Experimentos 3 y 4 aportan con potenciales tcnicas para
prevenir la recuperacin de la extincin de la respuesta de tolerancia.
Niveles de Autoeficacia y la Codependencia en un Grupo de Familiares de Pacientes
Drogadependientes y sus Principales Creencias Irracionales
William Guevara.
Psicologia, Univeridad Nacional Mayor de San Marcos, Lima, Peru.
Abstract Central: En la presente investigacin se estudian los niveles de Autoeficacia y
Codependencia de los familiares de pacientes drogodependientes que se encuentran
recibiendo tratamiento en Comunidades Teraputicas de Lima Metropolitana. La muestra esta
conformada por 115 familiares de pacientes que tienen problemas de dependencia a
sustancias psicoactivas como alcohol, pasta bsica de cocana, clorhidrato de cocana y
marihuana. Los instrumentos utilizados para la presente investigacin son: La "Escala de
Codependencia de Spann-Fischer" y la la "Escala de Autoeficacia generalizada" de BablerSchwarzer. Ambos nos permiten evaluar los niveles de Codependencia el primero y
Autoeficacia el segundo. El analisis psicometrico se realizo en base al analisis factorial, y la
consistencia interna se establecio utilizando el coeficiente de confiabilidad Alfa de Cronbach. A
travs de entrevistas se determin las principales creencias irracionales relacionadas con el
manejo y control del paciente a su cargo. Los resultados nos demuestran que existe una
relacin significativa entre la codependencia y la autoeficacia, no en trminos de puntajes sino
en trminos de niveles, as como algunas variables como edad, tiempo de tratamiento y nivel
de instruccin se relacionan significativa-mente con la codependencia. Otras como el nivel de
instruccin, tiempo de internamiento tienen relacin significativa con la codependencia.
Palabras Clave: Autoeficacia, Codependencia, Drogodependiente Comunidad Terapeutica.
Sex Offender Treatment in the Community Setting
Takayuki Harada1, 2, Akira Hosoya2, Kazutaka Nomura3, 2, Masayuki Oishi2.

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1. Mejiro University, Tokyo, Japan, 2. Oishi Clinic, Yokohama, Japan, 3. Waseda University,
Saitama, Japan.
Sex offender treatment is one of the most challenging issues in the field of mental health as well
as criminal justice. In Japan, the prison-based sex offender rehabilitation program was
implemented in 2006 and approximately 500 sex offenders have been treated annually in prison
(Ministry of Justice, Japan, 2006). However, after release, no treatment service has been
offered to them in the community settings. Moreover, sex offenders under probation have no
opportunities to receive treatment. We have developed the cognitive-behavioral treatment
program targeting these populations and implemented in private mental health clinics. The
program is consisted of 24 sessions and is implemented once a week in a group format. The
program is based on the relapse prevention model and the topics cover the identification of
triggers, coping skills training, emotional management, stress management and so on. The
program was conducted by licensed mental health professionals and the motivational
interviewing techniques were used during the program. The participants were 96 male sex
offenders and those who have compulsive sexual problems. 73 participants received the
program (mean age = 35.4, SD=5.05) and those who did not participate in the program joined to
a self-help group in the clinic once a week (mean age = 35.0, SD=5.87). The participants were
followed up for one year after the treatment completion. The primary outcome in this study was
reoffending/relapse and several psychological variables including self-efficacy and coping skills
were measured as the secondary outcomes. No significant difference was found in the pretreatment comparison between the 2 groups. During and after the treatment, no
relapse/reoffending was reported and no one was arrested. With regard to the attendance, the
mean attendance rate of the treatment group was significantly higher than the control
(t(71)=5.53, p<.01). The psychological variables were measured at the pre and post treatment
periods and the two-way repeated measures ANOVA was performed. The results showed that
coping skills of the treatment group were significantly improved after treatment (F(1,49)=10.37,
p<.01). These findings suggest the effectiveness of the treatment program because both
treatment attendance and coping skills are considered to be the powerful predictors of long term
treatment success (Marlatt & Witkiewitz, 2005). The findings of this study are important in two
points. First, the relapse prevention (RP) - based treatment has been rarely conducted outside
of the Western culture. However, the demonstrated effectiveness of the program suggested that
the RP-based treatment is also effective in other cultural settings. Second, although sex
offender treatment is predominantly conducted in the prison setting, treatment conducted in the
community setting is also effective and the majority of participants stay in treatment long
enough. The demonstrated effectiveness is very helpful to remove skepticism for sex offender
treatment and social fear toward sex offenders. However, this study did not have a randomized
control group. Moreover, the participants need to be followed up longer in order to measure the
longer-term relapse rate.
Brief motivational interviewing (MI) interventions for primary and comorbid substance
use disorders? How do they compare to CBT and can the impact of brief MIs be
enhanced?
Leanne Hides1, Amanda Baker4, Leanne Hides1, Leanne Hides1, David Kavanagh1, Mark
Daglish2, David Kavanagh1, Kate Witkiewitz5, Sharon Dawe3.
1. Instutue of Health & Biomedical Innovation, Queensland University of Technology, Brisbane,
QLD, Australia, 2. Department of Psychiatry, University of Queensland, Brisbane, QLD,
Australia, 3. School of Applied Psychology, Griffith University, Brisbane, QLD, Australia, 4.
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia, 5.
Department of Psychology, University of New Mexico, Albuquerque, NM, USA.

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Alcohol and cannabis use are the most commonly used licit and illicit drugs worldwide and
frequently co-occur with depression, anxiety and psychotic disorders. While there is growing
evidence for the effectiveness of cognitive behaviour therapy (CBT) interventions for alcohol
and cannabis use disorders and a range of comorbid substance use and mental health
disorders, it is unclear if these more intensive interventions are more effective than brief
motivational interviewing (MI) interventions for these primary and comorbid disorders. We also
have little understanding of what the active ingredients of either MI or CBT interventions are.
This symposium examines the evidence base for brief MI versus CBT approaches to these
disorders, attempts to identify the active ingredients of both approaches and presents the
results of recent clinical trials of brief MI interventions enhanced with cognitive-behavioural
coping skills training and imagery techniques.
Does size matter? Brief versus longer interventions for comorbid cannabis or alcohol
use
This paper summarizes the evidence from three recent systematic reviews of the literature
concerning randomized controlled trials (RCTs) of manual guided psychological interventions
reporting cannabis or alcohol outcomes among people with psychotic disorders or depressive /
anxiety disorders. RCTs of manual guided interventions among cannabis users with psychotic
disorders indicate that while brief interventions are associated with reductions in cannabis use,
longer interventions may be more effective. While brief interventions were generally as effective
as longer duration psychological interventions for reducing alcohol consumption among people
with psychotic disorders, longer interventions provided additional benefits for depression,
functioning and some alcohol outcomes. Among people with depressive and/or anxiety
symptoms, brief interventions were associated with significant improvements in both mental
health and alcohol use outcomes, but longer interventions were associated with even better
outcomes. In order to illustrate the findings, three year follow-up data from a large RCT
comparing brief and various 10 session interventions among people with co-existing depression
and alcohol misuse are presented. It is recommended that brief and longer (e.g., 10 session)
psychological interventions should be available to people with co-existing mental health and
cannabis or alcohol use problems.
Enhanced brief motivational interventions for reducing alcohol use and related harm in
young people
This paper summarizes the evidence from three recent systematic reviews of the literature
concerning randomized controlled trials (RCTs) of manual guided psychological interventions
reporting cannabis or alcohol outcomes among people with psychotic disorders or depressive /
anxiety disorders. RCTs of manual guided interventions among cannabis users with psychotic
disorders indicate that while brief interventions are associated with reductions in cannabis use,
longer interventions may be more effective. While brief interventions were generally as effective
as longer duration psychological interventions for reducing alcohol consumption among people
with psychotic disorders, longer interventions provided additional benefits for depression,
functioning and some alcohol outcomes. Among people with depressive and/or anxiety
symptoms, brief interventions were associated with significant improvements in both mental
health and alcohol use outcomes, but longer interventions were associated with even better
outcomes. In order to illustrate the findings, three year follow-up data from a large RCT
comparing brief and various 10 session interventions among people with co-existing depression
and alcohol misuse are presented. It is recommended that brief and longer (e.g., 10 session)
psychological interventions should be available to people with co-existing mental health and
cannabis or alcohol use problems

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Functional Imagery Training -A new ePsychology intervention with application to alcohol


misuse
Recent theoretical and empirical advances have demonstrated the importance of imagery in
motivation and desire, including desires to drink. Intense craving typically involves multisensory
imagery about a target such as alcohol or drinking. Interfering with this imagery (e.g. by tasks
that compete for the same working memory resources) also interferes with craving. Other
imagery is one such task. However, imagery for functional goals (e.g. control of drinking) is
often harder to elicit and maintain than imagery for alcohol, when making drinking decisions in
the natural environment. Functional Imagery Training uses imagery throughout motivation
enhancement, to accentuate functional desires. A smart phone cues home practice of imagery
about incentives, strategies and success at nominated times, using selections from photo
libraries. Users add photos about actual positive changes, effective strategies and successful
control as they occur. They also share a brief video about their commitment with a supporter,
who sends a complementary video about how they will help. Other features include mindfulness
exercises and audios to accentuate the vividness of practiced images. Users are supported by a
therapist/coach, initially in face-to-face sessions, and later by phone. The phone app is
demonstrated, data from pilot trials are presented, and the future research program described.
Does dose matter? Motivational Interviewing and Cognitive Behavioral Treatment
Components and Drinking Outcomes in the COMBINE Study
Brief interventions for alcohol use disorders are growing in popularity and many brief
interventions have considerable empirical support. Numerous studies have been conducted to
compare varying lengths of brief interventions, with many studies finding that varying lengths of
brief interventions do not produce different outcomes and that brief interventions tend to be as
effective as more extended treatments. The goal of the current study was to examine the effect
of brief intervention components, as part of a multi-component treatment. Specifically we were
interested in whether the amount and types of treatment received were associated with better
outcomes among individuals enrolled in the same treatment program.
To test these research questions we conducted secondary analyses of the combined behavioral
intervention data from the COMBINE study, a multi-site randomized trial designed to examine
the effect of combining pharmacotherapy with behavioral intervention for alcohol dependence.
Participants (n = 776) were randomly assigned to receive the multi-component combined
behavioral intervention, which consisted of motivational interviewing (MI) techniques to build
clients motivation for change (typically the first 2 sessions), functional analysis and treatment
planning (typically the 3rd through 4th or 5th session), cognitive behavioral treatment (CBT)
modules that were individualized to each clients situation and needs (typically the 4th or 5th
through 16th to 18th session), and maintenance check-ups (typically the final two sessions).
The intervention had a maximum of 20 treatments sessions over 16 weeks. Participants were
subsequently followed for 52 weeks posttreatment.
Ten percent of the sample (n~80) did not receive all of the MI components and 2% (n=14) did
not receive any MI components. Of those who received the MI components, 6% received only
one session, 70% received 2 sessions of MI, 16% received 3 sessions, 5% received 4 sessions,
and 3% received 5 or more sessions of MI. Results indicated that receiving 2 or 3 sessions of
the MI components was associated with significantly better drinking outcomes one year
following treatment than receiving 4 or more sessions, even after controlling for baseline
motivation to change, number of treatment sessions attended, and baseline drinking levels. If
combined with CBT components then only one session of MI was also associated with
significantly better drinking outcomes. Overall, results suggest that a little bit of MI goes a long
way and that more MI may be associated with worse outcomes.
Discussant

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1. How effective are brief MIs? Do standard brief MIs add anything to assessment effects? Are
enhanced BMIs more effective? Are longer CBT interventions necessary?
2. Does the type of substance being targeted or the extent of comorbidity impact on outcomes?
3. What can we conclude from research to date about the effectiveness of brief MIs?
Beating the Rush: A Web-Based Intervention for Amphetamine Use
Eliana Hirakis1, Leanne Casey2.
1. Griffith University, Brisbane, QLD, Australia, 2. Griffith University, Brisbane, QLD, Australia.
An increasing number of Australians are experiencing harms associated with psychostimulant
use, particularly amphetamines. Research has shown face-to-face delivery of cognitive
behaviour therapy (CBT) to be an effective intervention for the treatment of psychostimulant
use. Recent literature has shown CBT interventions delivered via the Internet effectively treat
substance use including alcohol and tobacco use. Web-based interventions provide an
innovative way of disseminating evidence-based treatment to clients who may be unwilling or
unable to present for face-to-face treatment as this form of treatment delivery has been found to
reduce barriers that are associated with face-to-face treatment. Despite evidence to suggest the
usefulness of web-based interventions in treating substance use, no previous research has
investigated whether CBT delivered via the Internet is an effective intervention for treating
amphetamine use. Thus, the aim of this research is to establish whether a web-based CBT
intervention is effective in treating amphetamine use and its associated harms. This
presentation will report on the current status of web-based interventions and describe the
development of a web-based brief intervention for amphetamine use.
The Relationship Between Cigarettes and Marijuana Use: Viewed Through the Lens of
Epidemiological and Intervention Studies
Hyman Hops, Holly Waldron, Charles Turner.
Oregon Research Institute, Eugene, OR, USA.
Abstract Central: Tobacco use is the leading cause of preventable death worldwide and has
also been associated with a host of problems across the age range. However, most smokers
initiate and establish smoking patterns during adolescence and cigarettes have been shown to
be the legal gateway drug to illicit substances such as marijuana. Yet, in most treatment
studies of adolescent drug use, tobacco as a target behavior remains overlooked. The purpose
of this paper is to assess the relationship between cigarettes and marijuana use within a familial
social context with data from two studies, a longitudinal epidemiologic investigation and a
randomized clinical trial for adolescent substance abuse. Within a 19-year age-cohortsequential longitudinal study, we examined the relationship between trajectories of adolescent
drug use including cigarettes (N =763) from early adolescence to young adulthood. Families
with a smoking parent and at least one adolescent between the ages of 11-15 were recruited
and assessed annually for approximately 15 years. Analyses showed significant common and
unique development trajectories of marijuana use with cigarette smoking and alcohol use.
Additional analyses showed (a) cigarette use predicted marijuana use onset, (b) parent use of
cigarettes and marijuana predicted adolescent use of similar substances, and (c) that mothers
were a major contributor to adolescent drug use. The randomized clinical trial (N = 263)
included families from two ethnic backgrounds, Hispanics and non-Hispanics, with an
adolescent referred for substance abuse, primarily marijuana. Youths and families were
randomly assigned to one of two evidence-based interventions, individual cognitive behavior
therapy (CBT) or an integrated family and individual cognitive-behavior therapy (IBFT). Baseline
predictors of better long term treatment outcome for marijuana included age at first use and

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duration of use. Moreover, smoking in youth was significantly associated with post-intervention
relapse up to 18 months post randomization, despite significant pre-post treatment effects.
Additionally, current tobacco use among youths was higher in families with parents who had
smoked for at least 5 years. In CBT, adolescents with parents who were current smokers had
poorer outcomes, but only among Hispanic families. In IBFT, the effect of parent smoking was
eliminated with similar outcomes across ethnicity and parent smoking history. Finally, we
extended the findings in the longitudinal analyses regarding mothers cigarette use by showing
that her current and historic use was particularly problematic for adolescent drug-abuse
intervention outcomes. Taken together, the results suggest that parent cigarette smoking, and
especially that of mothers, may be an important contributor to the differential likelihood of
adolescent smoking as well as to the long-term effects of treatment for marijuana abuse.
Differential effects for ethnicity by treatment condition were also noted. Implications and related
risk and protective factors will be discussed.
Comparison of Craving Responses to Crack/Cocaine and Tobacco After a Crack and
Tobacco Photography Exhibition
Vinicius Jobim Fischer1, 2, Alexandre Did Balbinot2, Paola Lucena dos Santos6, Maria da Graa
Tanori de Castro5, Rosemeri Pedroso4, Renata Araujo2, 3.
1. Faculty of Psychology, Pontifical University Catholic of Rio Grande do Sul, Porto Alegre,
Brazil, 2. So Pedro Psychiatric Hospital, Porto Alegre, Brazil, 3. Cognit Cognitive-Behavioral
Clinic, Porto Alegre, Brazil, 4. Federal University of Rio Grande do Sul, Porto Alegre, Brazil, 5.
Center of Family and Individual Studies-CEFI, Porto Alegre, Brazil, 6. Universidade de Coimbra,
Coimbra, Portugal.
Introduction: The conceptualization of craving is controversial, being understood as an intense
desire of use of an specific substance or in a multi-dimensional approach including desire to use
substance, intention of use, capacity to relief negative affects and abstinence symptoms and
positive expectance about drug effects. It is extremely important to investigate craving since it is
a variable which difficults the maintainence of abstinence, needing new strategies to increase
abstinence rates in crack/cocaine addicts. However, available research is still incipient, when
considering craving responses to Crack/cocaine. This study aims to compare craving responses
to crack/cocaine and tobacco after crack/cocaine and tobacco photography exhibition in patients
addicts to and crack/cocaine tobacco. Materials and Methods: Patients diagnosed with cocaine
and tobacco dependence according to ICD-10 admitted in a unit for detoxication of psychiatric
hospital were randomly assigned in 2 groups. Group 1-Crack (n= 30), group 2- Tobacco (n= 30).
Before the intervention of photo exposure, were administered a mini-mental and sociodemographical questionnaire. The intervention consisted of looking for two minutes to two
photos of crack(group 1) and to tobacco(group 2) followed by the completion of a visualanalogical scale of craving, CCQ-B (group 1) or QSU-B (group 2) and Beck`s Depression
Inventory (BDI). Results: Results: The mean age of the sample was 28.35 years (SD= 7.0; 1848) and the mean of years of education was 7.17 (SD= 1.96; 4-11). Subjects hospitalization
period was of 7.65 days (SD= 4.51). Considering the analogical scale of craving, group 1 scored
3.25 (SD= 3.14) and group 2 scored 5.72 (SD=3.6). The mean on the CCQ-B was 24.73 (SD=
14.31) and the QSU-B was 33.5 (SD= 19.34). Statiscally significance difference were found
when comparing QSU-B and CCQ-B craving scales (U-170.50; p= 0.045) and for the visualanalogical scale of craving (U= 175.00; p= 0.018). Conclusion: Patients of the tobacco
photography exhibition group (group 2) presented more intense craving responses than the
crack/cocaine group (group 1).

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The Role of Positive Outcome Expectancy in Predicting Adolescent Internet Addiction


among Junior High Schools in Taiwan: One-Year Follow Up
Huei-chen Ko1, 2, Li-An Wu2, Tsui-Yin Wong2.
1. Psychology, Asia University, Taichung, Taiwan, 2. Institute of Behavioral Medicine, National
Cheng Kung University, Tainan, Taiwan.
Introduction The peer influences and outcome expectancy have been found to be predictors for
Substance Use among adolescents. However, their roles in the Internet Addition which
becomes more prevalent recently remain unclear. Objectives This was a longitudinal study
designed to examine whether the peer influences positively predicted adolescent Internet
Addiction via positive outcome expectancy of internet addition among adolescents in one-year
follow up. Methodology A representative sample of 2290 students in junior high schools were
recruited by a stratified and cluster sampling in 2011 and were followed in 2012. The
participants completed the Scale for Outcome Expectancy of Internet Use, the Peer Influences
of Internet Use Questionnaire and the Chen Internet Addiction Scale. Results Hierarchical
multiple regression analyses and Sobel Test revealed that positive outcome expectancy of
internet use measured in the first year significantly and positively predicted Internet addiction
measured in the second year after controlling Internet Addition scores measured in the first
year. Moreover, the peer influences positively predicted adolescent Internet Addiction via
positive outcome expectancy of Internet Use in the second year. Conclusions Positive outcome
expectancy of internet use predicts and mediates the effect of peer influences on Internet
Addiction among junior high schools in Taiwan. Discussion The coping skills with peer
pressures for using internet and modifying skills for outcome expectancy of internet use should
be incorporated when designing intervention programs for Internet Addition among adolescents.
Aplicacin del Programa de Prevencin Estructurada de Recadas en un Caso de
Consumo de Tabaco
Edith Martinez, Mara Vital Cedillo.
Facultad de Psicologa, Universidad Nacional Autnoma de Mxico, Distrito Federal, Mexico.
Uno de los problemas centrales en el tratamiento de las adicciones a sustancias psicoactivas
es la alta tasa de recadas dentro de una amplia variedad de tratamientos. Al respecto, se sabe
que el desarrollo y aumento progresivo de autoeficacia en los pacientes es una herramienta
clave para lograr el mantenimiento de cambio conductual. El programa de Prevencin
Estructurada de Recadas para Estudiantes Universitarios es un tratamiento de tipo cognitivo
conductual, basado en la teora de la autoeficacia de Bandura y est conformado por cinco
componentes (evaluacin, entrevista motivacional, plan de tratamiento individualizado,
iniciacin al cambio y mantenimiento del cambio) mediante los que se busca aumentar los
niveles de autoeficacia a travs de la exposicin gradual del paciente a situaciones de riesgo
de la vida cotidiana, respecto al consumo de sustancias psicoactivas. Se llev a cabo la
aplicacin de dicho programa con un paciente que report una historia de diecisis aos de
consumo de tabaco. El componente evaluacin consisti en la exploracin de aspectos tales
como el funcionamiento psicosocial del paciente, la historia, los problemas y las consecuencias
asociadas al consumo de tabaco, las razones que el paciente manifest para cambiar su
conducta de consumo y el nivel de compromiso con dicho cambio, adems de las fortalezas y
dificultades de enfrentamiento del paciente ante situaciones de alto riesgo de consumo, en
complemento con un anlisis detallado de los disparadores de consumo ms problemticos
para el paciente desde un ao antes de ingresar al programa. En el segundo componente se
proporcion al paciente la retroalimentacin personalizada de los resultados de la evaluacin
dentro del contexto de la entrevista motivacional, enfocada en el anlisis de las razones

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expresadas por el paciente para cambiar su consumo de tabaco y del compromiso con dicho
cambio, as como de los disparadores del paciente para el consumo y las fortalezas de
enfrentamiento utilizadas ante situaciones de riesgo. Posteriormente, se involucr al paciente
en el desarrollo de un plan del tratamiento individualizado, comenzando por la orientacin
respecto al programa PEREU y la firma de un contrato de tratamiento; la revisin por parte del
paciente de los disparadores especficos y recientes en el consumo de tabaco, la jerarquizacin
de las reas de riesgo a tratar y el establecimiento de una meta inicial; a partir de ese momento
el paciente tuvo como asignacin de tarea el auto monitoreo, en el cual realiz un registro de
los disparadores de consumo detectados diariamente, las estrategias adoptadas y los
resultados obtenidos. El componente iniciacin se enfoc en la aplicacin de estrategias que se
sabe son tiles en la iniciacin de un cambio conductual, incluyendo la evitacin de situaciones
de riesgo para el consumo de tabaco y la bsqueda de apoyo por parte del paciente en
personas cercanas a l. La realizacin de anlisis funcional de episodios recientes de consumo
en conjunto con el paciente y la anticipacin de situaciones de riesgo y planeacin de
alternativas de enfrentamiento mediante la elaboracin de un plan semanal, son parte
fundamental en la iniciacin al cambio. El trabajo en prevencin de recadas se llev a cabo
durante la aplicacin del componente mantenimiento, por medio de la enseanza y aplicacin
de destrezas de enfrentamiento y la exposicin progresiva del paciente a situaciones de riesgo
a travs de la asignacin de tareas en las cuales se le involucr en la prctica de diversas
respuestas de enfrentamiento en situaciones cotidianas, a fin de incrementar la autoeficacia en
el paciente en funcin de la percepcin de dificultad de la tarea y del xito obtenido respecto al
control del consumo.
Comunidad Teraputica en Drogas: Una estrategia de la Psicologa Conductual
Jose Martinez.
1. Universidad Nacional Federico Villarreal, Lima, Peru, 2. Universidad de San Martin de
Porres, Lima, Peru.
Abstract Central: El presente trabajo argumenta porque la comunidad teraputica (CT) es un
modelo de abordaje para las adicciones desde la psicologa conductual. Analiza, desde una
postura conductista, al modelo CT; considerndolo como: un espacio de entrenamiento de
comportamientos que permitirn desarrollar competencias en sujetos adictos para mantenerlos
alejados del consumo de sustancias psicoactivas (SPAs). Describimos, tambin, todas las
tcnicas conductuales utilizadas por la CT, sustentadas en el condicionamiento clsico
(condicionamiento, contracondicionamiento, condicionamiento de orden superior),
condicionamiento operante (triple relacin de contingencias, anlisis funcional de la conducta,
diagnostico funcional de la conducta y el uso de reforzadores y castigos) y el anlisis
contingencial de la conducta (modelo de Kantor y Ribes). Consideramos que la rehabilitacin
del consumidor de SPAs, mas que darse como un proceso de cambios bioquimicos, es un
proceso de modificacin de conductas; un reaprendizaje de patrones de conductas
adaptativas y el mecanismo ideal para esto es la comunidad teraputica, entendida como una
estrategia de la psicologa conductual.
Psychoactive Substance Abuse and Addiction: CBT as an Integrative Factor for the
Multidisciplinary and Multiapproach Treatment in Brazil
Ana Maria Martins Serra1, Lelio Loureno2, Claudio da Silva3, Juliana Meirelles4.
1. Instituto de Terapia Cognitiva, So Paulo, Brazil, 2. UNIVERSIDADE FEDERAL DE JUIZ DE
FORA, JUIZ DE FORA, Brazil, 3. UNIFESP, SO PAULO, Brazil, 4. UNIFESP, SO PAULO,
Brazil.

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The application of Cognitive Behavior Therapy to the treatment of substance abuse has become
well-know, notably due to its efficacy. In contrast to the traditional view of the treatment of this
group of patients as a complex process of limited efficacy, and the deterministic
conceptualization of the disorder as a disease or as genetically inherited, the cognitive
behavioral model of the installation and maintenance of the disorder is based on the concept of
cognitive distortions and dysfunctional schemas, and is thus proposed as reversible. In the area
of substance abuse, and based on CBT theoretical and applied models, it is proposed that the
installation of a dysfunctional system of schemas and beliefs would favor adverse affective and
behavioral responses and the inefficacy of patients previous coping resources. Aligned with the
CBT model, and based on a similar proposal by Wright (1996) with psychotic patients, the first
presentation will highlight, in an innovative form, the integrative character of the applied model
of CBT, which is of great value in the treatment of substance abuse and addiction, in in- and
out-patients clinical facilities, through a multidisciplinary and multi-approach program. The
integrative model inspires patients, professionals and family members in a collaborative and
effective fashion. The second presentation will discuss comorbidity between social phobia and
alcohol consumption, proposing the relevance of the association between the occurrence of
phobias and the previous occurrence of alcohol abuse and addiction, whereas generalized
anxiety disorder tends to occur after the installation of alcohol abuse. Panic Disorder and
Obsessive-Compulsive Disorder, in turn, tend to occur either before or after alcoholism. The
third presentation will describe a CBT based treatment program on Alcohol and Drugs, at AME Ambulatrio Mdico Especializado (Specialized Medical Service), at Vila Maria, So Paulo,
Brazil. In addition, it will report a study conducted in order to produce a thorough data base,
containing profile information of the population attended to, in addition to registering information
pertaining to treatment adherence, by means of observational and retrospective research
methods. And the fourth presentation will report a study aimed at identifying factors associated
with the development of drug abuse and addiction and of mental disorders, in adolescents
admitted at AME - Ambulatrio Mdico Especializado (Specialized Medical Service), a
psychiatric out-patient clinic, in Vila Maria, So Paulo, Brazil. Specific objectives of this study
are to obtain a social-demographic profile of the youth population attended to at the Clinic. The
presentations, as a group, will offer relevant proposals and data, which may be explored by
professionals involved with the treatment of patients presenting with psychoactive substance
abuse and addiction.
THE USE OF COGNITIVE BEHAVIOR THERAPY AS AN INTEGRATIVE FACTOR
FOR THE MULTIDISCIPLINARY AND MULTI-APPROACH TREATMENT
OF IN AND OUT-PATIENTS PRESENTING WITH
PSYCHOACTIVE SUBSTANCE ABUSE AND ADDICTION
The integrative character of Cognitive Behavior Therapy (CBT) has been previously proposed
by Wright (1996) as applied to in- and out-patient facilities for the treatment of psychosis. This
presentation will emphasize, in an innovative fashion, the usefulness of the CBT model as an
integrative factor, when applied to in- and out-patient settings, for the treatment of patients
presenting with Psychoactive Substance Abuse and Addiction (PSAA). The use of the CBT
model facilitates the effectiveness of treatment based on a multidisciplinary and multi-approach
program. CBTs integrative character render it especially appropriate for the integration of
professional teams, using different treatment modalities, such as CBT, Behavior Therapy,
Family Therapy, Occupational Therapy, Medical and Psychiatric care, and Psychotherapeutic
treatment. In addition, CBT facilitates the combination of the aforementioned clinical modalities
with complementary techniques, such as motivational interviewing, relapse prevention, skills
training, etc. CBTs integrative and structured character increases the functional interaction
between individuals and teams within institutions, functioning as a common language. CBT`s

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collaborative nature inspires patients, staff members and families, by promoting productive
interactions. Co-morbidity with other mental health disorders, heterogeneity of patient groups
and other complicating factors may be attenuated by the objective and structured nature of the
CBT applied model. Problem-solving approach, which represents an important tool within the
CBT model, encourages the identification of difficulties and the definition of therapeutic goals
and strategies, at the same time modeling problem solving skills for patients and families, thus
reducing the length of treatment and favoring treatment efficacy. The psychoeducational aspect
of CBT is particularly suited for institutional intervention and of great relevance for patients and
families. The cognitive conceptualization of the disorder as a symptom or a compensatory
strategy of a previously acquired disorder encourages the conceptualization and treatment of
associated psychopathologies, encouraging collaboration among professionals and enhancing
relapse prevention. These aspects will be further discussed and complemented by two of the
other presentations, which will report examples of these proposals. We recommend that
professionals involved with PSAA patients consider exploring these possibilities for improved
clinical results.
COMORBIDITY BETWEEN SOCIAL PHOBIA AND ALCOHOL ABUSE AND ADDICTION: A
CONTEMPORARY PERSPECTIVE
Social phobia is characterized by excessive anxiety in social situations. The person has a
pattern of inadequate behavior, avoiding situations where he or she may be observed and
evaluated by others, or may become involved in a potentially embarrassing situation. Clinical
studies (Loureno et al, 2011) show that approximately 80% of social phobics report comorbidity
with other psychiatric disorders, such as depression, alcohol abuse/addiction and panic
disorder. In addition to clinical work, studies have been conducted in order to analyze the
prevalence of social phobia in association with alcohol abuse and addiction, as a means to
investigate forms of more effective treatments of patients presenting with this comorbidity. A
literature survey was carried out on the subject in national and international databases, as
follows: CAPES, PsiqWeb, Medline, SciELO, PsychInfo, Psyquiatryonline, and British Medical
Journal. Social phobia was first described in 1966; however, our survey focused on articles
published from 2002 to 2012. The literature demonstrated a relationship between social phobia
and alcohol abuse. However, in a brief quantitative survey conducted at the Applied Psychology
Unit, at Federal University of Juiz de For a (State of Minas Gerais, Brazil), the results did not
confirm this correlation. Adults were interviewed, using three instruments: AUDIT, BAI (Beck
Anxiety Inventory) and Liebowitz Social Anxiety Scale. Currently, an empirical research with the
same theme is being developed at the Basic Health Units, in the city of Juiz de For. A study with
the same group of alcoholics in tertiary care found an association between social phobia and
alcohol consumption, confirming our initial hypotheses and thus corroborating the literature
(Buckner, 2009; Robinson, 2009; Buckner, 2008; Thomas, 2008; Ham, 2007; Stewart, 2006;
Arch, 2006; Bakken, 2005). Social phobia, concomitant with other emotional disorders, has
been studied by several researchers (Loureno et al, 2011). Of all the Anxiety Disorders, the
presence of phobias (simple, social or agoraphobia) associated with the previous occurrence of
alcohol abuse and addiction is considerable in those studies, whereas Generalized Anxiety
Disorder tends to occur after the installation of alcohol abuse. Panic Disorder and ObsessiveCompulsive Disorder, on the other hand, may occur before or after alcoholism. According to
Hermesh, Marom, Gilboa-Schechtman and Weizman (2011), CBT is the modality of
psychotherapy most widely reported to treat this co-morbidity, both individually and in group.
SOCIAL-DEMOGRAPHIC PROFILE AND STUDY OF ADHERENCE TO TREATMENT OF
SUBSTANCE ADDICTED PATIENTS IN A SPECIALIZED MEDICAL OUTPATIENT CLINIC
Psychoactive drug use in Brazil is worrying, as it occurs on an increasing scale (Vargens et. al,
2011). As a consequence, there is an increased demand for specialized treatment for

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psychoactive substance abuse and addiction (Stark, 1992). This presentation will describe a
treatment program on Alcohol and Drugs, which is based on the cognitive-behavioral model, at
AME - Ambulatrio Mdico Especializado (Specialized Medical Service), at Vila Maria, So
Paulo, Brazil. From August 2010 to August 2011, a study was conducted in order to produce a
thorough data base, containing profile information of the population attended to, in addition to
registering information pertaining to treatment adherence. Observational and retrospective
methods were employed in compiling the data. Data were collected by structured interview and
descriptive analysis. The existence of associations among categorical variables was evaluated
by use of the Exact Qui-square Fisher Test, for a sample of 306 patients. Main results are as
follows: predominantly male patients (81% ), single (46%), average age 37 years,
socioeconomic status classes C and D of 52.4%; attended prior treatment 60%. History of
substance abuse: alcohol 96%, tobacco 83%, marijuana 63%, cocaine 62.3%. Problems related
to consumption: 76% family problems, 75% psychological problems. 40.5% of patients
accomplished seven months of treatment, 11.1% were referred to other services. The data base
permits knowing the attended population, which is fundamental as a means to improve
intervention. A social service-based CBT treatment promotes better adherence than that
generally reported in the international literature.
FACTORS ASSOCIATED WITH THE DEVELOPMENT OF
ADDICTION AND MENTAL DISORDERS IN YOUTH
IN SPECIALIZED MEDICAL OUTPATIENT CARE
The consumption of illicit drugs in the world generates a high incidence of disorders. A variation
in the pattern of initiation to psychoactive drugs has been observed. However, their use is
initiated early in Brazil (Degenhardt, Hall, 2012), around an average age of 16 years (Madruga,
2012). We conducted a study in order to identify factors associated with the development of
drug abuse and addiction and of mental disorders, in adolescents admitted at AME Ambulatrio Mdico Especializado (Specialized Medical Service), a psychiatric out-patient
clinic, in Vila Maria, So Paulo, Brazil, from September, 2012, and which is planned to end in
September, 2014. Specific objectives of this study are to obtain a social-demographic profile of
the attended youth population; to compile history and pattern of psychoactive substance
consumption, as well as historical and family data; and to gather data pertaining to psychosocial
problems related to consumption, comorbidities, consumption changing pattern, adherence and
referrals. The method employed is observational, descriptive and mixed; and qualitative and
quantitative. Observational and descriptive methods will involve retrospective study, medical
record data survey, and cross-section, in a sample of 40 people aged between 12 and 25 years.
Results are expected to provide preliminary data, correlating factors associated with use and
abuse of psychoactive substances and the sample profile.
Advances in the Study of Stress and Substance Use Disorders
R. Kathryn McHugh1, 2, R. Kathryn McHugh1, 2, Michael Otto3, Pia Pechtel1, 2, Diego Pizzagalli1, 2,
Therese Killeen4, Sudie Back4, Laura MacPherson5, Jessica Richards5, Jennifer Dahne5, Carl
Lejuez5, Nicholas Calvin6, Ian Evans7.
1. McLean Hospital, Belmont, MA, USA, 2. Harvard Medical School, Boston, MA, USA, 3.
Boston University, Boston, MA, USA, 4. Medical University of South Carolina, Charleston, SC,
USA, 5. University of Maryland, College Park, MD, USA, 6. Emory University, Atlanta, GA, USA,
7. Massey University, Wellington, New Zealand.
Stressful events and individual differences in stress reactivity are associated with risk for
maladaptive substance use and substance use disorders. Individuals with substance use
disorders who have heightened emotional and physiological reactivity to stressors are
significantly more likely to relapse to use following treatment, highlighting the importance of

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targeting this risk factor in treatment. Although much has been learned in recent years about the
complex interactions between stress and substance use, an important next step for this
research agenda is to further understand the mechanisms by which stress confers this
vulnerability in order to inform the development and refinement of behavioral treatments for
substance use disorders. The aim of this symposium is to examine the association between
stress and substance use from multiple levels of analysis with a focus on the implications for
prevention and treatment.
Talks will represent a range of research methods, including experimental, neuroimaging,
behavioral, and treatment outcome. Dr. McHugh will present the results of an experimental
study examining the effect of physical and emotional stress on domains of opioid craving:
stress-induced, cue-induced, and regulation, to attempt to specify the craving processes that
are impacted by stress in opioid-dependent individuals. Dr. Killeen will present an overview of
the application of an integrated exposure-based behavioral therapy for co-occurring substance
use disorders and post-traumatic stress disorder. Dr. Pechtel will examine the association
between early life stress and substance use, testing the hypothesis that emotion dysregulation
is the mechanism by which early life stress confers risk for later substance use and misuse.
Finally, Dr. MacPherson will present data examining the role of negative reinforcement in
substance use as a potential mechanism by which elevated stress and distress may motivate
substance use.
All presentations will include a dual focus on mechanisms by which stress and substance use
are linked as well as the clinical implications for these findings. Enhancing understanding of the
complex relationships between stress and substance use disorders is needed to facilitate the
improvement of treatments for those affected by these disorders.
Effect of Stress on Craving Reactivity and Regulation in Opioid-Dependent Patients
Opioid dependence is characterized by drug craving, which continues into periods of abstinence
and predicts relapse following treatment. Psychological treatments for opioid dependence
emphasize the importance of regulation of craving to the maintenance of abstinence. However,
the cognitive control processes required for craving regulation can vary across contexts and are
impaired by a number of factors. Most notable, stress--which is a common precipitant and
consequence of opioid dependence--has widespread deleterious effects on cognitive control
and thus may interfere with the regulation of craving in opioid-dependent individuals. The
current study will examine the impact of a stressor on the ability to regulate craving states in
recently abstinent opioid-dependent patients. Additionally, the impact of stress on craving and
the potentiation of cue-induced craving will be examined. Individuals receiving treatment for
opioid dependence are randomly assigned to either an emotional stress (Computerized Mirror
Tracing Persistence Task), a physical stress (cold pressor test), or a no-stress condition. State
craving is measured immediately prior to and following this induction. Then participants
complete a computer-based task, which measures both craving reactivity in response to pictorial
cues as well as the ability to downregulate craving states. Based on results from a pilot study
finding that heroin- and prescription opioid-dependent individuals experience craving in
response to different cues, validated pictorial stimuli will be matched to the primary opioid of
abuse (heroin, prescription opioids, or both). The impact of stress on craving, cue-induced
craving reactivity, and craving regulation following a cue will be examined. Data collection for
this project is ongoing, with expected completion in February, 2013. Implications for the
understanding of the association between stress and craving will be discussed as well as
implications for the treatment of opioid dependence.
The Link Childhood Sexual Abuse and Adolescent Substance Use: An fMRI Investigation
According to the US Department of Health and Human Services, almost 64,000 children
reported childhood sexual abuse (CSA) in 2010 in the US alone. CSA has been associated with

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a 2.7-fold increased risk for alcohol abuse and dependence and 6.6-fold increased risk for
abuse of other illicit substances. Although these behaviors may initially relieve CSA-related
distress, alcohol and substance use are primary predictors for sexual victimization. Despite this
circular development, little is known about the mechanism underlying these associations. To
address this gap, we examined behavioral and neural indices of emotion dysregulation in
adolescent females with a history CSA and healthy, non-abused adolescents using functional
magnetic resonance imaging (fMRI). Specifically, we hypothesized that adolescent girls with a
history of CSA would show (1) increased emotion reactivity (marked by faster reaction time and
increased amygdala reactivity) to negative stimuli and (2) decreased emotion regulation
(marked by decreased accuracy and ventromedial prefrontal cortex activation) when presented
with negative emotional cues. Moreover, we investigated if neural and behavioral indices of
emotion dysregulation contribute to frequency of substance use and increased risk for
revictimization. To this end, we recruited female adolescents between the ages of 13-19 with a
history of childhood sexual abuse or without a history of childhood trauma. Participants
completed self-report measures of adversity and substance use and completed two fMRI
paradigms to investigate potential abnormalities of the frontolimbic circuitry critically implicated
in emotion reactivity and emotion regulation. With data collection ongoing, results to date show
faster reaction time (p=.04) paired with increased amygdala activation (p<.05) to negative faces
compared neutral shapes (increased emotion reactivity) and demonstrate more errors on trials
that require response inhibition in the context of negative emotion. Together, findings suggest
heightened sensitivity to negative cues and difficulties regulating responses in the context
negative emotion (i.e., fear, anger). It will be of pivotal interest to investigate if these findings are
potentiated in young women with adverse childhood experiences and if exaggerated emotional
reactivity combined with deficits in emotional regulation may contribute to more frequent
substance use to relieve intense negative affect, thus increasing the risk of sexual
revictimization. Understanding the mechanisms by which emotion dysregulation confers risk for
substance use will allow for the design of treatments targeting emotion reactivity and regulation
early in development to help to break the common cycle of high-risk behavior and sexual
victimization among those with a history of CSA.
Overview of Concurrent Treatment for PTSD and Substance Use Disorders with
Prolonged Exposure
Individuals with PTSD are two to four times more likely than individuals without PTSD to have a
comorbid substance use disorder (SUD) and among treatment-seeking individuals with SUDs,
the prevalence of lifetime PTSD has been reported as high as 50% or greater. In the traditional
sequential model of treatment the SUD is first treated and then the PTSD is addressed once
abstinence is achieved and maintained. Untreated PTSD contributes to poorer treatment
outcome for substance use and is a predictor of relapse, thus underscoring the need for
integrated treatments that concurrently address both disorders. To date, integrated therapies
have shown only modest outcomes and there is much need for improvement. Interventions that
include exposure-based techniques, which are considered the treatment of choice for PTSD,
have not been well studied in substance abusing populations. Concurrent Treatment of PTSD
and Substance Use Disorders with Prolonged Exposure (COPE) is a manualized psychotherapy
that combines both imaginal and in vivo exposure techniques for PTSD with cognitive
behavioral techniques for SUDs. Preliminary studies using COPE demonstrate promise and
feasibility, and dispel the myth that substance abuse must be treated before any trauma work
can be implemented. COPE is currently being investigated in several large randomized trials.
This presentation will describe the COPE intervention, highlighting the modifications made to
effectively integrate the PTSD and SUD treatment components.

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Development and Initial Validation of a Behavioral Task of Negative Reinforcement


Underlying Risk-Taking and its Relation to Problem Alcohol Use in Older Adolescents
A long line of theoretical and empirical evidence implicates negative reinforcement as a process
underlying the etiology and maintenance of risky alcohol use behaviors from adolescence
through emerging adulthood. Yet, the majority of this literature has relied on self-report
measures, and there is a notable absence of behavioral modes of assessments of negative
reinforcement-based risk-taking and its relationship to substance use. To address this gap in the
literature, the current study presents data on the reliability and validity of the Maryland Resource
for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS), which is a
modified version of the well-established positive reinforcement-based Balloon Analogue Risk
Task (BART). Methods: Participants included a sample of 116 college freshmen ever regular
drinkers (Mean age = 18.1 years old; 45% female; 73% non-Hispanic White) who completed
both behavioral tasks; self-report measures of negative reinforcement/avoidance constructs and
of positive reinforcement/appetitive constructs to examine convergent validity and discriminant
validity, respectively; and self-report measures of alcohol use, alcohol-related problems, and
motives for drinking to examine criterion validity. Results: The MRBURNS evidenced sound
experimental properties and reliability across task trials. In support of convergent validity, risktaking on the MRBURNS correlated significantly with negative urgency, difficulties in emotion
regulation, and depressive and anxiety-related symptoms. In support of discriminant validity,
performance on the MRBURNS was unrelated to risk-taking on the BART, sensation seeking,
and trait impulsivity. Finally, pertaining to criterion validity, risk-taking on the MRBURNS was
related to alcohol-related problems but not heavy episodic alcohol use. Notably, risk-taking on
the MRBURNS was associated with negative reinforcement-based but not with positive
reinforcement-based drinking motives. One-year test-retest reliability data on the MRBURNS
will also be presented examining the stability of performance on the task over time.
Conclusions: Data from this initial investigation suggest the utility of the MRBURNS as a
behavioral measure of negative reinforcement-based risk-taking that can provide a useful
complement to existing self-report measures to improve our understanding of the relationship
between avoidant reinforcement processes and risky substance use.
DBT Skills Use in the Treatment of Substance Use Disorders in a Community Alcohol and
Drug Service
Angela McNaught, Victoria Howard.
School of Psychology, Massey University, Albany, New Zealand.
Abstract Central: Maladaptive and excessive substance use, particularly alcohol, is a
worldwide problem, with social, physical, psychological, societal, financial and criminal
difficulties associated with it. When individuals with such disorders present with co-morbid
personality disorders, the situation becomes more complex, and can make treatment
challenging. Dialectical Behaviour Therapy has been used with some effect to treat Borderline
Personality Disorder (BPD). The impulsivity and poor emotion regulation components of BPD
overlap with problematic substance use presentations, making it a potentially viable treatment
for Substance Use Disorders (SUDs). This study monitored daily skills usage over a 52 week
DBT programme for 13 individuals with BPD traits and substance use problems who were
engaged in treatment at a community alcohol and drug setting in urban New Zealand. Applied
longitudinal data analysis, empirical growth plots, and t-tests were employed, and results
demonstrated that, as expected, skills use increased over the course of treatment. In addition,
Core Mindfulness skills tended to be used with more frequency than the remaining three skills
modules. The relationship between skills use and urges to use substances as well as actual
substance use was also explored, both establishing the more skills used the less urges to use
and actual substance use occurred. The application of DBT with SUDs is relatively new, and

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this study is the first to explore skills usage within this group. Determining what skills are most
appropriate for a substance using group may help further target the intervention, but may also
widen DBTs overall applicability
Transtorno Mental: Comportamento Criminoso Luz da Teoria Cognitivo
Comportamental, uma Anlise em um Hospital de Custdia
Mariah Ramiro, Vilma Nascimento Menezes.
Psicologia, UNIP, Joao Pessoa, Brazil.
Os indivduos acometidos por transtorno mental que cometem crime so considerados pela
esfera jurdica como inimputveis, e so submetidos medida de segurana por tempo
indeterminado, que varia de um a trs anos de internao em hospital de custdia. Os casos de
inimputabilidade envolvem os quadros de transtornos psicticos (em especial a esquizofrenia),
o retardo mental e a epilepsia. Uma explicao para tais acontecimentos seria a teoria
Biopsicolgica da criminalidade (Eysenck, 1977) que explica o comportamento criminal como
resultado de uma interao entre fatores ambientais e caractersticas hereditrias, podendo
tambm ser justificado pelo pressuposto bsico da Teoria Cognitivo-comportamental descrito
por Aaron Beck Onde o afeto e comportamento do indivduo so amplamente determinados
pela forma como ele interpreta o mundo. Para avaliar a condio de inimputabilidade,
necessrio laudo psiquitrico que ir definir o diagnstico, como tambm o grau de
periculosidade do infrator doente mental. A Psiquiatria e a Psicologia Forense auxiliam a justia
fornecendo diagnsticos, laudos e exames, referente ao estado mental do periciando no
momento do ato infracionrio em questo. O propsito dessa pesquisa foi analisar a incidncia
e a tipificao do transtorno mental e sua relao com o crime dos internos em medida de
segurana. Essa pesquisa documental. Para isto, foi selecionada a penitenciria de
psiquiatria forense da Paraba, como lcus da pesquisa, e como metodologia foram utilizados
33 pronturios psiquitrico-criminal de inimputveis. Como resultado constatamos que 51,5%
apresentam transtornos psicticos, correspondendo a 68% de homicdios, 30,3% transtornos
decorrentes de uso de lcool, sendo 33,3% crime contra o patrimnio, 12,2% retardo mental,
75% crime contra o patrimnio e 12% transtorno de personalidade, porte ilegal de arma.
Conclui-se que h uma maior incidncia de transtornos psicticos, em especial a esquizofrenia
paranide em comorbidade com o lcool, e grande parte deles praticaram homicdios contra
parente de primeiro grau.
Deteccin de Barreras para Asistir a Tratamientos de Adicciones
Roberto Oropeza Tena, Mariana Ortz Sosa, Jonatan Cano Rodrguez.
Facultad de Psicologa, Universidad Michoacana de San Nicols de Hidalgo, Morelia, Mexico.
Abstract Central: La ltima Encuesta Nacional de Adicciones (2008) seala que de toda la
poblacin en Mxico, 1297912 personas consumidoras de sustancias necesitan atencin. Y de
todos los consumidores slo el 16.1% han acudido en alguna ocasin. El resto jams tenido
ningn tratamiento. Las barreras a tratamiento son todos los obstculos que impiden asistir por
ayuda para resolver algn problema de salud. Algunas de las barreras que presentan los
consumidores de sustancias son: estigmatizacin y marginacin, baja escolaridad, no tener
sobredosis, no tener enfermedades crnicas y llevar ms de cinco aos consumiendo, edad,
sexo, cultura, economa, distancia y sustancia, entre otras. El objetivo de esta investigacin es
conocer y comparar las barreras para acudir a tratamiento de adicciones en una poblacin de
adictos y otra de estudiantes Participaron dos grupos. Uno de 216 estudiantes (GE) de la
UMSNH, 42% hombres y 58% mujeres. Y otro de 112 consumidores de drogas(GC), 74%

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hombres y 26% mujeres. Se us el Instrumento de Barreras hacia Tratamientos de Adicciones


(BTA). Su objetivo es detectar las barreras que puede haber para asistir a un tratamiento de
adicciones. Tiene 83 reactivos con siete subescalas: familiar, econmico-laboral, social,
infraestructura, personal, salud y terapeuta; con cinco opciones de respuesta. Tiene una
consistencia interna de 0.977 . La aplicacin del GE grupal. Se acudi a cada saln y se explic
el objetivo. Quienes aceptaron participar, firmaron un consentimiento informado. La muestra del
GC se obtuvo usando el procedimiento de bola de nieve. Una vez que reunidos con el usuario,
se le explicaba el objetivo de la investigacin. Tambin ellos firmaron un consentimiento
informado. Se hizo un anlisis descriptivo de cada subescalas, del GE y del GC. GE: subescala
econmico-laboral tuvieron un puntaje promedio de 2.16; infraestructura 2.04, terapeuta 1.87,
familiar 1.84, salud 1.82, personal 1.76 y social 1.68. GC: subescala econmico-laboral tuvieron
un puntaje promedio de 2.4, infraestructura 2.33, personal 2.27, social y familiar 2.2, terapeuta
2.13 y salud 2.08. Se compararon las puntuaciones del GE vs GC en cada subescala, con la
prueba T de grupos independientes. En todas las comparaciones se encontraron diferencias
estadsticamente significativas: familiar (T=3.795, 325, p<. 0001), econmico-laboral (T=2.41,
326, p<0.016), social (T= 5.45, 322, p<0.0001), infraestructura del centro de servicios (T=
2.704, 223, p<0.007), personal (T= 5.656, 313, p<0.0001), salud (T= 2.544, 324, p< 0.01) y
terapeuta (T=2.591, 325, p<0.01). En esta investigacin podemos encontrar que los puntajes
de las ocho subescalas del GC fueron significativamente ms altos que los del GE. En ambos
grupos, la subescala ms alta fue econmico laboral, seguida de infraestructura. Es necesario
que los sistemas de salud generen alternativas viables para que sea posible romper esas
barreras y los pacientes puedan llegar al tratamiento.
The role of emotion in smoking behavior and related interventions
Georgia Panagiotou1, Maria Karelka1, Janice A. Blalock2, Bradley N. Collins3, Michelle
Schwarz3, Sean P. McCormick3, Uma S. Nair3, Katerina Konikkou1, Stella-Nicoletta Savvidou1.
1. University of Cyprus, Nicosia, Cyprus, 2. University of Texas MD Anderson Cancer Center,
Houston, TX, USA, 3. Temple University, Philadelphia, PA, USA.
Smoking is associated with multiple and severe health problems and represents a preventable
cause of mortality (WHO, 2008; World Lung Foundation, 2008). Recent evidence indicates that
emotional factors, especially the way in which people process negative emotions, are involved
in the etiology and maintenance of smoking behavior (Maude-Griffin & Tiffany, 1996; Bradley et.
at, 2007) and related consequences including second hand smoking exposure of children.
Evidence also indicates that characteristics such as anxiety sensitivity, emotional avoidance and
skills like emotion regulation may predict level of nicotine addiction and difficulty with remaining
abstinent (e.g. Steward & Kushner, 2001; Forsyth, Parker & Finlay, 2003). In addition to the
relevance of emotion to the maintenance of smoking behavior, momentary urges to smoke may
also be precipitated by the presence of stress, anxiety and negative emotions in general, in
association with other types of smoking cues (Cepeda-Benito & Tiffany, 1996). The presence of
persistent negative affect, as in the cases of comorbidity between smoking addiction and other
disorders (e.g. anxiety, depression) complicates the clinical picture and may negatively affect
response to smoking cessation treatment and modifications of health behaviors such as the
reduction of second hand smoking exposure of family members.
This symposium includes studies exporing the association between smoking and negative
emotions. Specifically, study 1 presents results addressing the effects of laboratory induced
stress on smoking urges, based on the hypothesis that smokers may experience the urge to
smoke when attempting to regulate negative and unwanted emotional experiences. The study
uses the PASAT paradigm to induce stress and psychophysiological measures to evaluate
induced emotion. Studies 2 & 3 assess the association between depression and smoking.

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Specifically study 2 examines the impact of comorbid depression on the treatment outcome of a
smoking cessation program. In this study the treatment outcome of a standard smoking
cessation therapy plus therapist time was compared to another group which included standard
smoking cessation therapy plus cognitive behavioral analysis system of psychotherapy for
depression. Study 3 examines factors that relate to depressive symptoms among underserved,
low-income women enrolled in a secondhand smoke exposure reduction trial, and the role of
depressive symptoms in predicting differential smoking response across repeated smoking cue
exposure trials. Variables examined as predictors of depression included social support and life
stress. Study 4 takes a practical stance toward the smoking cessation problem: Assuming that
smoking is potentially related to attempts at reducing or avoiding negative emotional
experiences and other unpleasant internal events, it tests a brief intervention aimed at
increasing motivation to quit smoking. The intervention uses a values clarification approach and
is based on principles of Acceptance and Commitment Therapy. In sum, the symposium will
provide an opportunity for a broad discussion of the role of emotion in smoking and smoking
related behaviors.
Can stress and frustration induced in a laboratory act as smoking cue to increase
cravings among college regular smokers?
Smoking craving is impacted by the presence of environmental and other cues associated with
smoking (Cepeda-Benito & Tiffany, 1996). Research experiments usually contacted with adults
as part of smoking cessation studies (Britt et al., 2001, Morissette et al., 2005), present both
self-reported and psychological increases in craving when confronted with smoking related cues
such as laboratory induced stress (Niaura et al., 2002, Conklin & Tiffnay, 2001). This study
aimed to examine the impact of a laboratory induced negative affective task (PASAT task) on
smoking cravings among a sample of college student smokers. This study was not conducted
as part of a smoking cessation trial. Forty-three participants (Mage = 21.03, SD = 1.67; 32
female) underwent a stress and frustration induction procedure (PASAT, Lejuez, Kahler &
Brown, 2003) while their physiological reactions (e.g. skin conductance, heart rate) and
subjective responses (e.g. SUDS ratings, Questionnaire of Smoking Urges, PANAS) were
monitored. Smoking urges, frustration, irritability and stress significantly increased from pre
experiment to mid (after completing two levels of increased difficulty of the task) to post
(following a 3rd even more difficult level) experiment, while anxiety did not significantly increase.
From the psychophysiological measures assessed only skin conductance was found to
significantly increase from baseline to mid point (mean levels 1 and 2) to the final 3rd level,
F(2,35) = 14,07, p< .001. Results suggest that conditions of stress and frustration act as
smoking cues and increase cravings (subjectively and physiologically) among college regular
smokers.
Results from a pilot study evaluating a depression-focused smoking cessation
intervention for smokers with current chronic depressive disorders
The prevalence of depressive disorders is elevated among smokers. A disproportionate number
of Americans who die each year from smoking-related causes, have a lifetime history of major
depressive disorder (MDD), and depression is strongly associated with increased medical
morbidity and mortality. The development of effective smoking cessation treatments for smokers
with current depressive disorders may have important clinical and public health significance in
reducing the overall morbidity and mortality associated with smoking. Because smoking
cessation treatment studies have traditionally excluded smokers with current MDD, very little is
known regarding the impact of more severe levels of depressive symptoms on smoking
cessation outcome. However, there is consistent evidence that subsyndromal levels of
depressive symptoms at baseline, or increases in depressive symptoms following the quit date
predict smoking cessation failure. This suggests that in order to be successful in achieving

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abstinence, smokers who enter treatment with current depressive disorders may require
additional treatment that targets their depressive symptoms. In this pilot study, 49 smokers
meeting criteria for chronic major depression (MDD) or dysthymia were randomly assigned to
receive 12 70-minute sessions of standard smoking cessation treatment plus cognitive
behavioral analysis system of psychotherapy (CBASP), an interpersonally-focused
psychotherapy specifically developed for the treatment of chronic depression; or to standard
smoking cessation treatment plus a therapist time and contact control condition focused on
health and wellness (HW). The majority of participants were male (61%) with education beyond
high school (69%), were an average age of 42 years and smoked on average 19 cigarettes per
day. Participants were assessed for 7-day point prevalence abstinence, depressive symptoms
with the Beck Depression Inventory (BDI), and withdrawal symptoms with the Positive and
Negative Affect Scale (PANAS) and Wisconsin Smoking Withdrawal Scale (WSWS), from
baseline through 6-months post-quit. We examined the interaction of group by time on these
measures, covarying for baseline values, gender, and 7-day point-prevalence abstinence.
Chronically depressed smokers in the CBASP group, relative to HW, smoked fewer cigarettes
and reported less depressive symptoms, negative affect, anger, anxiety, sadness, concentration
problems and craving to smoke over the study period. However, there was no effect of
treatment group on 7-day point-prevalence abstinence over time. Results suggest that a
depression-focused smoking cessation intervention was more effective than a therapist contact
control in reducing daily smoking rate, depression, craving and affective symptoms of
withdrawal. However, depression-focused treatment did not result in higher quit rates.
Depressive symptoms among women who smoke: Related factors and possible
mechanisms
Background: While much is known about depression-smoking associations among women in
general, less is known about factors that predict maternal depressive symptoms and behavioral
mechanisms that may explain this association among underserved, low-income women.
Objective: To examine factors that relate to depressive symptoms among underserved, lowincome women enrolled in a secondhand smoke exposure (SHSe) reduction trial, and whether
variability in depressive symptoms among women predict differential smoking response across
repeated smoking cue exposure trials.
Methods: As part of a randomized controlled trial targeting underserved maternal smokers with
the goal of reducing their children's secondhand smoke exposure (not a smoking cessation
trial), participants completed baseline and 16-week end of treatment (EOT) assessments
including the CES-D. A second study (smoking cessation trial) examined the influence of CES-D
on reactivity to smoking cues among women to explore a potential mechanism linking
depressive symptoms to smoking.
Results: Among 307 participants at baseline in Study 1, logistic regression analyses suggested
that more than one SHSe-related sick visit (OR 1.38, p<.001), greater life stress (OR 1.05,
p<.001) and less social support (OR 0.82, p<.001) within the last 3 months predicted CES-D
scores above 15 (significant depressive symptoms). At EOT in Study 1, additional smokers in
the home (OR 1.57, p=.049), greater life event stress (OR 1.04, p=.001), and less social support
(OR 0.88, p<.001) predicted CES-D scores above 15. Study 2 failed to show an association
between depressive symptoms and smoking cue reactivity when controlling for other factors
known to relate to reactivity.
Conclusions: Our findings suggest that SHSe-related child illness and social factors associated
with greater risk of child SHSe (e.g., other smokers in the home) relate to maternal depression.
We will discuss how maternal depression, smoking, and child illness may present as
reciprocally-determined interrelated factors, why depression may not affect women's reactivity to
smoking cues, and implications for both the treatment of depression and smoking among
women.

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A brief values intervention improves self-efficacy and smoking cessation intent: A pilot
study
Youth present with higher smoking rates than ever before and existing interventions may not
suffice in reducing smoking behavior. Acceptance and Commitment Therapy (ACT), recently
gained interest for smoking cessation especially as it targets the experiential avoidance or more
thoroughly deal with the emotional cues associated with smoking. Yet, there is no research on
which of its components may influence smoking parameters and cessation. This study aimed to
examine the effectiveness of the values component of ACT compared to a psychoeducational
intervention for increasing intent to quit smoking and quitting self-efficacy among youth.
Participants were randomly assigned to either a values or a psychoeducation group (30 in each)
and completed questionnaires assessing smoking behavior, intention to quit, and self-efficacy
prior to, after the completion, and one month post-intervention. Results showed an increase in
participants self-efficacy for quitting and higher intentions to quit, with the values intervention
resulting in modest but greater increases. At one month follow-up, self-efficacy and intention to
quit decreased compared to post-intervention but did not reach pre-intervention levels. The
potential and effectiveness of a one-session values intervention in increasing self-efficacy and
intention to quit smoking among young people is discussed.
The Crack Use Relapse Scale (CURS): Development and Psychometric Validation
Rosemeri Pedroso, Mrcia Pettenon, Luciano Guimares, Felix Kessler, Flavio Pechansky.
Center for Drug and Alcohol Research, Universidade Federal do Rio Grande do Sul, Porto
Alegre, Brazil.
Aims: To report the development and validation of the Crack Use Relapse Scale (CURS) in an
inpatient population. Methods: A pilot study with 30 male crack users was conducted to
generate 35 sentences related to the construct of interest. Content and semantic validation were
later obtained via a focus group of 8 male crack users, as well as an expert panel of 10 drug
dependence specialists. A five-point Likert scale with 25 items and, initially, 9 theoretical factors
was generated and utilized in a cross-sectional study with a sample of 333 hospitalized male
crack users. Results: The overall Cronbachs alpha obtained was = 0.86. The exploratory
factor analysis (EFA) with varimax rotation, kept the 25 items (factor loadings > 0.40) and 6
definitive factors, which explained 62.1% of the total variance. Confirmatory factor analysis
(CFA) indicated a well-fitting model for the CURS. Dimensionality: 1. Emotions, family and affect
( = 0.84), 2. Coping ( = 0.71), 3. Health, sex and treatment ( = 0.59), 4. Legal and social
aspects ( = 0.81) 5. Positive expectations ( = 0.77), 6. Craving ( = 0.80). Conclusions: The
six-factor model yielded by EFA of the CURS reflects the various dimensions of the construct
crack use relapse, assigning satisfactory values and demonstrating good psychometric
properties, including validity and reliability. Furthermore, CFA shows that the CURS model is
appropriate and well-fitting for assessment of latent variables common to psychiatric and
psychological constructsin this case, relapse of crack cocaine use after inpatient treatment.
Uso y Abuso del Internet en los Adolescentes de la Regin de Tumbes 2012
Abraham Perez.
tumbes, universidad, Tumbes, Peru.
Resumen Panel Autor: Abraham Eudes Prez Urruchi Universidad Nacional de Tumbes
Palabras claves: uso abuso, adiccin, internet. RESUMEN D Con el objetivo de determinar la
prevalencia del uso y abuso del internet en los estudiantes de educacin secundaria de la
regin de Tumbes Se aplic una encuesta con preguntas relacionados sobre el uso y abuso del

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internet, que luego se convertira en adiccin al internet que constituye actualmente un


importante problema de salud mental publica, que acarrea un gran nmero de problemas a
nivel personal, familiar, y social. En el presente estudio se analiza la prevalencia del uso y
abuso del internet en estudiantes de educacin secundaria. En la regin de Tumbes, con una
muestra de 184 estudiantes de 12 instituciones educativas, tomando como variables la edad,
sexo, tiempo de permanencia en una cabina de internet. Se aplic una encuesta de 05
preguntas seleccionadas, de los criterios de diagnstico para la adiccin al internet de Young.
De los cuales podemos agrupar en categoras de importancia como son la edad, encontrando
que los adolescentes de mayor incidencia son los de 13, 14,15, y 16 aos. Determinando que
la mayor cantidad de estudiantes que abusan del internet son los varones con un 72%.
asimismo el tiempo que dedican al abuso de internet es de 01 hora, con un 30%, sigue 02
horas (20%), y con 04 horas (24%) de los estudiantes que dedican como adiccin al internet
afectando sus capacidades cognitivas y emocionales. Tambin podemos mencionar que los
estudiantes que asisten todos los das a las cabinas de internet es de 151 estudiantes (82%) y
de manera interdiaria un total de 33 estudiantes (18%). Finalmente se propone
recomendaciones de carcter especfico, para prevenir la adiccin al internet en adolescentes y
nios de nuestra regin que afecta en su desarrollo psicosocial, y buscar estrategias para la
mejor convivencia con los padres de familia mediante talleres de escuelas de padres,
desarrollar habilidades sociales, como soporte de la educacin y desarrollo del adolescente.
Para as mejorar la calidad de vida y educativa de los adolescentes de la regin de Tumbes.
Aplicacin de un Programa Cognitivo-Conductual Denominado: Prevencin Estructurada
de Recadas en un Usuario Consumidor de Alcohol
Luis Perez-Romero, Maria Vital-Cedillo.
Universidad Nacional Autonoma de Mxico, Ciuda de Mexico, DF, Mexico.
El fenmeno de la adiccin al alcohol y otras drogas representa un problema que afecta a la
sociedad mexicana, lo que se refleja en indicadores como: delincuencia, desercin escolar,
desempleo, desintegracin familiar problemas laborales y accidentes automovilsticos, adems
de generar costos econmicos por atencin mdica y social, esto hace necesario contar con
programas de prevencin y tratamiento psicolgicos que impacten dicha problemtica. En este
sentido se plantea la aplicacin de un Programa cognitivo conductual, denominado Prevencin
Estructurado de Recadas para Estudiantes Universitarios (PEREU) traducido y adaptado del
desarrollado originalmente por Annis, Herie, & Watkin- Merek (1996) en un usuario con
dependencia sustancial al alcohol, con una historia de consumo de 19 aos y con problemas
asociados; familiares, financieros y de salud. La intervencin consisti en la aplicacin del
PEREU basado en la Teora del Aprendizaje Social de Albert Bandura cuyo principal constructo
es la autoeficacia que define como: la percepcin o juicio de un individuo con respecto a su
capacidad para llevar a cabo una conducta determinada y en el enfoque de prevencin de
recadas de Marlatt y Gordon que propone anticipar y afrontar los problemas de la cada o
recada en el cambio de una conducta adictiva. El PEREU consta de 5 componentes 1)
Evaluacin: se obtuvo informacin con respecto al paciente sobre su consumo de alcohol,
problemas asociados al mismo, razones para el cambio, adems de explorar detalladamente
los disparadores del paciente para uso de alcohol 2) Entrevista Motivacional: se proporcion la
Retroalimentacin Personalizada con base a los resultados de la evaluacin, se aplic el
Balance Decisional, que explor las razones del paciente para cambiar su uso de alcohol, as
como los pros y contras percibidos para continuar o cambiar su consumo, as como resolver la
ambivalencia ante el cambio, se estableci la meta del tratamiento que fue la abstinencia 3)
Plan de Tratamiento Individualizado: se involucr al paciente en el diseo del tratamiento, que
incluyo lo siguiente: una explicacin sobre el tratamiento y sus caractersticas, firma del

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contrato de tratamiento, revisin de los principales disparadores, una identificacin detallada de


las situaciones de uso problemtico del alcohol que se obtuvieron por medio de la evaluacin y
que posteriormente el paciente jerarquiz para ser utilizadas para la determinacin de las
destrezas y tareas asignadas durante el tratamiento y la explicacin del monitoreo diario 4)
Fase de iniciacin: se centra en las estrategias de consejo que se sabe son poderosas en la
iniciacin de un cambio como: la evitacin de situaciones de riesgo para el uso del alcohol, la
participacin de una persona significativa; y un papel relativamente directivo del terapeuta, est
fase implica cuatro sesiones, en el caso de este paciente el componente no se aplic debido a
que no haba consumido alcohol durante los ltimos 60 das y haba implementado algunas
estrategias por su cuenta para conseguir la abstinencia lo que lo sita en un estadio de
mantenimiento 5) Fase de Mantenimiento del cambio: se ensearon las destrezas de
enfrentamiento que se obtuvieron a partir de la evaluacin de las situaciones de riesgo y que
fueron: Manejo del enojo, Enfrentamiento de los deseos intensos, Asertividad, Enfrentamiento
de los sentimientos desagradables y traumas, Incremento del apoyo social y Solucin de
problemas, adems de exponer al paciente gradualmente a situaciones de riesgo de la vida
cotidiana. Resultados a la fecha: el usuario se ha mantenido en abstinencia mostrando un
grado de autoeficacia mayor al reportado en el inicio del tratamiento informa de mejoras en los
problemas asociados tanto econmicamente, como a nivel salud y familiares, lo que sugiere
una alta probabilidad que mantenga su abstinencia.
Impacto de Reestruturao da Crena Intermediria Na Masturbao Excessiva
Moacyr Pires Filho, Luciana Gropo, Ktia Petribu.
Hospital Universitrio Oswaldo Cruz/ C-TOC-PE / Universidade Estadual de Pernambuco,
Recife, Brazil.
O estudo de caso aqui relatado tem como objetivo verificar o impacto da interveno cognitivo
comportamental na compulso sexual, especificamente, masturbao excessiva, seguindo as
etapas do protocolo Kunrzler (2008), considerando que a reestruturao cognitiva em nvel de
crena intermediria primordial para a gerao de comportamento mais saudvel. A paciente
em questo uma jovem adolescente de 19 anos, sexo feminino, negra, baixa renda, segundo
grau completo que sofreu abuso sexual continuado, dirio, dos 7 aos 9 anos de idade. Os
resultados indicaram uma reduo tanto nos episdios de masturbao, adequando-se o
comportamento a um padro que pode ser considerado normal para sua idade, quanto nos
escores das escalas Beck para a depresso e a ansiedade. PALAVRAS CHAVES: interveno
cognitivo-comportamental; compulso sexual; masturbao excessiva.
Transtorno Mental: Comportamento Criminoso Luz da Teoria Cognitivo
Comportamental, uma Anlise em um Hospital de Custdia
Mariah Ramiro, Vilma Nascimento Menezes.
Psicologia, UNIP, Joao Pessoa, Brazil.
Os indivduos acometidos por transtorno mental que cometem crime so considerados pela
esfera jurdica como inimputveis, e so submetidos medida de segurana por tempo
indeterminado, que varia de um a trs anos de internao em hospital de custdia. Os casos de
inimputabilidade envolvem os quadros de transtornos psicticos (em especial a esquizofrenia),
o retardo mental e a epilepsia. Uma explicao para tais acontecimentos seria a teoria
Biopsicolgica da criminalidade (Eysenck, 1977) que explica o comportamento criminal como
resultado de uma interao entre fatores ambientais e caractersticas hereditrias, podendo
tambm ser justificado pelo pressuposto bsico da Teoria Cognitivo-comportamental descrito

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por Aaron Beck Onde o afeto e comportamento do indivduo so amplamente determinados


pela forma como ele interpreta o mundo. Para avaliar a condio de inimputabilidade,
necessrio laudo psiquitrico que ir definir o diagnstico, como tambm o grau de
periculosidade do infrator doente mental. A Psiquiatria e a Psicologia Forense auxiliam a justia
fornecendo diagnsticos, laudos e exames, referente ao estado mental do periciando no
momento do ato infracionrio em questo. O propsito dessa pesquisa foi analisar a incidncia
e a tipificao do transtorno mental e sua relao com o crime dos internos em medida de
segurana. Essa pesquisa documental. Para isto, foi selecionada a penitenciria de
psiquiatria forense da Paraba, como lcus da pesquisa, e como metodologia foram utilizados
33 pronturios psiquitrico-criminal de inimputveis. Como resultado constatamos que 51,5%
apresentam transtornos psicticos, correspondendo a 68% de homicdios, 30,3% transtornos
decorrentes de uso de lcool, sendo 33,3% crime contra o patrimnio, 12,2% retardo mental,
75% crime contra o patrimnio e 12% transtorno de personalidade, porte ilegal de arma.
Conclui-se que h uma maior incidncia de transtornos psicticos, em especial a esquizofrenia
paranide em comorbidade com o lcool, e grande parte deles praticaram homicdios contra
parente de primeiro grau.
El Estrs Acadmico y el Abuso de Bebidas con Alcohol en Mujeres Estudiantes
Mariana Robles-Gmez.
Universidad Nacional Autnoma de Mxico, Mxico, Mexico.
En las ltimas dcadas el consumo de sustancias ha sido considerado el abuso de bebidas con
alcohol como un problema de salud pblica, ya que representa el 4% de la mortalidad mundial.
En Amrica es un 50% mayor el promedio mundial de mortalidad adems estimaciones
epidemiolgicas sealan que, alrededor, del 32% del total de muertes al consumo de alcohol.
En la mayora de los pases la prevalencia de consumo de bebidas con alcohol en hombres es
del 30% al 70% mayor a las mujeres, en general tienden a mostrar diferencias entre hombres y
mujeres, mientras que los pases con menor prevalencia de consumo de alcohol tienden a
mostrar mayores diferencias por sexo. El Salvador, Guatemala, Mxico y Nicaragua se sitan
en niveles de baja prevalencia en el ao 2006, en algunos casos la prevalencia de uso de
consumo de alcohol se present peculiarmente en los hombres es dos a tres veces mayor que
en las mujeres. Los resultados obtenidos por sexo, se observ de 2002 a 2011, la opcin de
alguna vez en la vida, las respuestas en hombres aumento de 78.6% a 80.6% y en mujeres de
53.6% a 62.6%. La prevalencia del ltimo ao en mujeres pas de 34.2% a 40.8%, mientras
que en hombres el incremento se registr entre 2008 y 2011 (55.9% a 62.7%). Por ltimo, la
prevalencia del ltimo mes entre 2002 y 2011 aument en hombres de 33.6% a 44.3% y en
mujeres de 7.4% a 19.7%. As como de igual forma se ha observado que el estrs es un factor
que contribuye al consumo de alcohol La respuesta de estrs diferencial en hombres y mujeres
sobre la de las desiguales respuestas hormonales: las mujeres, por accin de la hormona
oxitcica (hormona tradicionalmente relacionada con el parto, reducen el nivel de estrs,
produciendo calma y bsqueda de contacto social, las mujeres que reportan consumo lo hacen
como una conducta evasiva frente a situaciones conflictivas o estresantes, relacionadas con
ciertos acontecimientos vitales traumticos, los conflictos y rupturas familiares o de pareja, son
circunstancias que en algunos casos explicara estn presentes entre las mujeres dependientes
de alcohol. Existen muchos factores, incluyendo antecedentes familiares, consigue predecir a la
mujer su consumo de bebidas con alcohol para enfrentar el estrs. Los antecedentes de una
mujer y sus hbitos de beber son importantes, diferentes personas tienen diferentes
expectativas acerca del efecto del alcohol sobre el estrs. Cmo maneja la mujer el estrs, y el
apoyo que tenga para hacerlo, tambin pueden influir sobre si consume alcohol como
respuesta al mismo. Con base a lo anterior, se ha visto la necesidad de plantear, programas de

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tratamiento en esta poblacin, se aplico un cuestionario acerca del consumo de bebidas con
alcohol a una poblacin de 2173 alumnos estudiantes de una universidad pblica de diferentes
grados acadmicos, durante la revisin estadstica descriptiva realizando una correlacin
acerca de sus hbitos de consumo y las emociones negativas que presentan las alumnas y su
percepcin de el estrs acadmico y como se relaciona sobre el consumo de bebidas con
alcohol las variables que se medirn son: el consumo de bebidas con alcohol, el estrs
reportado por la carga acadmica, continuando con el planteamiento de una intervencin donde
se vea afectado en la disminucin del consumo de bebidas con alcohol y el estrs reportado
por las participantes, en futuras investigaciones se planteara intervenciones preventivas para
evitar el abuso de la sustancia. Los resultados arrojados de esta investigacin, es la presencia
de emociones negativas se correlaciona al abuso de consumo de bebidas con alcohol y las
pocas habilidades de afrontamiento a las emociones negativas y la presencia de estrs se
presento que dentro de la poblacin se ve disminuido el consumo de bebidas con alcohol,
dentro de la poblacin que si presenta habilidades necesarias para afrontar las situaciones de
riesgo de consumo.
A Contribuio da Musicoterapia no Comportamento com Dependentes Qumicos Estudo de Caso - UAL - Universidade Autnoma de Lisboa - PT
Lourdes Aparecida Rocha.
Psicologia Clnica, UAL- Universidade Autnoma de Lisboa, Lisboa, Portugal.
A Dependncia qumica considerada hoje como um problema de sade publica, pois atinge
toda a sociedade desde as classes sociais mais elevadas s mais baixas. A droga est cada
vez mais presente na vida cotidiana das pessoas. O principal objetivo evidenciar a
contribuio da musicoterapia como uma possibilidade teraputica no tratamento da
dependncia qumica, favorecendo uma melhoria de qualidade de vida. Foram realizadas trinta
sesses, sendo que para este estudo analisamos vinte sesses. Nas experincias receptivas, o
paciente ouve msica e responde experincia de forma silenciosa, verbalmente ou atravs de
outra modalidade. A msica utilizada pode ser ao vivo ou gravaes de improvisaes,
execues ou composies do paciente ou do terapeuta, ou pode-se utilizar gravaes
comercias de musicais de diversos estilos (por exemplo, clssica, rock, jazz, country, new age,
entre outras). A experincia de ouvir pode enfocar os aspectos fsicos e psquicos da msica e
as respostas do paciente so moduladas de acordo com o objetivo teraputico da experincia.
Na anlise pode observar que no episdio de recada os dependentes, passaram por trs
situaes primrias associadas ao problema: 1- estados emocionais negativos; 2 - conflito
interpessoal recente e 3 - presso social. Devido s drogas constiturem, hoje o fator mais
importante de desorganizao social, familiar e individual, alm dos nveis insuportveis j
alcanados pelo elevado custo scio-econmico. A anlise da descrio, que focalizou as
circunstncias e os contextos associados s tentativas de recuperao, pode ser subdivida de
em quatro partes: 1 - experincias crticas que mobilizaram para a recuperao; 2 - abordagens
e recursos utilizados na recuperao; 3 - dificuldades pra se manter longe das drogas e 4 experincias de desintoxicao, sendo que os pacientes no fizeram uso de medicamentos.
Em nossos estudos de anlise focalizamos as dificuldades para manter se longe das drogas.
Na verdade, trata-se de uma condio essencial para a recuperao. Sem abstinncia no h
recuperao. Ao suprimir-se a incorporao do txico, necessrio enfrentar os mesmos
problemas dos quais estava tentando fugir: fragilidades, vivncias de vazio, dficit crnico de
estima, e depresso. O confronto entre as partes que estavam entre 1-2 e 4 (descrio) com a
parte focalizada na reduo mostra-nos um paradoxo. A droga que viabilizava a existncia
destes pacientes aproximava-os de prticas auto-destrutivas, podendo culminar na morte. Fezse necessrio que o paciente aprende-se a identificar qualquer situao que ponha em risco

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sua meta de recuperao. Ainda em relao recada deixamos claro que toda pessoa tem um
conjunto pessoal e nico de sinais que indicam que o processo de recada esta acontecendo.
Com estas anlises pde-se observar que a Musicoterapia provou mudanas positivas nos
sentimentos dos pacientes, atravs do problema aditivo por parte do dependente, resgate de
vnculos familiares, recomposio de auto-estima, afastamento de ambientes favorecedores da
adio entre outros, contribuindo assim na preveno das recadas.
Estudo de Efetividade da Interveno para Usurios de Crack Baseada No Modelo
Transterico de Mudana
Viviane Rodrigues2, 1, Karen Szupszynski1, Dhiordan Cardoso1, Juliana da Silva1, Paula Gths1,
Margareth Oliveira1.
1. PUCRS, Porto Alegre, Brazil, 2. UNIVATES, Lageado, Brazil.
O Modelo Transterico de Mudana desenvolvido por Prochaska e DiClemente (1982) tem
estudado a motivao e a prontido para mudana de comportamento. Este modelo prope
que a mudana comportamental acontece ao longo de um processo, no qual as pessoas
passam por diferentes nveis de motivao para mudana. O modelo transterico enfatiza a
mudana intencional de comportamento. Objetivo: Este estudo tem por objetivo verificar a
efetividade do tratamento baseado no Modelo Transterico de Mudana em usurios de crack,
para tratamento em regime de internao e ambulatorial. O tratamento ser uma adaptao do
programa proosto pelo manual americano Group Treatment for Substance Abuse: A Stages-ofChange Therapy Manual desenvolvido por Velasquez, Maurer, Crouch e DiClemente (2001).
Metodologia: Trata-se de um Ensaio clnico randomizado que contar com 120 pacientes
dependentes de crack, 60 do grupo controle e 60 do experimental. Os instrumentos utilizados
sero: questionrio scio-econmico semi-estruturado; ASR (Adult Self Report); Screening
Cognitivo do WAIS; Teste Wisconsin de Classificao de Cartas; Figuras complexas de Rey;
URICA (University of Rhode Island Change Assesment Scale); Escala de Auto-eficcia para
Abstinncia de Drogas; Escala de Situaes Tentadoras para Uso de Drogas; BHS - Inventrio
de Desesperana de Beck; Escala de Processos de Mudana; e Exame Toxicolgico (saliva e
urina). Resultados: Inicialmente for realizado uma adaptao das sesses no Manual
americano para a realidade brasileira. As sesses foram adequadamente traduzidas e
adaptadas para um programa de 8 sesses. Em relao a coleta de dados, at o momento foi
realizado um estudo piloto com o objetivo de avaliar a metodologia aplicada e os instrumentos
escolhidos. Neste estudo piloto, 30 pacientes passaram por uma avaliao inicial, interveno
(oito sesses) e reavaliao. Aps trs meses da reavaliao foram contatados novamente por
telefone. Este follow-up de 3 meses consistiu em realizar a primeira fase de avaliao da
efetividade da interveno. O intuito era averiguar como estavam os pacientes que participaram
do estudo. Dentre as perguntas realizadas na entrevista, questionou-se sobre a abstinncia. De
acordo com as respostas 20% dos participantes do grupo controle mantiveram-se abstinente,
enquanto 45% dos pacientes do grupo experimental permaneceram sem usar crack ou
cocana. Discusso: De acordo com os resultados apresentados, percebe-se que a interveno
(oito sesses) tem demonstrado uma forte tendncia para resultados satisfatrios, indicando a
continuidade do estudo e ampliao da amostra estudada. Alm disso, os instrumentos
mostraram-se eficientes aprresentandos bons coeficientes de fidedignidade e validade interna.
Correlaes estatsticas mais complexas no foram possveis em funo do pequeno nmero
da amostra do estudo piloto.
Habilidades Sociais e Consumo de Tabaco: Um Estudo com Universitrios Brasileiros
Regina Rondina1, Raul Arago Martins2, Antonio Jos Manzato2, Brunna Refberg1.

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1. Universidade Estadual Paulista Julio Mesquita Filho, Marilia, Brazil, 2. Universidade Estadual
Paulista Julio Mesquita Filho.IBILCE, So Jos do Rio Preto, Brazil.
Introduo: A literatura sugere que dficits em habilidades sociais podem predispor o indivduo
ao tabagismo e / ou dependncia nicotnica. Em especial, supe-se que dficits em
assertividade estejam relacionados ao comportamento de fumar tabaco, de alguma forma.
Contudo, ainda no existe consenso nesse sentido. Objetivo: avaliar caractersticas do
repertorio de habilidades sociais em universitrios fumantes e no fumantes. Mtodo: 1126
estudantes matriculados em uma universidade pblica do oeste paulista participaram deste
estudo. Foram aplicados um questionrio para levantamento de caractersticas scio demogrficas dos estudantes, o Teste de Fagerstrm para dependncia nicotnica e o
Inventrio de Habilidades Sociais - IHS (Del Prette & Del Prette, 2001). Resultados: Fumantes
obtiveram em mdia, pontuaes maiores no escore fatorial F1 do IHS (Enfrentamento com
Risco), em comparao a no-fumantes. Discusso: Os dados no confirmam a hiptese de
associao entre dficits em habilidades sociais e tabagismo, entre os participantes desta
pesquisa. Ao contrrio do esperado, fumantes se descreveram como mais assertivos, em
comparao a no-fumantes. Ainda so necessrios mais estudos, no sentido de confirmar
esse resultado. Pesquisas prospectivas e transversais sobre fatores subjacentes associao
entre tabagismo e assertividade tambm podem contribuir para compreenso do assunto.
Referncias: Del Prette, Z.A.P.; Del Prrete, A. (2001). Inventrio de Habilidades Sociais.
Manual de aplicao, apurao e interpretao. So Paulo: Casa do Psiclogo, 2001.
Implicit Processes in Addiction: Moving Forward in the Prediction of Behaviour
Elske Salemink1, Reinout Wiers1, Abi Rose2, Jason Sharbanee3, Werner Stritzke3, Reinout
Wiers1, Colin MacLeod3, Elske Salemink1, Reinout Wiers1, Sherry Stewart4, Melissa Stewart4,
Sunghwan Yi5, Pamela Collins4.
1. University of Amsterdam, Amsterdam, Netherlands, 2. University of Liverpool, Liverpool,
United Kingdom, 3. University of Western Australia, Perth, WA, Australia, 4. Dalhousie
University, Halifax, NS, Canada, 5. University of Guelph, Guelph, ON, Canada.
Addictive behaviours are associated with implicit processes such as biases in information
processing. In the field of alcohol addiction, research has shown that heavy drinkers not only
selectively attend to alcohol-related stimuli, but also interpret ambiguous scenes as alcoholrelated and have an automatic tendency to approach alcohol-related stimuli. Recent work has
begun to explore the possibility to modify these biases to affect addictive behaviour. These
studies have been promising and led to the possibility that such Cognitive Bias Modification
procedures might function as an innovative new intervention.
While we know that alcohol-related behaviour is associated with biases in information
processing, little is known regarding such implicit processes in other addictive behaviours such
as gambling. Furthermore, we also lack specific detailed knowledge regarding implicit
processes predicting drinking behaviour. That is, differentiating between drug seeking versus
drug taking; the relationship between different biases in predicting drinking behaviour, implicit
drinking motives, the role of working memory capacity, etc. Solid basic knowledge regarding the
detailed role of these processing biases in addiction is important to bring the field further and to
adequately optimize Cognitive Bias Modification paradigms.
The aim of this symposium is to review the current state of the literature regarding implicit
processes in addiction and to present data regarding important steps forward in the prediction of
addictive behaviour. Elske Salemink (the Netherlands) will serve as the chair of the symposium.
First, Abi Rose (UK) will share results regarding underlying implicit processes in drug seeking
versus taking. Second, Jason Sharbanee (Australia) explored whether alcohol-related

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attentional bias and action tendency bias derive from a common mechanism or from different
mechanisms. Third, Elske Salemink will present data regarding more implicit drinking motives;
alcohol-related interpretive biases in a positive and negative affect context and their predictive
validity in combination with levels of working memory capacity. Fourth, Sherry Stewart (Canada)
will focus on a different addiction; she will present data regarding implicit and more explicit
processes in gambling. Our discussant, Reinout Wiers (the Netherlands), will discuss
implications for future research and particularly implication for clinical practice.
Drug Seeking and Taking May Be Supported by Different Underlying Processes; Implicit
Attentional Bias May Be More Important in Drug Taking
Addiction develops over time despite the drug producing less positive effects and having a more
negative impact on life; indicating that substance-seeking becomes more habit-like and that
cues can trigger substance-seeking with little regard to the current value of the substance.
Hazardous substance users also demonstrate attentional biases for substance cues, an implicit
process which may be important in initiating and maintaining substance-related behaviour. Our
research investigated whether manipulation of alcohol value influenced subsequent alcohol
seeking (choice) and taking (drinking), and whether attention to alcohol cues mediated this
effect. Alcohol seeking was measured through a choice task in which pictures of alcoholic and
non-alcoholic drinks were simultaneously presented on a computer screen. Baseline choice was
measured before participants completed a pleasant or an aversive alcohol sip-prime procedure
and a second choice task. Attention was measured during the choice task through remote eye
tracking. Over two studies, devaluation decreased proportional alcohol choice, number of
attention fixations and dwell time on alcohol cues, and alcohol consumption. Mediation analysis
showed that dwell time on alcohol cues only partially mediated the relationship between
devaluation and choice (drug seeking). However, mediation analysis also showed that while
attention to alcohol cues mediated the effect of devaluation on alcohol consumption (drug
taking), alcohol choice did not. These findings offer important translational evidence for the
argument that drug seeking and drug taking may be governed by different underlying
processes. The current findings indicate that while drug seeking may involve more value-based
decision making processes, drug taking may involve more implicit processes.
Alcohol-Related Bias in Selective Attention and in Action Tendency Make Distinct
Contributions to Disregulated Drinking Behaviour
There is evidence that alcohol-related bias in attention and in action tendency contribute to the
eitiology of problem drinking. However, previous research has been equivocal about whether
selectivity in attention and in action tendency represent manifestations of the same underlying
bias in a shared mechanism, or whether these two types of selectivity instead reflect biases in
quite different mechanisms. Our aim was to distinguish the veracity of these positions by
assessing whether alcohol bias in attention and in action tendency uniquely predict ability to
regulate alcohol consumption. Two groups of social drinkers (total N=55) who differed in their
ability to regulate their alcohol consumption completed a novel Attention-Behaviour Task (ABT),
which separately assessed alcohol bias in selective attention and in action tendency. Results
indicated that a) drinkers who reported greater difficulty regulating their drinking displayed
greater bias towards alcohol, in both attention and action tendency, than drinkers who reported
less difficulty, b) there was no association between the alcohol bias in attention and in action
tendency, and c) alcohol bias in attention and action tendency each accounted for unique
variance in ability to regulate alcohol consumption. These results support the hypothesis that
alcohol-related bias in selective attention and in action tendency represent distinct mechanisms
that independently contribute to disregulated drinking behaviour.

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Alcohol-related Memory Associations in Positive and Negative Affect Situations:


Drinking Motives, Working Memory Capacity and Prospective Drinking
Dual process models conceptualize (psychopathological) behavior as an imbalance between
two distinct systems of information processing; a fast, impulsive, associative system and a
regulatory executive system that can moderate the impact of the impulsive system. Alcohol
(mis) use has been associated with several biases in the associative implicit system, including
an alcohol related interpretive bias; the tendency to associate ambiguous situations with alcohol
use. While studies on explicit alcohol cognitions have identified positive and negative reinforcing
drinking motives that are differentially related to drinking indices, such a distinction has received
less attention in studies on implicit cognitions.
Aim of the current study is to assess implicit positive nd negative reinforcement consequences
of drinking, examine their relationship with explicit reinforcement motives, and their capacity to
predict prospective drinking (in combination with levels of WMC). Participants were 92 students,
who completed a new alcohol interpretive bias measure (alcohol Word Sentence Association
Paradigm), an Operated Span task (measure of executive control), the Drinking Motives
Questionnaire and completed a Time Line Follow Back questionnaire a week later.
Results revealed that as predicted, individuals who drink for enhancement motives had a
stronger tendency to endorse alcohol-related words in positive affect situations compared to
individuals scoring low on that motive. Regarding predictive validity, this alcohol-related
interpretive bias in positive affect situations predicted prospective alcohol consumption and
number of binges in individuals with low levels of WMC, but not in individuals with high levels of
WMC. Results for alcohol associations in negative affect situations were less straightforward.
The current findings are consistent with dual process models that argue that behavior can be
conceptualized as the joint outcome of two processes. The findings shed more light on the
underpinnings of alcohol use and associated problems as they were most strongly predicted by
an alcohol-related interpretive bias, when not inhibited by executive control processes.
Furthermore, this study suggests that implicit memory processes and working memory capacity
might be important targets for intervention.
Effects of Gambling-Related Cues on the Activation of Implicit and Explicit
Gambling Outcome Expectancies in Regular Gamblers
This study examined whether the presentation of gambling-related cues facilitates the activation
of gambling outcome expectancies using both reaction time (RT) and self-report modes of
assessment. The present study also assessed whether these two modes of assessment of
gambling outcome expectancies independently predicts self-reported gambling behaviour.
Gambling outcome expectancies were assessed by having 58 regular casino or online gamblers
complete an outcome expectancy RT task, as well as a self-report measure of gambling
outcome expectancies, both before and after exposure to one of two randomly assigned cue
conditions (i.e., casino or control video, respectively). Consistent with hypotheses, participants
exposed to gambling-related cues (i.e., casino cue video condition) responded significantly
faster to positive outcome expectancy words preceded by gambling prime relative to nongambling prime pictures on the post-cue RT task. Similarly, participants in the casino cue video
condition self-reported significantly stronger positive gambling outcome expectancies than those
in the control cue video condition following cue exposure. Activation of negative gambling
outcome expectancies was not observed on either the RT task or self-report expectancy
measure. Lastly, both the RT task and self-report expectancy measure contributed significant
unique variance to the prediction of amount of time spent and money risked gambling. The
findings indicate that gambling cue exposure activates positive, but not negative, implicit and
explicit gambling outcome expectancies among regular gamblers. The results also indicate that
this novel RT task is a useful measure, in addition to self-report measures of gambling outcome

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expectancies, in terms of contributing unique information to the prediction of gambling


behaviour.
Alcohol Abuse/Dependence Prevention: Focus at the Family?
Luciano Souza, Evelin Kelbert, Gustavo Cavada, Karen Jansen, Ricardo Pinheiro, Alfredo
Lhulier, Ricardo Silva.
Programa de Ps-Graduao em Sade e Comportamento, Universidade Catlica de Pelotas,
Pelotas, Brazil.
Alcohol consumption is culturally accepted in many places. Among young adults, the use of
alcohol can cause individuals, families and society damages. However, high prevalence rates of
alcohol abuse in young adults have been identified worldwide. The aim of this study was to
evaluate the prevalence of alcohol abuse/dependence and its associated factors in 18 to 24
years population. In a cross-sectional population-based with 1621 youth in the city of Pelotas,
southern Brazil, was assessed using ASSIST (Alcohol, Smoking and Substance Involvement
Screening Test) to identify alcohol abuse/dependence (>4 cut off point). Of the total sample,
27.2% of young adults had abuse / alcohol dependence. The results show a significant
relationship with males, smokers and users of other psychoactive substances, as well as being
the child of divorced parents and not living with a partner. It is suggested that preventive
interventions to substance abuse are held together, with particular focus on the male population
and emphasizes the importance of family structure.
Estudo das Propriedades Psicomtrica da Escala de Processos de Mudana
Karen Szupszynski, Marina Yates, Andressa Avila, Margareth Oliveira.
PUCRS, Porto Alegre, Brazil.
O uso de substncias afeta todos os campos da vida do dependente. O Modelo Transterico de
Mudana, desenvolvido por Prochaska e DiClemente, acredita que a mudana de
comportamento um processo e de que as pessoas tm diversos nveis de motivao para
mudar. O construto dos processos de mudana possui uma escala para avaliar quais
processos a pessoa est usando em determinadas situaes. A Escala de Processos de
Mudana (EPM) uma escala likert que infere se a pessoa est utilizando processos mais
cognitivos como ampliao da conscincia ou mais comportamentais como controle de
estmulos. Objetivo: O objetivo deste estudo caracterizar a amostra que est sendo coletada
para a adaptao brasileira da EPM para dependentes. Metodologia: Este um estudo
transversal e para a aquisio dos resultados foram realizadas estatsticas descritivas e
inferenciais. Os instrumentos utilizados foram: questes sobre o padro de consumo,
Screening Cognitivo do WAIS-III (Subtestes Vocabulrio, Cubos, Cdigos e Dgitos) e a EPM.
Resultados: A amostra foi composta por 201 sujeitos, sendo 93% (n=187) do sexo masculino,
com idade mdia de 30,32 anos (DP=8,60) e 24,9% (n=50) possuem Ensino Mdio completo,
58,2% (n=117) so solteiros e 67,7% (n=136) esto trabalhando. No ltimo ano, 56,7% (n=114)
fumaram maconha, 80,1% (n=161) ingeriram bebida alcolica, 87,6% (n=176) utilizaram
tabaco, 62,2% (n=125) consumiram cocana e 76,6% (n=154) usaram crack. Em relao aos
processos de mudana, 57,2% (n=115) utilizam mais processos cognitivos e 42,3% (n=85)
utilizam mais processos comportamentais. Em relao fidedignidade da escala, o coeficiente
do alpha de Cronbach dos itens que avaliam os processos cognitivos resultou em = 0,734 e
dos itens que avaliam os processos comportamentais resultou em = 0,535. J o coeficiente do
alpha de Cronbach da escala total forneceu o valor de = 0,741 sendo considerado um
resultado satisfatrio. Discusso: A amostra ainda est sendo complementada, apara que as
exigncias estatsticas de psicometria sejam obedecidas. Com os resultados obtidos, a escala

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j mostra-se com resultados de validade interna satisfatrios. Este estudo complementa o


estudo do Modelo trasterico no Brasil e ressalta a importncia de estudos psicomtricos para
a avaliao e tratamento de usurios de drogas. Ressalta-se que o estudo ainda est em
andamento.
COMMIT (Collaborative Outreach Multi-disciplinary Motivational Interview Technique) to
Work with Involuntary Parents in Child Abuse and Neglect Cases
Kota Takaoka.
Research center for child mental development, Chiba University, Chiba, Japan.
1.Introduction : In child abuse cases, almost parents have no motivational, aggressive and
rejective attitude for clinical stuffs when they outreach to parents. There is very common reason
to happen conflict between parents and clinical stuffs in the world. In order to go over the
conflict situation, build some relationship with parents and connect them to more adaptive
support from prevention and intervention to treatment, we have to develop flexible and effective
collaboration of Motivational Interview techniques and Multi-Disciplinary-Team (; MDT). In order
to save children and support parents more effectively, we need to develop COMMIT
(Collaborative Outreach Multi-disciplinary Motivational Interview Technique) as first trial
research. So, this research purpose is finding hypothesis model of COMMIT for less
motivational, less helping-skills, aggressive and rejective parents in child abuse and neglect;
how we should focus on parents cognition, behavior and emotion in COMMIT. 2. Method :
Research recruiting; total 67 practitioner in Japan; 11 Nurseries in Nursery school, 12 Public
health nurse in Public health centers, 15 child care workers in parenting center in local
governments and 22 child social workers in Child Guidance center. -Interview style; Semistructured interview. Interview guide; Episode of difficult case, Working out points ; attitude,
intention, concrete function, so on, Conflict points ; complain, trouble, difficulty, complication,
request, so on, If you meet a same situation, how will you arrange and deal with? Analysis;
Grounded theory approach 3. Result : Result present along the each analysis steps. Firstly,
nurseries focus on parents daily life cognitions and parenting behaviors unless parents
voluntary disclose parents need. After that, they focus on parents small improving adapt
cognition and parenting behavior, nurseries empower and reinforce them. Secondly, community
nurses outreach is based on intentionally outreach as population approach. They have kept
continuing outreach and focusing on parents anxiety and their related useful social support
plan. Thirdly, local government caseworkers outreach mean searching evidence of child abuse
report and tell parents about psycho-education and case formulation about parenting confusion.
Then they make parents think merits to receive some support. Even if local government
caseworkers couldnt get relationship with parent, they never fail to give up until make a contract
as childrens safety. Finally, outreach of child social workers in child guidance centers mean
forcing to communicate with parents based on the Child welfare law. Of course the parents who
receive sudden social workers outreach feel angry with the social workers, when especially
child protection. The social workers intentionally coping with parents angry emotion and
rejective behaviors. Along their case formulation, they shake parents cognitions; parents do
NOT want to receive their outreach and support and If parents wont receive their support,
parents will have to continue this negotiation with the they until children will be safety that they
admit. After that, the social workers should focus on only negotiating minimum children safety
plan as parents can. 4.disscussion and conclusion: From the results, three hypothesizes
generated in following. (A) Relationship with parents not perfectly but minimally. (B) Sharing
childrens safety with other organizations and professions but each organization and
professions different step. (C) Reconsidering Limit of Communication not as failure of
outreach, but as keep outreaching more intentionally. These hypothesizes will be COMMITs

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first basement. 5.limitation of research They will be evaluated and examined in next qualitative
and quantitative research.
Internalizing and Externalizing Problems: Differences between a Drug User Population
and a General Population
Lauren Terroso, Andressa Avila, Marina Yates, Camila Oliveira, Irani Argimon, Margareth
Oliveira.
Ps Graduao em Psicologia, Pontifcia Universidade Catlica do Rio Grande do Sul, porto
Alegre, Brazil.
Introduo: O modelo composto por dois fatores, internalizantes e externalizantes, para explicar
relaes entre problemas psquicos altamente sugerido atualmente. Estudos demonstram
que estes fatores so altamente influenciados pelo ambiente. Internalizao se refere a
propenso a expressar sofrimento internamente, atravs de sintomas de ansiedade, depresso
e/ou isolamento e problemas somticos. J externalizao descreve a propenso de expressar
o sofrimento externamente, atravs da agressividade, quebra de regras e impulsividade.
Pesquisas apontam que problemas internalizantes e externalizantes se correlacionam e esto
relacionados com o incio e curso do uso de substncias. Objetivo: O objetivo do presente
estudo foi comparar uma amostra de dependentes qumicos e uma amostra da populao geral
quanto presena de problemas externalizantes e internalizantes. Mtodo: Trata-se de um
estudo com delineamento quantitativo e transversal. A amostra foi constituda por 608 sujeitos,
sendo 288 pertencentes populao geral, e 320 de dependentes qumicos que foram
recrutados em centros de tratamento. Para verificar a presena dos problemas internalizantes e
externalizantes foi utilizado o instrumento ASR (Adult Self Report), pertencente bateria
ASEBA (Achenbach System of Empirically Based Assessment) que se prope a identificar
aspectos do comportamento adaptativo e psicopatolgico, categorizando-os na faixa normal,
limtrofe e clnica. Tanto os aspectos dos comportamentos internalizantes: ansiedade e
depresso; isolamento/depresso e problemas somticos quanto os dos externalizantes:
comportamento agressivo, quebra de regras e comportamento intrusivo, foram comparados
separadamente entre as populaes. Resultados: A mdia de idade da populao geral 33,17
(DP=12,6) e da populao dependente qumica 35,18 (DP=11,5). As anlises foram realizadas
utilizando o teste qui-quadrado e foram considerados significativos valores de p<0,05. No que
se refere ansiedade e depresso, a populao geral teve 6,6% de escore clnico comparado
a 39,4% da populao dependente. Em relao ao isolamento e depresso, 4,5% da populao
geral teve escore clnico, comparado a 28,1% dos usurios de drogas. A populao
dependente tambm apresentou percentual clnico maior no que diz respeito aos problemas
somticos sendo este 18,4% comparado a 2,4% da populao geral. Quanto ao
comportamento agressivo e quebra de regras a populao dependente obteve 24,1% e 50%
respectivamente de escores clnicos, comparado a 1% e 2,4% da populao geral. Atravs do
modelo da regresso linear mltipla com o mtodo enter, verificou-se que as variveis
problemas externalizantes e sexo explicam 30% e 23%, respectivamente a dependncia
qumica, e as variveis sexo e escolaridade explicam 4% e 3% a presena de comportamentos
externalizantes. Concluso: Atravs da anlise dos dados, foi possvel verificar que o grupo de
dependentes qumicos teve significativamente maior prevalncia de escores clnicos
comparados a populao geral tanto em problemas internalizantes quanto em externalizantes.
Este resultado aponta a necessidade de maior conhecimento acerca de variveis relacionadas
ao uso de drogas a fim de favorecer os profissionais que atuam nas intervenes de
comportamentos aditivos.

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Assessment of Overload in Drug Addicts Caregivers


Lauren Terroso1, Camila de Oliveira1, Viviane Tabeleo2, Luciana Quevedo2, Elaine Tomasi3.
1. Ps Graduao em Psicologia, Pontifcia Universidade Catlica do Rio Grande do Sul, porto
Alegre, Brazil, 2. Universidade Catlica de Pelotas - UCPel, Pelotas, Brazil, 3. Universidade
Federal de Pelotas- UFPEL, Pelotas, Brazil.
Objetivo: O presente estudo teve como objetivo identificar caractersticas de cuidadores
informais de indivduos dependentes qumicos usurios de Centros de Ateno Psicossociais CAPS. Mtodo: Trata-se de um estudo com delineamento transversal. Os CAPS so servios
comunitrios que tem a funo de cuidar de pessoas que sofrem em decorrncia de problemas
psquicos. Na cidade de Pelotas-RS h sete CAPS, destes foram selecionados 92 cuidadores
devido a patologia principal do usurio ser referente ao uso de drogas. Foram excludos do
estudo os cuidadores com sofrimento psquico severo, identificados atravs dos pronturios
dos CAPS. Atravs dos dados fornecidos pelos CAPS os participantes receberam telefonemas
para agendamento da visita domiciliar de aplicao dos questionrios que foi realizada por
estudantes de psicologia previamente treinados por uma equipe de pesquisadores. Foi utilizado
questionrio estruturado composto por questes sobre dados scio-demogrficos e perguntas
acerca de hbitos do cuidador, bem como os seguintes instrumentos: a verso brasileira do
Zarit Burden Interview- ZBI para verificar a sobrecarga, pois esta escala avalia o quanto as
atividades relacionadas ao cuidado tm impacto sobre a vida social e o bem-estar fsico e
emocional do cuidador; o Beck Hopelessness Scale- BHS, para verificar a desesperana dos
sujeitos; e a sesso designada a risco de suicdio da Mini International Neuropsychiatric
Interview - MINI na verso 5.0 adaptada para o Brasil. Resultados: A mdia da idade dos
cuidadores foi de 51 anos (DP=14,4%) sendo a maioria do sexo feminino (90,2%). A maior
parte dos cuidadores tinham algum grau de parentesco com o usurio (94,4%), sendo 42,4%
me, 32,9% cnjuge, 10,6% irmo, 9,4% filho(a), 2,4% pai e 2,4% outros graus de parentesco.
Um percentual de 30% dos cuidadores relatou deixar de fazer atividades pessoais todos os
dias para cuidar do indivduo, e 28,4% relataram que gostariam de ter mais conhecimento
sobre a dependncia qumica. Em relao a desesperana dos cuidadores, 63,8%
apresentavam intensidade mnima de deseperana, 25% leve, 8,8% moderada e 2,5% grave.
Quanto sobrecarga, 47,3% dos indivduos no apresentavam escore significativo de
sobrecarga, 15,4% apresentavam ligeira sobrecarga e 37,4% intensa sobrecarga. No que se
refere a problemas de sade atribudos responsabilidade para com o usurio, 64,8% dos
cuidadores relataram ter algum, sendo 76,2% relativos ansiedade e/ou depresso, 16,9%
hipertenso e/ou problemas cardacos, 3,5% insnia, 1,7% cansao excessivo e 1,7% perda de
peso ou obesidade. Do total dos 92 cuidadores, 29,7% apresentavam risco de suicdio.
Concluses: Na amostra estudada, evidente a alta sobrecarga dos cuidadores informais de
dependentes qumicos, influenciando negativamente suas qualidades de vida. Torna-se
preocupante a prevalncia de risco de suicdio entre os participantes, bem como a quantidade
de patologias que estes atribuem dependncia qumica dos indivduos os quais cuidam. Os
participantes demonstraram ter curiosidade em relao ao transtorno do usurio fato que
evidencia a necessidade de uma psicoeducao acerca da dependncia qumica para
possibilitar a eles maior compreenso sobre a patologia.
Suicidal Potential In a Population of Substance Dependents
Lauren Terroso, Aline Bruschi, Lusa Steiger, Regina Maria Lopes, Fernanda Cerutti, Irani
Argimon.
Ps Graduao em Psicologia, Pontifcia Universidade Catlica do Rio Grande do Sul, porto
Alegre, Brazil.

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Introduo: Estudos apontam a forte associao entre tentativas de suicdio e desesperana


bem como o fator de risco que tentativas prvias de suicdio constituem para tentativas futuras.
No que se refere a dependentes qumicos, elevada a freqncia de comportamentos e
pensamentos suicidas. Populaes clnicas em tratamentos de desintoxicao configuram
grupo de risco para o suicdio, o que prejudica a adeso ao tratamento destes sujeitos,
impactando significativamente os resultados. Objetivo: Verificar a diferena quanto
desesperana e ideao suicida em dependentes qumicos com e sem tentativa prvia de
suicdio. Mtodo: Trata-se de um delineamento quantitativo e transversal. A amostra foi
constituda por 306 pacientes, com dependncia do lcool e de outras substncias, internados
em uma clnica especializada no tratamento da dependncia qumica. Do total da amostra, 45
usurios tinham histria prvia de tentativa de suicdio, identificada atravs do pronturio da
instituio e confirmada mediante relato do sujeito. Os instrumentos utilizados foram: Ficha de
dados scio-demogrficos e clnicos, Escala de Ideao Suicida de Beck (BSI), e a Escala de
Desesperana de Beck (BHS). Os participantes foram solicitados a preencher individualmente
os questionrios, que eram aplicados por uma psicloga, na clnica onde estavam em
tratamento. Todos os participantes assinaram Termo de Consentimento Livre e Esclarecido.
Resultados: Os resultados da anlise discriminante classificaram corretamente 87,91% dos
casos. As mdias da BSI e da BHS, para o grupo sem tentativa prvia, foram 1,60 (DP = 4,45)
e 3,62 (DP = 3,12), respectivamente, e, para o grupo com tentativa prvia, foram 10,80 (DP =
7,64) na BSI e 8,24 (DP = 4,17) na BHS, apresentando diferena significativa (p=0,000) entre
os grupos. Concluso: O presente estudo constatou diferena significativa entre os grupos com
e sem tentativa prvia de suicdio, no que se refere desesperana e ideao suicida.
notvel a maior quantidade de pensamentos suicidas e maior escore de desesperana no
grupo de usurios de drogas que j haviam tentado suicdio, o que confirma estudos anteriores
que consideram tentativas prvias como fator de risco para tentativas futuras. Assim, os
comportamentos suicidas em dependentes de substncias devem ser consideradas
seriamente, j que pacientes com tal histria se diferenciam dos outros pela persistncia da
ideao suicida e pelas expectativas negativas frente ao futuro o que prejudica o curso do
tratamento e agrava o risco de novas tentativas. Evidncias sugerem a necessidade de
programas de tratamento que abordem a desesperana e pensamentos suicidas nos pacientes
usurios de drogas a fim de reduzir a sobrecarga associada dependncia qumica.
Aplicacin del Programa de Satisfactores Cotidianos (PSC) en un Usuario Consumidor
de Cocana
Miriam Torres.
Universidad Nacional Autnoma de Mxico, Mxico, Mexico.
El consumo de drogas constituye en la actualidad uno de los problemas de salud pblica ms
importantes, en Mxico las dos ltimas dcadas el consumo de la cocana ha ido en aumento,
es por ello que es importante implementar programas de servicio de atencin adecuados para
las necesidades especficas de los consumidores. Existe un amplio soporte cientfico que avala
la eficacia de las tcnicas psicolgicas en el tratamiento de la drogadiccin. Dicha eficacia se
fundamenta en la evidencia emprica que ha demostrado que las conductas de uso y abuso de
drogas son conductas operantes y que las contingencias desempean un papel determinante
en el inicio, desarrollo y abandono de las mismas explicadas por Secades et al. en el ao 2007.
El Programa de Reforzamiento Comunitario (CRA) es avalado por NIDA para el tratamiento de
la adiccin a la cocana. El CRA busca el cambio teraputico manipulando las contingencias
naturales que pueden estar influyendo en el mantenimiento de la adiccin. El CRA fue
adaptado en Mxico en 2005 por Barragn y Flores en ese mismo ao, con el nombre de
Modelo Integral de Satisfaccin Cotidiana o Programa de Satisfactores Cotidianos logrando

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obtener resultados favorables. El Programa de Satisfactores Cotidianos (PSC) es un


tratamiento breve con un enfoque cognitivo conductual dirigido a usuarios que han desarrollado
una dependencia media a severa. El marco terico del programa de satisfactores cotidianos
consiste en el anlisis conductual aplicado. Este trabajo reporta la aplicacin del Programa de
Satisfactores Cotidianos (PSC) en el Centro de Atencin Para Conductas Adictivas, a un
usuario con dependencia sustancial a la cocana, con una historia de consumo de 11 aos y
con problemas asociados; familiares, financieros y de salud. El modelo tuvo una duracin de 16
sesiones, las sesiones fueron semanales con una duracin aproximada de 60 minutos cada
una, la intervencin consisti en la aplicacin del programa y al igual que en el (CRA) los
componentes especficos varan dependiendo del usuario y de sus necesidades individuales,
utilizando en este caso 10 componentes, adems de exponer al paciente gradualmente a
situaciones de riesgo de la vida cotidiana. Finalmente, terminado el tratamiento se llevaron a
cabo las sesiones de seguimiento. Resultados a la fecha: el usuario se ha mantenido en
abstinencia, esto comprobado con los autoregistros y aplicacin de dos antidoping durante las
sesiones de tratamiento, mostrando un grado de autoeficacia mayor al reportado en el inicio del
mismo, adems se informa de mejoras en los problemas asociados tanto a nivel econmico,
salud y familiares, lo que sugiere una alta probabilidad que mantenga su estado de abstinencia.
The Interplay Between Automatic and Controlled Processes in Problematic Alcohol Use
Denise Van Deursen, Elske Salemink, Reinout Wiers.
University of Amsterdam, Amsterdam, Netherlands.
Abstract Central: Dual process models of addition posit that problematic alcohol use is
maintained by an imbalance between strengthened automatic processes, and/or weakened
controlled processes, including executive functions and motivation (Wiers et al., 2007). In
support of this view, several studies have shown that automatic processes are more predictive
of alcohol use in individuals with lower working memory capacity or inhibitory control (Grenard
et al., 2008; Houben et al. 2009; Thush et al., 2008; Peeters et al., 2012). Since these studies
have been conducted in at risk samples, it remains unclear whether executive functions
continue to moderate the relation between automatic processes and alcohol use in individuals
already experiencing alcohol use problems. The current, ongoing study aims to answer this
question by investigating the relation between automatic processes (i.e. attentional bias and
implicit associations), executive functions (i.e. inhibition and working memory), and alcohol use,
in individuals seeking online help for problem drinking. So far, over 100 participants have been
included in the study. Knowledge on the interplay between automatic and controlled processes
could have important implications for practice, for example in determining who benefits most
from interventions aimed at retraining automatic processes, collectively referred to as Cognitive
Bias Modification.
Evaluacin de un Tratamiento Cognitivo-Conductual y los factores de riesgo para el
Consumo de Sustancias Adictivas en Adolescentes de la Frontera Noroeste de Mxico
Eunice Vargas1, Thalia Morales1, Lourdes Bautista-Tenorio1, Rubn Muoz-Ramrez1, Kalina
Martnez-Martnez2, Martha Ruiz-Garca1, Virginia Velasco-Ariza1, Eunice Vargas1, Eunice
Vargas1, Eunice Vargas1, Eunice Vargas1.
1. Universidad Autonoma de Baja California, Ensenada, Mexico, 2. Universidad Autonoma de
Aguascalientes, Aguascalientes, Mexico.
El consumo de sustancias en Mexico representa un problema de salud pblica que requiere de
atencin inmediata mediante programas que han sido validados empricamente. Dentro de la

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poblacin que requiere de mayor atencin son los adolescentes quienes tiene mayores factores
riesgos para iniciar en el consumo de sustancias adictivas debido a las caractersticas propias
de la etapa de vida, como el deseo de ser aceptados por un grupo social, curiosidad por
experimentar cosas nuevas, el reto a la autoridad y baja percepcin de riesgo.
Este simposio aborda el estudio que se hizo con 30 jvenes estudiantes de bachillerato de la
frontera noroeste de Mxico, en trminos de la relacion entre el abuso de alcohol y otras drogas
y los factores de riesgo que les rodean, como la conduca antisocial entre los que destacan:
tomar dinero o cosas que no le pertenecen, rias o peleas y destruir cosas que no les
pertenecen. Otro de los factores de riesgo asociados es la conducta sexual: como el mantener
relaciones ntimas estando bajo los efectos del alcohol, no utilizar metodos anticonceptivos, o
tenerlas cuando realmente no se desean. Tambin se revisan los sntomas depresivos de los
adolescentes, como tristeza recurrente, pensamientos sobre la muerte, creer que la familia
estara mejor sin ellos, y autoagresion. Y se evala la relacin entre el consumo de sustancias
de los padres y su influencia en la decisin de iniciar en esta conducta entre los adolescentes.
Se hace esta revisin con el propsito de conocer las caractersticas de adolescentes que
fueron invitados a participar en un tratamiento cognitivo-conductual denominado Programa de
Intervencion Breve para Adolescentes que Inician el Consumo de Alcohol y Otras Drogas
(Martnez, Salazar, Ruz, Barrientos y Ayala, 2004; 2007; 2009). Mismo que ha mostrado su
efectividad en en el consumo de alcohol y otras drogas, en los problemas relacionados y en la
percepcin de autoeficacia de adolescentes en la zona del centro de Mxico.
El presente simposio se compone de cuatro trabajos en donde se abordan:
1) Los resultados del Programa de Intervencion Breve para Adolescentes que Inician el
Consumo de Alcohol y otras Drogas en 30 jvenes del nivel medio superior. Los resultados
muestran efectividad para incidir en su forma de consumir as como tambin en las
consecuencias asociadas como bajo rendimiento escolar, problemas con los paps y con la
polica; adems en la percepcin de autoeficacia para controlar su consumo ante emociones
desagradables, la presin social, momentos agradables con otros y emociones agradables.
2) La relacion entre el consumo de alcohol y drogas en los sntomas depresivos y conducta
sexual de riesgo, asi como la relacion entre estos dos factores.
3) De igual manera se presentan los resultados de la evaluacin entre el consumo de alcohol y
drogas en los Adolescentes y sus Familiares abusadoras.
4) Para finalmente mostrar la incidencia que presentan los adolescentes con abuso de
sustancias adictivas en las conductas antisociales.
A travs de este estudio se esperan obtener datos sobre las caractersticas de riesgo de los
jvenes que participa en el programa cognitivo conductual para el abuso de sustancias en la
regin de Baja California Mxico para posteriormente disear estrategias que atiendan esos
factores y as incidir en el consumo de sustancias.
Resultados de la aplicacin de un programa cognitivo-conductual para adolescentes que
abusan del alcohol y otras drogas en la frontera noroeste de Mxico.
La experimentacin en el consumo de sustancias adictivas se da en los adolescentes como
una forma de imitar a sus amigos y/o de retar a la autoridad (Patterson, 2002). Sin embargo si
el adolescente pasa la fase de experimentacin y sigue consumiendo, puede afectar el rea
social, escolar y/o personal del individuo, ocasionando circunstancias riesgosas y problemas
legales relacionados con las sustancias (Vogelmann, Gutirrez, Morales, Viglione, Lojo, et al,
2008).
Para atender la problemtica del consumo de sustancias en la regin fronteriza, se ha
implementando el Programa de Intervencin Breve para Adolescentes que Inician el Consumo
de Alcohol y Otras Drogas [PIBA] (Martnez, Salazar, Ruz, Barrientos y Ayala, 2004; 2007;
2009), con la finalidad incidir en el consumo de sustancias de jvenes que estn en las

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primeras fases del proceso de adiccin. El objetivo de este trabajo es evaluar el efecto de la
aplicacin del PIBA en adolescentes de la regin fronteriza de Mxico en el patrn de consumo,
en los problemas relacionados y en la auto-eficacia percibida.
Mtodo
Los participantes fueron 30 estudiantes del nivel medio superior de 14 a 18 aos que
presentaran problemas derivados de su consumo. El escenario en donde se llev a cabo el
programa fue en cubculos de la propia escuela. Se trabaj mediante un diseo de caso nico
con 30 rplicas y con seguimientos a 3 y 6 meses despus de haber concluido el tratamiento.
El procedimiento que se sigui fue de acuerdo al protocolo del PIBA, donde se sealan seis
fases: deteccin de casos, admisin, evaluacin, induccin, cinco sesiones de tratamiento y
seguimiento.
Resultados
De acuerdo a los resultados obtenidos de la aplicacin del programa se observ una reduccin
estadsticamente significativa en el patrn de consumo en los participantes al terminar el
tratamiento con respecto a la lnea base. As mismo se observ un mantenimiento del cambio
en los seguimientos a tres y seis meses en relacin a la lnea base. De igual forma se
observaron cambios en el nmero de problemas relacionados y en la variable autoeficacia.
Discusin
El PIBA ha mostrado su eficacia con jvenes que abusan del alcohol y otras sustancias en
poblacin del centro de Mxico, especficamente en la Ciudad de Mxico y en el estado de
Aguascalientes (Martnez, et al., 2008; 2010). El objetivo de evaluar los resultados del PIBA con
poblacin del norte del pas se debi al inters de conocer si tambin es efectivo sabiendo las
diferencias en las caractersticas sociodemogrficas con respecto a la poblacin del centro y
por la cercana con los Estados Unidos es inevitable.
Relacin de sntomas depresivos y conducta sexual de riesgo en adolescentes que
abusan del alcohol y otras drogas en una ciudad de la frontera de Mexico con Estados
Unidos
La adolescencia es la etapa de vida en la que se manifiestan cambios biolgicos, psicolgicos y
sociales. Debido a la dimensin de esto se pueden manifestar problemas emocionales y
conductuales derivados del deseo de pertenecer a un grupo de amigos, lo que pudiera
repercutir en el inicio de las relaciones sexuales de riesgo, depresin y en el contacto
sustancias adictivas (Crean, 2004; Garca 2002).
El objetivo de este trabajo es presentar la relacin de la conducta sexual y sntomas depresivos
en jvenes que han participado en el Programa de Intervencin Breve para Adolescentes que
Inician el Consumo de Alcohol y Otras Drogas [PIBA] (Martnez, Salazar, Pedroza, Ruiz, Ayala,
2008),.
Mtodo
Participantes. La muestra est constituida por 30 adolescentes, con una edad promedio de 16
aos.
Escenario. Las entrevistas se llevaron a cabo en cubculos de una escuela de nivel
preparatoria.
Instrumentos. Se aplic el Cuestionario de Deteccion de Problemas de los Adolescentes
[POSIT] (Mario, Gonzalez-Forteza, Andrade, & Medina-Mora, 1997) y la Entrevista Inicial
(Saucedo & Salazar, 2004).
Procedimiento. Despus del proceso para identificar posibles candidatos al programa se trabaj
la Entrevista Inicial.
Resultados
Mediante la prueba de Spearman para muestras independientes se obtuvo una correlacion de
.63 (p=.130) entre el consumo de alcohol y la conducta sexual riesgosa, lo cual est
relacionado con no utilizar un mtodo anticonceptivo y tener relaciones despus de haber

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consumidor alcohol u otras drogas. Adems en relacin al consumo de alcohol y los sntomas
depresivos, como sentirse triste con frecuencia o sentir que no puede seguir adelante, se
encontr una correlacion de .20 (p=.07) Y finalmente en la relacin entre sntomas depresivos y
conducta sexual riesgosa indica una correlacion de .51 (p=.120).
Discusin
A partir de los resultados obtenidos se puede concluir que no existe una relacin
estadsticamente significativa entre la prctica de la conducta sexual riesgosa y el abuso de
alcohol. De igual forma se puede observar que solo en el 10% de la muestra los sntomas
depresivos y el consumo de alcohol estn relacionados. Los resultados son contrarios a los
hallazgos reportados por Crean (2004) y Borra (2003), en donde se relacionan estos factores.
Es importante subrayar que los participantes poseen caracteristicas que pueden influenciar en
los resultados como el hecho de ser estudiantes y que estn en la fase de abuso del alcohol
pero sin llegar a la dependencia. Ante estos resultados resulta importante aumentar la muestra
para ver si se mantienen estos resultados.
Padres que Abusan del Alcohol y Otras Drogas como predictor en el consumo de hijos
adolescentes en poblacin de la frontera noroeste de Mexico.
La transicin de nio a adolescente trae cierta ambivalencia y contradicciones junto con los
cambios fsicos y biolgicos en el proceso de una bsqueda de equilibrio con el adolescente y
con la sociedad (Salazar, Urgarte,Vasquez y Loaiza 2004). Es importante contextulizar la la
Teora del Aprendizaje Social en este escenario ya que propone que los individuos aprenden
comportamientos de los otros por medio de la observacin, la imitacin y el modelamiento
(Bandura, 1971).
El propsito de este trabajo es presentar los resultados de la evaluacin de la variable
familiares que consumen sustancias adictivas en adolescentes que participan en el Programa
de Intervencin Breve para Adolescentes que Inician el Consumo de Alcohol y Otras Drogas
[PIBA] (Martnez, Salazar, Pedroza, Ruiz, Ayala, 2008),
Mtodo
Se evaluaron 30 adolescentes, con una edad promedio de 16 aos. De los cuales 17 fueron
hombres y 13 mujeres. Los participantes cumplieron con los criterios para la insercion en el
programa, los cuales son: a) Consumo mayor a 4 copas estandar por ocasin, en ms de cinco
ocasiones durante los ltimos seis meses. b) Reportar problemas relacionados al patrn de
consumo sin mostrar dependencia. c) Tener entre 14 y 18 aos de edad y d) Ser estudiante del
nivel medio superior. Se aplic el instrumento de deteccin de poblemas asociados al consumo
POSIT (Mario, Gonzalez-Forteza, Andrade, & Medina-Mora, 1997) para la deteccion de
posibles candidatos, posteriormente se les aplic un cuestionario denominado Entrevista Inicial
(Saucedo & Salazar, 2004), en donde se obtienen 10 reas diferentes entre ellas familiar y
consumo de sustancias, que fueron de ayuda para obtener los datos de la presente evaluacion.
Se realiz una correlacion de Spearman para muestras independientes la que arrj una
correlacin de .19 (p=.120) entre el consumo de alcohol y otras sustancias de los adolescentes
y el consumo de sustancias de los familiares. Aunque los resultados pudieron ser influidos por
el tamao de la muestra asi como las caracteristicas de los participantes como el ser
estudiantes y no dependientes al alcohol es importante ampliar el tamao de la muestra para
establecer generalizaciones.
Consumo de drogas y actividad antisocial: conductas comunes en adolescentes que
recibieron una intervencin cognitivo-conductual para el consumo de sustancias en la
frontera noroeste de Mexico
El comportamiento antisocial se define como el patrn de conducta persistente y repetitivo en el
que no se respetan normas sociales ni los derechos de los dems (Arce, 2007). Desde este
perspectiva, los actos que en algunas ocasiones se pudieran llamar "travesuras" o "cosas de

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juventud" estn tipificados como actos delictivos, tales como tomar mercanca de las tiendas y
no pagarlas, las peleas e incluso el consumo de sustancias son considerados como actos
antisociales por lo que es importante definirlos claramente.
El Sistema de Vigilancia Epidemiolgica [SISVESA] (2007), realiz mediciones en consejos de
tutelares de menores infractores a nivel nacional. Los resultados en trminos de gnero,
indican que del grupo de menores usuarios de drogas, el 94.3% corresponda al gnero
masculino y consuman mayormente marihuana y metanfetamina. En cuanto a su nivel
educativo, el 50.4% tenan el nivel medio terminado o trunco. Y en relacin a la causa de la
insercin a la institucin era por robo en un 84.8%.
El objetivo de este trabajo es presentar la prevalencia entre el abuso de sustancias y conducta
antisocial en jvenes que recibieron una intervencin cognitivo-conductual para reducir el
consumo de alcohol y otras drogas.
Mtodo
La muestra est constituida por 30 jvenes de 16 a 18 aos, estudiantes del nivel medio
superior, con abuso de alcohol y/o a las drogas pero sin presentar dependencia. El lugar en
donde se realizaron las entrevistas fueron en cubculos de 3X3 metros. Los instrumentos que
se utilizaron fueron el Cuestionario de los Problemas de los Adolescentes [POSIT] (Mario,
Gonzalez-Forteza, Andrade, & Medina-Mora, 1997) y la Entrevista Inicial (Saucedo & Salazar,
2004), en donde se obtienen 10 reas diferentes entre ellas conducta delictivas y consumo de
sustancias. El procedimiento que se implement fue mediante la identificacin de jvenes que
abusan del alcohol y otras drogas en una escuela del nivel medio superior mediante el
instrumento de tamizaje para posteriormente realizar la exploracin de las conductas delictivas
y consumo de alcohol y otras drogas.
Resultados
Mediante el uso del Coeficiente de correlacin de Spearman para muestras independientes, se
obtuvo que existe una relacin estadsticamente significativa entre el abuso de alcohol y otras
sustancias adictivas y actos antisociales en los participantes. As mismo se observ que los
amigos tambin han cometido algn delito.
Discusin
Los resultados obtenidos muestran una relacin positiva entre consumo de sustancias adictivas
y conducta delictiva tal y como se reporta en la literatura. Adems confirma que los amigos son
de influencia en el comportamiento antisocial y en el inicio del consumo de alcohol y otras
drogas.
Factores de Riesgo y de Proteccion en el Consumo de Drogas Ilegales en Estudiantes
Unversitarios
Maria Vital-Cedillo.
Facultad de Psicologia, Universidad Nacional Autonoma de Mexico, Mexico, Mexico.
En las ltimas dcadas, el consumo de drogas ha ido en aumento tanto en la poblacin general
como en estudiantes universitarios. Especficamente, en Mxico, la Encuesta Nacional de
Adicciones correspondiente al ao del 2008 document que en poblacin de 12 a 65 aos de
edad, un 0.3% present un consumo diario, un 32.2% fueron bebedores altos, un 4.4% tuvo un
consumo consuetudinario y un 5.6% present abuso o dependencia. Al igual que en la
poblacin en general, el conocimiento de la existencia de problemas de alcohol y problemas
relacionados con el consumo de sustancias no son fenmenos recientes en una gran mayora
de los campi universitarios a nivel nacional e internacional. En los estudiantes mexicanos,
aproximadamente un 65% bebe alcohol, cerca de un 35% lo consume mensualmente y
alrededor de un 30% se involucra en un consumo episdico excesivo. Bajo este contexto, es
importante canalizar mayores esfuerzos a la prevencin universal de dicho problema, en los
distintos segmentos de la sociedad, con la intencin de disminuir la problemtica y, de manera

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especial, trabajar con la poblacin infantil, lo anterior, permite enmarcar de modo sinttico la
problemtica del consumo de alcohol, en tres ejes bsicos que son los siguientes: 1) Factores
que facilitan el inicio y mantenimiento en el consumo de las distintas sustancias en unas
personas respecto a otras; 2) Progresin en el consumo de las drogas legales a las ilegales en
una parte significativa de los que consumen las primeras respecto a los que no las consumen; y
3) Una serie de variables socio-culturales, biolgicas y psicolgicas que modulan los factores
de inicio, mantenimiento y la progresin o no en el consumo de sustancias. Conocer los
factores involucrados en el consumo de alcohol se convierte as en un punto de gran relevancia
para la estructuracin de estrategias para el abordaje de dicha problemtica. Es por ello, que
este estudio explor algunos factores de riesgo y proteccin en el consumo de drogas ilegales.
Para ello, se aplic una encueta conformada por 150 preguntas a travs de la cual se obtuvo la
prevalencia lpsica, as como la identificacin de factores de riesgo y de proteccin, fue
aplicada a 260 estudiantes del nivel medio superior de una universidad pblica que decidieron
participar de forma voluntaria en la aplicacin, la muestra estuvo compuesta por 130 mujeres y
130 hombres. El rango de edad fue entre los 16 y los 20 aos de edad. Los resultados indican
que el 8% de los estudiantes consuman mariguana, un 4% consuma cocana y el 3%
consuma inhalables. Respecto a los factores como la percepcin de la adquisicin de las
drogas, tolerancia social y antecedentes de consumo de otro significativo se observo que el
14.2% considera imposibles la adquisicin, el 11.5% la consider muy difcil, un 24.6% la
consider difcil, el 30.8% manifest adquirirla fcilmente y un 18.5% dijo que la consideraba
fcil. En la tolerancia social se obtuvo que la madre, el padre, los maestros y el mejor amigo el
95 % de los estudiantes encuestados respondi que dichas personas lo veran muy mal.
Finalmente, en cuanto si alguna persona cercana consuma drogas que no fueran alcohol ni
tabaco, se encontr que la madre, el padre, los hermanos y el mejor de amigo de los
estudiantes manifestaron no haberlo hecho. Comparando lo que ocurre en el consumo de
alcohol se puede observar que dichos factores tienen una relevancia importante en el inicio y
en el mantenimiento del consumo, sin embargo, en el consumo de otras sustancias se pudo
observar que la tolerancia social, adquisicin de la sustancia y el consumo de otras personas
significativas resultan ser factores que no se presentan en la poblacin encuestada por lo que
se puede aseverar que dichos factores tienen una relevancia en el no consumo.
Differences and Similarities in Cannabis Dependent Patients with and without PTSD
Andrea Wolf, Reinout Wiers, Elske Salemink.
Developmental psychology, University of Amsterdam, Amsterdam, Netherlands.
Introduction: Little research has been conducted on the high co-morbidity rate of substance
dependency and posttraumatic stress disorder (PTSD). In general, PTSD and substance use
disorders (SUD) often occur together, e.g., up to 43% of clinical patients with PTSD meet
criteria for lifetime SUD. Cannabis is the most commonly used illegal drug in most countries and
individuals with PTSD are three times more likely to have cannabis dependence as compared
with those without PTSD. Anxious individuals have a worse treatment prognosis than nonanxious individuals and patients with a combination of SUD and PTSD are at higher risk for
relapse. It is suggested that the association between PTSD and substance use may be more
mediated by negative emotionality, and less by cue-based urges. Assuming that substance use
weakens executive control and increases implicit biases the association between substance use
and trauma induced anxiety could go in both directions. Recent research indicates that
improvements in PTSD symptoms significantly results in improvements in SUD symptoms, but
the reciprocal relationship was not observed. If only SUD symptom reduction is attained, PTSD
symptoms seem to remain. This contradicts to the commonly practiced treatment approach
which posits that patients with both PTSD and SUD first have to receive specialized addiction

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treatment. Aim of this study is to get better insight into the dynamics of cannabis dependency
and the causal associations with PTSD, and to examine the differences and similarities in
biases, cue reactivity and drug-taking behavior between cannabis dependent individuals with
and without PTSD. . Method: Individuals with a principal diagnosis of cannabis dependence with
and without PTSD will be included. Approach and avoidance action tendencies in response to
cannabis and neutral stimuli primed by individual trauma-related stimuli will be assessed with a
newly developed version of the cannabis Approach Avoidance task (cannabis AAT). The
differences and similarities between cannabis dependents with and without PTSD will be
examined. Questionnaires will be used to map out individuals core anxiety, (depressive) mood,
compulsive drug taking behaviour and inhibition, and to differentiate between subjects with typeI and type-II PTSD. We estimate that cannabis-dependent individuals with and without PTSD
will show an approach bias towards cannabis-related cues. Further we expect that individuals
with PTSD will show excessive cue reactivity to both drug-related and trauma-related stimuli as
compared to patients with only cannabis addiction, and high levels of PTSD symptoms are
associated with a larger action tendency of avoiding trauma-related stimuli and faster approach
of cannabis-related stimuli; especially after exposure to trauma-related stimuli. Discussion:
Results will be discussed in terms of theoretical and clinical implications. In the long term, we
expect that this approach could lead to new therapies reflecting the needs of cannabis
dependent individuals with and without PTSD.
Results from a Five-Year Follow-up: Cognitive Distortions Predict Future Gambling
Behavior
Igor Yakovenko, David Hodgins, Jonathan Stea.
University of Calgary, Calgary, AB, Canada.
The sequence of the development of gambling problems is not well studied. Longitudinal
research on the temporal correlates of increased gambling activity is limited. Data from an
ongoing longitudinal study titled Leisure, Lifestyle, and Lifecycle Project (LLLP) was analyzed
using structural equation modeling (SEM; el-Guebaly et al., 2008). The hypothesized models
examined the predictors of cognitive distortions in gamblers and gambling involvement.
Gambling cognition was a latent variable with 8 indicators - items from the Gambling Fallacies
Scale (Williams, 2003). Gambling involvement was a latent variable with three indicators
(number of gambling activities involved in, frequency of gambling, and gambling expenditure).
Six SEM models were specified, varying the exogenous (i.e. dependent) variable between
cognition and involvement. It was hypothesized that the better fitting model would dictate
whether cognitive errors or increased gambling involvement arise first in the sequence of
problem gambling development. Furthermore, the stability of cognitive distortions over time was
examined. The dataset contained responses from 1372 participants aged 18 to 65 over four
collection waves (five years). Maximum likelihood estimation was employed to estimate the six
models. The results supported the idea that changes in gambling cognition precede and predict
changes in gambling involvement. This was indicated by better, more parsimonious models
representing the relationship. In addition, cognitive distortions appeared to significantly decline
over time. Broadly, the findings suggest that cognitive restructuring and addressing gambling
fallcies may be a more effective target for policy and prevention than limiting gambling
behaviour, as it appears to better predict future changes in gambling involvement or behaviour
than the inverse relationship. The results are discussed with respect to future research and
treatment implications. References el-Guebaly, N., Casey, D. M., Hodgins, D. C., Smith, G. J.,
Williams, R. J., Schopflocher, D. P., & Wood, R. T. (2008). Designing a Longitudinal Cohort
Study of Gambling in Alberta: Rationale, Methods, and Challenges. Journal of Gambling
Studies, 24(4), 479-504. doi: 10.1007/s10899-008-9108-6 Williams, R. J. (2003). Reliability and

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validity of four scales to assess gambling attitudes, gambling knowledge, gambling fallacies and
ability to calculate gambling odds. Unpublished technical report.
Survey of Addiction in Epilepsy Patients using a Self Report Questionnaire
S.Naz Yeni1, Ozge Tonguc2, Feray Bolukbasi1, Elvin Azaroglu2, A. Naz Bozok2.
1. Istanbul University Cerrahpasa Medical School, Istanbul, Turkey, 2. Koza Psychological
Consultancy, Istanbul, Turkey.
Addiction is described as an impaired control over substances and of behavior, and
preoccupation with substances and a particular behavior. Continued use of these substances
and/or persistent behavior despite consequences is a prerequisite for the diagnosis. Epilepsy
has psychiatric consequences, such as increased risk for depression, anxiety, psychosis,
suicidal behavior. It is proposed that increased risk of psychopathology in epilepsy is
overweighing the risks in other chronic medical or neurologic conditions implying underlying
common mechanisms between epilepsy and psychopathologies. On the other hand, to our
knowledge, there is no published data about addiction in epileptic patients. Therefore we plan a
survey using a self report questionnaire to search for addictive behaviors in patients with
epilepsy. Method One hundred six epilepsy patients between 18-65 years old were recruited to
the study from an outpatient epilepsy clinic in a tertiary center. Exclusion criteria was mental
retardation and illiteracy. The same questionnaire was assessed to 97 age and sex matched
control group. A self report questionnaire consisting of 30 questions was designed to screen
smoking, use of alcohol and illicit drugs, internet use. The questionnaire consists of 7 screening
questions for four domains of addictions, and the rest of the questions were used to make
severity comparisons. NCSS(Number Cruncher Statistical System) 2007 statistical software
(Utah, USA) was used for statsitical analyses. Independent t test, chi square test, yates
correction were applied(p>0.05). Results Fifty seven of 106 epilepsy patients were male and the
median age was 32.66 12,23. Fifty of 97 control cases were male and the median age was
35.7010,59 (p=0.062). There was a statistically significant difference between the two groups
with regard to marital status (P=0.045). Smoking habit was similar between patient and control
groups (p=0.530). Alchohol intake was statistically lower in patient group (p=0.0001). There was
no difference in using illicit drugs between the groups (P=0.262). There was no difference in
internet use between the groups (p=0.086). Conclusion It seems that epilepsy patients show no
different attitudes towards addiction when compared to age and sex-matched control group. The
unique difference is lower alcohol intake in epilepsy patients which imply physicians role.
Patients are usually recommended to avoid alcohol as it triggers seizures and also drug-alcohol
interactions may complicate treatment.
Relao Entre Abuso Emocional e Ansiedade em Pacientes Usurias de Substncias
Psicoativas
Bruna da Rocha.
PUCRS, Porto Alegre, Brazil.
Introduo: Eventos traumticos na infncia, como situaes de abuso emocional tm sido
relacionados com diversos problemas psicolgicos na fase adulta, podendo levar ao maior risco
de uso de substncias psicoativas. O abuso emocional se caracteriza por comportamentos que
visam humilhar, desvalorizar, aterrorizar e agredir verbalmente uma pessoa. No entanto, este
conceito apresenta dificuldade em definir a experincia traumtica, pois ainda no bem
delineado na literatura, pela sociedade e pelo prprio indivduo. Objetivo: avaliar e relacionar o
abuso emocional na infncia (AE) e as possveis consequncias de sintomas de ansiedade em

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mulheres dependentes de cocana tipo crack. Mtodo: uma amostra de 65 mulheres entre 18 a
49 anos, usurias de cocana tipo crack, em um perodo de vinte dias de internao em uma
unidade de desintoxicao. Os resultados das pacientes foram divididos em com abuso
emocional (AE+) e sem abuso emocional (AE-), definido pelo Childhood Trauma Questionnaire
(CTQ), para os dados de ansiedade foi utilizado a Escala de Ansiedade de Beck (BAI), foram
feitas trs aplicaes no decorrer da internao. Para verificar os efeitos de grupo e de tempo
nas variveis de ansiedade e AE utilizaram-se um modelo linear geral com medidas repetidas
Resultados: verificou-se que os sintomas de ansiedade tendem a diminuir durante o perodo da
internao em ambos os grupos. Porm as mulheres com AE+ apresentam maiores sintoma de
ansiedade do que com diferena de sintomas de ansiedade tende a aumentar, entre as
mulheres com e as sem histrico de abuso, durante a internao. Discusso: A partir destes
dados e estudos relacionados, conclumos que, a experincia do abuso emocional na infncia
pode mudar o desenvolvimento normal da criana, e suas consequncias podem repercutir na
fase na adulta. No entanto, este tipo de violncia muito difcil de ser diagnostica, pois muito
sutil e pouca materialidade dos fatos. As pessoas que passam por abuso emocional podem ter
o indicativo para diversas psicopatologias e neste estudo confirmando para sintomas de
ansiedade, indicando hiptese de um Transtorno de Ansiedade. Porm ainda h necessidades
de mais estudos que corroborem com esse achado.
Eventos Estressores Que Antecedem a Recada em Usurios de Substncias
Psicoativas: Reviso Sistemtica
Sabrina da Rocha.
Direo, Centro de Psicologia Vitalis, Porto Alegre, Brazil.
RESUMO OBJETIVO: Realizar uma reviso sistemtica a respeito da associao entre eventos
estressores e a recada em usurios de substncias psicoativas. MTODO: Reviso
sistemtica da literatura, realizada nas bases de dados eletrnicas EBSCO, ProQuest,
PubMed/ Medline e Web of Science. Os descritores utilizados foram: substance abuse,
substance dependence, drug abuse, drug addiction, stressful events, stressful life events,
stress. Como precipitador foi definido evento estressor e, como desfecho, a recada.
RESULTADOS: O nvel de estresse aumentou 1,66 o risco de recada e os eventos estressores
agudos aumentaram quase trs vezes esse risco. Os eventos estressores mais prevalentes
foram morte de um pai ou responsvel e dificuldades financeiras crnicas. CONCLUSES:
Indivduos com histrico de eventos estressantes na infncia so mais suscetveis ao uso de
substncias psicoativas. Os eventos estressores crnicos e os eventos estressores agudos
aumentam consideravelmente o risco de recada, sendo que os eventos agudos quase
triplicaram o risco e diminuindo o tempo at a recada. O que demonstra a necessidade de
interveno teraputica no tratamento do dependente qumico que est mais vulnervel.
Descritores: Abuso de substncias, dependncia de substncias, abuso de drogas,
dependncia de drogas, eventos estressores, eventos de vida estressores, estresse.
Centro de Reabilitao de aa - Peru: a Terapia Cognitivo-Comportamental Aplicada ao
Tratamento e Reabilitao na Dependncia Qumica
Edson da Silva.
Clinica Particular, Aracaju, Brazil.
O uso de drogas psicotrpicas tem crescido no Brasil, e como conseqncia, o aumento no
nmero de dependentes que demandam algum tipo de interveno profissional. Em um cenrio
propcio ao aumento dos prejuzos associados ao abuso de drogas, principalmente entre os

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mais jovens, a questo do tratamento destaca-se como uma rea importante, porm permeada
por dificuldades, que vo desde a escassez de profissionais capacitados para atender s
demandas singulares destas pessoas, ao baixo nmero de locais planejados e com
metodologias cientificamente comprovadas para o tratamento, reabilitao e insero social
dos dependentes. A partir do relato de uma observao Participante na Instituio denominada
como Centro de Reabilitao de aa, situada nas proximidades de Lima - Peru, este trabalho
pretende demonstrar como a Terapia Cognitivo-Comportamental se apresenta como parte
importante de um modelo bem sucedido de tratamento e reabilitao em dependncia qumica.
Crenas e Expectativas de Mulheres com Risco e Sem Risco de Desenvolver
Dependncia de lcool
Juliana da Silva, Margareth Oliveira, Andressa Avila, Dhiordan Cardoso.
Pontificia Universidade Catlica, Porto Alegre, Brazil.
As mulheres esto consumindo mais lcool nas ltimas dcadas, e o incio do consumo vem
ocorrendo em idades cada vez menores. Diversos fatores podem influenciar na deciso de
consumir lcool, tais como as expectativas e crenas. O presente estudo tem por objetivo
comparar mulheres com risco de desenvolver dependncia de lcool (grupo MCR) com
mulheres sem este risco (grupo MSR), quanto s diferenas e semelhanas nas crenas e
expectativas do uso de lcool. Trata-se de uma pesquisa descritiva, quantitativa, com
delineamento transversal e de associao de variveis. Viu-se que o grupo MCR apresentou
mais crenas positivas com relao ao grupo MSR a partir do IECPA, alm obterem um escore
acima do ponto de corte do instrumento, caracterizando vulnerabilidade para dependncia de
lcool. Expectativas de facilitao na interao social apareceram com maior mdia no grupo
MSR e expectativas de avaliao mais positiva de si mesmo apareceram em mais freqncia
no grupo MCR. necessrio o entendimento dos motivos pelos quais o sujeito usa lcool, para
atitudes de preveno do uso adequado da bebida alcolica e o planejamento de intervenes.
Aging/ Tercera Edad/ Terceira Idade
Social Skills and Affective Intergenerational Solidarity among Elderly and Adults:
Contributions for Family Therapy
Ana Braz1, 2, Zilda Del Prette1, Anne Fontaine2.
1. Programa de Ps Graduao em Psicologia, UFSCar, So Carlos, Brazil, 2. Faculdade de
Psicologia e Cincias da Educao, Universidade do Porto, Porto, Portugal.
Abstract Central: The family is more enduring the environment for interpersonal relationships.
In this context there are demands of social skills as well as opportunities for intergenerational
solidarity. There is evidence of an increase of interpersonal conflict between family, as well as
evidences of social skill deficits. These aspects have implications to the quality of parent-child
relationships. Despite sharing the context and complementary assumptions, there is not any
analysis of the interaction between the approaches of social skills and intergenerational
solidarity. Additionally, the Actor-Partner Interdependence Model (APIM) has been developed in
the context of family therapy and has shown to be an interesting strategy for the statistical
analysis of relational data. The objective of this study is to apply the APIM to the analysis of the
interface between the social skills (SS) and intergenerational solidarity (IS) in dyads of elderly
parents and their adult children. The study included 113 dyads of both sexes, socioeconomic
status ranging from the highest to the lowest. Social skills were assessed through IHS-DelPrette and IHSI-Del-Prette for adults and seniors, respectively. The assessments were

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performed by the Index of Intergenerational Solidarity. Based on the evidence presented in the
literature, we built a structural equation model in IBM SPSS Amos software, version 21, in which
we tested two effects of the actor (parents SS as predictors of parents IS, childrens SS as
predictors of childrens IS) and the effects of partner (parents SS as predictors of childrens IS
and childrens SS as predictors of parents IS). In the saturated model, we found a statistically
significant relationship of HSES parents as predictors of children's SIA (b = 0.336, Z = 1.980, p
= 0.048). After the imposition of constraints between three other effects evaluated, it was
obtained with a model chi-square (N = 113, df = 2) = 0.694, p = 0.707, indicating that these
three effects could be considered as equivalents. These effects became significant (b = 0.064, Z
= 1.783, p = 0.075) and showed excellent rates of model fit to the data (CFI = 1.000 and
RMSEA = 0.000). These results confirm the interdependence between parents and children for
HSES and AIS, as well as the importance of social skills of expression of feeling parents, even
in later developmental stages, to intergenerational solidarity affection of children. Additionally,
this preliminary model confirms the hypothesis of the interface between social skills and
intergenerational solidarity. We discuss the applications of these findings to family therapy and
we also suggest the importance of the social skills training in order to improve the quality of
relationships among parents and their children. Grant: FAPESP (Processo 2010/10000-8)
Adapting Cognitive-Behavioral Therapy for the Frail Elderly
David Casey.
Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, USA.
Abstract Central: Depression is a common psychiatric disorder of the aged. This session will
feature a brief review of the literature on the use of cognitive behavioral therapy (CBT) with the
elderly, and suggest some changes in using CBT with the elderly based on the literature as well
as the author's clinical experiences. The focus will be on the "old-old" and frail elderly.
Recommended changes in technique and common themes when dealing with the frail elderly
are described, including the use of "supportive CBT" for patients with mild cognitive impairment.
The authors' experiences suggest that CBT is an effective treatment for depression and other
affective disorders of the frail elderly, and is especially useful when somatic treatments are
contraindicated or produce intolerable side effects. Proposed modifications include simplification
of therapy techniques, repetition of key concepts, emphasis on behavioral activation, and
incorporation of family and caregivers into the therapy. Other suggestions are avoidance of
jargon, relaxation of the "here-and-now" focus of CBT to allow for reminiscence, and an
emphasis on directly addressing hopelessness and helplessness. Coming to terms with loss,
illness, pain, dependency and diminished autonomy are common themes of therapy and may be
discussed in a cognitive framework. Homework assignments often emphasize activity
scheduling and activation and may incorproate caregivers. Length of sessions and the amount
of material covered must be appropriate to the individual's stamina and attention span. A
discussion of beliefs and expectations about medication and compliance are also important.
CBT can be an effective tool in the management of depression in the elderly, including frail
elders.
Elderly with Alzheimer and Losses in Executive Duties
Fernanda Cerutti, Regina Maria Fernandes Lopes, Guilherme Guilherme Welter Wendt, Camila
Oliveira, Cristiane Esteves, Irani de Lima Argimon.
Pontifcia Universidade Catlica do Rio Grande do Sul - PUCRS, Porto Alegre, Brazil.
Esse estudo objetivou verificar as alteraes neuropsicolgicas e os prejuzos nas funes
executivas em idosos acometidos com a doena de Alzheimer (DA). Entende-se por funes
executivas um conjunto de habilidades cognitivas utilizado no desenvolvimento de tarefas. Para

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ir ao encontro do objetivo, foi realizada uma reviso sistemtica que identificou um panorama
de publicaes presentes nas bases de dados PsychInfo, Lilacs, Scielo, Bireme e Medline.
Utilizaram-se os seguintes descritores para o levantamento dos estudos: Doena de
Alzheimer e Funes executivas, juntamente com as respectivas equivalncias no idioma
ingls. Os estudos recuperados foram inicialmente avaliados pela leitura do abstract e para a
incluso na discusso dos dados foram estabelecidos os seguintes critrios: pesquisas que
exploraram as funes executivas em populaes com o diagnstico de doena de Alzheimer,
ano de publicao, disponibilidade em texto completo e trabalhos que continham explcita
meno s funes executivas. Ao realizar a anlise e comparao dos estudos e pesquisas
recuperados, concluiu-se que os idosos com DA apresentam alteraes nas regies frontais do
crtex cerebral e reas de conexo. Essas alteraes podem provocar mudanas em relao
ateno sustentada, memria semntica, pensamento abstrato, planejamento, auto-regulao
e coordenao motora fina. Observa-se que, no que se refere s estratgias de reabilitao,
estas so ainda discutidas.
Memria e Funes Executivas em Idosos: Estudo Comparativo Entre Idosos e Idosas
Cristiane Esteves, Tatiana Quarti Irigaray, Lusa Oliveira, Fernanda Cerutti, Aline Aparecida
Martins Ferreira, Camila Rosa de Oliveira, Irani Argimon.
PUCRS, Porto Alegre, Brazil.
Estudos que investigam diferenas na cognio de acordo com o sexo apresentam resultados
contraditrios. Observa-se que homens se saem melhor em habilidades visuoespaciais e
motoras (movimentos de grande amplitude). J as mulheres se sobressaem em tarefas que
utilizam habilidade motora fina e verbal, alm da velocidade perceptual. Assim, esse estudo
pretendeu comparar o desempenho cognitivo de idosos de acordo com a varivel sexo. A
amostra foi composta por 521 idosos, de 60 anos ou mais, recrutados de maneira aleatria
atravs do programa Estratgia de Sade da Famlia do municpio de Porto Alegre, Rio Grande
do Sul, Brasil. Como critrios de excluso da amostra foram utilizados os escores sugestivos
de sintomas depressivos avaliados pela Escala de Depresso Geritrica de 15 pontos (GDS15) e de demncia investigado pelo MiniExame do Estado Mental (MEEM), ajustado conforme
escolaridade do participante. Aps aplicao dos critrios de excluso, a amostra final contou
com 281 idosos. Todos os participantes preencheram o termo de consentimento livre e
esclarecido e responderam ao MEEM, GDS-15, Fluncia Verbal fonmica e semntica (FAS e
Animais), Teste de Nomeao de Boston de 15 itens, Teste de Memria Lgica (WMS-R) da
Escala de Memria de Wechsler (evocao imediata e tardia), Lista de Palavras do Consortium
to Establish a Registry for Alzheimers Disease (CERAD) (evocao imediata, tardia e
reconhecimento) e praxia construtiva do CERAD (cpia e evocao tardia). Para anlise dos
dados, utilizou-se o programa Statistical Package for the Social Sciences (SPSS) verso 17.0,
considerando como significativas as associaes com p 0,05 e intervalo de confiana de 95%.
Para descrio das variveis, utilizou-se frequncias absolutas e relativas e, quando cabveis,
mdia e desvio padro. Foi realizado o Teste t de Student para amostras independentes.
Atravs da anlise dos dados, 59,79% (n=168) da amostra era do sexo feminino e 40,21%
(n=113) do sexo masculino. A mdia de idade das mulheres foi de 68,39 (DP=6,47) e anos de
estudos foi de 4,55 (DP=3,08). Os homens apresentaram uma mdia de idade de 67,50
(DP=5,61) e de anos de estudos de 4,30 (DP=3,25). As mulheres apresentaram melhor
desempenho em todas as tarefas cognitivas. Entretanto, observou-se diferena
estatisticamente significativa entre os sexos nos testes Lista de palavras evocao imediata e
nos testes de evocao tardia Memria Lgica - WMS-R e Lista de palavras. Esses resultados
esto de acordo com a literatura, onde as evidncias empricas apontam que as mulheres
apresentam maior pontuao em testes que avaliavam memria. Tais resultados evidenciam

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que um melhor desempenho nas tarefas cognitivas pode estar associado ao sexo feminino,
especialmente em tarefas que avaliam memria episdica verbal (evocao imediata e tardia).
Os resultados do presente estudo no apontaram relaes entre sexo e o desempenho nos
testes de funes executivas de fluncia verbal (FAS e Animais). Dessa maneira, sugere-se
que novas pesquisas sejam realizadas a fim de verificar essas relaes em idosos, assunto
que ainda demanda mais investigaes.
Maus-Tratos na Velhice: Influncias na Cognio e na Sintomatologia Depressiva
Cristiane Esteves, Luiza Mothes, Lusa Steiger, Aline Aparecida Martins Ferreira, Tatiana Quarti
Irigaray, Regina Maria Fernandes Lopes, Irani Argimon.
PUCRS, Porto Alegre, Brazil.
Devido ao envelhecimento da populao, cresce o nmero de idosos com declnio funcional e
cognitivo, aumentando o risco para a ocorrncia de maus-tratos. Os maus-tratos contra idosos
podem ser classificados em maus-tratos: 1) fsicos, que corresponde ao uso de fora fsica que
pode produzir leso, dor ou incapacidade; 2) psicolgicos, que a ao de infligir pena ou
angstia atravs de expresses verbais ou no-verbais; 3) abuso financeiro, que a
explorao ilegal e/ou uso no consentido de recursos financeiros de um idoso; 4) abuso
sexual, que se caracteriza pelo contato sexual no-consentido e; 5) negligncia, que a recusa
ou falha em exercer a responsabilidade no ato de cuidar do idoso. O presente estudo teve
como objetivo descrever e identificar situaes de maus-tratos contra idosos e verificar a
associao entre maus-tratos na velhice, desempenho cognitivo e presena de sintomas
depressivos. O delineamento foi quantitativo transversal. A amostra deste estudo foi composta
por 250 idosos atendidos pela Estratgia de Sade da Famlia (ESF) do Municpio de Porto
Alegre. Os participantes foram avaliados atravs de uma entrevista individual, na qual
preencheram o Termo de Consentimento Livre e Esclarecido. Os instrumentos utilizados foram:
testes Lista de Palavras da Bateria Cognitiva CERAD, Teste de Memria Lgica da Escala de
Memria de Wechsler Revisada- WMS-R (evocao imediata e tardia), Teste de Nomeao de
Boston, Teste de Fluncia Verbal Fonmica (FAS) e Teste de Fluncia Verbal Semntica
(Categoria Animais). Para avaliar a presena de maus-tratos na velhice, foi utilizado um
questionrio, composto por 10 questes fechadas que avaliam a presena de maus-tratos
fsicos, maus-tratos psicolgicos, abuso financeiro ou material, abuso sexual e negligncia. O
Mini-Exame do Estado Mental foi utilizado para excluir os idosos que apresentassem
pontuao sugestiva de demncia. Alm disso, a Escala de Depresso Geritrica, composta
por 15 itens, foi aplicada para verificar a presena de sintomas depressivos. Do total da
amostra, 159 eram mulheres e 91 homens, com idades entre 60 a 95 anos e com mdia de 3,9
anos de estudo (DP=2,9). A anlise dos dados mostrou que 138 indivduos relataram ter sido
vtimas de maus-tratos na velhice, enquanto que 112 afirmaram no ter sofrido maus-tratos na
velhice. O grupo de idosos formado por vtimas de maus-tratos apresentou uma mdia de 3,7
anos de estudo e, em sua maioria, eram indivduos que no tinham companheiros (62%). Esse
grupo foi composto predominantemente por mulheres (70,3%). Por meio do Teste T de Student
para amostras independentes, verificaram-se diferenas estatisticamente significativas entre os
grupos, com e sem maus-tratos, no teste de Memria Lgica da Escala de Memria de
Wechsler Revisada (evocao imediata) e na Escala de Depresso Geritrica. Esses
resultados evidenciaram que os idosos vtimas de maus-tratos na velhice apresentaram pior
desempenho na memria episdica verbal (evocao imediata) e mais sintomas depressivos
em comparao aos participantes que no sofreram maus-tratos na velhice. Desta forma,
pode-se concluir que os maus-tratos sofridos na velhice levam a um pior desempenho da
memria episdica verbal e a uma maior prevalncia de sintomatologia depressiva.

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Desempenho deIidosos de Diferentes Faixas Etrias em Tarefas de Memria, Linguagem


e Funes Executivas
Cristiane Esteves, Camila Rosa de Oliveira, Lauren Terroso, Aline Aparecida Martins Ferreira,
Tatiana Quarti Irigaray, Irani Argimon, Irnio Gomes Filho.
PUCRS, Porto Alegre, Brazil.
Sabe-se que algumas funes cognitivas tendem a apresentar alteraes com o avano da
idade. Dessa forma, idosos, quando comparados a adultos, demonstram pior desempenho nas
funes executivas, memria verbal episdico-semntica e ateno. O entendimento dessas
alteraes importante para promover estratgias de interveno cognitiva na populao
idosa. Dessa forma, o objetivo desse estudo foi comparar o desempenho de idosos de
diferentes faixas etrias em tarefas de memria, linguagem e funes executivas. A amostra foi
composta por 266 idosos saudveis, cadastrados no Programa Estratgia de Sade da Famlia
de Porto Alegre, Rio Grande do Sul, Brasil. Todos os participantes assinaram o termo de
consentimento livre e esclarecido e foram distribudos conforme as faixas etrias de 60-64 anos
(n=94), 65-69 (n=83), 70-74 (n=56) e 75-79 (n=33). Para caracterizao da amostra e
verificao dos critrios de excluso, os idosos responderam a um questionrio
sociodemogrfico, ao Mini Exame do Estado Mental (MEEM) e Escala de Depresso
Geritrica de 15 pontos (GDS-15). Os idosos que apresentaram escores sugestivos de
sintomatologia depressiva na GDS-15 e de demncia no MEEM foram excludos da amostra.
Para avaliao cognitiva, utilizou-se a lista de palavras (evocao imediata, tardia e
reconhecimento da lista de palavras, e nomeao verbal) do Consortium to Establish a registry
for Alzheimers Disease (CERAD), o teste de memria lgica (WMS-R) da Escala Wechsler de
Memria (evocao imediata e tardia) e uma tarefa de fluncia verbal semntica (animais). A
comparao do desempenho cognitivo entre os grupos foi realizada por meio de anlise de
covarincia (ANCOVA), controlando-se o efeito dos anos de estudo, com post hoc Bonferroni.
A distribuio da varivel sexo foi investigada atravs do teste de qui-quadrado. Consideraramse resultados significativos quando p0,05. O pacote estatstico utilizado foi o SPSS 17. De
acordo com as anlises, os grupos no apresentaram diferenas significativas em relao
quantidade de sintomas depressivos, desempenho cognitivo geral avaliado pelo MEEM e na
distribuio quanto ao sexo. Em relao s tarefas de avaliao de memria, linguagem e
funes executivas, os grupos apresentaram diferenas significativas apenas na memria de
reconhecimento, sendo que os dois grupos mais jovens obtiveram melhor desempenho quando
comparados aos dois grupos mais velhos). A escolaridade influenciou significativamente nas
funes de memria verbal episdico-semntica de evocao imediata e tardia (lista de
palavras e texto), memria de reconhecimento, nomeao e fluncia verbal, sendo que o grupo
com menos anos de idade e mais escolaridade foi o que demonstrou escores mais elevados
nessas tarefas. A partir dos resultados apresentados, verificou-se que a anlise de intervalos
de idade menores parece contribuir para uma melhor caracterizao do perfil neuropsicolgico
de idosos. Ainda, a escolaridade demonstrou ser uma varivel influente no desempenho nas
funes avaliadas, estando esse resultado de acordo com a literatura. Dessa forma, sugere-se
que estudos futuros possam incluir comparaes entre idosos com diferentes nveis de
escolaridade e de idade.
Factor Validity of a Brazilian Instrument to Measure Older People's Involvement in
Pleasant Events: Preliminary Results
Heloisa Ferreira, Elizabeth Barham.
UFSCar, So Carlos, Brazil.

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The sense of pleasure that arises from engagement in activities is of fundamental importance
for the wellbeing of older people. Studies indicate that involvement in pleasant events acts as a
mediator variable in the prevention and treatment of various mental disorders, including
depression. The California Older Person Pleasant Events Schedule (COPPES) is an American
instrument designed for use in clinical contexts, to assist in the treatment of depressed older
people. The COPPES has two subscales, one to measure the frequency of the respondents
involvement in potentially pleasant events; and the other to evaluate the degree to which the
respondent perceives each event as being pleasant. The COPPES has already been culturally
adapted for use in Brazil (COPPES-BR), but further studies are needed to examine the internal
and external validity of the COPPES-BR. In the present study, we analyze evidence with
respect to the construct validity (factor validity) of the COPPES-BR, by performing a
Confirmatory Factor Analysis (CFA) and an Exploratory Factor Analysis (EFA). The American
factor structure, adjusted to a sample of 189 Brazilian older people, revealed a poor quality of
adjustment both for the frequency subscale (X2/df = 1,973; CFI = 0,738; GFI = 0,686; RMSEA =
0,072; P[rmsea < 0.05] < 0,000; MECVI = 11,720) and for the pleasure subscale (X2/df = 2,178;
CFI = 0,722; GFI = 0,674; RMSEA = 0,079; P[rmsea < 0.05] <0,000; MECVI = 12,788). For this
reason, an EFA was performed, yielding results which suggest that the subscales of the
COPPES-BR reflect 4 domains. For the Frequency subscale, these domains include: (1) social
competence, (2) cultural and leisure activities, (3) contemplative activities, and (4) household
activities, and for the pleasure subscale: (1) expressing positive feelings, (2) competence, (3)
practical activities, and (4) intellectual activities. The Cronbachs alpha values for these factors
ranged from .66 to .94. These factor structures still need to be confirmed using an additional
sample of Brazilian older people, in future investigations; however, these preliminary results
provide strong evidence of the internal validity of the COPPES-BR.
A Review of Research on Cognitive Behavior Therapy Groups for Elderly: The Need to
Look to Positive Traits
Eduarda Freitas, Altemir Jos Barbosa.
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
The increase in life expectancy is a worldwide phenomenon. This fact denotes the importance
to develop therapeutic modalities specifically for elderly. It is also relevant for therapist to
identify the strengths of the aged client so that the therapy can be advanced. This affirmative
become more important because character strengths are the foundation of optimal life-long
development and thriving and what most older persons who enter therapy want is not only to be
free from the symptoms associated with psychiatric disease, but also to learn skills and to
educate themselves in strategies that will help them cope better with circumstances of living that
may arise in the future. Aiming to identify positive traits that have been focus of the Cognitive
Behavior Therapy Groups for elderly (CBTG-E) people, this research examined empirical
studies published in articles format. These publications (N = 68) were retrieved using the index
term Cognitive Behavior Therapy Groups in PsycARTICLES and PsycINFO databases. It was
delimited that the sample should have subjects aged 65 years or more. It could be seen that this
scientific production is almost exclusively centered on the treatment of symptoms associated
with the disease. The focus of CBTG-E that emerged more frequently was depression,
obsessive-compulsive disorder, post traumatic stress disorder and pain. Only a few of the 68
studies assessed positive aspects such as quality of life and social skills. These results show
that CBTG-E are not considering the person as a whole. Thus, they are based on a narrowly
definition of the individual and her or his issues within a limited diagnostic category that includes
a discrete set of symptoms or problematic behaviors. This is not to say that symptom reduction

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is less important to well-being, but building the capacity to cope with ones challenges in either
way and strengthen the character strengths can be the key to the positive aging.
Promoviendo el Uso de la Terapia Cognitivo Conductual en Personas Mayores
Dante Gazzolo.
School of Psychology, Universidad Ricardo Palma, Lima, Peru.
Abstract Central: El envejecimiento de la poblacin mundial est conllevando a hacer frente a
una serie de dramticos cambios en la estructura de las sociedades y uno de estos planos es el
referido a la intervencin psicolgica con personas de 60 aos a ms. A pesar que es
mundialmente aceptado que las personas mayores se pueden beneficiar de intervenciones
psicoteraputicas , en nuestro medio local y regional todava existen ideas estereotipadas en el
gremio mdico y psicolgico generadas principalmente por la clsica opinin de Freud en 1905
quien sostena que las personas prximas a los cincuenta aos carecen de plasticidad en sus
procesos anmicos y que adems la acumulacin del material psquico prolongara
excesivamente el anlisis y por consiguiente no seran personas indicadas para la psicoterapia
. Por otro lado, hablar de salud mental en personas mayores causa an dificultad a nivel de
polticas pblicas para adaptar los sistemas de atencin a estas personas, cambios tcnicos
que se irn ejecutando en la medida que existan ms profesionales de la salud mental
capacitados en temas de gerontologa y en competencias relacionadas a las terapias
psicolgicas basadas en la evidencia emprica con nfasis en personas mayores. A partir del
enfoque del ciclo vital propuesto por Baltes y tomando en consideracin las modificaciones a la
estructura de las intervenciones cognitivo conductuales en personas mayores propuestas
inicialmente por Knight (1996) y modificadas por Laidlaw (2004) se pretende explicitar que la
TCC es una intervencin teraputica efectiva para tratar problemas depresivos, de ansiedad,
dolor crnico, problemas de sueo, entre otros. En este aspecto , ser necesario hacer uso de
los conocimientos que nos brinda la psicogerontologa actual a nivel cognitivo y afectivo para
entender con claridad que es fundamental modificar los procedimientos y contenidos
teraputicos y de esta forma incorporar las diferencias en los estilos de pensamiento de las
personas mayores as como otros ajustes tcnicos relacionados con la edad . Ser til precisar
como conceptualizar estos casos para llevar a cabo intervenciones especficas para el
problema a tratar; de igual manera se tratar cules son las cogniciones y creencias de los
pacientes mayores en relacin al proceso de su enfermedad y al proceso de psicoterapia en el
cual est involucrado, sin dejar de lado las creencias que puedan tener los psicoterapeutas en
relacin al proceso de cambios cognitivo y conductuales que se generan por el proceso del
envejecimiento. Finalmente, se discutir los aportes de las terapias cognitivas conductuales de
tercera generacin en el trabajo con personas mayores, sobre todo los alcances de la terapia
de aceptacin y compromiso y la terapia basada en la atencin plena ( mindfulness).
Desadaptao familiar e a necessidade de Re-significar crenas: um estudo de caso
clnico em Terapia Cognitivo-Comportamental
Spencer Jnior, Giliane Gomes.
Universidade de Pernambuco, Recife, Brazil.
O objetivo principal deste artigo se restringe a analisar um caso clnico e prever possveis reas
de atuao dentro do modelo comportamental-cognitivo, bem como sugerir algumas formas de
interveno com a finalidade de provocar mudanas em benefcio da qualidade de vida do
cliente em voga. Ressaltando que o estabelecimento de uma boa aliana teraputica
essencial para o sucesso teraputico. A Terapia Comportamental-Cognitiva tem como objetivo

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analisar o indivduo a luz dos princpios da aprendizagem, bem como tambm prioriza a
importncia dos eventos cognitivos na gerao dos problemas pessoais e transtornos
psiquitricos, ainda considerando a relao destes princpios com outros sistemas, como por
exemplo o fisiolgico (Dryden e Rentoul, 1991; Zarb, 1992). Apresentao do Caso Dados
clnicos: SNS, paciente 59 anos, graduao superior, funcionria pblica. aposentada com
renda prpria e boa situao financeira e social. Portadora de doena auto-imune e transtorno
depressivo recorrente. Quatro filhos que crescem e se emancipam profissional e afetivamente,
isto somado a uma separao conjugal com um casamento de 40 anos. Abordagem adotada
TCC. Perodo Maro 2011 a Outubro de 2012. Avaliao diagnstica: Evoluo cognitiva com
re-significao de crenas intermedirias e centrais. Crena central: "Eu no acredito mais que
posso recompor a minha vida". Constitutivos da crena: Desarrumao familiar. Intervenes e
estratgias teraputicas: delineamentos dos pensamentos automticos e distores cognitivas
como rotulao, generalizao, dramatizao e ideias arbitrrias. Atividades comportamentais
com recursos de leituras transversais, filmes e vivncias com ambientao familiar. Como
tambm treinar situaes de relacionamentos sociais em consultrio, tendo em vista o aumento
das habilidades sociais e reforar situaes de contato social. Visto que as estratgias
comportamentais objetivam basicamente avaliar as conseqncias das condutas do individuo e
de que forma elas mantm um funcionamento desadaptativo. Desse modo, tenta-se esse
funcionamento de forma a implementar novos tipos de comportamentos que beneficiem tanto o
prprio individuo quanto as pessoas ao seu redor. Os resultados apontaram para uma remisso
de sintomas depressivos com remoo da crena central e pensamentos automticos por
crenas funcionais. "Agora eu volto a acreditar na minha vida". Surgindo a adequao das
funes cognitivas em alinhamento com um projeto de vida promovedor de reinsero social e
maior mobilidade fsica e psicolgica com atividades multidimensionais. Diante da remisso
cognitiva que a cliente apresentou possvel concluir e entender que a utilizao de estratgias
teraputicas adequadas depende da clara conceitualizao e descrio dos problemas do
cliente, pois somente desta maneira o clnico tem capacidade de compreender todas as
variveis que podem contribuir na anlise dos casos atendidos, alm de poder desenvolver
procedimentos eficazes na modificao dos comportamentos inadequados, bem como na
modificao das crenas disfuncionais, que auxiliam a distorcer a viso racional que o homem
tem dos eventos da vida.
A Autopercepo de Sade Impacta na Emoo e Cognio? Um Estudo Preliminar com
Idosos Brasileiros
Regina Maria Lopes, Guilherme Welter Wendt, Lauren Terroso, Cristiane Esteves, Irani
Argimon.
PSICOLOGIA, PUCRS, Porto Alegre, Brazil.
Conforme indica a literatura, a autopercepo que o indivduo tem sobre sua prpria condio
de sade pode ser um importante indicativo na avaliao da qualidade de vida de uma
comunidade, sobretudo na populao idosa. Uma nica questo sobre a sade subjetiva, ou
seja, a sua auto-avaliao ou autopercepo pode predizer a mortalidade na vida adulta e ser
de extrema relevncia ao profissional que esteja realizando uma avaliao de indivduo idoso.
Em face ao exposto, este estudo teve como objetivo caracterizar a autopercepo de sade em
uma amostra de idosos. Alm disso, buscou investigar associaes com variveis cognitivas e
aspectos emocionais (sintomas de depresso e ansiedade), de modo a avanar no
conhecimento existente, at o presente momento, no tocante ao tema. No que diz respeito
metodologia, essa investigao adquire cunho descritivo e exploratrio, com delineamento
quantitativo e transversal. Participaram desse estudo 187 (M=70,01; DP=7,21) idosos com mais
de 65 anos de idade, residentes na cidade de Porto Alegre. Os idosos foram selecionados

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aleatoriamente e responderam a uma entrevista semiestruturada que continha questes


sociodemogrficas, bem como sobre hbitos de sade e acerca da autopercepo da prpria
condio de sade. Os instrumentos utilizados nessa investigao foram selecionados com
base nos pressupostos da TCC: Inventrio de Ansiedade de Beck (BAI), Inventrio de
Depresso de Beck (BDI-I) e os seguintes subtestes da WAIS-III: dgitos, vocabulrio e
cdigos. A avaliao em relao sade foi dicotomizada entre aqueles que classificaram-se
enquanto portadores de condio regular ou ruim e condio boa de sade. A maior parte
dos idosos encontra-se na faixa etria de 65 at 74 anos e relatou ter um mdico regular,
usando os servios pblicos de sade, e fazendo uso regular de medicao. Porm, um
nmero elevado de participantes (72,7%) no deixa de realizar atividades por motivos de
sade. Este estudo constatou que os idosos que avaliaram a sade de modo positivo
apresentaram mdias significativamente distintas na esfera emocional (ansiedade e depresso)
e nos aspectos cognitivos (subtestes da escala de inteligncia para adultos Cdigos, Dgitos e
Vocabulrio). Sugere-se que, quando da avaliao e indivduos idosos, seja em contextos
clnicos como em investigaes cientficas, a questo da autopercepo de sade seja
considerada.
Bienestar Psicolgico y Calidad de Vida en Adultos Mayores Ex Migrantes Zacatecanos
Ana Macas.
: Universidad Autnoma de Zacatecas. Unidad acadmica de Psicologa, Zacatecas, Mexico.
Abstract Central: RESUMEN Recientemente la vejez se ha convertido en un fenmeno global,
debido al aumento en la poblacin de Adultos Mayores. En algunos aos, el grueso de la
poblacin mexicana estar constituida por Adultos Mayores. Actualmente no es suficiente con
vivir, sino que es necesario vivir bien, que las personas disfruten su vida y se sienten
satisfechos de vivirla, que tengan calidad de vida, percibindose a s mismos subjetiva y
objetivamente en condiciones de bienestar tanto biolgico, sociocultural como psicolgico. Por
tal motivo el objetivo de este estudio fue conocer el bienestar psicolgico y la calidad de vida en
adultos mayores ex migrantes de una comunidad de Zacatecas, para ello se trabaj con una
muestra de 108 varones, de los cuales 54 vivieron en Estados Unidos y los otros 54 nunca han
emigrado. Para medir el bienestar psicolgico, se utiliz la versin del instrumento para adultos
BIEPS-A (Casull, 2002) y para medir la calidad de vida, se aplicaron las vietas del COOPWONCA (WONCA, 1988). Se puede observar que los sujetos que vivieron en Estados Unidos
presentan un mejor bienestar psicolgico y calidad de vida que los que nunca han emigrado.
Palabras Clave: Adultos mayores, Calidad de vida, Bienestar psicolgico, Ex migrantes.
Cognitive-Behavioral Therapy for Insomnia in Parkinsons disease
Regina Margis1, Simone Machado2.
1. pratica privada, Porto Alegre, Brazil, 2. Nucleo de Estudos e Atendimentos em Psicoterapias
Cognitivas, Porto Alegre, Brazil.
Parkinsons disease is a neurodegenerative disease characterized by resting tremor, rigidity,
bradykinesia and loss of postural reflexes. Subjects with Parkinsons disease (PD) can also
show a variety of non-motor symptoms including cognitive impairment, depression and sleep
disturbances. Several studies have shown that complaints of sleep disorders are frequent in PD,
including insomnia. PD is associated with increasing sleep latency, fragmented sleep
architecture and early morning awakening. Pharmacotherapy is a widely used treatment for
insomnia in clinical practice in PD. Cognitive and behavioral therapy (CBT) is effective in
treating insomnia symptoms in adult population. Previous studies showed that pharmacological

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and behavioral treatments for chronic insomnia have, approximately, equivalent efficacy. The
aim of this study was to review the literature in order to evaluate CBT studies in the treatment of
insomnia in PD patients. For that, it was performed a literature review from PUBMED and
LILLACS database, selecting studies published from 1995 to 2012. The search consisted of
mixing the words insomnia and Parkinsons disease with expressions as cognitive therapy,
cognitive behavioral therapy and sleep hygiene. CBT has been proposed as a kind of insomnia
treatment; however, few studies have examined the utility of CBT for insomnia in Parkinsons
disease. In sum, more studies are necessary evaluating different samples and considering PD
staging and clinical and psychiatric comorbidities, besides a reassessment of dysfunctional
beliefs related to insomnia in PD patients.
Trastornos Conductuales y Sociodemograficos Diferenciales Entre el Envejecimiento y el
Deterioro de Riesgo de Demencia
Carlos Mias1, 2, Raquel Krawchik2, Silvia Aylln2.
1. Facultad de Psicologa, UNiversidad Nacional Crdoba, Crdoba, Argentina, 2. Fundacin
SEMAS, Crdoba, Argentina.
INTRODUCCION: En una poblacin mundial que envejece de manera creciente, se ha
despertado en el mundo entero un creciente inters por la zona limtrofe entre el envejecimiento
normal y ciertas enfermedades asociadas a la edad, como la enfermedad de Alzheimer. Entre
todos los cambios relacionados con el envejecimiento, las prdidas de memoria las ms
evidentes. Tambin cambios en la conducta, como variaciones del humor, depresin,
obsesividad, sensibilidad interpersonal, ansiedad, y aislamiento entre otras, tambin son
frecuentes y pueden implicar un deterioro conductual leve asociado a problemas cognitivos. Por
otro lado, continan en estudio factores sociodemogrficos de riesgo para el deterioro
cognitivo, entre los que cuentan la edad y el nivel de instruccin. Se exploran aqu, trastornos
conductuales y sociodemogrficos diferenciales entre el envejecimiento y el deterioro cognitivo
leve (DCL). Las diferencias pueden alertar al clnico, sobre un deterioro conductual o cognitivo
leve, que puede ser la antesala a un sndrome demencial. OBJETIVOS: 1. Determinar
trastornos conductuales y sociodemogrficos diferenciales entre envejecimiento y DCL. 2.
Analizar la relacin entre trastornos conductuales y resultados en test neuropsicolgicos.
MATERIAL Y METODO: Estudio exploratorio y transeccional. Muestra: sujetos voluntarios
concurrentes a servicios de Neuropsicologa de Facultad de Psicologa, Hospital de Clnicas y
Fundacin SEMAS. Se comparan sujetos con deterioro leve (n=63), con sujetos controles
(n=63), sin diferencias de gnero, edad e instruccin. Instrumentos: Cuestionario de screening
SCL-90 y escala de Yesavage, escala de Actividades bsicas e instrumentales de la Vida diaria
(Lawton y Brody, y entrevista semiestructurada con el interesado y un familiar. Pruebas
neuropsicolgicas: MMSE de Folstein, test del reloj, de fluidez verbal, Test Neuropsi de
memoria, figura de Rey, test del trazo, y subtest del Wais III. RESULTADOS: 1. El grupo
Deterioro difiere de los controles, con mayores ndices de ansiedad, hostilidad, ideacin
paranoide, psicoticismo y depresin, con mayor distres y sntomas positivos (p>0,01). 2.
Indicadores de psicoticismo e ideacin paranoide correlacionan con test de fluidez verbal
semntica y fonolgica (p>0,05). 3. Mediante anlisis de regresin multiple, se encontr como
variables de riesgo de deterioro (p>0,05), la edad, el nivel de instruccin, baja lectura diaria y la
percepcin de informante sobre cambios de memoria. CONCLUSION: El DCL presenta
mayores cambios conductuales que los controles. Mayores indicadores de distres, como de
psicoticismo e ideacin paranoide correlacionan con test sensibles al deterioro del lbulo
frontal, memoria operativa y semntica. La edad a partir de los 65 aos, el menor nivel de
instruccin formal, el bajo nivel de lectura diaria, y la percepcin de un informante o familiar

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sobre una disminucin de la memoria, constituyen variables de riesgo para un deterioro objetivo
de la memoria y un posible sndrome demencial.
O Mini-Exame do Estado Mental (MEEM) em Idosos: Questes de Gnero e Escolaridade
Lusa Oliveira, Cristiane Esteves, Lauren Terroso, Camila Oliveira, Regina Maria Lopes, Irani
Argimon.
PUCRS, Porto Alegre, Brazil.
O envelhecimento populacional uma preocupao mundial e exige estratgias de preveno
de sade a serem adotadas com a maior brevidade possvel. Diante disso, avaliaes para a
deteco na fase inicial de declnio cognitivo podem proporcionar populao idosa uma
melhor qualidade de vida. Um dos instrumentos mais utilizados como rastreio de declnio
cognitivo o Mini Exame do Estado Mental (MEEM). O objetivo do presente estudo foi analisar
a existncia de diferenas entre o desempenho cognitivo de idosos, avaliados por meio do
MEEM, em relao ao sexo, bem como a relao entre a escolaridade dos participantes com o
desempenho no referido instrumento. O delineamento foi quantitativo transversal, com uma
amostra 488 idosos, de 60 anos ou mais, do sexo feminino e masculino. Os instrumentos
utilizados foram uma ficha de avaliao sociodemogrfica e o MEEM, que composto por
questes agrupadas em sete categorias: orientao tmporo-espacial, registro imediato e
evocao de palavras, ateno e clculo, linguagem e capacidade construtiva visual. A soma
dos escores pode variar de um mnimo de zero at o mximo de 30 pontos. As aplicaes dos
instrumentos foram feitas em uma entrevista individual e duraram cerca de 30 minutos. O
procedimento para anlises de dados foi descritivo, inferencial por meio de Teste t de Student
para amostras independentes e correlao de Pearson, sendo considerados resultados
significativos quando p0,05. Os achados mostraram que dos 488 idosos que participaram da
pesquisa, 344 foram mulheres (70,5%) e 144 homens (29,5%), com idades variando entre 60 a
96 anos (M=70,40, DP=7,66). A mdia de anos de estudo foi 5,80 (DP=4,24). Os participantes
no se diferenciaram de maneira significativa em relao escolaridade nem idade. Os
resultados apontaram que os homens tiveram a pontuao mdia no MEEM de 25,28
(DP=3,61) e as mulheres 24,51 (DP=3,97), sendo que a comparao entre essas mdias foi
significava. Alm disso, encontrou-se uma correlao positiva significativa, embora fraca, entre
anos de escolaridade e desempenho no MEEM. A partir dos resultados obtidos, verificou-se
que idosos do sexo masculino apresentaram melhores escores no MEEM. Com isso, concluiuse que a varivel sexo teve influncias sobre o desempenho cognitivo geral nessa amostra.
Sabe-se que o MEEM considerado um instrumento de rastreio do comprometimento
cognitivo, dessa maneira, sugere-se que novos estudos sejam realizados e que incluam
avaliaes cognitivas mais aprofundadas a fim de uma melhor compreenso da varivel sexo
para o desempenho neuropsicolgico.
Estudo Comparativo do Desempenho Cognitivo de Idosos com e Sem Sintomas
Depressivos
Lusa Oliveira, Cristiane Esteves, Camila Oliveira, Tatiana Quarti Irigaray, Luiza Mothes, Juliana
Ortiz, Irani Argimon.
PUCRS, Porto Alegre, Brazil.
A depresso, quando manifestada na velhice, apresenta uma reduo da resposta emocional,
da energia e do prazer em realizar atividades habituais. Junto a isso, h tambm uma
diminuio na qualidade de vida do idoso, que pode ser associada ao isolamento social e ao
surgimento de doenas graves. Observa-se que idosos que apresentam sintomas depressivos

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tendem a demonstrar pior desempenho nas funes atencionais, mnemnicas e executivas.


Dessa forma, esse estudo pretendeu comparar o funcionamento cognitivo de idosos com e sem
sintomas depressivos. A amostra foi composta por 442 idosos de 60 anos ou mais, de ambos
os sexos, cadastrados no programa Estratgia de Sade da Famlia do municpio de Porto
Alegre, RS, Brasil. Os participantes responderam Escala de Depresso Geritrica de 15
pontos (GDS-15), ao Mini Exame do Estado Mental (MEEM), lista de palavras do Consortium
to Establish a Registry for Alzheimers Disease (CERAD) (evocao imediata, tardia e
reconhecimento), s tarefas de fluncia verbal fonmica e semntica (FAS e Animais), s
tarefas de praxia construtiva (cpia e evocao tardia) do CERAD, tarefa de memria lgica
da Escala Wechsler de Memria (WMS-R) e ao Teste de Nomeao de Boston de 15 itens
(TNB-15). Os participantes foram agrupados como tendo (escores com 5 a 15 pontos na GDS15) ou no sinais sugestivos de depresso. Assim, o grupo sem sintomas sugestivos de
depresso (DA) foi composto por 280 idosos e o grupo com sintomas (DP) por 162 indivduos.
A comparao entre os grupos no desempenho nas tarefas cognitivas foi realizada atravs do
Teste t de Student para amostras independentes. O teste qui-quadrado foi utilizado na
comparao de variveis categricas. Foram considerados resultados significativos quando
p0,05. O pacote estatstico utilizado foi o SPSS 17.0. O grupo DA apresentou 59% idosos do
sexo feminino e 41% do sexo masculino, enquanto o grupo DP os percentuais foram 74% e
26%, respectivamente. A distribuio de sexo entre os grupos foi significativamente diferente. O
grupo DP teve mdia de idade de 68,53 (DP=7,71) e 3,61 (DP=2,62) de estudo. O grupo DA
teve a mdia de idade 68,81 (DP=6,95) e 3,87 (DP=2,51) de estudo. Os idosos do grupo DP
apresentaram desempenho significativamente inferior nos resultados dos testes de capacidade
cognitiva geral, lista de palavras imediata e tardia, praxia construtiva cpia e tardia, memria
lgica imediata e tardia, nomeao verbal e fluncia verbal fonmica. A partir da anlise de
dados foi possvel perceber que os sintomas depressivos podem estar associados a um pior
desempenho na capacidade de armazenar e recuperar informaes verbais, praxia construtiva,
nomeao verbal e funes executivas. Os resultados encontrados esto de acordo com a
literatura e demonstram que a presena de sinais depressivos pode ser considerada um fator
importante na avaliao cognitiva de idosos. Destacam-se como limitaes desse estudo a no
avaliao de outras funes cognitivas como ateno concentrada, ateno dividida e
velocidade de processamento. Sendo assim, sugere-se que novas pesquisas sejam realizadas
considerando-se essas habilidades, assim como a influncia da varivel sexo no desempenho
cognitivo.
Risk Perception and Decision Making in Gambling
Michael Spurrier.
University of Sydney, Sydney, NSW, Australia.
Abstract Central: Gambling is associated with significant problems for some users. Evidence
suggests that there are differences in how some gamblers evaluate and manage gambling risk.
Identification of critical bugs in gambling decision making may therefore guide development of
interventions for disordered gambling. The aim of the current project was to investigate
gambling risk perception and decision making via systematic literature review, qualitative
interview and quantitative questionnaire data. Information was then used to identify critical
bugs in the decision making models of disordered gamblers. Data collection and analysis
followed the Mental Models methodology (proposed by Morgan, Fischhoff, Bostrom & Atman,
2002). Literature review, interview and questionnaire data revealed that gambler decision
making is vulnerable to a number of risk and protective factors, including: erroneous,
incomplete, or maladaptive cognitions about game outcome and determination; exposure and
sensitivity to environmental cues and mental states; and the way in which individuals engage

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with and resolve motivational conflicts. An integrative model of disordered gambling is


proposed, that argues for individualised assessment and formulation according to a number of
key risk and protective factors. Morgan, M. G., Fischhoff, B., Bostrom, A., & Atman, C. J. (2002).
Risk communication: a mental models approach. Cambridge, England: Cambridge University
Press.
Trs desafios no desenvolvimento de adultos, ligados ao envelhecimento
Cristiane Telles Nunes, Elizabeth Barham, Heloisa Ferreira, Francine Pinto, Heloisa Ferreira,
Cristiane Telles Nunes, Cristiane Telles Nunes, Elizabeth Barham, Francine Pinto, Elizabeth
Barham, Heloisa Ferreira, Elizabeth Barham.
Programa de Ps-graduao em Psicologia, Universidade Federal de So Carlos - UFSCar,
So Carlos, Brazil.
Ao longo do processo de envelhecimento, surgem desafios que requerem adaptaes
significativas na forma como pensamos e agimos, para que possamos manter nosso bem estar
fsico e psicolgico na meia-idade e na velhice. Este simpsio tem por objetivo apresentar
achados de pesquisas conduzidas no Brasil, que descrevem algumas das estratgias que
pessoas usam para lidar com trs transies de vida que so cada vez mais comuns entre
adultos, para identificar habilidades intra e interpessoais especficas que podem contribuir para
um processo de envelhecimento bem-sucedido. A primeira apresentadora descrever dados de
pesquisa que apontam para habilidades que so importantes para gerenciar o processo de
transio entre a vida profissional e a aposentadoria. Sero discutidos dados sobre as
percepes de pr-aposentados com relao prxima etapa de suas vidas e s habilidades
que precisam para que possam construir planos viveis para o futuro. A segunda
apresentadora discutir os resultados de sua reviso da literatura, focada nas habilidades
sociais de cuidadores de idosos, que podem contribuir para a construo de relaes de maior
qualidade entre os cuidadores e: (a) seu familiar idoso dependente, (b) outros parentes do
idoso dependente e (c) profissionais da rea de sade que acompanham o idoso. A terceira
pesquisadora discutir a questo de bem estar na velhice e descrever alguns dos fatores
associados com a prtica mais freqente de atividades prazerosas entre idosos brasileiros,
incluindo suas condies fsicas, psicolgicas e socioeconmicas. Em suma, nota-se que
planejar a aposentadoria, desenvolver habilidades sociais adequadas para desempenhar o
papel de cuidador e praticar atividades prazerosas requerem o uso de diversas habilidades
inter- e intrapessoais, as quais so associadas a uma melhor qualidade de vida, ao longo do
processo de envelhecimento.
Apoio: FAPESP
Transio para a aposentadoria: avaliao da percepo e dos planos de vida de praposentados
O envelhecimento da populao brasileira levou a um rpido aumento do nmero de
aposentados, fazendo da aposentadoria um desafio normativo no processo de envelhecimento.
O bem-estar na aposentadoria depende das atitudes e habilidades das pessoas diante deste
evento da vida para prevenir sentimentos de inutilidade e promover o engajamento em
atividades que so percebidas como importantes e prazerosas. O presente estudo, de carter
qualitativo, objetivou identificar a percepo de pr-aposentados com relao sua
aposentadoria e avaliar os seus planos de vida para o futuro. Participaram quatro
trabalhadores, dois homens e duas mulheres, caracterizados como pr-aposentados por
estarem prximos em at trs anos da aposentadoria. Os instrumentos incluram um roteiro de
entrevista semi-estruturado e uma srie de questes relacionadas aos planos para
aposentadoria. A anlise das entrevistas evidenciou que a aposentadoria percebida pelos

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participantes como mais uma etapa da vida, caracterizada primariamente como um perodo de
maior liberdade, privilegiado para atividades de lazer, envolvimentos familiares e outros
relacionamentos sociais. Entretanto, no geral, os participantes tambm se sentem preocupados
e inseguros com relao chegada da aposentadoria, principalmente porque relacionam
aposentadoria velhice e s limitaes de sade que podem surgir nesta fase do
desenvolvimento humano. Alm disso, trs dos quatro participantes relataram ter interesse em
continuar trabalhando ps-aposentadoria, como forma de se sentirem teis, seguros e evitarem
grandes perdas financeiras. Os planos de vida analisados incluram oito dimenses: atividades
profissionais; desenvolvimento pessoal; condio financeira; sade fsica; bem-estar
psicolgico; relacionamentos sociais; relacionamentos familiares; lazer e atividades culturais.
Os participantes descreveram com maior clareza seus planos nas dimenses profissional,
sade fsica e relacionamentos familiares. Entretanto, seus planos ps-carreira parecem refletir
uma falta de habilidades organizacionais, o que pode ter dificultado a sua capacidade de
identificar maneiras de usar o seu tempo no futuro. A participao em um Programa de
Orientao para Aposentadoria poderia fornecer uma oportunidade para os participantes
(re)definirem e (re)pensarem seus planos de vida em todas as dimenses avaliadas, alm de
minimizar a probabilidade de surgimento de transtornos de sade fsica e emocional na fase de
transio para a aposentadoria, permitindo uma melhor qualidade de vida durante o perodo de
ps-aposentadoria.
Apoio: FAPESP
Habilidades sociais em cuidadores de idosos: O que dizem os estudos?
Cuidar de um idoso pode levar, muitas vezes, a uma reduo significativa na percepo de
bem estar e da qualidade de vida por parte do cuidador. Nesse sentido, a presena de algumas
habilidades psicolgicas pode contribuir de forma positiva para os relacionamentos
interpessoais desse cuidador. Por outro lado, a falta dessas habilidades pode comprometer a
sade do idoso e assim aumentar as presses sobre o cuidador. Percebe-se que algumas
habilidades gerais, tais como as habilidades sociais, embasam o desenvolvimento de
habilidades especficas de um cuidador de idoso, uma vez que h estudos que mostram que o
uso das mesmas implica na melhora da qualidade de vida e em um menor ndice de depresso
entre a populao em geral. O objetivo desse trabalho foi levantar estudos que abordassem a
temtica habilidades sociais em cuidadores de idoso e verificar o que se conhece sobre o tema.
Realizou-se um levantamento bibliogrfico nas bases de dados PsychInfo, Lilacs, Scielo,
Gerontological Society of America, Redalyc e banco de teses da CAPES. Foram encontrados 2
artigos e 3 dissertaes (N=5), sendo que dentre eles 4 avaliavam intervenes e 1
correlacionava habilidades sociais com medidas de bem estar psicolgico. Os resultados
sugeriram que o uso de habilidades sociais fortalece as relaes interpessoais de cuidadores
de idosos e colabora para uma melhor qualidade de vida, tanto do cuidador como do idoso
cuidado. Tambm encontrou-se que cuidadores de idosos que utilizam mais dessas
habilidades, se sentem menos sobrecarregados. No entanto, com essa reviso percebeu-se
que estudar habilidades sociais em cuidadores de idosos algo novo e outros estudos sobre a
temtica se fazem necessrios. Alm disso, seria interessante desenvolver instrumentos
especificamente para esse publico, uma vez que ele contm especificidades que no
abrangem a populao em geral.
Apoio: Fapesp
Relao entre atividades prazerosas na velhice com condies psicolgicas fsicas e
socioeconmicas: evidncias de validade externa de um instrumento
Estudos indicam que o envolvimento de idosos em atividades prazerosas uma varivel que
desempenha um papel importante no bem estar na velhice, atuando como varivel mediadora
na preveno de desordens mentais, como a depresso, e associando-se a um melhor estado

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funcional e a melhores condies socioeconmicas do idoso. O objetivo desse estudo foi


verificar as relaes existentes entre uma verso brasileira de um instrumento que avalia o
envolvimento de idosos em atividades prazerosas (COPPES-BR) com sintomas depressivos,
estado funcional, e condies socioeconmicas numa amostra estruturada em 201 idosos
brasileiros no-institucionalizados e sem comprometimento cognitivo. Os dados foram
coletados utilizando-se o Inventrio de Depresso de Beck, Escala de Pfeffer, Critrio Brasil, e
uma nova verso do The California Older Persons Pleasant Events Schedule, instrumento
adaptado culturalmente para o Brasil que mensura a frequncia de envolvimento de idosos em
atividades prazerosas. Os resultados mostraram que ambas as estruturas fatoriais da
subescala frequncia e agradabilidade do COPPES-BR apresentaram correlaes negativas
com vulnerabilidade social, sintomas depressivos, estado funcional e idade; e correlaes
positivas com poder aquisitivo e anos de estudo. Quanto maior a frequncia e o prazer
experimentado em atividades, menor a vulnerabilidade social, a idade, o grau de depresso e
de dependncia do idoso; e maior a escolaridade e poder aquisitivo. Esses resultados sugerem
evidncia de validade externa do COPPES-BR.
Apoio: FAPESP
Velhice e Depresso: Qual o Papel da Incluso Social?
Mnica da Silva, Elizabeth Barham, Francine Pinto.
Psicologia (PPGPsi), UFSCAR, Araras, Brazil.
Com o aumento da expectativa de vida e no nmero de idosos no Brasil e no mundo, aumenta
tambm a preocupao com as possibilidades de melhorar as condies psicossociais dessa
populao. Sendo assim, o presente estudo teve como objetivo realizar uma anlise de artigos
que evidenciaram a temtica da incluso social na velhice, considerando o sentimento de estar
includo como um fator de proteo para a sade mental do idoso, especialmente prevenindo
quadros depressivos. Para isso, foi realizada uma reviso da literatura, priorizando as
publicaes divulgadas entre os anos de 2000 e 2012. Para a busca foram utilizados como
descritores os termos incluso social de idosos, aspectos sociais do envelhecimento e
depresso na velhice. Em cada fase do desenvolvimento humano, o indivduo se depara com
novos desafios e dificuldades que caracterizam particularmente cada uma das etapas da vida,
seja a infncia, a adolescncia, idade adulta ou a velhice. Muitas vezes, o que facilita o
envelhecimento saudvel o equilbrio entre os aspectos biopsicossociais de cada idoso.
Dependendo de como esses fatores se apresentam, o processo de envelhecimento poder
contar com possibilidade de mudanas e adaptaes que melhoram as condies de vida e o
bem-estar psicolgico nesta fase. Estudos com idosos geralmente apontam que a incluso
social se tornou uma medida que ajuda na preveno de problemas de sade mental na
velhice e evidenciam a importncia do envolvimento do idoso em atividades prazerosas como
alternativas que buscam a promoo do envelhecimento bem sucedido. Pesquisas descrevem
a importncia da atividade fsica, dos grupos de convivncia e da participao em
Universidades para Terceira Idade como estratgias preventivas que combatem a
sintomatologia depressiva. O engajamento social em situaes prazerosas, familiares ou no,
pode transformar a velhice em uma fase mais produtiva. Contudo, a relevncia das propostas
de incluso social no se aplica somente a este contingente populacional, o tema abrange
tambm outras populaes ou grupos etrios. Convm mencionar, que a identificao de
estratgias que promovam bem-estar psicolgico e melhores condies de vida na velhice
significa levar em considerao as caractersticas pessoais de cada idoso, facilitando o
exerccio dirio de cidadania, conforme prev o Estatuto do Idoso. Diante disso, este
levantamento bibliogrfico encontrou que a incluso social funciona um fator de proteo contra
o isolamento no saudvel dos idosos, uma vez que o decrscimo de contatos que ocorre na
velhice pode resultar no aparecimento de sintomas depressivos. Alm disso, como ainda no

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h consenso na identificao de sentimentos que caracterizam o sentir-se includo socialmente,


maiores esforos e estudos nesse sentido so necessrios. Palavras-chave: Incluso social,
velhice, depresso.
Anxiety Disorders/ Trastornos de Ansiedad/ Transtornos de Ansiedade
A Meta-analytic Examination of Randomized Controlled Trials for Childhood Anxiety
Disorder Treatment Components
Chelsea Ale, Lilianne Rothschild, Stephen Whiteside.
Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
Anxiety disorders in children can be especially disabling because they interfere with social and
emotional development. By frequently avoiding feared situations, clinically anxious children
often miss opportunities to interact with others, build social skills, and gain confidence with
developmental tasks (Merikangas, & Avenevoli, 2002). Estimates of child anxiety disorders
reach 10% - 20% by school age with one-year prevalence rates estimated to be 10% for specific
phobia, 7% for social anxiety disorder, 3% for generalized anxiety disorder, and 3% for
separation anxiety disorder (Chavira, et al., 2004; Merikangas, et al., 2011). In the largest
randomized controlled trial (RCT) of treatment for CADs (Walkup, et al., 2008), remission rates
for CBT, medication, and combined treatment ranged from 20% to 68% (Ginsburg, et al., 2011).
Therapy alone did not differ from medication on symptom reduction and both underperformed
combination treatment (Walkup, et al., 2008). For instance, a recent meta-analysis found that
with an effect size (ES) of .53 CBT for CADs was only moderately effective while CBT for OCD
was highly effective (ES= 1.68; Reynolds, et al., 2012). There is wide variety among treatment
studies and components included in protocols for childhood anxiety disorders, which may
contribute the range in effectiveness across diagnoses. The current study sought to compare
examine components of treatment protocols which relate to treatment effects. It was
hypothesized that treatments which employ more exposure sessions, earlier in treatment will
demonstrate larger effect sizes than treatments that do not include exposure. Additionally, it was
hypothesized that treatment protocols which include parents during exposure tasks will have
larger effects than those that either do not include parents or only provide parent education.
Included in the meta-analysis were 84 randomized controlled trials for anxiety disorders (i.e.,
separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic
stress disorder, and obsessive compulsive disorder) in children ages 2-18 published between
1996 and November, 2012. Published manuscripts were reviewed for treatment content by two
researchers and authors were contacted when treatment details were not provided or were
unclear. Results revealed that only 64% of studies included in-vivo exposure and 52% included
homework exposures in their protocol. Examining differences between protocols by diagnosis,
CBT for OCD introduced exposure earlier (mean session = 4) than protocols for mixed anxiety
disorder (social anxiety disorder, separation anxiety disorder, or generalized anxiety disorder)
(mean session = 6.42). Further, CBT for mixed disorders only outperformed no-treatment, but
was not significantly different than active control interventions (ES = .65 and .14, respectively)
whereas treatment for OCD outperformed both comparisons (ES = 2.09 and .66). Additional
analyses will be presented. These preliminary results will be discussed in the context of
optimizing treatment for child anxiety disorders and underlining the need for dismantling studies
to identify the putative mechanisms of change.
Innovative Approaches to and Novel Predictors of Treatment for Anxiety-Disordered
Youth

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Candice Alfano1, Deborah Beidel2, Jennifer Hudson4, Kathryn Lester5, Cathryn Lewis5, Maria
Tropeano5, Cathy Creswell6, David Collier5, Peter Cooper6, Heidi Lyneham4, Ronald Rapee4,
Jenny Donald4, Thalia Eley5, Michelle Clementi1, Candice Alfano1, Deborah Beidel2, Josh
Spitalnick3, Nina Wong2.
1. Psychology, University of Houston, Houston, TX, USA, 2. University of Central Florida,
Orlando, FL, USA, 3. Virtually Better, Inc., Decatur, GA, USA, 4. Macquarie University, Sydney,
NSW, Australia, 5. Kings College London, London, United Kingdom, 6. University of Reading,
Reading, United Kingdom.
Randomized controlled trials (RCTs), the gold-standard in treatment research, indicate
traditional cognitive-behavioral therapies (CBT) are efficacious for to of children with
anxiety disorders. Unfortunately, this means that up to one-half of children do not evidence
significant improvement following treatment. This symposium includes three papers aimed at
understanding why CBT may fail for some anxious youth and introduces current treatment
development efforts attempting to build upon the success of existing treatments. In the first
paper by Hudson and colleagues, the authors build on previous work showing two specific
genotypes to be associated with child response to CBT. They specifically examine whether
clinical and genetics factors predict treatment outcome among anxious youth. These data have
implications for interpreting outcome data and may help identify children in need of more
intensive or enhanced interventions.
The second paper by Clementi and Alfano focuses on children generalized anxiety disorder
(GAD) specifically, which is characterized by a more fluctuating and unstable course compared
to other forms of childhood anxiety. Using a time-series design, outcomes based on a newly developed intervention for childhood GAD, Targeted Behavioral Therapy (TBT), are examined.
TBT focuses on anxiety as well as sleep problems based on research showing some form of
sleep disruption to be present in 90% of children with primary GAD. Results from this study
raise important questions regarding the level and process of change during treatment.
Consideration of how and why improvement might occur, the role of sleep disturbance in
treating childhood GAD, and measurement of improvement will be discussed.
Finally, Beidel et al. present an exciting, new treatment for childhood social anxiety disorder
(SAD) incorporating an interactive set of virtual environments that provide children with intensive
behavioral practice opportunities for social skill acquisition and generalization. These virtual
environments allow children to interact with various life-like characters using any standard
computer, and thus without the need for formal peer group activities or parental involvement.
This innovative treatment specifically addresses practical challenges associated with conducting
social skills training in clinical settings as well as dissemination to socially-anxious youth across
different settings. Dr. Beidel will also serve as Discussant for this symposium, extracting the
broader implications of these papers for practitioners as well as scientists.
Combining Clinical and Genetic Information to Predict Treatment Outcomes in Children
with Anxiety Disorders
Background. Clinical factors such as severity and comorbidity have been associated with
response to Cognitive Behaviour Therapy (CBT) in child anxiety. We recently demonstrated that
two genotypes (Serotonin Transporter Promoter Polymorphism; 5HTTLPR and marker rs6330 in
Nerve Growth Factor gene; NGF) are associated with response to CBT in child anxiety.
Aims. We tested whether response to CBT in anxious children can be predicted from clinical
and genetics factors.
Method. DNA was collected from 559 anxious children undergoing CBT. We tested our risk
model in 5 cross-validation training sets.
Results. Six variables significantly predicted treatment response in at least one of the training
sets and had a minimum mean beta value of 0.5 across all 5 sets: 5HTTLPR, NGF rs6330,

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gender, primary anxiety severity, comorbid mood disorder and comorbid externalising disorder.
A risk index (range 0-8) made from these variables had moderate predictive ability. Children
scoring high on this index (5-8) were approximately three times as likely to have their primary
anxiety disorder at follow-up as compared to those children scoring 2 or less.
Conclusion. This approach could identify which children are less likely to benefit from CBT alone
or thus require an enhanced treatment.
Targeted Behavioral Therapy (TBT) for Childhood Generalized Anxiety Disorder (GAD): A
Time-Series Analysis of Change
Background. Generalized anxiety disorder (GAD) is a chronic and impairing disorder with a
notably fluctuating course, yet intervention research has generally failed to consider the
instability of GAD symptoms in conceptualizing treatment outcomes. In addition, although 90%
of children with GAD experience sleep problems, including persistent difficulty initiating and/or
maintaining sleep, it is unknown whether these problems improve or need to be directly targeted
as part of treatment for childhood GAD. Targeted Behavioral Treatment (TBT) was developed to
target both anxiety and sleep problems in children with GAD.
Method. Using a time-series design, 4 children (7-12 years) with a primary GAD diagnosis were
treated with TBT which includes: psycho-education about anxiety and sleep, strategies for
improving sleep (2 sessions), relaxation, and in-vivo exposures, sequentially. Parent and childreported anxiety and sleep problems were examined at baseline, after 14 weeks of treatment
and 3 months follow-up. Simulation modeling analysis (SMA; Borckardt, 2006) also was used to
examine level and slope of symptom change based on weekly ratings during a 4-week baseline
and 14-weeks of treatment.
Results. At post treatment, 2/4 (50%) children did not meet criteria for GAD and no child had a
GAD diagnosis at 3 months follow-up. By comparison, time-series analyses using SMA showed
significant symptom level change (i.e., meaningful improvement in symptoms between baseline
and treatment phases) in only 1 of the 4 children treated, whereas changes in slope (i.e.,
whether symptom changes were specifically related to the course of treatment) were nonsignificant for all 4 children.
Conclusion. While examination of broad-based outcomes among children with anxiety disorders
provides limited understanding of how or why improvement might occur, time-series designs
allows researchers to examine phase effects and individual patterns of symptom change. Our
findings among children with primary GAD underscore several important areas in need to
attention in treatment including the disorders fluctuating course, the role of sleep disturbance,
and measurement of impairment/improvement.
Using Virtual Environments to Augment Traditional Social Skills Training for SociallyAnxious Youth
Emerging data suggest that interventions for childhood social anxiety disorder (SAD) that
include social skills training, formal peer generalization sessions, and homework assignments
as part of an overall treatment strategy show enhanced efficacy when compared to interventions
without these components. The latter two elements are specifically designed to enhance skill
generalization yet are often difficult to implement in traditional clinical settings, limiting optimal
dissemination to youth in need of these services in different settings (e.g., at school, outpatient,
or community facilities). To respond to this need, we have developed an interactive set of virtual
environments to provide intensive behavioral practice opportunities that are critical for skill
generalization. Virtual environments enable the child to interact with virtual school characters on
any standard computer, allowing daily intensive practice of social skills without the need for
formal peer group activities (in-clinic solution) or intensive parental involvement (at-home
solution).The virtual character responses appear to be responsive to the users interactions,
creating a simulated live scenario and potentially optimizing clinical services by promoting the

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transfer of social skills acquired through traditional social skills training into real-life situations for
children through repeated practice in a simulated social virtual environment. In this presentation,
we will describe the development of the environment and present feasibility, accessibility and
acceptability data for parents and children, in addition to preliminary treatment outcome data.
Tratamiento de los Trastornos de Ansiedad Mediante Exposicin a Entornos de Realidad
Virtual: Resultados de Usabilidad y Satisfaccin del Terapeuta
Ivan Alsina-Jurnet.
1. VirtualWare, Barcelona, Spain, 2. Hospital Clnic, Barcelona, Spain.
Abstract Central: Durante los ltimos aos las Nuevas Tecnologas de la Informacin y la
Comunicacin (TICs) han modificado de una forma drstica el mbito de la Piscologa Clnica.
En particular, la exposicin a entornos de RV ha empezado a situarse como una de las tcnicas
ms prometedoras para el estudio, la evaluacin y el tratamiento de los trastornos de ansiedad.
A pesar de la gran eficacia clnica que ha mostrado la RV desde mediados de la dcada de los
aos 90, las aplicaciones y sistemas diseados son an inaccesibles para la gran mayora de
profesionales del campo de la Salud Mental. En esta lnea tambin resulta importante destacar
que la investigacin realizada a da de hoy, se ha centrado bsicamente en el paciente y los
resultados del tratamiento, pero muy poco se conoce acerca de la experiencia del terapeuta.
Con el objetivo de superar estas limitaciones y hacer accesible la tecnologa de la RV a todos
los psicoterapeutas que lo deseen, se presenta la plataforma VirtualRet. Se trata de la primera
plataforma de RV dirigida al tratamiento de los trastornos de ansiedad ms comunes entre la
poblacin clnica: agorafobia con/sin pnico, miedo a hablar en pblico, trastorno de ansiedad
generalizada, fobia a volar, acrofobia, fobia a la sangre, claustrofobia y fobia a animales. A
continuacin se presentarn los resultados de usabilidad y satisfaccin clnica de una muestra
formada por 20 psicoterapeutas que utilizan VirtualRet en su prctica clnica habitual. Los
resultados ayudarn a comprender mejor cules son, en la perspectiva del psicoterapeuta, los
aspectos ms relevantes de un sistema de RV para una prctica clnica eficaz. Adems
proporcionarn una gua para el diseo y desarrollo de futuras aplicaciones de RV dirigidas al
campo de la Salud Mental.
Tratamiento de la Agorafobia Mediante la Plataforma Virtualret: Un Estudio de Caso
Ivan Alsina-Jurnet.
1. VirtualWare, Barcelona, Spain, 2. Hospital Clnic, Barcelona, Spain.
Abstract Central: La Realidad Virtual se ha empezado a situar como una de las herramientas
ms prometedoras para el campo de la Salud Mental. As lo confirman diferentes estudios
realizados a lo largo de la ltima dcada y que muestran su gran eficacia clnica para el
tratamiento de diferentes trastornos psicolgicos. A pesar de ello, el elevado coste de los
equipos y sistemas existentes provoca que slo el 3% de los psicoterapeutas estn utilizando
esta tecnologa en su prctica clnica. En el presente estudio, se pretende evaluar la eficacia de
una plataforma de Realidad Virtual de bajo coste para el tratamiento de un caso de Agorafobia.
Con este fin se utiliza VirtualRet, se trata de una plataforma de Realidad Virtual dirigida al
tratamiento de diferentes trs. de ansiedad y fobias cuyo objetivo es, precisamente, hacer
accesible esta tecnologa a la mayora de los profesionales del mbito de la Salud Mental.
Durante la sesin se describir, sesin a sesin, el protocolo de tratamiento utilizado en un
paciente diagnosticado de Agorafobia. Para evaluar su eficacia se tomaron medidas de
Agorafobia, ansiedad rasgo, ansiedad estado, estado de nimo deprimido y perfil
psicopatolgico en tres momentos: pre-tratamiento, post-tratamiento y en un seguimiento

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realizado a los tres meses. Los resultados mostraron la eficacia de VirtualRet para el
tratamiento de la Agorafobia, mantenindose los resultados en el tiempo.
The Contribution of Acceptance and Catastrophic Beliefs in the Prediction of Panic and
Anxiety in Individuals with Anxiety Disorders
Ayelen Andreoli1, 2, Pablo Lpez1, 2, Liliana Traiber1, 2, Paula Tripicchio1, 2, Emillio Compte1, 2,
Marcelo Cetkovich1, 2, Fernando Torrente1, 2, Rafael Kichic1, 2.
1. Anxiety Clinic, Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina, 2. Institute
of Neurosciences, Favaloro University, Buenos Aires, Argentina.
The cognitive-behavioral model states that dysfunctional beliefs about threat are associated with
symptoms of anxiety and panic. However, those beliefs do not account for all the variability of
anxiety symptoms. Recently, acceptance and commitment therapy suggested that experiential
avoidance (EA) play a role in the onset and maintenance of anxiety disorders. The purpose of
the present study was to explore the contribution of EA and catastrophic beliefs to predict
anxiety and panic symptoms. Sixty adults (34 women) with diagnosis of anxiety disorder
participated in the study. Diagnosis was established with a semi-structured interview by an
expert in anxiety disorders. Participants subsequently completed a set of self-report measures
including the Acceptance and Action Questionnaire (AAQ), the Agoraphobic cognitions
Questionnaire (ACQ), the State and Trait Anxiety (STAI), the Body Sensations Questionnaire
(BSQ), and the Beck Depression Inventory (BDI-II). Results indicate that both theoretical
measures were significantly correlated to panic and anxiety symptoms (all p < .01). When
controlling for depression, correlations were reduced but most of them remained significant.
Because the BSQ was originally developed to assess typical panic cognitions, we recalculated
correlations between theoretical predictors and panic while excluding panic patients. The ACQ
(r (47) = .74; p = .000) but not the EA (r (47) = .39; p = .08) was significantly associated with
panic symptoms. After controlling for the AAQ, the ACQ still significantly predicted panic and
state anxiety symptoms. When controlling for the ACQ, the AAQ remained significantly
correlated to state and trait anxiety but not to panic symptoms. Consistent with both theoretical
models, our results suggest that catastrophic beliefs and EA are associated with state anxiety.
This association can not be accounted for depression symptoms. Furthermore, catastrophic
beliefs predicted panic and state anxiety symptoms independently of EA and depression. In line
with previous research, these findings suggest that catastrophic beliefs constitute a more
specific construct than EA to explain panic symptoms. Theoretical and treatment implications of
the results are discussed.
Tratamento Cognitivo-Comportamental Realizado em Adolescente Vtima de Bullying:
Relato de Caso
Juliana Apolnio1, Reginete Pereira2, 3, Rosana Silva1.
1. Faculdade Frassinetti do Recife (FAFIRE), Recife, Brazil, 2. UFRPE, Recife, Brazil, 3. ATCPE, Recife, Brazil.
A prtica a ser descrita e apresentada, foi realizada na Faculdade Frassinetti do Recife
(FAFIRE), mais precisamente na Clnica-escola Psicolgica Paula Frassinetti. Est situada no
bairro Boa Vista, na cidade de Recife-PE. Populao: O processo a ser descrito, foi realizado
com 1 (um) adolescente de 16 anos, sexo masculino, estudante do ensino mdio, morador do
interior do estado de Pernambuco. Apresentou como queixa ter sido vtima de Bullying e como
consequncia, aumento da ansiedade, gagueira e sentimentos diversos por vezes em
descontrole. Prtica: A prtica desenvolvida consiste em processo teraputico individual,

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realizado na abordagem cognitivo-comportamental. Esta atividade desenvolvida em ambiente


de clnica-escola e tem por objetivo disponibilizar apoio psicolgico s pessoas de menor poder
aquisitivo. Os atendimentos foram realizados por uma concluinte do curso de Psicologia da
Faculdade Frassinetti do Recife (FAFIRE), tendo a prtica supervisionada por duas Mestres
orientadoras em frequncia semanal. O acompanhamento foi realizado a partir de intervenes
e tcnicas provenientes da terapia cognitivo-comportamental tais como o questionamento
socrtico, a psicoeducao, anlise das evidncias, registros de pensamento dirio, respirao
diafragmtica, pareamento de lembranas, restruturao cognitiva, treinamento assertivo. Os
atendimentos em clnica-escola tem por base a psicoterapia breve. Resultados/Impactos: A
partir da aliana teraputica formada, das tcnicas empregadas e principalmente do empirismo
colaborativo presente de modo efetivo, foi possvel perceber passo-a-passo a remisso dos
sintomas inicialmente apresentados pelo paciente. Houve uma diminuio considervel dos
nveis de ansiedade apresentados. Desaparecimento da gagueira, melhoras no seu
desenvolvimento interpessoal e de suas habilidades sociais. Houve ainda uma resignificao a
cerca das memrias instaladas e postas como rgidas e dolorosas. Gradativamente foram feitas
associaes com as quais foram possveis promover uma reduo do impacto causado pelas
lembranas de sofrimento, permitindo assim uma modificao clara da forma como o paciente
reage e como o mesmo hoje percebe seus agressores e envolvidos nas situaes. Foi evidente
e manifesto por parte do paciente a melhora na viso de si e satisfao pessoal. O mesmo
valida o processo e reconhece seus progressos.
What Predicts Response to Group Therapy for Social Anxiety Disorder among College
Students?
Andri Bjornsson, Fanney Thorsdottir, Dadey Albertsdottir, Helgi Hafsteinsson.
Psychology, University of Iceland, Reykjavik, Iceland.
Abstract Central: It is important to assess predictors of treatment response in order to aid
future treatment development and identify those individuals who are less likely to benefit from
treatment. This study used data from a randomized controlled trial which compared cognitivebehavioral group therapy (CBGT) and group psychotherapy (GPT) for social anxiety disorder
(SAD) among 45 college students that had SAD as their primary diagnosis. In this study, the
following predictors of treatment response were tested with multivariate regression analyses;
avoidant personality disorder symptoms (AVPDS), symptom severity, and, finally, a diagnosis of
current major depressive disorder or dysthymia at baseline (depression). The results indicated
that avoidant personality disorder symptoms did not predict treatment response in either
treatment. Greater symptom severity predicted better outcome in both treatment interventions.
Individuals diagnosed with depression at baseline did worse in CBGT than other participants.
This was not the case for GPT. Discussion of these findings include suggestions for further
treatment development, in particular how the two treatments can be integrated in order to
reduce attrition rates and to make CBGT more efficacious for individuals who suffer from
depression in addition to SAD.
The Blocking Procedure as a Laboratory Model for Studying Fear Generalization
Yannick Boddez1, Frank Baeyens1, Dirk Hermans1, Tom Beckers1, 2.
1. KU Leuven, Leuven, Belgium, 2. University of Amsterdam, Amsterdam, Netherlands.
Abstract Central: Non-selectivity of fear is a core aspect of what makes anxiety disorders so
impairing: Fear does not remain tied to a single stimulus paired with danger, but generalizes to
a broad set of stimuli, resulting in a snowballing of threat signals. The blocking procedure can

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provide a valuable laboratory model for gaining insight into the learning component of this
generalization process. In this procedure, a conditioned stimulus (CS X) is paired with an
unconditioned stimulus (US), such as electric shock, in a first stage. During the subsequent
stage, CS X is presented in compound with a second CS, commonly referred to as the blocked
stimulus (CS Y), and the XY compound is followed by the same US. Early fear conditioning
studies in non-human animals have demonstrated that fear responding to the blocked stimulus
is typically low when this stimulus is tested on its own after stage two training, despite its being
paired with the US. We use the blocking procedure as a laboratory model for studying (deficits
in) selective threat appraisal. We present two human fear conditioning studies in healthy
participants that make use of the blocking procedure and aim to provide insight in the
pathogenesis of overgeneralized defensive behavior. The results of these studies suggest that
learning processes and individual differences therein are indeed critically involved in the
development of overgeneralized fear responding: High trait anxious participants reported higher
US expectancies to a blocked CS Y than low trait anxious individuals (as measured with the
State-Trait Anxiety Inventory, STAI; Spielberger et al., 1970). On a more positive note, the
findings of a third study indicate that retrospectively installing selectivity may be a promising
route to remediate overgeneralized fear responding. Participants received presentations of two
neutral stimuli preceding an aversive shock, followed by written instructions identifying one of
both stimuli as an actual cause of shock. Results demonstrate that identifying one stimulus as
cause of shock successfully reduced fear responding to the other stimulus that preceded the
aversive shock event, relative to an appropriate control. In summary, we hope to contribute to a
fuller understanding of the pathogenesis and the treatment of overgeneralized fear responding.
The Associations between Emotion Regulation Difficulties and Anxiety during Pregnancy
Amanda Bordfeld, Randy Fingerhut, Kendra Ellway, Jennifer Bush.
La Salle University, Philadelphia, PA, USA.
It has been estimated that between eight and 25 percent of women experience anxiety during or
after pregnancy (Wenzel, 2011; Reid, Power, & Chesire, 2009). Prenatal anxiety is a condition
that is believed to defy cultural boundaries, affecting a variety of women from diverse
backgrounds and socioeconomic statuses (Buist, Ross, & Meiner, 2006). Prenatal anxiety has
been linked to problems during pregnancy, labor, delivery, and postpartum adjustment (Wenzel,
2011). In addition, research has found that anxiety during pregnancy can be an independent
predictor of postpartum depression after controlling for prenatal depression and other risk
factors (Sutter-Dallay, Giaconne-Marcesche, Glatigny-Dallay, & Verdoux, 2004). Anxiety
disorders, according to Barlow (1991), are fundamentally emotional regulation disorders.
Anxious individuals experience a heightened intensity of emotional reactions that occur quickly
and easily, have a poor understanding of their emotions and view them as undifferentiated
overwhelming states, and lack effective skills in managing their emotions (Farach & Menin,
2007). Enhancing our understanding of emotion regulation during pregnancy can help treatment
providers identify women at risk for developing prenatal anxiety and inform psychological
interventions during the prenatal and postpartum periods. The purpose of this study was to
better understand the associations between emotion regulation and state and trait anxiety. It
was hypothesized that higher levels of trait anxiety and greater difficulties in emotion regulation
would predict higher levels of state anxiety. One hundred and seven women in their second and
third trimesters were recruited from an obstetrics/gynecology office within a northeastern United
States hospital to participate in an IRB approved study. Participants completed a demographics
questionnaire, The Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), The
Postpartum Depression Predictors Inventory-Revised (PDPI-R; Beck, 2002), and The StateTrait Anxiety Inventory (STAI; Spielberger, Gorusch, Lushene, Vagg, & Jacobs, 1983). Results

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revealed significant correlations between trait anxiety and state anxiety, r(101) = .85, p < .01, as
well as between emotion regulation difficulties and state anxiety, r(103) = .63, p < .01. A post
hoc regression found that of the six subscales of the DERS, Strategies, which measures ones
access to regulation strategies one perceives as effective, was the only significant predictor
subscale of state anxiety, b = .36, t (98) = 3.08, p < .01. Results suggest that trait anxiety and
emotion regulation skill deficits may represent vulnerabilities to experiencing anxiety during
pregnancy. This offers specific psychosocial targets for screening, prevention, and treatment of
women with prenatal and postpartum anxiety.
Age Differences in Anxiety-Linked Attentional Biases
Melissa Burgess, Daniel Rudaizky, Cindy Cabeleira, Romola Bucks, Colin MacLeod.
School of Psychology, University of Western Australia, Crawley, WA, Australia.
Abstract Central: In younger adults, heightened anxiety vulnerability is characterised by a
selective processing advantage for emotionally negative stimuli, such that that anxious young
adults show preferential allocation of attention to threat stimuli compared to neutral stimuli when
the two compete for processing priority (Bar-Haim, Lamy, Pergamin, Bakermans-Kranenburg, &
van Ijzendoorn, 2007). Previous research in this area has focused largely in young adult
samples, with relatively few studies exploring anxiety-linked attentional biases in older adults.
The current study examines anxiety-linked attentional biases in both younger and older adults in
order to explore attentional biases in this neglected population. It is of particular interest to
explore how dimensions underlying anxiety vulnerability change over the adult lifespan, given
that on average older adults show a reduced incidence of anxiety disorders (Jorm, 2000).
Despite the fact that growing older is associated with increased risks, such as decline in
average levels of wealth, status, and physical health, people tend to report experiencing fewer
negative emotions as they age (Carstensen, Pasupathi, Mayr, & Nesselroade, 2000; Skarborn &
Nicki, 2000). Such age-related changes in anxiety suggest that the mechanisms associated with
anxiety dysfunction may change with advancing years. Some research suggests that older
adults do not demonstrate attentional bias for threat, and attend to negative stimuli less than
their younger counterparts (Mather & Carstensen, 2003; Knight et al., 2007); however
methodological limitations in these studies preclude any firm conclusions regarding age
differences in anxiety-linked attentional biases. The current study employed a dot-probe task
modified to allow independent assessment of the speed with which participants engaged with
and disengaged from negative images compared to neutral images. Younger and older adults
with both high and low trait anxiety were assessed to determine whether the attentional
characteristics of anxiety vary as a function of age. Results suggest that in younger adults,
those in the high trait anxiety group showed greater attentional preference for threat than those
in the low trait anxiety group. Interestingly, older adults did not demonstrate anxiety-linked
differences in attention to threat stimuli. This suggests that anxiety-linked attentional biases may
attenuate with age, which may contribute to age-related decline in anxiety vulnerability.
Exploring Age Differences in Engagement and Disengagement Biases
Melissa Burgess, Daniel Rudaizky, Cindy Cabeleira, Romola Bucks, Colin MacLeod.
School of Psychology, University of Western Australia, Crawley, WA, Australia.
In younger adults, heightened anxiety vulnerability is characterised by a selective processing
advantage for emotionally negative stimuli, such that that anxious young adults show
preferential allocation of attention to threat stimuli compared to neutral stimuli when the two
compete for processing priority (Bar-Haim, Lamy, Pergamin, Bakermans-Kranenburg, & van

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Ijzendoorn, 2007). Older adults display reduced anxiety vulnerability relative to their younger
counterparts (Jorm, 2000). Some research suggests that older adults do not demonstrate
attentional bias for threat, and attend to negative stimuli less than their younger counterparts
(Mather & Carstensen, 2003; Knight et al., 2007); however methodological limitations in these
studies preclude any firm conclusions regarding age differences in anxiety-linked attentional
biases. The current study employed a dot-probe task modified to allow independent assessment
of the speed with which participants engaged with and disengaged from negative images
compared to neutral images. Younger and older adults with both high and low trait anxiety were
assessed, to determine whether the attentional characteristics of anxiety vary as a function of
age. Preliminary results suggest that in younger adults, those in the high trait anxiety group
showed greater attentional preference for threat than those in the low trait anxiety group.
Interestingly, older adults did not demonstrate anxiety-linked differences in attention to threat
stimuli. This suggests that anxiety-linked attentional biases may attenuate with age, which may
contribute to age-related decline in anxiety vulnerability.
The Efficacy of Cognitive Behavior Therapy Applied to Generalized Anxiety Disorder in
Patients with Low Educational Status
Patricia Campos.
Pratica Privada, Belo Horizonte, Brazil.
This presentation summary aims to demonstrate the effectiveness of CBT applied to a clinical
case of a patient with low educational status, diagnosed with TAG associated with panic attacks
using the standard CBT. The patient is married, 39 years old, has studied only up to 6th grade
and works in a family business, has two children (18 and 2 years old), lives in Belo Horizonte,
MG - Brazil. The patient's initial scores were Beck Depression Inventory (BDI) = 14, Beck
Anxiety Inventory (BAI) = 23) and Beck Hopelessness Scale (BHS) = 04. As a chief complaint,
the patient reported constant anxiety, excessive worry and panic episodes. He also reported
difficulties in making decisions, in managing problems and standing up to his father and brother
at work. Another problem reported was the avoidance of visiting his son in prison, who was
arrested for involvement with drugs. The cognitive conceptualization of the case suggested
primary schemas of inadequacy and inability and a secondary schema of vulnerability. The
patient had beliefs that "the world is dangerous and I have no resources to face it", "As I am
incompetent, my father does not listen to my ideas in the company" and "I'm inferior to my
brother, so people do not respect me". The clinical intervention was initiated by
psychoeducation about the cognitive model for anxiety and panic attacks. Several techniques
were used at this stage, such as mood monitoring, relaxation training, identifying and
challenging automatic thoughts using thought record forms, identifying typical cognitive errors,
Paul Salkovisks`s (1996) anxiety equation, development of assertiveness, and problem solving
techniques. After mastering cognitive flexibility, the intermediate phase of the treatment was
initiated, during which dysfunctional beliefs were challenged, in an attempt to develop more
functional beliefs, thus facilitating cognitive restructuring. In the final phase, efforts were devoted
to generalization of therapeutic gains and relapse prevention. The Beck scales` scores
remained at zero in the last follow-up session, conducted one year after termination. The patient
reported absence of symptoms, his return to school, including an award for best student in his
classroom. He also reported his promotion within the company, the good relationship with his
father and brother at work, who were open to his influence on the management of their
business. He also reported that he now regularly visits his son in prison.

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Problemas clnicos desde una perspectiva transdiganstica Clinical problems from a


transdiagnostic perspective
Leonidas Castro Camacho1, Diana Melissa Quant Quintero1, Ruth Sarmiento2, Sandy Silva2,
Silvia Daz-Granados1, Diana Hurtado1, Lina Marcela Villegas1.
1. Universidad de los Andes, Bogota, Colombia, 2. Armada Nacional de Colombia, Bogota,
Colombia.
La investigacin actual en ciencia clnica indica que los procesos psicolgicos bsicos juegan
un papel vital en la explicacin de los problemas y trastornos psicolgicos. El abordaje
explicativo de los problemas que resultan ser relevantes a nivel clnico, dado su impacto en las
reas de ajuste de una persona, ha sufrido una serie de cambios que han permitido el
planteamiento de nuevas perspectivas para llevar a cabo procesos de formulacin y de
implementacin de estrategias de intervencin. Hasta hace unos aos, se privilegiaba un
sistema categrico que agrupa y describe la sintomatologa de los trastornos mentales y
emocionales, donde los criterios de evaluacin se encontraban orientados a identificar la
cantidad de sntomas que una persona cumpla, y se promova la realizacin un diagnstico
diferencial que permitiera descartar o validar las hiptesis preliminares. Sin embargo, el auge
de diversos protocolos de intervencin para problemticas especficas se convirti en una
oportunidad para identificar que existen procesos psicolgicos que estn presentes en
diferentes problemticas, lo cual aporta a la psicologa clnica elementos importantes en
relacin con la explicacin de las problemticas de tipo psicolgico, y evidencia la necesidad de
proponer estrategias de evaluacin orientadas a identificar los procesos psicolgicos bsicos
asociados a un problema, y de disear estrategias de intervencin transdiagnsticas. Este
simposio tiene como objetivo discutir la implicacin de los procesos psicolgicos bsicos en la
evaluacin y tratamientos de problemticas de inters clnico y de la salud. El simposio est
compuesto por 5 estudios as: en primer lugar se presenta una revisin terico y emprica en
relacin con la implicacin de los procesos psicolgicos bsicos en problemticas emocionales
y del estado del nimo. De otro lado, se presentan los datos de dos protocolos de intervencin
que tienen como eje principal los procesos psicolgicos bsicos; se presenta un estudio que
busc identificar la diferencia entre personas que reportan tener exhibir altos niveles de
ansiedad ante las presentaciones orales, y las que no refieren dicho nivel de malestar, en
relacin con los procesos psicolgicos bsicos. Finalmente, se presenta una investigacin que
tuvo como objetivo validar 4 instrumentos de evaluacin clnica en poblacin militar colombiana.
Procesos psicolgicos transdiagnsticos en relacin con los problemas emocionales y
del estado del animo
El abordaje de las explicaciones que dan cuenta del mantenimiento de los problemas
psicolgicos ha sido un tpico de gran inters en la psicologa clnica, debido a que se
constituye el punto de base para disear e implementar estrategias de intervencin. Las causas
de los problemas, tradicionalmente se han propuesto teniendo como pilar diferentes enfoques;
cada uno de los cuales ha planteado diferentes hiptesis que dan cuenta de la forma como
interactan diferentes variables para evidenciar un problema de tipo psicolgico. No obstante,
los hallazgos en investigaciones sugieren que explicar un problema psicolgico privilegiando
una nica postura terica puede resultar insuficiente para identificar las variables crticas que
estn relacionadas con el mantenimiento de la problemtica clnica. Teniendo en cuenta lo
anterior, el objetivo de este estudio fue realizar una revisin terica y emprica en relacin con
los parmetros que se han tenido en cuenta para establecer las hiptesis de mantenimiento de
problemas clnicos y sublclnicos relacionados con el estado del nimo, la ansiedad, y las
dificultades en regulacin emocional. El estudio se llev a cabo en 3 fases: en la primera se
inici la bsqueda de artculos que abordaran casos clnicos, diseo e implementacin de
protocolos de intervencin clnica, y aspectos explicativos de los problemas emocionales. La

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segunda fase consisti en diligenciar unas fichas de anlisis de los artculos, para
posteriormente organizar en una matriz los principales hallazgos encontrados. Finalmente, en
la tercera fase se realiz un anlisis de la matriz que permiti identificar vacos conceptuales y
metodolgicos que dan lugar al planteamiento de nuevas investigaciones. Los resultados del
estudio indican que existen procesos psicolgicos bsicos comunes a diferentes problemticas
clnicas, por lo cual identificar el aporte que realiza cada uno de los procesos al mantenimiento
de la problemtica, parece optimizar los recursos empleados en un proceso teraputico para
alcanzar los objetivos planteados. De igual forma, se evidencia la necesidad de realizar
investigaciones que se encuentren orientadas a identificar la forma como interactan los
procesos psicolgicos bsicos en el establecimiento y mantenimiento de problemas de
relevancia clnica.
Efectividad de un tratamiento de regulacin emocional en situaciones de evaluacin y
presentaciones orales
El objetivo de estudio fue evaluar los efectos de un programa de intervencin en regulacin
emocional en situaciones de examen y presentaciones orales sobre los sntomas de la
ansiedad ante la evaluacin negativa y sntomas de depresin. El proyecto se desarroll en 3
fases: en la primera fase se abri la convocatoria en las Universidades por medio de la Unidad
acadmico -administrativa designada, se realiz la sesin de evaluacin, en la cual se
explicaron a los participantes los objetivos del programa, las condiciones del estudio, se firm el
consentimiento informado y el contrato conductual; y se dieron las instrucciones para realizar la
evaluacin pre. Posteriormente, los participantes fueron asignados aleatoriamente al grupo de
tratamiento y al grupo de lista de espera; los participantes del grupo de lnea de espera
recibieron el tratamiento una vez se finaliz el estudio. En la segunda fase se realiz la
aplicacin del programa y en la tercera fase se realiz en anlisis de los datos. Los
participantes fueron estudiantes universitarios de la ciudad de Bogot, quienes fueron
distribuidos de manera aleatoria a las dos condiciones: grupo de tratamiento y lista de espera.
El programa const de 4 sesiones de intervencin as: primera sesin: psicoeducacin de la
respuesta emocional y motivacin para el cambio; segunda sesin: entrenamiento en
estrategias para el manejo de la ansiedad anticipatoria; tercera sesin: entrenamiento en
estrategias para el manejo de ansiedad en la situacin de evaluacin; y cuarta sesin: ejercicio
de exposicin. Los resultados indican que se encuentran diferencias significativas entre las
medidas pre y pos del grupo experimental en el miedo a la evaluacin negativa, sntomas
depresivos y sntomas generales de ansiedad. De otro lado, se encuentran diferencias
significativas entre el grupo de lista de espera y la condicin experimental en relacin con la
reduccin de los sntomas de ansiedad general.
Efectividad de un protocolo de entrenamiento en regulacin emocional PREM - ARC en
personal militar de la Armada Nacional de Colombia
Por la naturaleza de su actividad, el personal militar est sometido permanentemente a
condiciones que implican enfrentarse a constantes situaciones estresantes, que pueden
generar respuestas emocionales intensas que facilitan el desarrollo y mantenimiento de
patrones de evitacin emocional, agresivos e impulsivos. El propsito de este estudio fue
evaluar la efectividad del protocolo de entrenamiento en regulacin emocional (PREM-ARC)
que tiene como objetivo desarrollar en los participantes habilidades para regular de manera
efectiva y funcional las emociones. El proyecto se desarroll en 3 fases: en la primera fase se
tomaron las medidas pre, posteriormente la Armada Nacional realiz la aplicacin del programa
que const de 8 sesiones as: 1) Introduccin y motivacin: La naturaleza de las emociones y
sus componentes y por qu es importante participar en este programa, 2) Cmo funcionan las
emociones en contexto?, 3) Cmo funcionan las emociones en nuestro cerebro y como se
puede perder el control? 4) regulacin de activacin fisiolgica: Respiracin diafragmtica y

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Relajacin muscular progresiva, 5) Revaloracin y flexibilizacin de pensamiento, 6) Atencin


Plena en el momento presente (Mindfulness), 7) Aceptacin y tolerancia emocional, y 8)
Entrenamiento en accin opuesta: Comunicacin y solucin de problemas. En la segunda fase
se aplicaron las medidas pos, y en la tercera fase se realiz el anlisis estadstico de los datos.
Los participantes fueron hombres militares en formacin en las escuelas de la Armada Nacional
de Colombia. Como medidas se utilizaron; el PANAS, el ERSQ, el ERQ, EMO-CHECK, y una
prueba de conocimientos. Los resultados encontrados indican que existen diferencias
significativas entre las pruebas pre y pos en las medidas evaluaban: conocimiento ciclo de la
respuesta emocional, el afecto positivo, y las habilidades en revaloracin y en regulacin
emocional.
Procesos psicolgicos bsicos asociados a la ansiedad ante los exmenes y las
presentaciones orales
El objetivo de estudio identificar la diferencia en relacin con los procesos psicolgicos y
sntomas de ansiedad entre personas que reportaban altos niveles de ansiedad ante los
exmenes y presentaciones orales, y personas que no reportaban ansiedad ante los exmenes
y presentaciones orales. El proyecto se desarroll en 3 fases: en la primera fase se abri la
convocatoria en las Universidades se realiz una explicacin a los participantes sobre los
objetivos del estudio, se firm el consentimiento informado y se aplic un cuestionario en
relacin con el reporte de altos niveles de ansiedad ante los exmenes y presentaciones
orales. En la segunda fase se realiz la aplicacin de los instrumentos y en la tercera fase se
realiz en anlisis de los datos. Los participantes fueron estudiantes universitarios de la ciudad
de Bogot, quienes decidieron participar de forma voluntaria en el estudio. Los resultados
indican que existen diferencias significativas entre el grupo de estudiantes que reportaba altos
niveles de ansiedad ante los exmenes y presentaciones orales y los que no, en relacin con:
la actitud hacia el estudio, donde aquellas personas que no reportaban ansiedad evidenciaron
una mayor disposicin a la realizacin de actividades acadmicas. De otro lado se encuentran
diferencias significativas en: sntomas generales de ansiedad, sntomas depresivos,
autoesquemas desadaptativos de fobia social, malestar a la interaccin con personas
desconocidas y personas del sexo opuesto, malestar a situaciones donde se puedan poner en
ridculo, expresin asertiva de pensamientos y emociones, percepcin ante la evaluacin
negativa, ansiedad social, y ansiedad ante presentaciones en pblico. Los datos sugieren que
existen diferencias significativas en las respuestas fisiolgicas ante situaciones de evaluacin,
valoraciones y reglas en relacin con el desempeo y la evaluacin negativa, y conductas de
interaccin social.
Propiedades psicomtricas y validacin de los instrumentos PANAS, el ERSQ, el ERQ-10
y EMO-CHECK en poblacin miliar colombiana
El objetivo del estudio fue realizar la validacin de: PANAS, el REM SABER, el ERQ y EMOCHECK en poblacin militar colombiana. El PANAS (Watson y Tellegen) consta de 2 escalas:
afecto positivo y afecto negativo. Estas dos dimensiones han sido caracterizadas como
continuos donde el puntaje alto evidencia un estado de alto afecto, siendo un puntaje bajo la
expresin de un bajo afecto, respecto a una emocin positiva o negativa. El afecto positivo (AP)
refleja el punto hasta el cual una persona se siente entusiasta, activa, alerta, con energa y
participacin gratificante. As, un puntaje alto indica estados de alta energa, entusiasmo, pero
un puntaje bajo indica desgano, falta de entusiasmo y baja energa. El afecto negativo (AN)
representa una dimensin general de malestar subjetivo y participacin desagradable que
incluye una variedad de estados emocionales aversivos como disgusto, ira, culpa, miedo y
nerviosismo. Un puntaje alto en afecto negativo indica un estado de ira, agresividad, molestia,
mientras que un puntaje bajo indica tranquilidad, calma y ausencia de molestia. El EMOCHECK (Berking y Matthias), la primera parte de la prueba EMO es un inventario emocional

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que evala 50 estados emocionales bsicos, agrupados en 9 escalas. La segunda parte de la


prueba EMO, incluye 27 afirmaciones, en donde se evalan 9 habilidades bsicas en el manejo
de las emociones. El ERQ-10 (Gross y John) consta de dos escalas: reevaluacin cognitiva y
supresin expresiva. La primera evala las estrategias anticipatorias que consiguen cambiar la
experiencia emocional. La supresin expresiva esta orientada a evaluar el nivel de modificacin
de la expresin emocional. El REM SABER evala del manejo de situaciones de regulacin
emocional. Los participantes fueron hombres militares en formacin en las escuelas de la
Armada Nacional de Colombia. El anlisis de datos arroj una medida de confiabilidad por
medio del Alpha de Cronbach as: PANAS= 0,73; REM SABER = 0,82; ERQ-10 = 0,71; EMO
Parte 1= 0,78 y EMO parte 2 = 0,93. Lo anterior indica que todos los instrumentos cuentan con
un adecuado ndice de confiabilidad lo que cual excluye la necesidad de eliminar tems. Para la
validez de contenido de la pruena REM SABER se realiz un juicio de expertos con tres
psiclogos, dos pertenecientes a la Armada Nacional, especializadas en Psicologa Clnica y
con entrenamiento de postgrado en Regulacin emocional y una Psicloga con especialidad en
Psicometra. Para demostrar la validez del PANAS, EMO CHECK, ERQ-10 se realiz un
anlisis factorial con rotacin varimax y extraccin de factores mediante componentes
principales. La varianza total explicada para cada uno de los instrumentos fue: 53%, 51,7% y
55% respectivamente.
Emotional Responses and Biased Estimates of Aversion in Intolerance of Uncertainty:
Implications for Generalized Anxiety Disorder
Jessamine Chen1, 3, Peter Lovibond1, Kim Felmingham2.
1. University of NSW, Sydney, NSW, Australia, 2. University of Tasmania, Hobart, TAS,
Australia, 3. Westmead Hospital Anxiety Treatment & Research Unit, Sydney, NSW, Australia.
Abstract Central: Intolerance of Uncertainty (IU) has recently garnered significant research
interest as a vulnerability factor for the etiology of pathological worry in Generalized Anxiety
Disorder. The hypothesis that IU is implicated in the process of worry by exacerbating cognitive
bias (Dugas et al., 2005) has not been empirically examined extensively, as existing IU studies
have typically relied on correlational designs. The present study examined the impact of
uncertainty on biased expectancies of aversion. 80 non-clinical participants with high (n= 40)
and low (n=40) levels of IU viewed four different cues: one preceded aversive pictures 100% of
the time, one preceded aversive pictures 0% of the time, one preceded aversive and neutral
pictures at an equal ratio (participants were informed of the equal ratio). One cue (uncertain
cue), which is not explained at all in the instructions, also preceded aversive and neutral
pictures at a 50/50 ratio. Online self-report data revealed negatively biased expectancies of
aversion after uncertain cues. The degree of this online expectancy bias predicted estimates of
the relationship between uncertain cues and aversive pictures. The uncertain cues that
preceded aversive pictures (relative to the certain cues that preceded aversive pictures) were
accompanied by increased skin conductance responses. These findings that uncertainty is
accompanied by biased expectancies of aversion and heightened responses to aversion
provide preliminary understanding of the mechanisms that mediate the impact of IU on
pathological worry.
Intolerance of Uncertainty: Investigation of Underlying Mechanisms
Jessamine Chen1, 3, Kim Felmingham2, Peter Lovibond1.
1. University of New South Wales, Sydney, NSW, Australia, 2. University of Tasmania, Hobart,
TAS, Australia, 3. Westmead Hospital Anxiety Treatment and Research Unit, Sydney, NSW,
Australia.

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Abstract Central: Intolerance of Uncertainty (IU) has recently gained significant research
interest as a vulnerability factor for the etiology of worry in Generalized Anxiety Disorder and as
a potential mediator of transdiagnostic processes in other anxiety disorders. Despite
considerable clinical interest in IU, the specific underlying mechanisms of IU remain unclear.
The present study examined the underlying mechanisms of IU. Participants with high (n= 30)
and low (n=30) levels of IU appraised ambiguous, negative, and positive situations in a vignette
task (Koerner & Dugas, 2008). Participants received either ambiguous or unambiguous
performance feedback as part of the IU manipulation. Results showed that on the postmanipulation appraisal task, high IU individuals reported a higher level of concern in response to
ambiguous scenarios relative to low IU individuals. This finding was associated with a lower
level of task-related confidence, and a higher level of arousal on salivary measures (salivary
cortisol). In line with the IU model (Dugas et al., 1998), these results support the hypothesis that
biased appraisal of ambiguous situations plays an important role in mediating IU among
individuals with high levels of IU and this appears to be accompanied by poorer self-efficacy,
and higher arousal levels.
Intensive Cognitive-Behavioral Therapy for Anxiety Disorders
Maria Comis1, 2, Roseli Oliveira1, Wilze Bruscato1.
1. Irmandade Santa Casa de Misericrdia de So Paulo, So Paulo, Brazil, 2. Centro
Universitrio Padre Anchieta, Jundia, Brazil.
Abstract Central: A alta prevalncia de transtornos ansiosos na populao geral e o aumento
do nmero de encaminhamentos para atendimento psicolgico para portadores destes
transtornos demonstra a necessidade de intervenes que atendam a grande demanda de
pacientes. Sendo a Terapia Cognitivo-Comportamental (TCC) uma das abordagens mais
citadas na literatura para o tratamento da ansiedade patolgica, compreende-se que o
atendimento sob a tica dessa abordagem o mais adequado para o contexto de Instituies
de Sade Mental. A TCC uma abordagem na qual a modalidade em grupo
comprovadamente eficaz na reduo dos sintomas ansiosos e capaz de proporcionar melhora
na qualidade de vida. Objetivo: Averiguar os benefcios de uma interveno psicolgica
intensiva em grupo, baseada na abordagem Cognitivo-Comportamental, em adultos ansiosos.
Mtodo: Estudo descritivo, de acompanhamento longitudinal por oito semanas, em que foram
selecionados sete adultos de ambos os sexos, com hiptese diagnstica de Transtornos de
Ansiedade, sendo eles: Transtorno Obsessivo Compulsivo, Transtorno de Pnico e Transtorno
de Ansiedade Generalizada, com comorbidade de quadro depressivo. As sesses ocorreram
de forma intensiva, duas vezes por semana, com durao de uma hora e meia. Entre os
procedimentos utilizados estavam a psicoeducao, reestruturao cognitiva, adequao dos
comportamentos disfuncionais, hierarquizao de problemas, tcnicas de relaxamento,
exposio interoceptiva e role play. Utilizou-se o Inventrio Beck de Depresso (BDI) e o
Inventrio Beck de Ansiedade (BAI) antes e aps a interveno. Resultados: Houve importante
reduo nos sintomas de ansiedade e depresso. A partir do discurso dos participantes e da
observao clnica, percebeu-se melhora no repertrio comportamental do grupo, no humor e
na capacidade para a resoluo de problemas. Concluso: O tratamento intensivo em grupo
favoreceu uma melhora dos sintomas e proporcionou aumento da qualidade de vida dos
participantes em menor tempo, entretanto, sugere-se estudos controlados e com amostras
mais representativas para melhor generalizao dos resultados.
Estrs Acadmico. Aplicacin de la Tcnica de Relajacin Neuromuscular en
Estudiantes Universitarios con Sntomas de Estrs

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Maria Correche, Gomez Maria Alejandra.


Universidad Nacional de San Luis, San Luis, Argentina.
Lazarus y Folkman (1986) definen el estrs como el resultado de una relacin particular entre el
individuo y el entorno que es evaluado por este como desbordante de sus recursos, poniendo
en peligro su bienestar. En el estudiante universitario una de las situaciones de mayores
niveles de estrs son los exmenes. Este trabajo estuvo orientado a facilitar la adquisicin de
habilidades de afrontamiento, para poder contribuir a la reduccin de niveles de estrs,
alentando a un sentimiento de bienestar en los universitarios. El programa se llev a cabo en
las instalaciones de la Universidad Nacional de San Luis-Argentina. El grupo estuvo
conformado por 12 estudiantes voluntarias con dificultades para enfrentar las situaciones de
exmenes. Se hipotetiz que estas habilidades aprendidas podran ser transferidas a
situaciones de la vida real para controlar la ansiedad y reducir el estrs. Se aplic la tcnica de
relajacin neuromuscular de Jacobson que es es un efectivo mtodo de dominio de la ansiedad
y el estrs. El tono muscular se encuentra directamente bajo control cerebral, existiendo una
interdependencia entre el grado de tensin muscular y el de tensin psicolgica. Metodologa:
Muestra: estuvo conformada por 12 estudiantes de la carrera de psicologa (rango de edad: 1921 aos, M:21,50 y DE:1,93). Los instrumentos utilizados fueron: 1) Entrevista estructurada adhoc, 2)Chequeo de Sntomas Psicosomticos, 3) Cuestionario de Ansiedad,4) Inventario de
Depresin de Beck. Se aplicaron a las 12 participantes y se suministr informacin general con
respecto al Taller Anti-Estrs. Anlisis y discusin de los resultados: Se realizaron las
comparaciones pre y post tratamiento. En trminos generales, los resultados fueron los
siguientes: con respecto a la variable alteraciones psicosomticas, se logr disminuir
notablemente los sntomas que presentaban elevados puntajes en la fase Pre-tratamiento
(insomnio, msculos tensos, dolor de cabeza, palpitaciones cardacas y dolor de ojos). Con
respecto a la variable rendimiento (evaluada por medio de una escala analgica) se observ
diferencias significativas, indicando, mayor eficacia en las estudiantes al enfrentar la situacin
de examen. Se encontraron diferencias altamente significativas en los valores pre y post del
inventario de depresin, donde mejoraron su estado emocional, experimentando menos
sentimientos negativos. Es importante para este tipo de intervenciones, la motivacin y la
disposicin individual, tanto para el aprendizaje de la tcnica en las distintas sesiones
programadas, como para la prctica del estudiante a solas, en su casa. El presente trabajo
tiende a confirmar una mayor efectividad del procedimiento de Relajacin y la importancia del
entrenamiento en estrategias cognitivas conductuales que facilitan el afrontamiento a
situaciones estresantes, propiciando estados saludables.
Factores Tomados de la Terapia Cognitiva Conductual que Curan la Ansiedad Generaliza
Clara Cueva.
UN Pedro Ruiz Gallo, Lambayeque, Peru.
Abstract Central: Se realiz el presente trabajo de investigacin, con el objetivo de determinar
algunos factores que curan la ansiedad generalizada. La metodologa utilizada ha sido de
respiracin lenta y controlada, relajacin progresiva, pensamientos realistas, pensamientos
positivos,lectura de frases positivas, aceptacin de sus cualidades, cambio de pensamientos,
tarea de logros, aceptacin en blanco y negro por parte del terapeuta. Se curo a la paciente de
35 aos que tena ansiedad generalizada. Se concluye que la secuencia de tcnicas es
decisiva para relajar al paciente y que se sienta en armona con su ser. La aceptacin de quin
es en positivo y el corte mental con el ambiente negativo aun viviendo en l resultaron eficaces.

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Volviendo a casa: Recuperando la Mente Emocional a Travs del Cuerpo Terapia de


Activacin Emocional (TEA)
Mirta Dall Occhio1, Gernot Hauke2.
1. Centro Hemera, Buenos Aires, Argentina, 2. Centre for Integrative Psychotherapy, Munich,
Germany.
Abstract Central: Presentaremos un proceso bien estructurado, en siete pasos, que permite
un trabajo intenso con las emociones. El proceso de activacin y regulacin emocional es
sostenido por el cuerpo. Numerosos estudios en el rea de la cognicin asociada al cuerpo han
demostrado que los movimientos de ciertas partes del cuerpo, la actitud corporal completa, los
gestos, la mmica, estn asociados a las evaluaciones, motivaciones y procesos emocionales
de las personas (Price et al., 2012 for a review). Instruyendo a las personas a realizar una
modificacin especfica en la postura corporal, la mmica y los patrones efectores respiratorios,
podemos conducirlos a experimentar diferentes emociones (Bloch, 1993). Nosotros usamos
estos hallazgos para crear un nuevo mtodo de psicoterapia que posibilita trabajar de manera
ms profunda con las emociones. (1) Usando los conceptos de emociones primaria y
secundaria, podemos tomar en cuenta los problemas de regulacin emocional. (2)
Encontramos que la mayora de las situaciones problemticas estn asociadas a una familia
de emociones, no a una sola emocin. Comenzamos a trabajar con los pacientes
construyendo con ellos un mapa emocional. Partimos desde la emocin nuclear hasta la
categorizacin verbal. Sabemos que las imgenes nos permiten traducir las emociones en
palabras (Bucci 2002, Shultneiss 2011) (3) Identificamos los problemas de desregulacin
emocional y, mediante la aplicacin de estrategias especficas, facilitamos a travs del cuerpo
el restablecimiento de la habilidad regulatoria. (4) Mediante el entrenamiento emocional
guiamos al paciente al logro de sus metas. En este momento estamos llevando a cabo una
investigacin con este mtodo en 20 pacientes con diagnstico de Trastornos de Ansiedad.
Presentaremos los resultados empiricos de ese trabajo y discutiremos los hallazgos y cambios.
Need for Cognition and Experience of Anxiety Symptoms
Natasha DePesa.
Psychology, University of Central Florida, Orlando, FL, USA.
Greater need for cognition, an individuals tendency to enjoy and engage in effortful thinking,
has been found to predict life satisfaction amongst college students (Coutinho & Woolery,
2004). Anxiety is linked to poor academic performance as well as a litany of negative mental
and physical health outcomes and is commonly seen in college students (Bardone, et al., 1998;
Cassady, 2004; Woodward & Ferguson, 2001). Need for cognition is not related to overall
symptoms of anxiety (Cacioppo, Petty, Feinstein, & Jarvis, 1996). The relation between need for
cognition and cognitive anxiety, however, has not been examined The current study surveyed
101 university students (69.3% female; mean age of 21.1) in order to examine the effects of
need for cognition, as measured by the Need for Cognition scale (NFC; Cacioppo & Petty,
1982), on an individuals experience of anxiety, as measured by the Beck Anxiety Inventory
(BAI; Osman, Kopper, Barrios, Osman, & Wade, 1997). Anxiety symptoms were examined in
terms of somatic (e.g., racing heart) versus cognitive (e.g., worry) symptoms using the BAI
factors derived by Osman and colleagues. Hierarchical regression analyses were ran to
examine the effects of NFC scale score on BAI cognitive symptoms after removing the variance
contributed by BAI somatic symptoms. As expected, need for cognition did not predict overall
anxiety symptoms, but did significantly predict cognitive anxiety symptoms after controlling for
somatic anxiety symptoms, t (1, 91) = 2.33, p = .02, partial eta2 = .035. The entire model
accounted for 41.7% of the variance in BAI-Cog scores with NFC scores uniquely predicting

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3.5% of the variance. Since anxiety is such a broad construct with considerable heterogeneity in
clinical presentation, it is important to identify individual differences that determine how anxiety
is experienced in order to intervene effectively. Need for cognition could potentially serve as a
buffer against anxiety (Cacioppo et al.); however, anxious individuals with high need for
cognition may be more likely to have cognitively-based symptoms (e.g., worry) in relation to
somatically-based symptoms (e.g., racing heart). Given that those with greater need for
cognition have the tendency to engage more in effortful thinking, it could be the case that
anxious stimuli are thought on more and more intensely, which could lead to a ruminative cycle,
exacerbating symptoms. Current interventions for anxiety typically contain both a cognitive and
a behavioral component. Interventions broadly address anxiety, but knowing which factors
moderate treatment outcomes can lead to the delivery of more effective treatment. For example,
those with greater cognitive versus somatic anxiety might benefit from a more cognitivelyfocused therapy. More research needs to be done to highlight individual differences in cognitive
versus somatic manifestation of anxiety and response to treatment. This study sheds some light
on individual variations in symptom experience amongst university students. Since anxiety is so
prevalent amongst college students and can lead to academic failure, these results might also
have implications for the development of broad, cognitive-based preventative intervention
efforts.
Psychological Problems, Cognitive Ability and Academic Performance in College
Students
Frances Deavers.
University of Central Florida, Oviedo, FL, USA.
In recent years, there has been a steady increase in the reported number of college students
with serious psychological problems (Kitzrow, 2009). In addition to the impact that mental health
problems can have on students emotional, interpersonal, and physical wellbeing, common
psychological problems such as depression and anxiety may also affect individuals cognitive
abilities and academic performance. In a study examining mental health and college grades,
Svanum and Zody (2001) found overall psychological problems to be weakly associated with
semester grades. While anxiety was associated with higher grades, depression was not
significantly related to semester grades. The authors suggested that understanding the complex
association between psychological problems and academic performance would require
considering the role of other factors in the relationship. Specific cognitive abilities are likely to
play a role in this relationship. Cognitive abilities such as working memory and abstract
reasoning have been linked to academic performance in specific subject areas, though
investigation into their relationships with overall academic performance has been limited (Kurtz,
1980; St Clair-Thompson & Gathercole, 2006). The impact of psychological problems on
working memory and abstract reasoning has also been considered. Depression has been
associated with deficits in working memory and anxiety is linked to impairment in abstract
reasoning (Landro, Stiles, & Sletvold, 2001; Leon & Revelle, 1985). Although many of the links
between psychological problems, cognitive abilities, and academic performance have been
examined in isolation, they have yet to be considered in concert. This study aims to clarify the
nature of the associations between depression, anxiety, working memory, abstract reasoning,
and academic performance and to explore the implications for intervention. Since depression
and anxiety may be heterogeneous in their manifestation, the underlying factors will be
examined to determine more specifically which symptoms account for any relationships with
measures of cognitive ability and academic performance. Preliminary analyses tested the
following hypotheses: 1) anxiety will be negatively related to abstract reasoning ability and 2)
depression will be positively related to working memory deficits. A primarily Caucasian (53%)

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sample of 220 undergraduate students (55 male) who had finished an average of 2.5 years of
college, completed the Beck Anxiety Inventory, Beck Depression Inventory, Behavior Rating
Inventory of Executive Functioning (working memory), and Shipley-Hartford (abstract reasoning)
through a secure, online survey system. Anxiety was significantly predictive of abstract
reasoning. Neurophysiological symptoms of anxiety were significantly negatively related to
abstract reasoning (R2 = .037) while autonomic symptoms were significantly positively related
(R2 = .021). Depression was significantly predictive of working memory deficits. Somatic
symptoms of depression were significantly positively related to working memory deficits (R2 =
.132) while cognitive-affective symptoms were not significantly related. The following
hypotheses will also be tested: 1) depression and anxiety will not be directly related to academic
performance; 2) deficits in working memory and abstract reasoning will be associated with
poorer academic performance; 5) depression will be related to academic performance through
working memory; and 6) anxiety will be related to academic performance through abstract
reasoning.
Reviso Sistemtica Sobre Tratamento Cognitivo/Cognitivo-Comportamental em Grupo
para Fobia Social
Mayla Diniz, Llio Loureno.
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
A Fobia Social (FS) ou Transtorno de Ansiedade Social (TAS) tem como caracterstica um
medo marcante de uma ou mais situaes sociais ou de desempenho. Os modelos
psicolgicos cognitivos da fobia social so baseados em diversas crenas distorcidas dos
fbicos sociais sobre si e sobre o mundo. O modelo etiolgico atual para a FS multifatorial e
incompleto; cada indivduo apresenta componentes genticos, desenvolvimento precoce e
experincias de vida diferentes, responsveis por determinar o surgimento da doena, quando
combinados. A Terapia Cognitiva /Terapia Cognitivo-Comportamental (TC/TCC) constitui o
tratamento mais eficaz para tal transtorno; pode ser realizada tanto individualmente quanto em
grupo, sendo que este, de acordo com a literatura, apesar de se mostrar ainda inferior ao
tratamento individual, tem apresentado melhor relao custo-efetividade. O presente estudo
tem como objetivo apresentar os resultados de uma anlise bibliomtrica e de contedo sobre
FS e TC/TCC em grupo de artigos publicados entre os anos de 2007 e 2012 em quatro bases
de dados instaladas na Plataforma Capes (Web of Science, PsycInfo, Pubmed e Redalyc). Tal
busca foi norteada pela associao das expresses "Cognitive Behavior Therapy"/"Cognitive
Therapy", group/group processes e social phobia. Foram encontrados 49 artigos,
correspondentes amostra deste estudo. Com relao a produo anual, 24,49% encontravase em 2008. Dentre todos os estudos, em 81,63% os diagnsticos foram de FS ou TAS; o
instrumento mais utilizado para tal diagnstico foi Structured Clinical Interview for DSM-IV axis
I disorders (SCID-I) em 34,69% dos estudos; 89,79% usaram um protocolo de TC/TCC em
grupo ou se basearam em um; o instrumento mais utilizado para avaliao dos tratamentos foi
a Escala de Ansiedade e Interao Social (SIAS), em 20 estudos (40,81%). Para a realizao
dos grupos certo nmero de sesses semanais foi utilizado, tendo prevalecido o de 12 sesses
semanais de 2 horas cada, em 6 estudos (12,24%). Foi possvel notar que o tratamento de
TC/TCC em grupo se mostra eficaz, mas o individual ainda apresenta resultados superiores;
por outro lado, o grupo apresenta melhor relao custo-efetividade. Alm disso, no foi possvel
notar a existncia de um padro no que diz respeito aos tratamentos analisados, ou seja,
apenas 26,53% dos estudos possua um protocolo em comum. Pode-se observar que tal
temtica apresenta extensa publicao, entretanto alguns dados se mostram incoerentes, o
que revela a importncia de serem realizados mais estudos.

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Comparison of Attention Training and Cognitive Therapy in the Treatment of Social


Phobia: A Preliminary Investigation
Juliet Donald2, Maree Abbott2, Evelyn Smith1.
1. University of New South Wales, LEICHHARDT, NSW, Australia, 2. University of Sydney,
Sydney, NSW, Australia.
Background: Prominent models of social phobia highlight the role played by attentional factors,
such as self-focused attention, in the development and maintenance of social phobia. Elevated
self-focused attention is associated with increases in self-rated anxiety. Treatments that aim to
modify and change attentional processes, specifically self-focused attention, will have a direct
effect on social phobia symptoms. Thus, Attention Training targets attentional focus. Aim: The
present study aimed to investigate the efficacy of Attention Training in comparison to an
established treatment for social phobia, Cognitive Therapy. Method: Participants (Intention-totreat = 45; completers = 30) were allocated to either 6 weeks of Attention Training or Cognitive
Therapy, and a three-month follow-up was conducted. It was hypothesized that both treatments
would be effective in reducing social phobia symptoms, but that Attention Training would work
primarily by reducing levels of self-focused attention. Results: The results found an overall
effectiveness of both treatment conditions in reducing social phobia symptoms, which was
maintained at 3 month follow up. However, Attention Training significantly improved scores on
the Self-Focused Attention questionnaire and the Brief Fear of Negative Evaluation
questionnaire compared to Cognitive Therapy. Conclusion: Attention Training seems to be a
promising treatment for social phobia.
Uma Proposta de Tratamento Individual da TCC para a Ansiedade Social
Ana Nunes, Beneria Donato.
Psicologia, Faculdade Estcio, Recife, Brazil.
Abstract Central: Uma proposta de tratamento individual da TCC para a Ansiedade Social A
abordagem cognitiva comportamental tem proposto e divulgado diversas tcnicas para o
tratamento da Fobia Social. Nosso objetivo descrever os procedimentos para tratamento da
Fobia Social, dando nfase ao treino de habilidades sociais na forma individual. A literatura
refora que, em alguns casos, a forma grupal mais eficaz, no entanto, sentimos a
necessidade de propor uma forma individual, pois, alm de tambm ser eficaz, algumas vezes
o psicoterapeuta no dispe de um grupo adequado (Donato, 2003). O Treinamento em
Habilidades Sociais (THS) tem sido utilizado para tratamento da fobia Social, por que em geral
os fbicos sociais apresentam dficits de habilidades sociais que mantm a fobia e dificultam a
exposio. Neste sentido ensinar um repertrio adequado de habilidades sociais pode facilitar a
reduo da ansiedade no confronto interpessoal e na exposio gradual. De acordo com
Caballo, (2003) o comportamento socialmente habilidoso um conjunto de comportamentos
emitidos por um indivduo, dentro de um contexto interpessoal, que expressa os sentimentos,
atitudes, desejos, opinies ou direitos desse indivduo, de um modo adequado situao,
respeitando esses comportamentos nos demais, e que geralmente resolve os problemas
imediatos da situao enquanto minimizam a probabilidade de futuros problemas. Algumas
intervenes utilizadas na proposta individual so o ensaio comportamental, jogo de papis e
vdeo feedback. O tratamento dividido em cinco momentos: primeiro realizado a avaliao,
construo da lista de dificuldades e uma educao; posteriormente o treinamento das
habilidades no consultrio apenas com o terapeuta; em terceiro lugar o treinamento das
habilidades no consultrio com o terapeuta e o co-terapeuta; em quarto lugar o treinamento das
habilidades e exposio gradual ao vivo com o co-terapeuta; finalmente a reavaliao dos
objetivos e das dificuldades atravs do IHS-Del-Prette, Escala Fobia Social e Escala SUDS da

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hierarquia de exposio. Os resultados alcanados com esta proposta de protocolo individual


nos fazem concluir, com humildade, que o treino de habilidades individual propicia repertrio
adequado exposio, permitindo ao paciente uma maior confiana para enfrentar as
situaes sociais. Entretanto, so necessrios mais estudos controlados e de seguimento que
possam demonstrar a eficcia da proposta individual de maneira mais cientfica.
The Dimensional Structure of Panic Attack Bodily Symptoms Among Panic Disorder
Patients and its Relation to Anxiety Sensitivity and Suffocation Fear
Isabelle Drenckhan1, Angelika Glckner-Rist3, Alexander Gerlach2, Fred Rist1.
1. Clinical Psychology and Psychotherapy, University of Mnster, Mnster, Germany, 2.
University of Cologne, Cologne, Germany, 3. GESIS Leibniz Institute for the Social Sciences,
Mannheim, Germany.
Theoretical background: DSM-IV criteria for panic attacks include the presence of 4 out of a set
of 13 bodily and cognitive symptoms. Studies examining the factor structure of the bodily
symptoms consistently reported a respiratory dimension (Kircanski, Craske, Epstein & Wittchen,
2009). A vestibular factor is often suggested as well. From a clinical and theoretical point of view
a cardiac factor could be expected, too, although rarely supported by previous studies. Body
symptom clusters and dimensions also seem to be linked to specific panic related catastrophic
cognitions (Andor, Glckner-Rist, Gerlach & Rist, 2008). Thus, it seems necessary to distinguish
these dimensions to properly examine the relation of panic disorder and its correlates and risk
factors, e.g. anxiety sensitivity and suffocation fear. Method: The present study examined the
factor structure of the 10 body symptoms according to DSM-IV experienced during a typical
panic attack among 350 PD patients with agoraphobia in an outpatient multi-center study
(Mechanism of action in CBT (MAC) study) by using nonlinear confirmatory factor analysis.
Structural equation modelling was used to analyse the relation of the body symptoms
(symptoms of a panic attack questionnaire; Gloster, 2009) to cognitive panic symptoms
(agoraphobic cognition questionnaire; Chambless, Caputo, Craig & Gallagher, 1984), the
suffocation fear scale (SFS) of the claustrophobia questionnaire (Radomsky, 2001) and the
anxiety sensitivity questionnaire (ASI; Reiss, Peterson, Gursky & McNally; 1987). Results: A
three factor model with a cardiac, a respiratory and a vestibular factor fit the data best. The
validity of this factor structure was supported by high factor loadings and good model fit and by
specific differential associations of these dimensions with catastrophic cognitions, anxiety
sensitivity dimensions and suffocation fear. Conclusion: Cognitive-behavioral models of panic
attacks, the influence of risk factors and the progression to panic disorder may be formulated
and tested more specifically, if these three panic attack symptom dimensions are taken into
account.
Can Attentional Response to Threat be Measured using Dot Probe Emotional Faces with
Adults who have an Intellectual Disability?
Stephen Edwards, Henry Jackson.
Psychology, Melbourne University, Moonee Ponds, VIC, Australia.
Abstract Central: Attentional bias for threatening stimuli has been found in groups of adults
with diagnoses and high levels of anxiety using the dot probe paradigm with emotional faces or
words as stimuli. This confirms an important aspect of information processing underlying the
cognitive theory of anxiety but the finding is less robust along the developmental continuum
amongst adolescents and children. Some child studies have found a bias toward happy faces
as well as angry ones. Bias toward threat can reduce as cognitive behavioural treatment

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reduces anxiety symptoms. Furthermore, recent studies have shown that reducing bias through
attentional training may also reduce symptoms. Surprisingly, there has been no investigation of
the relationship between ability and the attentional response to fear especially given the use of
faces eliminates verbal processing demands and facial emotions can be identified even at low
levels of intellectual ability. If motor co-ordination and sensory capacity is adequate then the
experimental task might be mastered. This study aimed to establish whether a laptop based dot
probe experiment using emotional faces was feasible with adults with intellectual disability and if
so what it would reveal about attentional response to threat in this understudied group. Adults
using support services were recruited and screened for emotional face recognition and scoring
ability after receptive language had been tested. They were then interviewed using the Beck
Anxiety Inventory (BAI) and given a practice procedure of the dot probe task whilst carefully
observed for mastery. Two blocks of eighty trials followed for the 51 who achieved mastery
using congruent, non-congruent and filler trials with happy, angry and neutral faces already
validated in the general population at 500ms exposures. Adequate correct trials were contained
in 43 cases for block one and 45 for block two. Response times were analysed to establish bias
toward or away from the emotional faces and the relationship between bias and ability
examined
The role of perfectionism in post-traumatic stress disorder and the efficacy of cognitive
behavioural treatment of perfectionism across disorders
Sarah Egan, Mary Hattaway, Robert Kane, Kimberley Hoiles, Sarah Egan, Robert Kane, Clare
Rees, Sarah Egan, Kimberley Hoiles, Abby Chee, Vivienne Willan.
School of Psychology and Speech Pathology, Curtin University, Perth, WA, Australia.
This symposium will present the results of three studies on perfectionism. The first study is the
only to date that has investigated the role of perfectionism in post-traumatic stress disorder
(PTSD) and found that rumination was a significant mediator of the relationship. The importance
of considering these transdiagnostic cognitive constructs in the cognitive behavioural treatment
of PTSD will be outlined. The second paper focuses on the results of a randomised controlled
trial evaluating the efficacy of cognitive-behavioural therapy for perfectionism delivered via
guided self-help. The results demonstrated that significant decreases in depression were
mediated by perfectionism, indicating that it is the changes in perfectionism due to treatment
that are leading to changes in depressive symptoms. This is important as to date little research
in cognitive behavioural treatment of perfectionism has focused on mechanisms of change and
if perfectionism is the variable responsible for reduction in psychopathology. The final paper
describes the results of another randomised controlled trial that compared online self-help with
individual face to face therapy for perfectionism. This study is the first RCT to date to evaluate
the efficacy of individual face to face cognitive behavioural treatment for perfectionism with an
adequate sample size. The promising results across studies are important for demonstrating the
efficacy of cognitive behavioural treatment for perfectionism as a transdiagnostic treatment
effective in reducing a wide range of psychopathologies. Furthermore, the results indicating that
self-help including that delivered online is also an effective form of treatment for perfectionism
are important when considering the wide scale dissemination of treatment for perfectionism
which holds appeal as a transdiagnostic treatment applicable across anxiety, depression and
eating disorders.
The role of the transdiagnostic processes of rumination and perfectionism in PostTraumatic Stress Disorder
Perfectionism has been proposed as a transdiagnostic process that is a predisposing and
maintaining factor across anxiety disorders, eating disorders and depression. There is extensive

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evidence demonstrating the link between perfectionism and anxiety disorders including panic
disorder, obsessive compulsive disorder and social anxiety disorder. There has been no
research to date however that has investigated perfectionism in Post Traumatic Stress Disorder
(PTSD). The aim of the study was to examine if there is a relationship between perfectionism
and PTSD. A further aim was to examine if another important transdiagnostic process, namely
rumination, was a mediator of the relationship between PTSD and perfectionism. The sample
consisted of 30 participants who were receiving psychological treatment for PTSD following
sexual trauma. There was evidence that perfectionism and PTSD symptoms were significantly
correlated. In addition, rumination was a significant mediator of the relationship between
perfectionism and PTSD. These findings increase understanding of the relationship between
perfectionism and rumination in PTSD. Treatment implications will be discussed.
Cognitive behavioural therapy for clinical perfectionism: A randomised controlled trial
using guided self-help
Perfectionism is a predisposing and maintaining factor for a variety of disorders such as
depression, anxiety disorders and eating disorders. Evidence suggests that perfectionism is a
transdiagnostic process as it is seen as a maintaining mechanism across a number of these
disorders and interferes with the course of treatment. The aim of the study was assess the
efficacy of a guided self-help Cognitive Behavioural Therapy for Clinical Perfectionism (CBTCP). A further aim was to assess if clinical perfectionism was a mediator of the reduction in
psychopathology. An 8 week guided self-help intervention for perfectionism group (n=20) was
compared with a waitlist control condition (n=20). Results indicated that guided self-help for
perfectionism was effective in reducing clinical perfectionism and depression. Furthermore, the
treatment reduced levels of clinical perfectionism which in turn reduced levels of depressive
symptomatology, indicating it was the mediating effect of change in perfectionism that was
responsible for reductions in depression. The implications of an effective self-help intervention
for perfectionism in terms of dissemination of a transdiagnostic treatment for a range of
disorders will be discussed.
A randomized controlled trial of face to face versus online self-help cognitive behavioural
treatment of perfectionism
Perfectionism has been proposed as a transdiagnostic process that is a risk and maintaining
factor of eating disorders, anxiety disorders and depression. There is some evidence to date
that Cognitive Behaviour Therapy (CBT) for perfectionism is effective however only two
relatively small randomised controlled trials (RCTs) have been conducted, one in a mixed
anxious and depressive sample and the other with individuals with Bulimia Nervosa. To date
there has been no RCT that has examined CBT for perfectionism applied as a transdiagnostic
treatment across diagnostic groups with an adequate sample size. The results of an RCT that
compared individual face to face therapy versus online self-help and a wait list control in
individuals with mixed anxiety, depression and eating disorders will be discussed. The impact
across a number of outcomes of psychopathology and perfectionism at post treatment and 6
month follow up will be outlined. Clinical implications for targeting perfectionism across
diagnoses will be discussed.
Producing Written Narratives: An Anxiety-Control Strategy
Maria Helena Favero.
Instituto de Psicologia, Universidade de Braslia, Braslia, Brazil.
Abstract Central: In this work, we take narrative as a tool of the mind in the process of
construing reality, to which emotions conceived as a relational phenomenon are integrated. We
advocate potential autonomy and creativity of consciousness by stressing non-dissociation

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between cognition and emotion. Therefore, the proposal of our work is compatible with the
research on the relationship between narrative and personality maturity, considering that the
latter associates itself with the characteristics of the narrative of the self. They reflect its
exploratory process, defined as the narrators active and engaged effort to reflect and analyze
his or her life experience and incorporating a sense of change into that narrators life story.
Maturity thus conceived is closely related to gaining conscious awareness in the process of reelaborating life conceptions and personal paradigms. We describe the use of written narrative
with V. - a 36-year-old Brazilian woman with a college education, professionally successful, with
an upper-middle-class background - as a tool in the psychotherapeutic process. Subjective
wellbeing, defined as life satisfaction and the presence of positive affect and absence of
negative affect, was associated in that process to a pattern of coherent positive resolution, that
is, the construction of a coherent and complex story about a difficult event that has a positive
ending and leads to a sense of emotional resolution or closure. V.s verbal narrative shows:
panic syndrome episodes as a result of a process built since childhood and which manifested
itself in situations she saw as demanding; the description of gendered socialization focused on
production of female personalities based on relationship and connection, and on concern with
others judgment, thus demanding perfection based on the explicit and implicit idea of having
necessarily to please to be loved; depression playing a secondary role in the process, based on
the vicious and malicious circle around the negative idea of incompetence that expanded to
other situations than those triggering panic. Psychotherapeutic targets aimed at re-elaborating
her personal paradigm through tasks directed at self-observation, observation of family
relations, and writing narratives that described and analyzed them. The discussion of those
analyses was resumed in sessions that brought up new themes to be written about, such as:
Being alive is a good experience; I can: Ill embrace my professional life; Ill travel and open
that window of possibilities for myself; Fear sensations are transitory; I must keep in mind the
personal headway Ive already made. The analysis of narratives showed the relevance of
taking them as a tool for reflection and dialogue to oneself, since it engenders conscious
awareness about the nature of ones inter-personal relations and ones own paradigm, thus
allowing its re-elaboration and liberation from the emotional domain of events. That, in turn,
allows the persons life story to be re-directed.
Mechanisms at work in anxiety treatment for youth
Krister Fjermestad1, Gro Janne Wergeland2, Bente Haugland3, Silje Ormhaug4, Wendy
Silverman5.
1. Frambu centre for rare disorders, Siggerud, Norway, 2. University of Bergen, Bergen,
Norway, 3. Centre for Child and Adolescent Mental Health, Bergen, Norway, 4. Norwegian
Centre for Violence and Traumatic Stress Studies, Oslo, Norway, 5. Florida International
University, Miami, FL, USA.
Anxiety disorders are among the most common disorders in youth. If left untreated, anxiety
disorders may have severe impact on academic and social functioning. Cognitive behavioral
treatment (CBT) has been proven both effective and efficacious for youth anxiety disorders, but
up to half of participants remain symptomatic at post-treatment. Several questions remain to
improve CBT practice for youth anxiety disorders. Questions include what factors predict
treatment effects, how to differentiate treatments based on different anxiety disorders, and what
mechanisms are at work in the development and maintenance of anxiety symptoms. The
current symposium addresses these questions through four presentations and a discussion.
The first three presentations are based on the child part of the Assessment and Treatment Anxiety in Children and Adults (ATACA) study, a large randomized controlled trial comparing
individual CBT (ICBT) and group CBT (GCBT) to waitlist for youth anxiety disorders (separation

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anxiety disorder (SAD), social phobia (SoP), and generalized anxiety disorder (GAD); N = 182,
M age = 11.5). The study took place in community clinics with regular clinicians in Norway. The
treatment program was the manualized FRIENDS for life program. The first presentation from
this trial concerns predictors of outcome and droput in this trial. Demographic variables did not
predict outcome or dropout, whereas perceived treatment credibility was a significant predictor
of both effect and dropout. Youths self concept and temperamental style was associated with
treatment effects. The second presentation from this trial concerns the role of children's
negative automatic thoughts in anxiety disorders. The main question asked in presentation 2 is
whether CBT has an effect on children's negative automatic thoughts, and how this effect
relates to effects on anxiety and depression symptoms. The third presentation from the ATACA
trial concerns the therapeutic alliance, or the emotional collaboration between client and
therapist. The alliance tends to explain some of the variation in treatment effects across youth
studies, but it is currently not clear whether this is the case in CBT for youth anxiety disorders.
Presentation 3 compares the role of the alliance for outcome in ICBT and GCBT. Both treatment
format, alliance rater, and time of measurement impacts on the alliance-outcome association.
The final presentation is from another randomized controlled trial comparing trauma-focused
CBT (TF-CBT) to treatment as usual (TAU) for post traumatic stress disorder (PTSD) in youth
(N = 79, M age = 15.0). The focus is on predictors of outcome. Like the study behind the first
three presentations, the final study also took place in community clinics with regular clinicians in
Norway. Both TF-CBT and TAU was effective treatments, with larger treatment effects in TFCBT. Predictors of outcome of both PTSD treatments will be discussed in presentation 4. The
four presentations will be followed by a discussion session led by Professor Wendy K.
Silverman. The focus will on the implications the current presentations have for improving CBT
in usual care for youth anxiety treatment.
Predictors of outcome in CBT for youth anxiety disorders
CBT has been found to be effective for anxious children, but approximately one-third of the
children who receive CBT continue to meet criteria for their primary anxiety disorder posttreatment. Up to 20% of the children find it difficult to adhere to treatment and drop out
prematurely. Few reliable predictors for non-response and drop out have been identified. The
present study examines reasons for non-response to treatment and predictors of dropout from a
10 week randomized controlled effectiveness trial of a group (GCBT) versus individual (ICBT)
cognitive behavior therapy program conducted in seven public mental health outpatient clinics.
Participants were children (N= 182, ages 8-15, M = 11.5, SD = 2.1) with a primary diagnosis of
separation anxiety disorder, social anxiety disorder or general anxiety disorder. We examined
pre-treatment child and adolescent characteristics as predictor of outcome. Client demographic
(age, gender) and clinical factors (type of diagnosis, pre-treatment severity, comorbidity) were
examined. There were non- significant association between demographic factors with treatment
outcomes. However, for the clinical factors there were significant associations between type of
diagnosis and response to treatment, with poorer treatment outcome for children with a primary
diagnosis of SOP. The dropout rate was 14.3%. Dropout rates were similar in ICBT and GCBT.
Overall, there were few differences between the completers and non-completers, both with
respect to demographic and clinical characteristics. However, baseline scores of child-rated
perceived treatment credibility (TC) and self concept, as well as parent-rated TC and youth
inhibited temperament significantly differed between completers and non- completers. Only
child-rated TC significantly predicted dropout with an OR = 0.845, 95% CI: 0.770, 0.927,
p<0.0005. The most frequently patient reported reason for dropout was low motivation for
therapy. Implication of these findings for future research and clinical practice will be discussed.
The role of childrens negative automatic thoughts in youth anxiety disorders

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Anxious youth have been found to have high level of threat-related self-statements or
cognitions. These are assumed to be important mediators in treatment for youth with anxiety
disorders. In this presentation we will examine whether anxious self-statements change during
CBT treatment, if changes in anxious cognitions are related to diagnostic status and/or symptom
level at the end of treatment, and finally if level of and change in anxious thinking predict
outcome in diagnostic status and symptoms of anxiety at one year follow-up (N= 182, M = 11.5,
SD = 2.1). Negative self-statements are measured by the childrens Automatic Thought Scale
(CATS; Schniering & Rapee, 2002), administered pre- and post-treatment. The results will be
discussed with regard to the childs gender, age, treatment format (group/individual) and pretreatment diagnosis (Separation Anxiety Disorder, Social Phobia, Generalized Anxiety
Disorder).
The alliance in individual and group CBT for youth anxiety disorders
The alliance, or the collaborative bond between clients and therapist, has been postulated to be
a stable predictor of treatment outcome across youth studies, generally explaining a small
amount of treatment effects. In CBT for youth anxiety disorders, the picture is not that clear, and
it seems that when the alliance is measured, whose perspective it is measured from, and what
treatment format (group vs individual) may affect the alliance-outcome association. The current
study examined alliance measured early and late in treatment from the perspectives of youth
clients and therapists in relation to youth and parent rated outcome at post-treatment and at
one-year follow up (N= 182, M = 11.5, SD = 2.1). The alliance was also examined in relation to
dropout. Multilevel analyses (Hierarchical Linerar Modelling) indicated that the alliance does
predict both outcome and dropout, but there was considerable variation based on alliance rater
perspective and treatment format.
Predictors of outcome in CBT for PTSD in youth
This presentation presents results from a a randomized controlled trial comparing TraumaFocused CBT (TF-CBT) to treatment as usual (TAU) for post traumatic stress disorder (PTSD)
in youth. Results show that participants who received TF-CBT had less PTSD symptoms posttreatment compared to participants randomized to the TAU condition. However, around 18% of
participants in the TF-CBT condition did still satisfy diagnostic criteria for PTSD after 15
sessions of treatment. This presentation will look at what characterize this group of nonresponders, and two possible predictors will be investigated (N = 79, M age = 15.0, SD = 2.2).
The first is the youths trauma history. It is often found that exposure to repeated interpersonal
trauma has more severe consequences compared to more single traumatic events, and it can
thus be hypothesized that the more severely traumatized youth may respond less to treatment,
or require more time to recover. The second predictor is the therapeutic alliance. This is a
therapy-internal factor that has been found to predict outcome in a wide range of treatment
types and age groups. As many traumatized youth may have a lack of trust in others, forming a
strong alliance is believed to be of particular importance in treatment of this group.
When a Signaling Cue Loses Its Signaling Properties: Recovery of Contextual Anxiety
Riet Fonteyne, Debora Vansteenwegen, Dirk Hermans.
University of Leuven, Leuven, Belgium.
Relapse of specific fears and phobias after successful treatment can be seen as the clinical
analogue of return of conditioned responses after Pavlovian extinction. Conditioned responses
often recover with the passage of time, after a change of context, or following an unsignaled
aversive event (Bouton, 2002). These findings concerning return of fear show that extinction
does not erase the previously acquired fear memory, but entails the learning of a new safety
memory, which temporally suppresses the fear memory. To date, however, return of more

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generalized and chronic forms of anxiety (such as observed in GAD and panic disorder) has not
yet been systematically investigated. Building on work of Grillon and Davis (1997), we
developed a within cue- and context-conditioning paradigm that enables us to investigate the
processes involved in acquisition and extinction of both fear and anxiety: Participants were
conditioned to a discrete cue by presenting cue-shock pairings in one context (cue-conditioning
as a model of fear), whereas in a second context shocks were presented unpredictable
(installing context-conditioning as a model of anxiety; see also Fonteyne et al., 2009, 2010).
After successful acquisition, contextual anxiety (measured by the fear-potentiated startle
response and online shock-expectancy ratings) was be significantly reduced by offering novel
predictors of threat in the previously unpredictable situation (i.e., signaling procedure; Fonteyne
et al., 2009). This signaling procedure dovetails with the clinical treatment of panic disorder,
where panic attacks are put under control of internal bodily cues that occur before the attack.
Next, we tested whether extinguished contextual anxiety re-emerges after an unexpected nonreinforced presentation of the novel predictor. Our data clearly suggest that when the signaling
cue loses its signaling properties, the sense of unpredictability recurs which leads to a recovery
of contextual anxiety.
A Qualitative Investigation of Reactions to Uncertainty in Individuals with Generalized
Anxiety Disorder
Katie Fracalanza, Naomi Koerner, Kelly McShane, Martin Antony.
Psychology, Ryerson University, Toronto, ON, Canada.
Abstract Central: Introduction: Intolerance of uncertainty (IU) is a dispositional characteristic
that results from a set of negative beliefs about uncertainty and its implications (Dugas &
Robichaud, 2007). IU is theorized to be a central cognitive process that underlies and maintains
generalized anxiety disorder (GAD; Dugas et al., 1998), and there is substantial support for this
theory (Dugas & Robichaud, 2007). To date, IU has been assessed in GAD research using
primarily a self-report measure called the Intolerance of Uncertainty Scale (IUS; Buhr & Dugas,
2002). Although the IUS assesses the extent to which uncertainty is appraised as a negative
experience, it does not assess the full range of potential reactions (e.g., behaviors, thoughts,
and emotions) to uncertainty. Further, the reasons for reactions to uncertainty have not been
studied in people with GAD. This ongoing qualitative study seeks to extend the current
understanding of how individuals with GAD and healthy controls react to uncertainty, and the
reasons for these reactions. Method: Adults whose symptoms meet criteria for GAD and adults
without an Axis I condition (assessed using the Mini International Neuropsychiatric Interview)
participate in a 2-hour interview about their reactions to uncertainty. The IUS served as a
starting point for the development of the interview questions and research on uncertainty in
other areas of psychology (e.g., behavioral decision-making) informed additional questions. A
content analysis of the interview transcripts will be conducted (i.e., participant responses to
questions will be coded into themes). The frequency with which individuals with GAD and
healthy controls describe each theme will be reported. Results: Data collection and analysis has
been ongoing since October 2012 and will be complete by May 2013. It is hypothesized that
individuals with GAD will report a greater range of negative reactions to uncertainty than will
healthy controls. It is expected that individuals with GAD will describe reactions to uncertainty
that have not yet been documented. In addition, it is hypothesized that individuals with GAD will
report uncertainty aversion because uncertainty elicits feelings of personal inadequacy and
pessimism; healthy controls are not expected to report uncertainty aversion for these reasons. It
is also expected that novel reasons for uncertainty aversion will be elucidated. Discussion: This
study will extend our understanding of the range of known reactions to uncertainty and reasons
for these reactions in individuals with GAD and healthy controls. To date, no study has

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addressed these study objectives using a qualitative method. The current study will provide
original data that have the potential to validate and extend the cognitive model of GAD proposed
by Dugas and colleagues. In addition, these data have the potential to inform treatment
strategies for the modification of problematic beliefs and behaviors that maintain GAD.
Transtorno do Pnico : Avaliao Clnico-Comportamental
Rosana Garcia.
1. UNIVERSIDADE PAULISTA - UNIP, So Jos do Rio Preto, Brazil, 2. Instituto de
Psicoterapia Cognitivo comportamental - IPC, So Jos do Rio Preto, Brazil.
Abstract Central: O presente estudo objetivou analisar as variveis funcionais na
determinao e manuteno do transtorno do pnico. Foi utilizado anlise funcional do
comportamento de quatro casos com diagnstico clnico de transtorno do pnico. Foram
realizadas entrevistas clnicas diagnsticas com cada sujeito. Os resultados apontaram para
algumas variveis comuns, como histrias familiares pouco reforadoras e altamente punitivas
e comportamentos de esquiva devido a contingncias aversivas. Foi possvel observar que este
transtorno no tem etiologia nica, havendo diferenas individuais significativas. Portanto a
avaliao e o tratamento adequados, passam pelo modelo interdisciplinar, onde o conjunto de
profissionais o responsvel pela interveno adequada ao sujeito. Tambm ficou explcito a
necessidade de se utilizar a anlise funcional como mtodo eficaz de avaliao
comportamental, a fim de se estabelecer a relao entre as variveis ambientais e o
comportamento, favorecendo assim uma melhor compreenso do transtorno do pnico.
Nuevos retos en la evaluacion y tratamiento de trastornos de ansiedad New challenges
in the assessment and treatment of anxiety disorders
LuisJoaquin Garcia-Lopez3, Vicente Caballo1, Alfonso Ordoez-Ortega3, Cristina Botella4,
Benito Arias2, Isabel Salazar1, Mara Irurtia2, LuisJoaquin Garcia-Lopez3, Jose Muela-Martinez3,
Lourdes Espinosa-Fernandez3, Juani Breton-Lopez4, Maria Lopez-Loras4, Maria Angeles PerezAra4, Soledad Quero4, Cristina Botella4, Rosa Baos5, Mariola Garcia-Olcina6, Jose Espada6,
Mireia Orgiles6, Jose Carballo6, Marta Calderero1, Jose Antonio Piqueras6, Mariola GarciaOlcina6, Rosa Baos5.
1. university of granada, granada, Spain, 2. university of valladolid, valladolid, Spain, 3.
university of jaen, jaen, Spain, 4. university jaime I, castellon, Spain, 5. university of valencia,
valencia, Spain, 6. university miguel hernandez, elche, Spain.
En una primera comunicacion. Dr. Caballo presentara datos sobre el desarrollo y validacin de
una nueva medida para la evaluacin de la ansiedad social en nios, el Cuestionario de
ansiedad social para nios (CASO-N24), mientras que la segunda comunicacion versa sobre
un seguimiento a largo plazo de nios con inhibicion conductual y el desarrollo de problemas de
ansiedad. Para continuar, Dr. Breton informar sobre los resultados del tratamiento de
exposicion vs. realidad aumentada para fobia especificas. En cuarto lugar, se presentan los
datos sobre una nueva escala para detectar problemas emocionales por el Dr. Piqueras.
Diferencias y similitudes en ansiedad social entre nios de doce pases latinoamericanos
y Espaa
Differences and similarities in social anxiety among children of twelve Latin American
countries and Spain
Existen muy pocas investigaciones transculturales que comparen diferentes pases con
respecto a la ansiedad social en adultos y an menos que lo hagan en el caso de nios. El

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desarrollo y validacin de una nueva medida para la evaluacin de la ansiedad social en nios,
el Cuestionario de ansiedad social para nios (CASO-N24), compuesto por 24 tems y seis
dimensiones, nos permiti aplicarla a doce pases latinoamericanos y Espaa. Los participantes
fueron 12.801 nios con edades comprendidas entre los 9 y los 15 aos y distribuidos
aproximadamente al 50% para cada sexo. El anlisis factorial confirmatorio, incluyendo todos
los pases, dio respaldo a la estructura de seis factores del cuestionario. Se compararon los
siete pases que haban aportado ms de 400 nios al estudio en estas seis dimensiones y en
la ansiedad social global. Las nias puntuaron ms que los nios, de forma estadsticamente
significativa, en todas ellas (p< 0,0001). Sin embargo, estas diferencias o bien eran pequeas
(dimensiones de Interaccin con el sexo opuesto, Quedar en evidencia/Hacer el ridculo y
ansiedad social general) (0,20 >d< 0,50) o bien eran triviales (todas las dems dimensiones)
(d< 0,20), segn la d de Cohen. Con respecto a las diferencias entre pases dentro del mismo
sexo, se encontraron ms diferencias en las nias que en los nios. No obstante, la magnitud
de las diferencias variaba dependiendo de la dimensin concreta. As, mientras que no haba
diferencias entre pases en el caso de los nios en dos dimensiones, siempre se encontraron
diferencias entre algunos pases en todas las dimensiones en el caso de las nias. Con
respecto a la edad, no se encontr ninguna tendencia en ninguna dimensin ni en ninguno de
los sexos conforme los nios van creciendo.
Problemas de adaptacin socioemocional y conductual en nios de Educacin Infantil
con inhibicin conductual: dos aos de seguimiento.
Problems of emotional and behavioral adaptation in preschool children with behavioral
inhibition: two year follow-up.
El objetivo de este trabajo es examinar la presencia de problemas de adaptacin en el mbito
socioemocional y conductual en nios que presentan inhibicin conductual (IC) y con un
seguimiento de dos aos. La muestra inicial se compuso de 104 alumnos de Educacin Infantil,
de entre 4 y 6 aos, siendo 40,38% nios y 59,61% nias, los cuales cursaban segundo ciclo
de Educacin Infantil en colegios pblicos y concertados de la localidad de Jan capital. Todos
los datos sobre los hijos fueron cumplimentados por los padres y madres biolgicos (96,63%) o
las actuales parejas (2,88%) y por las 16 maestras especialistas en Educacin Infantil tutoras
de los nios. Las medidas utilizadas fueron las Escalas de reas de Conductas-Problema, el
Inventario del Comportamiento de Nios y el Sistema de Evaluacin de la Conducta de Nios y
Adolescentes. En la evaluacin inicial, los resultados muestran que para las distintas muestras
formadas por diferentes informantes (padres, madres y maestras) los nios que presentan IC
obtienen mayores puntuaciones en las variables inadaptativas (retraimiento, agresividad,
hiperactividad, problemas de atencin, ansiedad, depresin, atipicidad, reactividad emocional,
quejas somticas y problemas de sueo) y menores puntuaciones para las variables
adaptativas (habilidades sociales y adaptabilidad). Adems, para las variables retraimiento y
adaptabilidad, los datos muestran diferencias significativas para todos los instrumentos e
informantes en general, con tamaos del efecto altos y medios. Igualmente, se presentarn los
datos relativos a la evaluacin, sobre las variables socioemocionales y conductuales
relacionadas con la IC, en el seguimiento a dos aos realizado a los nios entre los 6 y 8 aos
de edad.
Variabilidad del asco en el tratamiento de exposicin En Vivo versus Realidad
Aumentada para la fobia a los animales pequeos
Variability of disgust in in-vivo exposure treatment versus Increased Reality for phobia to
small animals
El presente trabajo tiene como objetivo principal un anlisis de las relaciones entre la variables
de asco y miedo, as como de la variabilidad de la variable asco, en sus dos formas, la
propensin y la sensibilidad al asco en dos condiciones de tratamiento (exposicin en vivo

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versus mediante Realidad Aumentada -RA-), para el tratamiento de la fobia a los animales
pequeos, concretamente araas y cucarachas. Los participantes del estudio fueron 64
personas que cumplan criterios de fobia especfica, segn el DSM-IV-TR (APA, 2000), siendo
un N=55 para fobia a las cucarachas y un N=9 para fobia a las araas. La edad media fue
31.98 aos (DT= 10.84), oscilando el rango de edad entre 20 y 70. Se emple un diseo entregrupos mediante un estudio controlado de manera que 31 participantes recibieron el
tratamiento de exposicin en vivo y 33 exposicin mediante RA. Ambos tratamientos se
llevaron a cabo siguiendo las directrices de una sesin intensiva desarrolladas por st et al.
(1991). Los datos pusieron de manifiesto correlaciones significativas y positivas entre la
variable asco (en sus medidas de propensin y sensibilidad al asco) y la variable de temor
hacia los animales pequeos (valores entre r=.30 y r=.47). Adems, y en cuanto a la
variabilidad de la variable asco tras el tratamiento, se concluye que es la variable propensin al
asco la que experimenta una reduccin mayor y significativa tanto en la condicin de
exposicin en vivo (t=5.22, p=0.000) como en la condicin de RA (t=2.89, p=0.007). El trabajo
pone de manifiesto una mejora y reduccin de las variables de asco, tanto en sensibilidad al
asco como en propensin, siendo en este ltimo caso dicha reduccin significativa en ambas
condiciones de tratamiento. En el estudio la variable de propensin al asco es ms sensible a
los cambios producidos durante el tratamiento llevado a cabo, obteniendo resultados similares
a otros estudios previos en la literatura.
DETECCIN DE ANSIEDAD MEDIANTE EL DETECTA-WEB EN NIOS Y ADOLESCENTES
ESPAOLES
DETECTION OF ANXIETY THROUGH THE DETECTA-WEB PROGRAM IN SPANISH
CHILDREN AND ADOLESCENTS
El objetivo de este trabajo es presentar los datos de deteccin de problemas de ansiedad en el
mbito escolar a travs del programa DETECTA-WEB. La muestra estuvo formada por 2000
nios y adolescentes espaoles (rango = 8-17). Cumplimentaron un cuestionario
sociodemogrfico, el cuestionario DETECTA-WEB, el Revised Child Anxiety and Depression
Scales (RCADS) y unos 200 fueron entrevistados mediante la entrevista diagnstica de
trastornos de ansiedad para nios (ADIS-IV-C). Se calcularon descriptivos (M y DT) y
frecuencias de sintomatologa en funcin del punto de corte (> 2 DT), Odds Ratio y datos de
prevalencia segen el ADIS-IV-C. Los resultados indicaron que el nmero de sujetos
detectados mediante la puntuacin total del DETECTA-WEB se sito en el 4,3%, siendo mayor
la presencia de chicas (5,5%) frente a los chicos (3,1%). Segn el cuestionario DETECTAWEB,
las sintomatologas ms frecuentes fueron la ansiedad por separacin y la ansiedad social
(6%). La entrevista diagnstica ofreci valores de 6% para el trastorno de Ansiedad
Generalizada, 4% para el Trastorno de Ansiedad Social, 3% para el Trastorno de Ansiedad por
Separacin, 2% para el Trastorno de Pnico con Agorafobia y 1% para el Trastorno de Estrs
Postraumtico. Las Odds Ratio indicaron que las subescalas del DETECTA-WEB y la
puntuacin total predijeron todos los trastornos diagnsticos segn el DSM-IV-TR, excepto el
Trastorno de Estrs Postraumtico. En resumen, los datos son consistentes con estudios
previos al mostrar estimaciones de frecuencia y prevalencia de trastornos de ansiedad entre el
1% y el 6% segn la entrevista y entre el 1% y el 6% segn los autoinformes. As, el
cuestionario DETECTAWEB se muestra como una herramienta vlida y til para la deteccin
de sintomatologa ansiosa en nios y adolescentes espaoles.
The Impact of Obsessive Beliefs and Worry in the Moral Cognition of Patients with
Anxiety Disorders
Ezequiel Gleichgerrcht1, 2, Ayelen Andreoli1, 2, Emillio Compte1, 2, Marcelo Cetkovich1, 2,
Fernando Torrente1, 2, Rafael Kichic1, 2.

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1. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina, 2. Institute of


Neurosciences, Favaloro University, Buenos Aires, Argentina.
A large proportion of patients with anxiety disorders show excessive levels of worry and
frequent obsessive beliefs (e.g. overestimation of threat, intolerance of uncertainty). Although
the impact of worry and these beliefs on anxiety symptoms has been widely studied, little is
known about their influence on the judgments of acts carrying moral burden, to which we are
often faced in our daily lives. Patients meeting diagnosis of anxiety disorder (n = 48) according
to DSM-IV completed measures of worry (Penn State Worry Questionnaire, PSWQ) and
obsessive beliefs (Interpretations of Intrusions Inventory, III-31). They were then presented with
a battery of vignettes, including: 1) non-moral dilemmas, 2) impersonal moral dilemmas (indirect
damage), 3) personal moral dilemmas (direct damage). For each scenario, we assessed
utilitarian judgment (e.g., kill one to save many) and the emotional reactivity reported by
participants. Obsessive beliefs of responsibility and the total score in the III-31 were significantly
correlated with emotional reactivity in both impersonal and personal moral scenarios. Worry
(total PSWQ score), however, was significantly and exclusively associated with judgment on the
personal moral dilemma, but not with the impersonal. These results suggest that the process of
emotional reactivity associated with moral judgment seems to be associated with the frequency
and severity of obsessive beliefs in anxious patients. In addition, worry, a process that activates
the amygdala, seems to be involved in this emotional reactivity process particularly when a
personal dilemma is presented.
The CBT Applicability of the Social Anxiety Disorders: A Case Study
Luiz Gonzaga, Vivian Mascella.
Catholic University of Campinas, Campinas, Brazil.
Abstract Central: The Cognitive-Behavioral Therapy (CBT) has as a principle that the
cognitions and interpretations determines an individual's emotions and behaviors which reflect
the same idiosyncratic ways of processing information. The interpretation here refers to
automatic thoughts which in turn derive from rules, attitudes and assumptions; intermediate
beliefs, which ultimately are linked to core beliefs. In short, the CBT process would be to check
this model, coming up to the core beliefs from the identification of automatic thoughts. Being a
singular system of psychotherapy, and considered as a new focus of intervention, the CognitiveBehavioral Therapy integrates a cognitive model of psychopathology and a set of techniques
and therapeutic strategies based directly on that model of interpretation supported by
substantial empirical evidence. We conducted a case study from the perspective of a client of
CBT. A client, 33 years, male, single, public servant, with a chief complaint related to deficits in
personal, social and professional area. He was referred by a general practitioner who advised
him to seek therapy for the symptoms of high blood pressure caused by emotional factors.
Some tools and therapeutic strategies were used like semidirected interview, framework of selfperception, technical problem solving, Socratic questioning, cognitive restructuring, social skills
training (SST) and role playing. The therapy session was performed once a week, with an
average of 50 minutes. Aimed to work on issues relating to the client's life that were affecting
him socially, as well as directing a major focus to the thread and progress of the session.The
procedure also included the initial assessment (case formulation), the final assessment and
intervention (cognitive diagram). Throughout the sessions, followed by a cognitive
conceptualization and formulation of the case, diagnostic hypothesis (HD) from Social Anxiety
Disorder.was given therapeutic interventions were promoted for 8 months that provided him with
significant changes that resulted in his ability to participate in social activities like traveling and
restructuring of automatic thoughts that made him return to prep school and interact with

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classmates. It is remarkable and worthy of recognition what the Cognitive-Behavioral approach


has achieved over the years. Its merit is remarkable in scientific circles, with several works
showing the extent of the cognitive model. We must also be attentive to the quality and the
establishment of the therapeutic relationship, which can be seen as an interaction of mutual
influence between therapist and client, possessing character predictor of good outcomes. It is
regarded as a very positive relationship in which the patient can fully open up and display his
feelings, values and beliefs without the fear of likely rejection from the therapist.
La Desregulacin de las Emocionales: Procesos Emocionales Transdiagnosticos de los
Trastornos de Ansiedad y del Estado de nimo
Manuel Gonzalez Rodriguez, Ignacio Ibez, Lastenia Hernndez.
Personalidad, Evaluacin y Tratamientos Psicolgicos, Universidad de La Laguna, La Laguna,
Spain.
Abstract Central: El proceso transdiagnstico, se refiriere a la existencia de un factor de riesgo
comn o a un proceso que pudiera estar en la etiologa y el mantenimientos de diversos
trastornos (Egan et al., 2011). El estudio de la co-ocurrencia de procesos a travs de diversos
trastornos an es muy limitado, pero la evidencia de que tales procesos contribuyen a la
etiologa y al mantenimiento de diversas psicopatologas tiene implicaciones importantes para
la explicacin, prevencin, el tratamiento transdiagnstico y la reduccin de los costes
personales, sociales y econmicos asociados. La naturaleza transdiagnstica de los procesos
emocionales viene dada por cuatro reas de investigacin: a) los procesos emocionales y
cognitivos se han relacionado como un factor de riesgo y de mantenimiento a travs de
diversos trastornos psicopatolgicos; b) esos procesos dominantes se asocian a la
comorbilidad en los trastornos psicopatolgicos; c) los procesos se incluyen como mecanismo
explicativo en el mantenimiento de una variedad de trastornos psicopatolgicos, y d) el
tratamiento cognitivo-conductual reduce una variedad de psicopatologas. En los ltimos aos
ha comenzado a emerger un cambio en la conceptualizacin de los trastornos de ansiedad, con
un nfasis en las concordancias entre los diversos diagnsticos. Tales conceptualizaciones
sostienen que las distinciones entre los sntomas de los trastornos de ansiedad del DSM-IV-TR
(2000) son algo artificiales o innecesarias, mientras que los factores comunes son de mayor
importancia clnica. De hecho, algunos autores han sugerido que con esta conceptualizacin, la
ansiedad y los trastornos del estado de nimo se podran incluir bajo una sola etiqueta de
sndromes del afecto negativo (Barrow, Allen y Coate, 2004). Los problemas con la emocin o
la regulacin emocional caracterizan ms del 75% de las categoras diagnsticas en el DSMIV-TR (APA, 2000) (Kring y Werner, 2004; Werner y Gross, 2011). En algunos casos, como en
los estados de nimo y los trastornos de ansiedad, la desregulacin de las emociones son tan
relevantes que los trastornos son definidos sobre la base de los desajustes emocionales
(Mineka y Sutton, 1992). En otros casos, como el trastorno lmite de la personalidad, el estrs
postraumtico, indican que las dificultades en la regulacin de las emociones estn a la base
de muchos trastos psicopatolgicos, y los tratamientos transdiagnsticos pueden ser la clave
para su mejora (Wegner y Gross, 2011). Las teoras contemporneas de la emocin acentan
la importancia de las emociones en preparar el comportamiento motor, y las respuestas
fisiolgicas, en la facilitacin de la toma de decisiones y en las relaciones interpersonales
(Gross y Thompson, 2007). Con todo, las emociones pueden ayudarnos, pero tambin pueden
perjudicarnos. Las emociones son disfuncionales cuando se expresan de manera inapropiada,
ocurren en un contexto inadecuado, son demasiado intensas o estn referidas al pasado. En
este trabajo presentamos algunas estrategias de desregulacin de emociones relacionadas con
trastornos de ansiedad y del estado de nimo.

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El Modelo de Intolerancia a la Incertidumbre del Trastorno de Ansiedad Generalizada:


Una Intervencin Cognitivo-Conductual Transdiagnstica?
Manuel Gonzalez Rodriguez, Ignacio Ibez, Anna Rovella.
Personalidad, Evaluacin y Tratamientos Psicolgicos, Universidad de La Laguna, La Laguna,
Spain.
Abstract Central: Los estudios de prevalencia vida del TAG oscilan entre el 5%-13%., siendo
en atencin primaria de un 7,3%, y en unidades de salud Mental del 13,7%, donde un
porcentaje del 71,4% de pacientes con TAG consultaba por sntomas de ansiedad. El riesgo de
TAG es el doble en las mujeres que en los hombres (Holmes y Newman, 2006, p. 104). En una
muestra espaola de 3.247 personas que tomaban ansiolticos e hipnticos, los trastornos de
ansiedad eran los ms frecuentes, el 13,8%, y de stos el ms comn con un 65% fue el TAG
(Garca del Pozo et al., 2004). Si tenemos en cuenta los ndices de comorbilidad, los trastornos
de ansiedad tambin tienden a co-ocurrir con otras condiciones psiquitricas (Kessler, Chiu,
Demler, Merikangas, y Walters, 2005), se asocian a altas tasas de enfermedad biomdica
crnica (Roy-Byrne et al., 2008) y de sntomas fsicos mdicamente inexplicados (Katon, Lin, y
Kroenke, 2007). Al igual que los otros trastornos de ansiedad, el TAG es altamente comrbido,
con aproximadamente un 80-90% de personas que cumplen los criterios del TAG presentando
uno o ms trastornos psiquitricos (Judd et al., 1998). Aproximadamente dos tercios de
aquellos con TAG tienen una historia de Trastorno Depresivo Mayor (TDM) en su vida (Judd et
al., 1998), teniendo el TAG un inicio cronolgico ms temprano en un 63% de todos los casos
(Fava et al., 2000). El TAG es una condicin crnica e incapacitante. La probabilidad de
remisin en pacientes con TAG es solo del 0,15 tras un ao y del 0,25 tras dos aos. Incluso si
se alcanza la remisin de los sntomas del TAG, la probabilidad de llegar a estar asintomtico
de todas las condiciones psiquitricas es menor del 10% (Yonkers et al., 1996). En cuanto al
tratamiento del TAG, la terapia cognitivo conductual presentaba resultados modestos, adems
de ndices de abandonos considerables, y donde las intervenciones se han llevado a cabo con
la finalidad de conocer la eficacia o no de determinado programa cognitivo-conductual, sin
utilizar un modelo racional unificador o especfico del TAG que fuera guiado por una teora, con
un apoyo emprico y con claras implicaciones para el tratamiento. Por o tanto, en esta
comunicacin partimos del Modelo de Intolerancia a la Incertidumbre del TAG propuesto por
Robichaud y Dugas (2007). Este modelo propone la existencia de cuatro procesos cognitivos
relacionados con el TAG, a saber: intolerancia a la incertidumbre, orientacin negativa al
problema, evitacin cognitiva y metacreencias sobre utilidad de la preocupacin y se aplic una
intervencin cognitiva-conductual y metacognitiva sobre las variables antes mencionadas. El
programa de intervencin se aplic a 46 pacientes con TAG, que fueron remitidos por
psiclogos clnicos y psiquiatras de seis unidades de salud mental de la isla de Tenerife. El
programa se aplic de forma individual por siete terapeutas licenciados en psicologa que
formaba parte del programa de prcticas del posgrado oficial de nuestro departamento.
Presentados aqu los resultados del postratamiento y del seguimiento realizado a los seis
meses, tanto de los procesos cognitivos y de las variables del sntomas, y si adems del TAG,
las personas mejoran en otros trastornos muy comorbidos con ste ltimo.
Emotion in Motion: A Novel Approach to the Assessment and modification of Attentional
Bias
Ben Grafton, Lies Notebaert, Colin MacLeod.
University of Western Australia, Crawley, WA, Australia.
Abstract Central: Cognitive theories propose that an attentional preference for negative
information plays a key role in the development of anxiety vulnerability. There is now a wealth of

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evidence demonstrating that elevated susceptibility to experience intense anxiety is associated


with an attentional bias to negative information. More recently, investigators have established
the causal status of this association by showing that the modification of negative attentional bias
can serve to alter anxiety responses to a stressor. Of course, the capacity of such attentional
bias modification (ABM) procedures to alter real-world anxiety will be maximised by ensuring the
facets of attentional selectivity targeted for modification are most similar to those that operate in
real-world settings. When considering the clinical impressions of how attentional selectivity
operates in real-world environments, there is a striking contrast between how such attentional
processing has been assessed and modified within the laboratory.The former is characterised
by stimuli that operate within a dynamic environment, and the latter by stimuli that operate within
a static environment. Thus, there is potential value in developing laboratory procedures that can
assess and modify such dynamic attentional processing. In this study, we report the
development of a novel ABM procedure in which we introduce motion into displays. Specifically,
participants were required to scan for and track a target stimulus embedded among an array of
distractor stimuli which moved around the screen. The findings reveal that our ABM procedure
was indeed capable of assessing and modifying naturalistic styles of dynamic attention, and that
such modification was particularly effective in attenuating anxiety reactivity. Implications for the
field of attentional bias modification will be discussed.
Nuevas tcnicas cognitivas en los trastornos de la ansiedad New cognitive techniques in
anxiety disorders
Nicols Hernndez Lira, Beatriz Ramirez Beltrn, Carol Garcia Prez, Elizabeth Calzada
Snchez.
Instituto Cognitivo Conductual de Salud Mental de Mxico, Mxico, Mexico.
Resumen del simposio:
Coordinadora del simposio: Mtra. Beatriz Ramrez Beltrn (contacto@incosame.com.mx).
Los trastornos de la ansiedad son ampliamente conocidos, sin embargo; an se investigan
nuevas tcnicas que puedan mejorar los resultados de los tratamientos psicolgicos para lograr
que los pacientes rpidamente recuperen la calidad de vida que estos trastornos disminuyen.
Este simposio abarca distintas investigaciones realizadas a alrededor de nuevas tcnicas para
los trastornos de ansiedad en distintas modalidades.
La primera intervencin se refiere a una investigacin realizada por la Mtra. Beatriz Ramrez
sobre una tcnica creada por ella y que titula: Tcnica de la analoga en la que se intenta de
manera indirecta realizar una restructuracin cognitiva tratando de disminuir la ansiedad que
genera este proceso.
La Segunda intervencin se refiere a los resultados preliminares de una investigacin realizada
por la Psic. Carol Garca referente a una Tcnica que ha denominado de atencin plena
emprica para la ansiedad basada en la terapia cognitivo conductual y Mindfulness (conciencia
plena), en donde explica paso a paso la aplicacin de esta tratando de evitar confusiones en el
procedimiento, algo que generalmente sucede con la tcnica de Mindfulness.
La tercera intervencin la realiza el Mtro. Nicols Hernndez Lira en donde muestra los
resultados preliminares de una investigacin sobre el uso de las tcnicas cognitivo
conductuales para los trastornos de ansiedad con base en las nuevas tecnologas, donde se
realiza la pregunta de que tecnologa electrnica se utiliza ms y ofrece mayores beneficios
segn la opinin de los profesionales que la utilizan.
Por ultimo la cuarta intervencin la realiza la Psic. Elizabeth Araceli Calzada Snchez,
mostrando los resultados de la investigacin sobre El estado del tema de las tcnicas
cognitivas para los trastornos de la ansiedad, en donde se muestra que tcnica cognitiva es

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mayormente utilizada por los profesionales de la salud en el tratamiento de los trastornos de


ansiedad.
Ttulo: Tcnica de la Analoga para trastornos de ansiedad
Ponente: Beatriz Ramrez Beltrn (contacto@incosame.com.mx).
Resumen: Existen varias tcnicas para tratar los distintos trastornos de ansiedad, tanto
cognitivas como conductuales. En este trabajo se propone la Analoga, una tcnica cognitiva
que trata de manera indirecta el significado que tiene el pensamiento del paciente y cmo
estructura el entorno para controlar o no el ataque de ansiedad (en lugar de atacar
directamente las creencias irracionales). Se espera que haya una resignificacin y un cambio
en sus esquemas de vida utilizando analogas que se disean a partir de la experiencia de vida
del paciente. Se exponen los primeros resultados de dos aos de investigacin (en el sector
pblico y solamente en trastornos de ansiedad), en la aplicacin de esta tcnica comparada
con otras igualmente cognitivas y en combinacin con algunas conductuales. Los resultados
muestran que la tcnica de la Analoga permite abordar con menor ansiedad los significados
del paciente referentes a creencias y a sus esquemas (comparada con otras tcnicas
cognitivas como el debate de creencias a travs del dilogo socrtico o la identificacin de la
distorsin) y se potencializa combinada con tcnicas conductuales como la comprobacin
emprica y el registro de actividades), logrando una resignificacin ms rpida al permitir mayor
comprensin del proceso por parte del paciente. Ser necesario la investigacin de
seguimiento, adems de observar si la restructuracin de los esquemas se generaliza a otras
reas y si esta misma tcnica obtiene los mismos resultados en otros trastornos, la cual ya se
esta llevando a cabo en la actualidad.
Tcnica de atencin plena emprica para la ansiedad basada en la terapia cognitivo
conductual y mindfulness (conciencia plena).
Ponente: Carol Garca Prez (contacto@incosame.com.mx).
Resumen: Los principios de mindfulness (conciencia plena), son cada vez ms aplicados a la
terapia cognitivo conductual en distintos trastornos, sin embargo parece haber cierta
ambigedad en su aplicacin, por lo cual se propone una tcnica denominada atencin plena
emprica, que logra conjuntar la cuestin de contrastacin emprica con la atencin plena ms
all de la referencia del paciente o de la cuestin poco medible del mindfulness (conciencia
plena). Para evitar confusiones en su aplicacin se ha desarrollado un procedimiento paso a
paso en la aplicacin de esta tcnica, la forma de registrar tanto las emociones como los
pensamientos del paciente y cmo desarrollar la atencin plena en la comprobacin emprica
de los pensamientos intrusos controlando la liberacin de la ansiedad. Con dicha tcnica se ha
realizado una investigacin de un ao y medio con pacientes que padecen ataques de pnico,
presentando los resultados preliminares obtenidos a lo largo de este tiempo. Se compar la
Tcnica de atencin plena emprica con otras humanistas (la resonancia emptica, la
consideracin positiva incondicional y la congruencia interna del terapeuta y otras cognitivas y
conductuales (descatastrofizacin y clasificacin de las distorsiones cognitivas) obteniendo
como resultado que la Tcnica de atencin plena emprica logra tener una diferencia
estadsticamente significativa sobre todo en la mejora de los sntomas. Tambin se observ
que es ms fcil para el paciente procesar los pensamientos intrusos de manera menos
ansiosa y por ende con un desarrollo fluido en el anlisis de las creencias. Se est realizando
an la ltima parte de la investigacin, pero se espera que la tendencia de los actuales
resultados contine, incluso a los seis meses cuando se realice el seguimiento.
El uso de las tcnicas cognitivo conductuales para los trastornos de ansiedad con base
en las nuevas tecnologas.
Ponente: Nicols Alejandro Hernndez Lira (contacto@incosame.com.mx).

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Resumen: Las tcnicas cognitivo conductuales que se utilizan para los trastornos de ansiedad
son ya conocidas, tanto en su aplicacin individual como grupal, y sus variaciones se han ido
adaptando al paciente respetando los principios del enfoque, pero qu hay de la aplicacin de
estas tcnicas a la luz de las nuevas tecnologas? (internet, videoconferencia, etc.), son
realmente usados por los psicoterapeutas?, consideran que se obtienen los mismos
resultados que de forma presencial o se potencializan sus resultados al apoyarse en ellas?,
afectan stas el establecimiento de la relacin teraputica?, es necesario cambiar la forma,
el tiempo, el rapport, en s las caractersticas de aplicacin cuando se utilice la tecnologa? Se
presentan los resultados preliminares de una investigacin que se est realizando desde hace
un ao con psicoterapeutas cognitivo conductuales, de los cuales unos utilizan y otros no, las
nuevas tecnologas para la atencin de sus pacientes. Se ha obtenido como resultado que
dependiendo de la tecnologa y de la facilidad que tiene el paciente al usarla, el trabajo
psicoteraputico se puede facilitar, sobre todo porque se dan menos ndices de abandono
psicoteraputico, as mismo dependiendo de las habilidades tecnolgicas del terapeuta, los
pacientes pueden acostumbrarse a esta forma de atencin. Sin embargo, no todas las
tecnologas son tan tiles para la labor psicoteraputica, predominan en su uso y resultados
positivos la videoconferencia, siendo en ltimo lugar el conocido como chat, pues algunos
terapeutas lo consideran ms impersonal, no permitiendo conocer realmente las expresiones
del paciente. An falta un ao ms de investigacin, pero la tendencia apunta al mayor uso de
estas herramientas tecnolgicas en el uso psicoteraputico.
El estado del tema de las tcnicas cognitivas para los trastornos de la ansiedad.
Ponente: Elizabeth Araceli Calzada Snchez (contacto@incosame.com.mx).
Resumen: Cul es el estado actual respecto a las terapias cognitivo conductuales para el
tratamiento de los trastornos de ansiedad?, se han propuesto o desarrollado nuevas
tcnicas?, qu avances se han obtenido?, cuntas investigaciones han tenido un buen
resultado a la luz de un metaanlisis?, cules son las tcnicas ms aplicadas en la actualidad
y realmente son ms cognitivas o conductuales? Estas son las preguntas que se intentan
contestar en esta exposicin como resultado de una investigacin que se realiza en la
actualidad tomando como muestra revistas indexadas (MEDLINE/Index Medicus, Psychological
Abstracts, PsycInfo/PsycLIT, Redinet, Psicodoc, Scopus, Dialnet, Latindex y Redalyc),
encuestas entre psiclogos y psiquiatras que se dedican a la prctica e investigacin del
planteamiento cognitivo conductual. Dichas actividades tuvieron una duracin de nueve meses.
Todo esto para conocer los avances reales en tcnicas psicoteraputicas para este tipo de
trastornos y saber si lo que se propone en la actualidad realmente logra marcar una diferencia
entre lo que se hacia y lo que se hace. Tambin se toman en cuenta las tcnicas propuestas
por las llamadas terapias de tercera generacin, sus investigaciones, sus resultados en
cuanto a este trastorno, a partir de sus propios informes y de los que otras investigaciones con
las mismas tcnicas han obtenido. An falta por integrar informacin de meta-anlisis de
investigaciones, pero parece que la tendencia hacia nuevas tcnicas y sus resultados
favorables es lenta debido al escaso rigor metodolgico de muchas investigaciones, a la poca
rplica de las mismas y a la poca publicacin que se hace al respecto, por lo que se continuar
el anlisis en los prximos meses restantes de la investigacin para ver si esta tendencia se
mantiene.
Mindfulness and Self Compassion Based Cognitive Therapy for Social Phobia:
Preliminary Report
Pawel Holas.
Warsaw Medical University, Warsaw, Poland.

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Self criticism, plays a key role in many psychiatric disorders and predicts poor outcome in
psychotherapy, whereas self compassion is an important predictor of good mental health. Social
phobia (SP) is characterized by particularly high levels of self-criticism as well as concern about
others negative evaluation of ones performance. Individuals with SP reported low-self-esteem,
are less self-kind and less self-compassionate than healthy individuals. Therefore, the aim of
this preliminary study was to find out if the cognitive group therapy, enriched with self
compassion and mindfulness exercises would lead to an increase in self-compassion and its
subscales along with clinical improvement. 10 generalized SP patients with comorbid
depression were included into the study and measured pre and post treatment with a battery of
questionnaires including LSAS, IPSM, BDI, SC and TAS. The treatment protocol was based on
Mindful Self-Compassion (MSC) program developed by Neff and Germer (2012) to enhance
self-compassion blended with some cognitive therapy interventions, namely psychoeducation
and behavioral experiments. Similarly to MBSR structure, participants met for 2 or 2 1/2 hours
once a week over the course of 8 weeks with an additional half-day meditation retreat. The
results showed a robust clinical improvement reflected in a decrease in social anxiety,
depression and interpersonal rejection. Therapy also led to an increase of self-esteem and selfkindness and a decrease of judgmental stance. Interestingly, there were also positive changes
relating to regulating emotions as after the treatment the patients were better able to identify
and describe their emotions. In conclusion, these preliminary results suggest that mindfulness
and self-compassion based cognitive therapy seems to be an effective treatment for social
phobia with comorbid depression and call for adding self-compassion enhancement exercises to
the standard cognitive group therapy. However in order to establish its efficacy quality studies
with experimental design are needed.
No Worries! Program: Evaluation of a Generalised Anxiety Disorder Treatment Program
for Children
Monique Holmes, Caroline Donovan, Lara Farrell.
School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
Although worry is a normal phenomenon commonly experienced by children in response to daily
stressors, excessive and uncontrollable worry is the core feature of Generalised Anxiety
Disorder (GAD). GAD can be very upsetting for the child and his/her family and because it may
persevere into adolescence and adulthood, early treatment is paramount. Previous research
has typically used treatment programs which take a general approach and target various forms
of anxiety in the same program (e.g. social fears, specific fears and separation fears). Although
these programs have been shown to be effective in reducing generalised anxiety in children and
adolescents, many children with GAD continue to experience difficulties following treatment. We
are interested in examining whether we can improve treatment outcomes by tailoring the
content of the intervention to the core underlying features of GAD. A GAD-specific treatment
program (No Worries! Program) has been developed that targets the four underlying features of
GAD including Intolerance of Uncertainty, Negative Beliefs about Worry, Thoughts Suppression
and Negative Problem Orientation. A Randomised Controlled Trial (N=40) is currently being
conducted to assess the efficacy of No Worries! Program for children (aged 8-12years) with
Generalised Anxiety Disorder. Participants were randomly allocated to the active treatment
group (GAD-TX) or the Waitlist Control (WLC) group. It was predicted that children in the GADspecific treatment group would demonstrate significantly greater reductions from pre-treatment
to post-treatment in primary GAD diagnostic status, self and parent-reported anxiety, overall
global functioning, Intolerance of Uncertainty, Negative Beliefs about Worry, Thoughts
Suppression and Negative Problem Orientation. Preliminary results will be presented and
discussed.

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The Effects of Safety Behaviour and the World View of Healthy Individuals
Vivian Huang, Shadi Beshai, Keith Dobson.
University of Calgary, Calgary, AB, Canada.
Individuals who suffer from anxiety often engage in safety behaviours (Salkovskis, 1991; SB).
These behaviours act to prevent a perceived disaster and as such can temporarily reduce
anxiety, thus reinforcing their continued use. SB have been found to have an adverse effect in
clinical samples. Research on the effect of SB in a healthy sample is lacking, however,
specifically with respect to general anxiety and its relationship to perceptions of the world. The
current study examined the effects of SB on beliefs of world danger in a healthy student sample.
Healthy undergraduate students (N = 140) were recruited from the University of Calgary
Participant Recruitment System. Participants were randomly assigned to either the experimental
or the control condition. The experimental group was asked to engage in anxiety provoking
behaviours (e.g. wash or disinfect hands after touching door handles) for a duration of seven
consecutive days, while the control group engaged in non-anxiety provoking behaviours (e.g.
update music library) for the same duration. Participant in both conditions were asked to
complete the same series of questionnaires at baseline and seven days later, after the
completion of the manipulation phase. These questionnaires measured generalized anxiety (the
Generalized Anxiety Disorder 7-Item Scale; GAD-7) and their beliefs in a dangerous world
(Beliefs in a Dangerous World Scale; BDW). Based on preliminary analyses, a trend of
differences was found between the experimental and control groups wherein the experimental
group exhibited higher scores on the BDW in the post assessment phase. Potential treatment
implications and future research directions are discussed.
Cognitive Biases in Depersonalisation Disorder
Elaine Hunter1, 2, Paul Salkovskis3, Anthony David1.
1. Institute of Psychiatry, London, United Kingdom, 2. South London & Maudsley NHS
Foundation Trust & Institute of Psychiatry, London, United Kingdom, 3. Psychology
Department,University of Bath, Bath, United Kingdom.
Abstract Central: Depersonalisation Disorder (DPD) is a chronic and distressing condition
characterized by a sense of unreality about the self (depersonalisation) and/or the external
world (derealisation). A common misperception is that depersonalisation is rare but a review of
the epidemiology of DPD found symptoms of DP/DR are very common in non-clinical and
psychiatric populations (Hunter, Sierra & David, 2004) and prevalence rates of clinically
significant levels of DPD range from 1-2.4% in randomised community samples. A study of the
phenomenology of DPD in 204 referrals to the Depersonalisation Research Unit at the Institute
of Psychiatry in London highlighted the close association between anxiety and DPD, rather than
trauma and DPD, which might have been predicted from the literature linking trauma and
dissociation more generally. A cognitive behavioural model of DPD was developed (Hunter et
al., 2003). This drew on the links between anxiety and depersonalisation in both the onset and
maintenance of the disorder. In essence, the CBT model of DPD suggests that the chronic
disorder develops when the common, transient and benign symptoms of depersonalisation
and/or derealisation are catastrophically misinterpreted as threatening. This leads to a vicious
cycle of cognitive and behavioural responses to the initial symptoms which act to exacerbate
and maintain these. Such responses often include increased symptom monitoring with a
resulting reduced threshold for perception of threat from bodily symptoms. In this way, typically
transient symptoms can develop into a chronic disorder. The CBT model has proved useful for

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both the theoretical and clinical advancement of DPD. In collaboration with other dissociation
researchers (Holmes et al., 2005) it became increasingly clear that rather than a homogenous
phenomenon, it was more useful to consider dissociation as comprised of two broad categories
of phenomena: those of compartmentalisation (e.g. such as dissociative amnesia or conversion
disorders) compared to those of detachment (such as DPD). The CBT model also provided a
framework for treatment. This will be outlined briefly in the presentation. A small scale open trial
into CBT for DPD (Hunter et al., 2005) demonstrated the efficacy of this approach. More recent
research has supported this approach to DPD. A study into the childhood antecedents of DPD
(Lee et al., 2012) found that an objective rating of anxiety by teachers of students age 13 was a
significant predictor of adult DPD. Moreover, empirical testing of cognitive biases predicted by
the CBT model of DPD (Hunter et al, under review) found that when compared to healthy
controls, participants with DPD had significantly more catastrophic appraisals and less
normalising attributions for a range of ambiguous symptoms and were very similar to those
participants in an anxiety disorder control group. However, when compared on experimental
tasks designed to inhibit cognitive biases, the DPD group showed a reduction in DPD symptoms
whereas the other two groups showed an increase. The findings are consistent with the
hypothesis that cognitive biases play an important role in the development and maintenance of
DPD.
Parental Meta-Emotion Philosophy and Emotion Coaching in Families of Children with an
Anxiety Disorder
Katherine Hurrell, Jennifer Hudson, Carolyn Schniering.
Psychology, Macquarie University, North Ryde, NSW, Australia.
Abstract Central: Parental meta-emotion philosophy (MEP; Gottman, Katz & Hooven, 1997) is
purported to influence the ways in which children are socialised to experience and express
emotions. MEP is defined as an organized set of feelings and thoughts about ones own
emotions and ones childrens emotions. Emerging research documents that parents of anxious
children tend to engage in less emotion socialisation practices and that this may have
implications for childrens emotional functioning. To date, no known studies have examined
parental meta-emotion philosophy in families of anxious children and the role this might play in
childrens emotion regulation (ER). Furthermore, little research has examined MEP in fathers
and few studies have observed father-child interactions in a sample of anxious children. As
such, the current study examined whether mothers and fathers of anxiety-disordered children
(AD) differ from parents of children with no diagnoses (ND) in their awareness and coaching of
emotions. Differences in childrens emotion regulation were also investigated. Youth (ages 7-16)
discussed with their parents a regular conflict at home, for 3 minutes each. Parental behaviours
were later coded using a global rating system that comprised the following five components of
emotion-coaching: structuring of emotion, sensitivity and acceptance of the child, validation and
encouragement, enthusiasm for the task, and levels of intimacy, warmth and affection. Parents
were interviewed to assess their MEP for the emotions of fear, sadness and anger and
completed the Parental Emotional Styles Questionnaire (PESQ; derived from the Maternal
Emotional Styles Questionnaire) to assess attitudes towards emotion-coaching. Parents also
reported on their childrens emotion regulation using the Emotion Regulation Checklist (ERC). It
was hypothesised that parents of AD children would be less aware of their own emotions and
less coaching of their childrens emotions compared to parents of ND children. It was also
hypothesised that parents of AD children would display less coaching behaviours during the
discussion task than parents of ND children. Finally, AD children were expected to score lower
on measures assessing ER and that this would be predicted by and related to levels of parental
emotion-coaching.

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The Moderating Effect of Positive Beliefs about Worry on the Relation between Stressful
Events and Worry
Yudai Iijima, Yoshihiko Tanno.
The University of Tokyo, Tokyo, Japan.
Some cognitive models of worry and generalized anxiety disorder point out, in the process of
worry, the role of positive beliefs about worry, such as worry is useful or worry prevents a
future negative result. Borkovecs model (Borkovec, 2004) suggests that worry is reinforced by
positive beliefs. In the intolerance of uncertainty model (Dugas et al., 1998; Dugas et al., 2005),
positive beliefs contribute in the process of generating worry with intolerance of uncertainty. In
the metacognitive model (Wells, 1995, 2006), positive beliefs lead to non-pathological worry.
Positive beliefs are found widely in people who do not have pathological states to some extent;
however, the person with pathological worry can have strong beliefs about worry. Thus,
promoted by positive beliefs, worry would become excessive. It is assumed that positive beliefs
promote the use of worry as a problem-solving strategy in these models. Though several crosssectional studies have revealed an association between positive beliefs and worry, few
longitudinal studies have been conducted on this topic. When prospective analysis was used in
a previous study, contrary to the theoretical hypotheses, positive beliefs were not found to
predict worry (Sica et al., 2007). However, the previous study examined only the direct effects of
positive beliefs on worry. According to the theoretical models of worry, when stressful events
which are subject to worry occur, positive beliefs promote the strategic use of worry for problem
solving. That is, it is assumed that having positive beliefs is a moderator in problem solving.
Therefore, investigating only the direct effect of positive beliefs is not sufficient to grasp the
relationship between these beliefs and worry. In this context, the present study conducted a
two-wave longitudinal study to examine the effect of positive beliefs as a moderator on worry
when stressful events occur. One hundred and ninety-four Japanese college students voluntary
completed questionnaires during the class. Hierarchical regressions analysis showed that a
prospective relationship between the experience of stressful events and the subjective report of
worry. Stressful events predicted a significant increase in extent of worry at the 4-week followup. Moreover, this relationship was qualified by its interaction with positive beliefs: for individuals
with higher levels of positive beliefs, stressful events become over time a stronger predictor of
the extent of worry ( = 1.51, SE = 0.28, t = 5.43, p < .001) than for those with lower levels of
positive beliefs ( = 0.53, SE = 0.25, t = 2.14, p < .05). This moderating role of positive beliefs
suggests that the level of positive beliefs amplifies the threat of worry caused by stressful
events; that is, the experience of stressful events in individuals with higher levels of positive
beliefs leads to greater worry than it does in individuals with lower levels of positive beliefs. The
implications of these data and several problems are discussed.
Eficacia del Tratamiento Cognitivo-Conductual Grupal en Trastorno de Ansiedad para
Pacientes Tratados en el Ambulatorio
Nuria Jaurrieta1, 2, David Chesa1, Agueda Solivellas1, Esther Oller1, Anna Iniesta1, Contxita
Clos1, Carles Franquelo1.
1. Mental Health Services, Sagrat Cor, Martorell, Spain, 2. Bellvitge University Hospital,
Barcelona, Spain.
Objetivo: Explorar la eficacia de tratamiento cognitivo-conductual de tipo grupal en pacientes
diagnosticados de trastorno de ansiedad con y sin agorafobia, segn criterios del DSM-IV.
Diseo: Diseo de tipo cuasi experimental. Para la comparacin de las variables pre-post se ha

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utilizado una Prueba T para variables relacionadas. Para los cuestionarios BDI-II se ha utilizado
una prueba no paramtrica T de Wilcoxon. Participantes: La muestra inicial era de 40 pacientes
(distribuidos en 4 grupos) que iniciaron tratamiento grupal de orientacin cognitivo conductual
en el centro de atencin primaria con la psicloga. La muestra final del estudio fue de 29
pacientes, 7 abandonaron el tratamiento y 4 no retornaron los cuestionarios al finalizar el
tratamiento. La muestra total estaba compuesta por 19 mujeres y 21 hombres, (edad
media=32,25; DE=6,76). En relacin al estado civil, en el momento de realizar el tratamiento 22
(55%) casados, 15 (37,5) solteros, 2 (5%) viven en pareja y 1 (2,5%) separado. El nivel de
estudios era el siguiente, 10 (25%) haban realizado estudios primarios, 19 (47,5%) de grado
medio y 11 (27,5%) estudios universitarios. A nivel laboral, 18 (45%) estaban trabajando en el
momento de realizar el tratamiento, 7 (17,5%) estudiantes, 7 (17,5%) baja laboral, 7 (17,5%) en
paro y 2 (5%) amas de casa. De la muestra total 33 (82,5%) pacientes no haban realizado un
tratamiento cognitivo-conductual anteriormente y 7 (17,5%) si lo haban realizado. Mtodo: Los
pacientes fueron derivados por el mdico de atencin primaria o el psiquiatra al psiclogo y
ste valor la inclusin de los pacientes en el tratamiento grupal. La duracin del grupo fue de 9
sesiones de tratamiento y un seguimiento a los 2 meses. Se administraron 5 cuestionarios
autoinformados antes y despus del tratamiento: Inventario de sntomas SCL-90-R (Derogatis,
1999), Inventario de expresin de ira estado rasgo (STAXI-2; Spielberg, 1991), Escala de
satisfaccin familiar por adjetivos (ESFA; Barraca y Lpez, 1997), Inventario de Ansiedad de
Beck (BAI; Beck, 1993) y Inventario de Depresin de Beck (BDI-II; Beck, 1996). Resultados:
Los anlisis muestran que los pacientes al finalizar el tratamiento psicolgico presentaron
diferencias estadsticamente significativas en algunos valores psicomtricos. Concretamente,
se observaron diferencias en las medias en; sintomatologa somtica de 9.14 puntos, en
obsesiva-compulsiva de 5.79 puntos, en depresin de 17.69 puntos, en ansiedad de 6.62
puntos, en hostilidad de 2.34 puntos y en ansiedad fbica de 1.86 puntos. Por otro lado, se
observaron diferencias estadsticamente significativas en relacin al rasgo de la ira,
concretamente en el temperamento con una diferencia pre-post de 2.17 puntos, en la reaccin
de la ira de 1.48 puntos, y en el total de 3.66. Adems se observaron valores significativos en la
expresin y el control de la ira con una diferencia de la media pre-post, concretamente en la
expresin externa de 1.55 puntos, en la expresin interna de 1.78 puntos, en el control interno
de 2.21 puntos y en el ndice de expresin de la ira de 6.89 puntos. En relacin a la satisfaccin
familiar, se observaron diferencias estadsticamente significativas, la deferencia de la media
antes y despus del tratamiento fue de -9.96 puntos. Finalmente, la diferencia de las medias en
relacin a la sintomatologa ansiosa fue de 8.31 y depresiva de 10.05 puntos, medidas con el
instrumento de Beck, se observaron diferencias significativas Conclusiones: los pacientes que
realizaron un tratamiento grupal de tipo cognitivo-conductual en el ambulatorio, redujeron la
sintomatologa somtica, obsesiva-compulsiva, depresiva, ansiosa, hostilidad y ansiedad
fbica. Por otro lado, redujeron los niveles de expresin interna y externa de la ira y el control
interno de la ira. Adems mejoraron la satisfaccin familiar tras realizar el tratamiento.
Terapia Racional Emotiva para Depresin Mayor y Ansiedad Generalizada
Juan Jimnez, Arabi Soriano, Tania Pereira Salgado, Mario Romero Euroza.
UNAM FES Zaragoza, Mxico, D.F., Mexico.
Juan Jimnez Flores, Arab Eduardo Soriano Gonzlez Tania Elianet Pereira Salgado, Mario
Eduardo Romero Euroza Facultad de Estudios Superiores Zaragoza, UNAM Entre los
trastornos mentales ms frecuentes, la ansiedad y la depresin, ocasionan deterioro en la salud
de las personas. La ansiedad ha sido definida como un estado subjetivo de malestar, tensin y
alarma que surge como reaccin a situaciones percibidas como amenazantes, incluye aspectos
cognoscitivos, somticos, emocionales y conductuales (Hernndez-Guzmn, 1999). Este

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trabajo se centra en el trastorno de ansiedad generalizada (TAG), es crnico, caracterizado por


sntomas de ansiedad de larga duracin que no se centran en un estmulo o situacin
especficos. El padecer ansiedad generalizada es un importante factor de riesgo para
desarrollar un trastorno depresivo mayor. Se calcula que el 80% de los pacientes que
presentan ansiedad generalizada desarrollan por lo menos un episodio depresivo mayor a lo
largo de la vida (Agudelo, Buela Casal & Donald, 2007). Una de las grandes demandas con que
se enfrentan los psiclogos es precisamente la intervencin y la prevencin de los sntomas de
ansiedad y de depresin que presentan los pacientes. La literatura informa de una gama de
estrategias de intervencin que han probado su efectividad, la terapia racional emotiva fue el
modelo que, de acuerdo con las evidencias, ha demostrado mayor eficacia para la intervencin
en dichos trastornos. De acuerdo con lo mencionado anteriormente, el presente trabajo
contribuye con una propuesta de intervencin. Mtodo Descripcin del paciente Mujer de 44
aos de edad, casada y con tres hijos, escolaridad bsica, trabajadora domstica. Acudi al
servicio de psicologa presentando los siguientes sntomas: mareos, dolores de cabeza,
palpitaciones, tensin muscular, llanto, boca seca, problemas intestinales, hormigueo,
entumecimientos, tics, fatiga, dolores de espalda, temblores, imgenes mentales negativas,
miedo a salir de su casa, mal humor, insomnio, ideacin suicida. Instrumentos de evaluacin
Historia clnica multimodal (Lazarus, 2000). Inventario de Salud, Estilos de Vida y
Comportamiento (Snchez Sosa & Hernndez Guzmn,1993). Inventario de Depresin de Beck
(Beck, Steer & Brown, 2009). Inventario de Ansiedad de Beck (Robles, Jurado & Pez, 1993).
Diagnstico multiaxial Eje I: Trastorno delirante, tipo no especificado. Trastorno depresivo
mayor Trastorno de ansiedad generalizada Eje II Trastornos de la personalidad del grupo
Trastorno lmite de la personalidad Eje III. No se informa de trastornos mdicos Eje IV
Problemas de acceso a los servicios de asistencia sanitaria. Problemas relativos a la
interaccin con el sistema legal o el crimen. Eje V EGF: 52 puntos Objetivos de intervencin
Reducir los sntomas de depresin mayor y ansiedad generalizada. Racionalizacin de sus
pensamientos Desarrollar conductas asertivas Modificacin de comportamientos desadaptados
Procedimiento Se trabaj durante 12 sesiones, las tres primeras se enfocaron a recolectar
informacin y aplicar los instrumentos. A partir de la cuarta sesin y hasta la onceaba se
entren a la paciente en la identificacin y modificacin de sus ideas irracionales. En la ltima
sesin se aplic un post-test, y se entrevist nuevamente a la paciente Evaluacin de la
intervencin Se compararon las puntuaciones obtenidas y se valor el cambio en los
comportamientos. Por otra parte, se le solicit que informara cmo se senta, cmo pensaba y
cmo se comportaba en funcin de lo objetivos planteados. Conclusin La informacin
proporcionada da evidencia de cambios importantes, elimin sus comportamientos agresivos,
desarroll habilidades de interaccin social, modific sus pensamientos negativos. Se observ
mejora en su apariencia fsica, expresin facial y en su comportamiento. Actualmente, se le da
seguimiento en sesiones individuales cada tres meses.
Psychological Treatment for Chronic Nightmares - Randomized Controlled Trial with two
Active Treatments and Wait-list Control
Viktor Kaldo1, Jaap Lancee2, Lisa Nmm3, Sara Ytterbrink3, Niels Ek3, Erik Hougfeldt3, Jerker
Hetta1, Susanna Jernelv1.
1. Karolinska Institutet, Stockholm, Sweden, 2. Utrecht University, Utrecht, Netherlands, 3.
Stockholm University, Stockholm, Sweden.
Abstract Central: Introduction Nightmares are distressing or frightening dreams and 2-5% of
the population suffer from recurrent and distressing nightmares. Disturbed sleep, fear and
distress during night and/or day, expectancy anxiety and impaired functioning are common.
Nightmares seem to contribute to the development and maintenance of other psychiatric

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problems. For example, individuals with nightmares are more often categorized as suicidal, high
levels of nightmares predict premature death, and among psychiatric patients in Sweden suicide
attempts were about 5 times as common for those with nightmares. Various forms of CBT have
been used to treat nightmares. Applied Relaxation has some empirical support but Imagery
Rehearsal Therapy (IRT) is so far the most empirically supported treatment. IRT consists of
approaching the dreams and visualize a positive ending. So far IRT has been compared to
untreated controls or treatments that have included methods similar to those in IRT, and it is
therefore difficult to determine the specific effect of IRT. Self-help-CBT with therapist support,
including Internet-delivered CBT (ICBT) is effective for a wide range of psychiatric conditions.
Some self-help treatments for nightmares have been tested, but often non-supported and so far
no ICBT-studies have been conducted. ICBT is an attractive methodological option for
comparing different treatment manuals. The high level of standardization ensures treatment
adherence and the formats effective use of therapist time and wide uptake area facilitates
inclusion of large numbers of participants. Method This randomized controlled trial compares
two six-week long guided ICBT-programs, IRT (n=74) and Applied Relaxation (AR; n=73) with
each other and with a wait-list control group (WL; n = 28). The proposed criteria in the DSM-V
were used for diagnoses The interventions were carefully designed to not include any of the
components that are expected to be effective according to the opponent treatment rationale.
The AR thus promotes a relaxation and distancing strategy, and not working directly with dream
content, while the IRT rather focuses on exposure, reconstructing dream content, and imagery
rehearsal, without relaxation components. The step-by-step treatment modules were delivered
on a web-platform which also provided a secure message system where patients reported
homework and received feedback by a therapist with thorough training in CBT, spending
approximately 10-15 minutes each week on a patient. Primary outcomes measured at posttreatment and nine months after treatment were frequency (number of nightmares per week)
and nightmare related distress as measured both by a two-week diary and by retrospective
questionnaires. Insomnia and depression were measured as secondary outcomes. Results
Preliminary results for the first 85 patients showed significant superiority of IRT compared to
both AR and WL on frequency and distress when measured with the two-week diary at posttreatment. On retrospective ratings, IRT was only significantly superior to WL. Final results for
post-treatment and preliminary data from the nine-month follow-up will be presented.
Attentional Avoidance of Threatening Stimuli in Social Anxiety and the Relative
Contributions of Arousal and Self-Focused Attention
Bradley King.
Cancer Services and Pallliative Care, St Vincent's Hospital Sydney, Sydney, NSW, Australia.
A number of attentional biases have been identified as important in the etiology and
maintenance of social anxiety, including attentional avoidance of socially threatening facial
expressions. Two key mechanisms have been proposed to underlie attentional avoidance of
threat in social anxiety; physiological arousal and self-focused attention (SFA). The current
study examined attentional avoidance in social anxiety and its proposed mechanisms by
exposing high trait socially anxious (HSA) and low trait socially anxious (LSA) participants to
socially threatening and non-threatening facial expressions. Attentional avoidance was indexed
by recording the time participants viewed each facial expression, with the prediction that HSA
would spend less time viewing threatening faces than LSA. Physiological arousal was indexed
using salivary alpha amylase (sAA), a biomarker of endogenous noradrenergic arousal.Fiftyseven undergraduate students (33 women) were recruited and allocated to HSA (n=29) or LSA
(n=28). In a mixed model design, participants provided salivary samples (sAA) both before and
after the view time task andcompleted a self-report measure of focus of attention after the view

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time task. Results provided mixed support for initial hypotheses: HSA endorsed greater SFA
during the view time task and spent less time viewing both socially and non-threatening facial
expressions than LSA.Further, regression analysis revealed that arousal was a unique predictor
of decreased time viewing social facial expressions in LSA, but not in HSA, while SFA did not
predict viewing times for either group. These results provide mixed support for current models of
social anxiety and underscore the need for further investigation into attentional biases in social
anxiety.
Novel Findings in Anxiety Sensitivity Research
Kristina Korte1, Kristina Korte1, Amanda Raines1, Aaron Norr1, Daniel Capron1, Norman
Schmidt1, Daniel Capron1, Amanda Raines1, Kristina Korte1, Aaron Norr1, Norman Schmidt1,
Amanda Raines1, Kristina Korte1, Aaron Norr1, Daniel Capron1, Norman Schmidt1, Michael
Zvolensky2, Richard Macatee1, Jesse Cougle1, Aaron Norr1, Daniel Capron1, Kristina Korte1,
Amanda Raines1, Norman Schmidt1, Bunmi Olatunji3.
1. Psychology, Florida State University, Tallahassee, FL, USA, 2. University of Houston,
Houston, TX, USA, 3. Vanderbilt University, Nashville, TN, USA.
Considerable research has examined the role of cognitive vulnerability factors in the
development of anxiety psychopathology. Much of this literature has focused on anxiety
sensitivity (AS; Reiss & McNally, 1985), the fear of anxiety and its related consequences.
Indeed, AS has been shown to predict the development of anxiety psychopathology, especially
panic (Schmidt, Lerew, & Jackson, 1997) and posttraumatic stress related symptoms (Olatunji &
Wolitzky-Taylor, 2009). Elevated AS has also been associated with marijuana use and smoking
dependence (Zvolensky et al., 2006), highlighting the diverse range of problems associated with
elevated levels of AS. Given the widespread impact of AS, efforts aimed at understanding the
nature of AS and the potential methods for intervention are crucial for furthering this line of
research.
The purpose of this symposium is to present novel findings and recent advances in AS
research. The presentations will begin by discussing new approaches in the reduction of AS.
First, Kristina Korte will discuss the effect of motivation enhancement therapy in the reduction of
AS. Second, Dan Capron will discuss the efficacy of a cognitive-bias modification paradigm in
reducing AS. Third, Amanda Medley will discuss the use of an AS intervention in a communitybased population of smokers. Fourth, Richard Macatee will discuss the use of a low affect
tolerance intervention in reducing anxiety sensitivity. In the final presentation, Aaron Norr will
discuss the use of an experimental manipulation aimed at increasing AS by priming healthrelated concerns. Implications of the results on the nature of AS and will be discussed. Dr.
Bunmi Olatuji, an expert in cognitive-vulnerabilities for anxiety psychopathology, will serve as
the discussant for this symposium. Dr. Olatunji will integrate the presented findings, incorporate
these findings with the existing body of literature, and highlight avenues for continued innovative
studies on AS.
Motivation Enhancement Therapy Reduces Anxiety Sensitivity
Anxiety sensitivity (AS), the fear of the consequences of anxiety, is known to be a risk factor in
the development and maintenance of anxiety psychopathology. In recent years, AS has been
shown to be responsive to a variety of interventions aimed at reducing this malleable risk factor.
Motivational interviewing (MI) and motivation enhancement treatment (MET) have been shown
to be effective in enhancing the treatment of anxiety disorders. Thus, it was hypothesized that
motivational interventions may also be effective in those with elevated AS. The aim of the
present study was to examine whether the use of MI/MET would be effective in reducing AS.
Participants (N = 65) with elevated AS were randomized into an MET or health-focused

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psychoeducation control group. Results revealed that the MET condition showed a significant
reduction in AS in comparison to the control group (27% reduction in the MET group, 16%
reduction in the psychoeducation control group). These findings are comparable to reductions
observed in other AS interventions and are the first to demonstrate the efficacy of using MI/MET
strategies to reduce AS. Implications of the use of MI/MET as risk prevention interventions are
discussed.
Interpretation Bias Modification for Anxiety Sensitivity: Pilot Results
Evidence supports the role of anxiety sensitivity (AS) as a risk factor for a variety of forms of
psychopathology. Cognitive biases could potentially explain part of the etiology and persistence
of AS in vulnerable individuals. Very anxious individuals or those who have been diagnosed with
an anxiety disorder usually experience threat related biases in their cognitive processing.
Specifically, individuals with high AS appear to have an interpretation bias (interpreting
emotionally ambiguous situations in a negative manner) for anxiety sensations. A constellation
of procedures known as cognitive bias modification (CBM) have been developed to reduce
these cognitive biases. In this pilot study we randomized 29 individuals to receive an active
interpretation bias modification or a control interpretation bias modification. Results show that
the active condition is successful in reducing AS [F(1,26) = 14.65, p = .001, partial eta squared
= .36). These results will be discussed in terms of future clinical and research applications.
Efficacy of a Panic Prevention Program in Smokers with Elevated Anxiety Sensitivity
Empirical evidence suggests that cigarette smokers are at increased risk for developing panic
attacks (Breslau & Klein, 1999), panic disorder (Johnson et al., 2000), and anxiety related bodily
sensations (Zvolensky et al., 2004). In addition, research has demonstrated that panic
vulnerability factors, such as anxiety sensitivity (AS), are associated with poor smoking
cessation outcomes (Brown, Kahler, Zvolensky, Lejuez, & Ramsey, 2001). Despite these bidirectional associations, there has been little effort to develop intervention programs targeting
psychological vulnerability factors such as AS within smoking populations. Thus, the current
study aimed to assess the effects of a panic prevention focused smoking program or a general
smoking program on reductions in AS. Participants consisted of 222 adult daily smokers.
Results revealed that there was not a significant main effect of treatment condition, (F (1,195) =
2.54, p = .11, partial eta squared = .01) or condition by time interaction between treatment
condition and time (F (1,195) = .23, p = .63, partial eta squared = .00). However, there was
significant main effect for time, F (1,195) = 38.46, p < .001, partial eta squared = .17, with both
groups showing a significant reduction in AS from baseline to week 1 follow-up. Implications for
future research and treatment will be discussed.
A Computerized Intervention for Low Affect Tolerance and its Effect on Anxiety
Sensitivity and Associated Pathology
Anxiety sensitivity has been linked to a number of anxiety conditions (Deacon & Abramowitz,
2006). Other transdiagnostic emotional vulnerability factors, such as distress tolerance (DT),
have been linked to anxiety disorders as well. However, the relationship between AS and other
affect intolerance constructs (e.g., DT) remains unclear. One study found AS and DT to be
related but distinct lower-order factors of a higher-order affect sensitivity and tolerance factor
(Bernstein et al., 2009). Indeed, both constructs were found to be independently related to a
variety of anxiety symptoms (Keough et al., 2010). More research is necessary to determine
how increasing broad affect tolerance affects different domains of AS (i.e., physical, social,
cognitive). It has been demonstrated that AS can be effectively targeted using a brief
intervention that utilizes only psychoeducation and interoceptive exposure (Keough & Schmidt,
2012). However, it is unclear if a broader intervention targeting general affect intolerance can
similarly affect AS. Therefore, a brief computerized intervention aimed at increasing affect

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tolerance was developed utilizing only psychoeducation and emotional exposure. Forty
participants reporting low affect tolerance were randomized to the treatment condition or a waitlist control. The effect of the intervention on AS will be discussed. In addition, the potential
mediating role of changes in AS on reduction in different anxiety symptom domains will be
explored.
Health Anxiety, Medical Information Seeking, and Anxiety Sensitivity
Anxiety Sensitivity (AS), or a fear of anxiety symptoms, is a well-researched risk factor for the
development of psychopathology. There is a substantial literature linking AS to anxiety
disorders. More recently, researchers have found an association between AS and health
anxiety, particularly one facet of AS, the physical subscale (which represents fears of physical
anxiety sensations such as: racing heart, sweating). Patients with anxiety, particularly health
anxiety, often engage in persistent, exaggerated health seeking behaviors such as using the
internet to better understand vague, somatic symptoms. For example, heath anxiety patients
commonly report frequently checking medical information websites (e.g. WebMD) to investigate
bodily sensations. Although seeking out appropriate medical advise is often very helpful, often
those with anxiety do not obtain long-term reassurance and relief from viewing internet
websites. Given the connection between health anxiety and AS, we decided to investigate what
role of medical information plays in maintaining AS. The current study presented individuals with
PDFs of real medical information websites that related to commonly experienced anxiety
symptoms (e.g. rapid heart rate, dizziness) with instructions to study the information presented.
Participants were randomly assigned to the experimental condition or a control condition in
which they were presented PDFs of websites about healthy living (e.g. exercise and nutrition).
Participants AS was measured before and after the website studying period which lasts 20
minutes. Consistent with expectation results indicated a significant condition x time effect such
that individuals in the experimental condition reported significantly higher levels of AS than
those in the control condition following the manipulation. These results have implications for
health seeking behaviors including use of the internet to seek out medical information.
Public Speaking Fear: Its Extinction and Return
Mario Laborda1, Casey Schofield2, Emily Johnson3, Jessica Schubert3, Daniel George-Denn3,
Meredith Coles3, Ralph Miller3.
1. Departamento de Psicologa, FACSO, Universidad de Chile, Santiago, Chile, 2. Skidmore
College, Saratoga Springs, NY, USA, 3. Binghamton University, Binghamton, NY, USA.
Abstract Central: Prior studies have shown that extinguished fear to some extent returns when
participants are evaluated outside the context in which exposure practice took place. However,
some techniques have been shown to reduce this return of fear. A cue from the exposure
context (i.e., an extinction cue) that is also presented in the context of testing has proven
successful in attenuating the return of fear in several conditioning preparations, but has recently
failed to diminish the return of fear of public speaking. Here we assess whether the return of
fear of public speaking is a reliable finding, and whether either of two types of extinction cues
can attenuate it. Participants fearful of public speaking gave speeches of graduated difficulty in
an exposure practice session. Two days later, all participants were evaluated for self-reported
public speaking anxiety in a different context. Fourteen participants were tested in the presence
of a physical cue presented during exposure practice, twelve participants were tested after
mentally rehearsing the exposure practice session, and twelve participants were tested in the
absence of either extinction cue. Participants reduced their fear of public speaking by giving
speeches of graduated difficulty, but fear responses partially returned when participants were
tested two days later in a different context. Neither physical or mental extinction cues reduced
the return of fear of public speaking. The return of extinguished fear of public speaking seems to

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be a reliable effect, but at least in some circumstances is not substantially responsive to the
effects of extinction cues.
Influencia de variables dependientes especificas en el desarrollo y mantenimiento de la
Ansiedad y sus Trastornos Coordinadora: Mara Esther Lagos (Uruguay)
Maria Lagos1, 2, Raquel Zamora1, 2, Eduardo Keegan1, 2, Maria Lagos1, 2, Bernard Rang1, 2.
1. ALAPCO - Asociacion Latinoamericana de Psicoerapias Cognitivas, Montevideo, Uruguay, 2.
SUAMOC, Soc.Uruguaya de Analisis y Modificacin de la Conducta, Montevideo, Uruguay.
La ansiedad y sus trastornos junto con la depresin, se han convertido en un motivo de
consulta cada vez as frecuente. Lo datos de la OMS nos dicen que la depresin es el trastorno
mental que ms afecta a la poblacin en el mundo. En Amrica Latina y el Caribe, la depresin
es la ms comn (5%), seguida por los trastornos de ansiedad (3,4%) )
Mltiples investigaciones dan cuenta de la alta comorbilidad entre depresin y ansiedad, de que
los trastornos de ansiedad aumentan el riesgo de depresin y que la depresin aumenta el
riesgo de enfermedad cardiovascular
Con nuestro modelo de trabajo podemos conceptualizar los diferentes problemas,
diagnosticarlos, formular hiptesis y, en funcin de ella organizar la estrategia de tratamiento.
Varios de nuestros consultantes comparten diagnsticos, al cumplir con los criterios de los
actuales manuales clasificatorios, sin embargo hay diferencias cualitativas muy importantes
entre individuos.
Como resultado de una evaluacin conductual es tarea fundamental poder identificar las
variables intervinientes centrales, que varan de consultante a consultante. Es en funcin de
ellas que organizaremos nuestra intervencin.
Si bien hay protocolos de tratamiento manualizados que han demostrado su eficacia y que son
utilizados exitosamente, se investigan e identifican aspectos cada vez ms especficos que nos
hacen afinar nuestra intervencin.
En este Simposio integrado por psicoterapeutas latinoamericanos, se expondrn algunos de
estos aspectos (VI) especficos y su relacin con el mantenimiento de la ansiedad y sus
trastornos.
De la ansiedad rasgo a los trastornos de personalidad ansiosos
Dra Raquel Zamora - Uruguay
rzamora19@gmail.com
ramora@gmail.com
Se comenzar presentando la ansiedad como rasgo o dimensin de la personalidad,
desarrollada en base a un temperamento ansioso heredado y a variables biolgicas que actan
durante el perodo pre y perinatal. La presencia de factores de estrs severo durante el
embarazo predispone al desarrollo de un fenotipo vulnerable por estimulacin inapropiada del
eje hipotlamo- hipfiso-adrenal y un predominio del sistema nervioso simptico y as la mayor
probabilidad que ese rasgo se convierta en desadaptativo. El tipo de apego madre-hijo, las
caractersticas de personalidad de los padres que actuarn como modelos, los estilos de
crianza, la presencia de estresores como el maltrato y el abuso, el instituto de enseanza al
que concurra el nio, otros modelos adultos, el vnculo con pares incidirn para que la ansiedad
quede como rasgo adaptativo o se convierta en un patrn persistente, inflexible que produzca
deterioro funcional. As se llega a personalidades ansiosas y temerosas, como la evitativa y la
obsesivo-compulsiva. En la primera la ansiedad a exponerse a situaciones que le generen el
sentimiento de rechazo o de ser socialmente inepto, conduce a evitar cualquier tipo de riesgo, a
la aparicin de cogniciones negativas cada vez ms slidas y ms limitantes. En el obsesivo la
ansiedad es la consecuencia de la necesidad permanente a actuar en forma perfecta para no

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defraudar o ser castigado, as contiene sus emociones, persiste en lo ya aprendido y conocido


para evitar el dolor que le produce el cambio y la incertidumbre. Otros trastornos de
personalidades como el esquizotpico o el lmite tambin desarrollan rasgos ansiosos
maladaptativos mezclados con otros que llegan a ser los ms relevantes.
El tratamiento de pacientes con estos trastornos de personalidad tendr como objetivo la
enseanza de estrategias que le ayuden a lidiar con los sntomas ansiosos que le limitan y
minimizar los deterioros que le producen en el diario vivir.
Perfeccionismo y trastornos emocionales
Dr.Eduardo Keegan (Argentina)
ekeegan@gmail.com
El perfeccionismo ha sido asociado a diversas patologas, en especial trastornos emocionales.
Los enfoques mas actuales han postulado distintos perfiles de perfeccionismo. Esto va en lnea
con la perspectiva transdiagnostica que ha arrojado importantes resultados en la psicopatologa
y la clnica de los trastornos del nimo y de la ansiedad. En nuestra ponencia habremos de
presentar nuestro trabajo de investigacin sobre perfeccionismo en estudiantes universitarios,
asi como las estrategias que hemos impelementado en una intervencin psicoeducativa bajo
estudio.
Nuestra investigacin ha respaldado el modelo multidimensional, revelando distintos perfiles de
perfeccionismo (adaptativo, desadaptativo y no perfeccionistas). Nuestro estudio confirma el
lugar central dado a la discrepancia en varios modelos.
El perfeccionismo clnico no se relaciona con altos estandares per se, sino por la discrepancia,
definindola como la distancia percibida entre el estandar elevado perseguido y el logro
alcanzado, junto con una actitud critica y temerosa de cometer errores. Debido a esto, el foco
clnico debera centrarse en la reduccin de la discrepancia.
Adems, describiremos el estado del arte del perfeccionismo en los trastornos de ansiedad y
nuestro proyecto de investigacin e intervencin sobre el punto.
Aspectos Cognitivos centrales en los Trastornos por Ansiedad
Lic. Ps.Mara Esther Lagos
melagos10@gmail.com
Los tratamientos de los trastornos por ansiedad requieren, tanto como cualquier otro trastorno,
una evaluacin diagnstica- conductual exhaustiva: un corte transversal profundo en el aqu y
ahora y una evaluacin de su historia (variables etiolgicas, de desarrollo y de mantenimiento
del problema), a fin de poder formularnos una hiptesis explicativa que nos permita entonces
organizar una estrategia de abordaje. La intervencin implica naturalmente atender
especficamente la demanda del paciente, pero tambin aspectos generales relacionados.
En el caso de los trastornos de ansiedad en principio la intervencin se dirije a reducir la
sintomatologa ansiosa dado que muchas veces interfiere significativamente con su vida para,
posteriormente, atender los factores que disparan la ansiedad y que fundamentalmente son
cognitivos.
En general el abordaje teraputico consiste en:
Ensearle al consultante a entender su problema
Brindarle herramientas de manejo de la ansiedad Modificar sus expectativas catastrficas y suspensamientos anticipatorios ansigenos .
Ayudarlo a exponerse, enfrentando en forma graduada o masiva, tanto en la imaginacin como
en la realidad, las situaciones asociadas a cada trastorno de ansiedad en particular.
Ms all de lo que es especfico de cada uno de los trastornos, hay varios aspectos que todos
comparten. A saber:
En todos ellos la ansiedad se dispara en situaciones en las cuales no es una reaccin
adaptativa sino desadaptativa.

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Muchos de los recursos teraputicos que son utilizados para tratar por ejemplo un ataque de
pnico, son perfectamente compatibles con los utilizados para los dems trastornos de
ansiedad.
Todos evitan experimentar ansiedad, y lo que evitan depende de cada trastorno, es decir que
las diferencias fundamentales estn ms en la exposicin que en cualquier otro de los aspectos
de tratamiento
En la exposicin sern desarrollados fundamentalmente los aspectos cognitivos -ideas
irracionales, distorsiones y atribuciones equivocadas- que los pacientes presentan en relacin a
la ansiedad y su sintomatologia, cuya modificacin es indispensable a fin de evitar recadas.
Quality of Life and Anxiety Disorders
Lisa Liberman1, Deborah Beidel2, Nina Wong2, Dustin Sarver2, Lars-Gran st3, Lisa Liberman1,
Maria Paz Altuzarra1, Lars-Gran st3, Thomas Ollendick7, Thomas Ollendick7, Ronald Rapee4,
Heidi Lyneham4, Carolyn Schniering4, Denise Chavira5, Mikael Thastum6.
1. Psychology, Universidad de los Andes, Santiago, Chile, 2. University of Central Florida,
Orlando, FL, USA, 3. Stockholm University, Stockholm, Sweden, 4. Macquaire University,
Sydney, NSW, Australia, 5. University of California, Los Angeles, CA, USA, 6. Aarhus
University, Aarhus, Denmark, 7. VirginiaTech, Blacksburg, VA, USA.
The purpose of our symposium is to examine the quality of life impairments among children and
adults suffering from different types of anxiety disorders. Across the studies, children and adults
suffering from anxiety disorders have been compared with normal controls, in order to study the
potential effect of anxiety disorders on individuals subjective quality of life. A related concept
that is discussed in the symposium is life interference. Some of the presentations within the
symposium also look at the effect that a successful anxiety treatment might have on individuals
quality of life. The studies within this symposium show that children and adults suffering from
generalized types of anxiety disorders (generalized social anxiety disorder, agoraphobia and
generalized anxiety disorder) report a significantly lower quality of life (or a higher life
interference) than normal controls or children and adults suffering from non-generalized anxiety
disorders (specific phobias and non-generalized social anxiety) do. On the other hand, anxiety
patients who are successfully treated for their disorders seem to experience a significant
improvement in their self-reported quality of life.
Quality of Life Impairments among Adults with Social Phobia: The Impact of Subtype
Social phobia is characterized by extreme fear in social or performance situations in which the
individual may be exposed to embarrassment or scrutiny by others, which creates occupational,
social and academic impairment. To date, there are few data examining the relationship of
social phobia impairments to quality of life. In this investigation, we examined how demographic
characteristics, comorbidity, and social competence are related to quality of life among patients
with social phobia and normal controls. In addition, we examined the impact of social phobia
subtype.
Results indicated that individuals with generalized social phobia had significantly impaired
quality of life when compared to individuals with no disorder or individuals with nongeneralized
social phobia. Comorbid disorders decreased quality of life only for patients with nongeneralized
social phobia. Hierarchical linear regression revealed that a diagnosis of social phobia and
observer ratings of social effectiveness exerted strong and independent effects on quality of life
scores. Results are discussed in
terms of the role of social anxiety, social competence, and comorbidity on the quality of life for
adults
with social phobia.

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Quality of life in anxiety disorders


Quality of life defined as subjective well-being or life satisfaction was assessed with the Quality
of Life Inventory (QOLI) in three carefully DSM-diagnosed samples of anxiety disorder patients:
social phobics (n=79), agoraphobics (n=78) and generalized anxiety disorder (n=35), and
compared with a sex- and age-matched sample of normal community residents (n=100) without
any psychiatric disorders.
The results showed that the anxiety patients had significantly lower quality of life than the
normals, and that the GAD-patients and the agoraphobics had lower scores than the social
phobics. There were no gender differences. Married patients had a better quality of life than
unmarried or divorced, and patients who worked full-time or part-time had better quality of life
than those unemployed or on sick-leave. Only self-reported and assessor-rated depression had
significant independent contributions to the prediction of QOLI-scores.
Life Satisfaction in Anxious Children and Normal Controls
To date, there are few data examining the relationship between two types of anxiety disorders
and childrens subjective quality of life. In this cross-cultural study, we examined how
demographic characteristics and anxiety diagnoses (social anxiety and specific phobias) are
related to subjective quality of life, in 8-14 year old children from three different countries
(Sweden, USA and Chile). Results indicated that children who suffer from suffer from social
anxiety are significantly less satisfied with several areas of their lives than children suffering
from specific phobias or children from the normal population. Some important aspects of this
decreased life satisfaction, or quality of life, are related to social areas and, even more
importantly, self-respect, something that might have important practical implications in the
treatment of this disorder.
Assessment of life interference in anxious children
Mental disorders produce significant impact on people's lives and result in large burden on
individuals and societies. Life interference is also a key factor differentiating sub-clinical
difficulties or personality styles from clinical disorders. This makes the impact and life
interference associated with mental disorders arguably the key issue of relevance to both
sufferers and therapists. Yet among both childhood and adult disorders the primary focus in
terms of assessment and treatment is on symptoms, with far less attention paid to the impact of
these symptoms on the sufferer's life. This imbalance has particularly characterised research on
child anxiety where few studies have examined either the impact of anxiety disorders on
children's lives or the effects of treatments on life interference. To some extent this lack of
attention has come from a lack of well developed measures to assess life interference derived
from symptoms of anxiety. Broader and more general life interference measures tend to have
minimal relevance for children with anxiety disorders.
The current paper will describe two measures of life interference that have been developed at
the Centre for Emotional Health directed at children and adolescents. One measure, the
Children's Anxiety Life Interference Scale (CALIS) was developed to assess interference directly
associated with symptoms of anxiety in children and adolescents, while the other, the
Adolescent Life Interference Scale (ALIS) is a broader measure of life interference of direct
relevance to adolescents. The talk will describe psychometric properties and will then provide a
descriptive coverage of levels of interference associated with different anxiety disorders. Age
differences, gender differences, and additional correlates will be described and use of the
CALIS with samples in other countries will also be described.
Developmental Perspectives on Anxiety-Linked Cognitive Biases and their Modification
Heather Liebregts1, Jennifer Hudson2, Lavinia Cheie3, Mircea Miclea3, Laura Visu-Petra3,
Patrick Clarke1, Lies Notebaert1, Kathryn Lester4, Suzanne Broeren2, Colin MacLeod1, Allison

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Waters5, Brendan Bradley6, Karin Mogg6, Jennifer Lau7, Cathy Creswell8, Elske Salemink9,
Reinout Weirs9.
1. School of Psychology, University of Western Australia, Crawley, WA, Australia, 2. Macquarie
University, Sydney, NSW, Australia, 3. Babes-Bolyai University, Cluj-Napoca, Romania, 4.
King's College London, London, United Kingdom, 5. Griffith University, Gold Coast, QLD,
Australia, 6. University of Southampton, Southampton, United Kingdom, 7. Oxford University,
Oxford, United Kingdom, 8. University of Reading, Reading, United Kingdom, 9. University of
Amsterdam, Amsterdam, Netherlands.
Anxiety symptoms in children and adolescents have been associated with interpretive biases.
Cognitive theories suggest that such biases in information processing play a crucial role in the
development and maintenance of anxiety. It is increasingly recognised that the nature of the
manifestation of these interpretive biases in early development is complex, and associated with
factors such as memory, malleability and anxiety disorder type. Despite these complexities
however, Cognitive Bias Modification of Interpretations (CBM-I) has shown promise in reducing
anxiety symptoms in children and adolescents through the modification of these biases. Our
symposium explores different developmental perspectives on anxiety-linked cognitive biases,
and how these biases can be modified in children and adolescents to reduce anxiety. First,
Laura Visu-Petra will demonstrate that anxious children have an explicit memory bias towards
negative information, suggesting that anxiety-linked cognitive biases could already be present
during early development while processing anxiety-relevant emotional information. In a second
presentation, Patrick Clarke will show that the malleability, or readiness with which an
attentional bias to threat can be evoked represents a common cognitive potential which may
contribute to the concordance between parent and child anxiety levels. Thirdly, Allison Waters
will show that a distinction can be made between fear and distress disorder types in terms of
vigilance for, and avoidance of, threat. Jennifer Lau will then present research showing that
CBM-I training is effective in adolescents. In a final presentation, Elske Salemink will
demonstrate that not only is CBM-I effective in adolescents, but that this effect is particularly
pronounced in more vulnerable individuals, such as those who have a pre-existing threat-related
interpretive bias or low executive control.
Trait Anxiety and Memory Biases for Emotional Information in Children
Introduction. Although symptoms of subclinical and clinical anxiety are common even in the
preschool period and persist through the childhood years and into adulthood (Hadwin & Field,
2010), research analyzing the onset of childrens anxiety-related cognitive biases has been
scarce and often contradictory. To date, most of the developmental researchers studying
cognitive vulnerability factors in high-anxious children, have been interested in investigating
attentional biases towards threat and threat appraisal distortions. However, data regarding
childrens cognitive vulnerability factors, especially with respect to remembering emotional
information, remains scarce and inconsistent.
Aim and results. The general aim of this series of three studies was to address critical issues in
the cognitive bias development domain, by focusing on the role of individual differences in trait
anxiety in young and school-age children on various aspects of their memory for emotional
information. The findings revealed that, compared to their low-anxious counterparts, highanxious children tend to display: (1) immediate poorer recall of negative words (Study 1, N = 76,
mean age = 65.5 months); (2) an impaired recognition (Study 1) and updating (Study 2, N = 60,
mean age = 73.6 months) of identities with happy facial expressions, as well as a better delayed
recognition and a superior update performance for identities expressing anger; (3) an emotion
induced memory trade-off, as children better recalled negative visual central information, at the
cost of a poorer recall of the neutral peripheral elements accompanying the negative stimuli
(Study 3, N = 99, mean age = 125.8 months). Hence, our overall results confirm the existence of

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an explicit memory bias towards negative information in high-anxious children.


Conclusions. The current findings allow us to speculate that anxiety-related cognitive biases
could already be present during early development, while processing anxiety-relevant emotional
information. The results also reveal that memory biases are not found at clinical levels of anxiety
only, supporting the possibility of a continuum of anxiety symptoms - anxiety disorders
documented by previous research with children (Schniering, Hudson, & Rapee, 2000).
Identifying the Cognitive Basis of Shared Parent-Child Anxiety: Assessing the
Relationship between Attentional Bias, its Malleability, and Anxiety Vulnerability
There is considerable evidence that anxiety vulnerability tends to run in families (e.g. Cooper et
al, 2006). While shared genetics undoubtedly contribute to this, environmental factors, including
parental cognitive biases are also likely to contribute to shared parent-child anxiety. Attentional
vigilance for threatening information is known to characterise heightened anxiety vulnerability
(Cisler & Koster, 2010) and, it is now well established that altering patterns of selective attention
for negative information causally influences emotional vulnerability to stress (Hakamata et al,
2010). Recent studies have also found that individual differences in the degree to which an
attentional bias for threatening information can be evoked predicts the development of
heightened anxiety over time in response to extended mild stress (Clarke et al, 2008). Such
research suggests that attentional malleability may represent a critical cognitive mechanism
which renders individuals differentially susceptible to becoming more anxious over time. It is
possible therefore that parents and children share the tendency for an attentional bias to be
evoked in response to environmental contingencies involving threat, more than they share an
existing attentional bias, and that it is the former which is associated with commonalities in
anxiety vulnerability.
The current study sought to examine the relationship between parents and childrens existing
attentional bias, their evoked attentional bias, and their trait anxiety levels. Attentional bias for
threat was assessed using an attentional probe assessment task. To assess the degree to
which an attentional bias can be evoked participants completed a brief version of the attentional
probe training task which encouraged an attentional preference for threat, before again
assessing attentional bias. Results revealed that parents attentional bias predicted their
childrens current trait anxiety (r = .44). Parents and childrens current attention bias was not
significantly associated (r = .18), however, the parents and childrens evoked attentional bias
was significantly associated (r = .42). These results are consistent with the possibility that the
readiness with which an attentional bias for threat can be evoked represents a common
cognitive potential which may contribute to the concordance between parent and child anxiety
levels. These results will be discussed in light of recent research highlighting that genetic
markers associated with anxiety vulnerability are also associated with the readiness to alter
selective attention for threat.
Biased Attention to Threat in Paediatric Anxiety Disorders: Vigilance and Avoidance as a
function of Distress versus Fear Disorders
Background: Structural models of emotional disorders propose that anxiety disorders can be
classified into fear and distress disorders. Sources of evidence for this distinction come from
genetic, self-report, and neurophysiological data from adults. The present study examined
whether this distinction relates to cognitive processes, indexed by attention bias towards threat,
which is thought to cause and maintain anxiety disorders. Methods: Diagnostic and attention
bias data were analysed from 435 children between 5 and 13 years of age; 158 had principal
fear disorder (specific phobia, social phobia, or separation anxiety disorder), 75 had principal
distress disorder (GAD) and 202 had no psychiatric disorder. Anxious children were a clinicbased treatment-seeking sample. Attention bias was assessed on a visual probe task with
angry, neutral and happy faces. Results: Compared to healthy controls, children with principal

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distress disorder showed a significant bias towards threat relative to neutral faces, whereas
children with principal fear disorder showed an attention bias away from threat relative to neutral
faces. Overall, children displayed an attention bias towards happy faces, irrespective of
diagnostic groups. Conclusions: Findings support the distinction between fear and distress
disorders, and extend empirically-derived structural models of emotional disorders to threat
processing in childhood, when many anxiety disorders begin and predict lifetime impairment.
Reducing childrens social anxiety symptoms:
Exploring a novel parent-administered cognitive bias modification training intervention
Social fears and worries in children are common and can be disabling - with considerable
impact on educational and social outcomes. As these conditions also have long-term effects on
well-being and mental health, it is imperative to treat symptoms early. Yet, questions have been
raised over the efficacy, suitability and accessibility of current frontline treatments. Recent data
implicate Cognitive Bias Modification of Interpretations (CBM-I) training in the reduction of adult
social anxiety. Targeting interpretations might be particularly important in social situations,
because social cues are often ambiguous and thus open to distorted interpretation. CBM-I
training involves repeatedly presenting participants with incomplete ambiguous scenarios, which
can only be completed satisfactorily by endorsing a benign assessment of the scenario. The
idea is that over time, these positive resolutions, which are reinforced by feedback, become
automatic, overriding any negative interpretational tendencies, thus reducing anxietyvulnerability.
Biased interpretations have also been linked with social anxiety in children. Extending CBM-I to
children could yield therapeutic benefits for this age range given that training relies on simple
reinforcement learning mechanisms, similar to those by which children and adolescents first
acquire negative anxious cognitions. Second, as late childhood and early adolescence
coincides with a period of protracted brain maturation, tentatively, training-facilitated learning
may benefit from higher levels of plasticity. Despite these compelling reasons, CBM-I
extensions to developmental samples have yielded inconsistent effects on mood. One reason
for this may be that multiple sessions are necessary for CBM-I benefits to take effect. Another
reason may be that the computerised or experimental interface of the training tool lacks
ecological validity. Here, we present data following a novel parent-administered CBM-I training
tool in which training items are presented as bedtime stories, read aloud by a parent to the child.
Training sessions occur over three nights. Initial data from 19 children are promising: compared
to a test retest control group (n=17), those assigned to receive CBM-I reported greater
endorsement of benign items after (t(34) = 2.41, p<0.05) but not before training. Moreover,
these participants also showed a significant reduction in social anxiety symptoms (t(18) = 3.69,
p<0.05), a finding that did not characterise the test-retest control group (t(16) = 1.49, p=n.s.).
Studies are underway to compare these findings with a placebo and active control group.
Modifying threat-related interpretations in adolescents: Effectiveness and moderating
variables
Objectives
Socially anxious feelings sharply increase during adolescence and such feelings have been
associated with interpretive biases. Cognitive theories argue that such biases in information
processing play a crucial role in the development and maintenance of anxiety. Studies in adults
have shown that such interpretive biases can be modified using Cognitive Bias Modification
procedures (CBM-I) and, clinically most interesting, subsequent effects on anxiety have been
observed. The current study was designed to examine whether the CBM-I training procedure
has similar effects in adolescents and what factors moderate the effectiveness of training (level
of pre-training anxiety, interpretive bias and executive control).
Methods

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Unselected adolescents were randomly allocated to either a positive interpretation training


(n=88) or a placebo-control condition (n=82). Participants in the positive interpretation training
condition received short scenarios (in total 50 scenarios) describing ambiguous social situations
that contained a word fragment. Participants solved the fragments which resulted in a positive
interpretation. Anxiety was assessed with the STAI questionnaire and executive control with the
classical Stroop task.
Results
Results revealed that the training was successful in modifying interpretations. Adolescents who
received the positive training interpreted new ambiguous social information more positively and
less negatively than adolescents in the control condition. The interpretive bias effects were most
pronounced in the more vulnerable individuals, that is in individuals with a threat-related
interpretive bias at pre-test and in individuals with low executive control. No effects on state
anxiety were observed.
Conclusions
The current findings are promising in that they revealed the malleability of threat-related
interpretations in adolescents. In addition, it was shown that the more vulnerable individuals
benefitted the most. This suggests that in a more vulnerable population such as clinically
anxious adolescents beneficial effects on dysfunctional cognitions might be obtained using such
a short computerized training paradigm. These findings reveal the relevance of basic cognitive
experimental research for the development of novel interventions in clinical practice.
Emotion Regulation after Social Exclusion in Generalized Social Anxiety Disorder
Michelle Lim, Thomas Rodebaugh.
Washington University in St Louis, St Louis, MO, USA.
Abstract Central: Emotional hyper-reactivity and dysregulation are central features in cognitive
models of social anxiety (Hofmann, 2004). One common stressor is social exclusion, which is
thought to challenge emotion regulation in most people, and particularly so for people with
higher social anxiety (Oaten et al., 2008). We therefore expected that individuals diagnosed with
generalized social anxiety disorder (GSAD) would report more negative affect and consume
more unhealthy food after being socially excluded when compared with individuals with no
social anxiety disorder (NOSAD). Participants include 42 individuals with GSAD and 38 NOSAD
individuals who are demographically equivalent. To induce negative affect, all participants were
excluded in a Cyberball task (Williams & Jarvis, 2006) that simulated playing with individuals the
person identified as being close to them. Participants were offered cookies and chips to eat and
left for 10 minutes after exclusion. Positive and negative affect scores were measured at
baseline, after exclusion, and recovery phases (10 minutes after exclusion). The Difficulties for
Emotional Regulation questionnaire (DERS; Gratz & Roemer, 2004) was also administered as a
trait-level measure of emotion regulation problems. Individuals with GSAD consumed more
unhealthy food after being socially excluded when compared with individuals with NOSAD (d =
0.51, p = .03). For the DERS, GSAD participants reported significantly more difficulties with
regulating emotions compared with NOSAD participants (d = 1.30, p = .00). There were
however no significant changes in state positive and negative affect post exclusion between
GSAD and NOSAD participants. Results suggest that the trait-like tendencies toward poor
emotion regulation reported by GSAD participants are not as evident during a direct challenge.
There was more evidence for problems with emotion regulation as measured by food
consumption than changes in mood. It seems plausible that although GSAD is related to poorer
emotion regulation, individuals with GSAD may have only a limited ability to recognize the forms
taken by their emotion regulation problems. These results have clinical implications for the
treatment of individuals with GSAD.

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Jumping to Conclusions Bias in Generalized Social Anxiety Disorder: An introduction to


the Social Probabilistic Inference Task
Michelle Lim, Thomas Rodebaugh.
Washington University in St Louis, St Louis, MO, USA.
Abstract Central: The jumping to conclusions (JTC) bias refers to a tendency to gather less
evidence before reaching a decision (Dudley et al., 2011). The JTC bias is a cognitive reasoning
style associated with the severity of delusional beliefs (So et al., 2010), but a tendency toward a
JTC bias has also been found in nonclinical samples (Freeman et al., 2008). There is emerging
interest on the impact of anxiety on the JTC bias. One study found that individuals with higher
trait anxiety showed a significant JTC bias compared with individuals lower in trait anxiety
(Bensi & Giusberti, 2007), but another study found that social anxiety did not have an impact on
the JTC bias (Lincoln et al, 2010). These tentative findings contributed to the development of
the Social Probabilistic Inference Task (SPIT), which is a modified version of the standard
probabilistic inference task designed to measure the JTC bias. Participants were presented with
a series of positive and negative facial expressions, which were described as occurring in a
social situation. The main index drawn from the task is the number of facial expressions a
participant requests before reaching a decision of whether he or she was liked or disliked by
another person. Participants were given an easier SPIT condition (85:15) where the task was
biased towards one answer over another, and a more difficult SPIT condition (60:40) where the
task was less biased towards one answer. It was anticipated that individuals diagnosed with
Generalized Social Anxiety Disorder (GSAD; n = 42) would demonstrate significantly more JTC
bias (regardless of task difficulty) when compared with individuals with matching demographics
but no GSAD (NOSAD; n = 38). Current results indicate that individuals with GSAD
demonstrated a significantly higher JTC bias when compared with individuals with NOSAD
above and beyond paranoia (d = 1.00, p = .001) only in a difficult SPIT task condition (60:40).
There was a trend towards significance for the easier SPIT condition (85:15) where individuals
with GSAD demonstrated higher JTC bias when compared with individuals with NOSAD above
and beyond paranoia (d = 0.54, p = .07). Overall, a more difficult SPIT condition highlighted
reasoning differences between individuals with GSAD and individuals with NOSAD. When
presented with a difficult SPIT condition, individuals with GSAD requested fewer facial
expressions before making a decision of whether they were liked or disliked by someone when
compared with individuals with NOSAD. This difference does not seem to be straightforwardly
related to GSAD participants being simply more paranoid than NOSAD individuals. The SPIT
task is a novel experimental method of measuring the JTC bias in the context of social anxiety
and may illuminate how biases in reasoning may affect the development of interpersonal
relationships. There are clinical implications in refining the assessment of biased reasoning
styles in people with social anxiety disorder as reasoning biases may be implicated in the
formation and maintenance of mental disorders.
Assessing the Causal Contribution of Biased Attention to Spider Fear
Alea Losch, Colin MacLeod.
Psychology, The University of Western Australia, Perth, WA, Australia.
Cognitive theories on anxiety propose that attentional biases to threat play a key role in the
development and maintenance of anxiety disorders, ranging from the disposition to experience
anxiety in general to the disposition to experience anxiety in response to specific fears. The
attentional dot probe task has proved particularly persuasive in providing evidence of this. Using
a training version of the attentional dot probe task it has been found that for individuals
experiencing anxiety in general, differentially training either an attentional response to threat or

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an attentional response away from threat resulted in an elevation and reduction in the emotional
reactivity experienced towards a subsequent stressor, respectively. This experimental
manipulation of attentional responses to threat, now known as attentional bias modification, and
the subsequent changes in emotional responses to stressors has reliably been observed in
individuals experiencing anxiety in general. However, it remains to be seen whether for
individuals experiencing anxiety in response to specific fears, in particular spider fear,
attentional bias modification will subsequently impact the emotional fear response experienced
by these individuals when exposed to a live spider. In order to assess this, the present study
differentially trained 40 midrange spider-fearful students to either attend towards spider images
(Attend Threat Condition; n =20) or to attend away from spider images (Attend Neutral
Condition; n =20). Prior to and following the attentional dot probe training task the participants
were required to approach a live spider and rate the anxiety they experienced in their approach.
This task is known as a behavioural approach task (BAT). Using the BAT, the participants
emotional fear responses were computed, which was defined as the rate at which their anxiety
changed per step travelled towards the live spider. This design enabled assessment of whether
differentially training attentional responses to spider images subsequently impacted on the
emotional fear responses of the individuals when exposed to a live spider. The results of the
present study showed that those individuals trained to attend away from spider images showed
an inhibited attentional response to spider images and a significantly lower emotional fear
response following training compared to those individuals trained to attend towards the spider
images. This research has important implications in understanding the development and
maintenance of specific fears, as well as practical implications in the treatment of specific fears.
Arachnids, Attention and Anxiety: Determining the Causal Role of Biased Attention in
Spider Fear
Alea Losch, Colin MacLeod.
Psychology, The University of Western Australia, Perth, WA, Australia.
Abstract Central: Cognitive theories of anxiety propose that attentional biases to threat play a
key role in the development and maintenance of anxiety disorders, ranging from those that
involve the elevated experience of general anxiety to those that instead reflect specific fear
responses to specific stimuli. The attentional dot probe task has been widely used to assess
such anxiety-linked attentional bias. Moreover, using a bias modification version of the
attentional dot probe task it has been found that inducing differential attentional responses to
threat information can serve to influence anxiety reactivity to a subsequent stressor. The
attenuation of attentional bias to threat, using such attentional bias modification, has been
shown to reduce general anxiety. However, it remains to be seen whether such attentional bias
modification can attenuate specific fears responses, for example by reducing the anxiety elicited
when spider fearful people are exposed to a live spider. To address this issue, the present study
trained 40 midrange spider-fearful students to either attend towards spider images (Attend
Threat Condition; n =20) or away from spider images (Attend Neutral Condition; n =20). Before
and after this attentional bias modification procedure, the participants were required to report
their anxiety levels as they approached a live spider, which permitted calculation of the rate at
which their anxiety grew with increasing proximity to this feared stimulus. It was found that
participants who were trained to attend away from spider images not only came to show
inhibited attention to the spider images, compared to participants who were trained to attend
towards these images, but also evidenced significantly lower elevations of anxiety as they
approached the live spider. The implications of this research for understanding the development
and maintenance of specific fears, and for treating such fears, will be discussed.

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Estudo da Comorbidade Entre Fobia Social e o Abuso/Dependncia de lcool No


Universo da Ateno Primria Sade de Juiz de Fora - MG
Lelio Loureno, Andrezza Martinez, Andriele Oliveira, Auxiliatrice Badar, Brbara Loures,
Carolina Dittz, Ernani Gomes, Greice Pavo, Jonayne Souza, Laura Amieiro, Lucas Silva, Vtor
Souza, Daniel Gomes, Francesca Stephan.
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
O transtorno de ansiedade social (TAS) ou fobia social, como tambm conhecido,
caracterizado pelo medo acentuado diante de situaes sociais ou de desempenho.
Considerado um problema de sade mental, possui curso crnico e muitas vezes incapacitante.
Cerca de 80% dos pacientes com esse transtorno relatam comorbidade com pelo menos uma
outra doena psiquitrica. O estudo das comorbidades importante em vrias condies
clnicas por diversas razes: epidemiolgicas, diagnsticas, fisiopatolgicas e de tratamento
(Nardi, 2000; Falcone, 1995). O abuso ou dependncia de lcool se caracteriza como uma das
comorbidades mais frequentes do TAS. A Ateno Primria Sade (APS) um dos contextos
de sade estratgicos para se estudar e investigar problemas relacionados ao consumo de
lcool e transtornos de ansiedade, sendo um nvel de ateno importante para as prticas
preventivas e que carece de investigaes sobre o desenho do perfil da demanda que busca
este servio de sade. Sendo assim, tornam-se relevantes estudos sobre a comorbidade entre
FS e o consumo de lcool na populao brasileira, principalmente na ateno primria a sade.
A presente pesquisa tem como objetivo investigar a associao entre a fobia social e o
alcoolismo no universo da Ateno Primria Sade de Juiz de Fora - MG. Foram
selecionados 254 sujeitos entre 18 e 60 anos, moradores de 31 bairros pertencentes a rea de
abrangncia do Programa de Sade da Famlia (PSF) em Juiz de Fora - MG. Para a coleta de
dados esto sendo utilizados trs questionrios fechados, de auto preenchimento: a Escala de
Ansiedade Social de Liebowitz; o Inventrio de Ansiedade de Beck e o Teste para Identificao
de Problemas relacionados ao Uso de lcool (Audit). Foi realizado contato com as Unidades de
APS que possuem PSF. Nas unidades selecionamos os participantes que esto inscritos na
ficha de cadastro das famlias. Aps essa seleo, em alguns casos, em companhia dos
agentes de sade, os pesquisadores vo casa dos participantes para aplicao dos
instrumentos de acordo com a tica profissional. O presente estudo possui aprovao do
Comit de tica em Pesquisa da Universidade Federal de Juiz de Fora (UFJF) e tambm da
Secretaria Municipal de Sade de Juiz de Fora. A pesquisa encontra-se na fase de coleta de
dados desde maro de 2012. J foram coletados questionrios em seis bairros. Foram
realizadas 78 entrevistas, cerca de 30% do total a ser pesquisado. Os dados esto sendo
digitalizados e posteriormente sero analisados. Como limitaes do estudo podemos apontar
as seguintes dificuldades no que diz respeito coleta de dados: a contagem dos participantes a
partir dos registros das fichas tem sido difcil, uma vez que existem diferenas na organizao
dos dados entre as Unidades de APS; e, encontrar os participantes selecionados em casa, j
que a maioria encontra-se no perodo de trabalho, o que envolve voltar vrias vezes ao mesmo
local, inclusive aos sbados. No entanto, os dados esto sendo colhidos e a previso de
trmino da coleta de dados no final do ano de 2013.
Estudo da Eficcia de Terapia Cognitivo-Comportamental em Grupo para Fbicos
Sociais
Lelio Loureno, Auxiliatrice Badar, Carolina Dittz, Victor Gomes, Daniel Gomes, Francesca
Stephan.
PPG Psicologia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.

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Abstract Central: A fobia social (FS), tambm conhecida como transtorno de ansiedade social
(TAS), caracterizada por um medo acentuado de situaes sociais ou de desempenho, nas
quais o indivduo teme se sentir envergonhado ou embaraado (DSM-IV-TR, 2002). A FS pode
prejudicar o desenvolvimento humano, podendo afetar vrias reas, como o trabalho, escola e
outras atividades sociais. (Del Rey & Pacini, 2005). Para Knijnik (2008) Para Knijnik (2008) a
FS possui causas mltiplas, advindas da interao dos fatores gentico, biolgico, psicolgico,
cognitivo, comportamental e psicodinmico. Estima-se que o TAS seja alto na populao, com
5% a 13% de incidncia (Nardi, 2000; Book & Randall, 2002; Picon, 2006), alm da alta
comorbidade, que ocorre em 75% dos casos (Barros Neto, 2000). Atualmente, o tratamento
reconhecido para a FS so a farmacoterapia e a terapia cognitiva e/ou comportamental (TCC),
pois se mostram eficazes na reduo de ansiedade social em indivduos com TAS (Del Rey &
Pacini, 2006; Ito & Roso, 2008; Muluno, Menezes, Fontenelle & Versiane, 2009). Na TCC se
destaca o trabalho em grupo, visto que o contato social por si s estimulado evitando ainda
mais o isolamento (Hofmann, 2004). Diante disso, verifica-se a importncia de intensificar
estudos sobre este transtorno, como aponta Chagas e cols. (2010), para quem a fobia social
sub-reconhecida e subdiagnosticada por profissionais da sade. O presente estudo faz parte
das atividades do Ncleo de Estudos em Violncia e Ansiedade Social (NEVAS), do
departamento de Psicologia da Universidade Federal de Juiz de Fora - UFJF, financiado pela
Fapemig (Fundao de Amparo Pesquisa do estado de Minas Gerais). O projeto em vigor
busca acolher a comunidade acima de 18 anos, atravs do tratamento da fobia social baseado
nos padres da Terapia Cognitiva Comportamental em Grupo. Nosso primeiro procedimento
consiste na aplicao de instrumentos de rastreio, entre eles a Escala Liebowitz de Ansiedade
Social, o Inventrio de ansiedade de Beck e o Inventrio de depresso de Beck. Atravs destas
escalas conseguimos identificar o nvel de ansiedade social bem como as possveis
coomorbidades, que podem inviabilizar o tratamento. Aps a avaliao dos instrumentos
iniciaram-se os encontros semanais, de 90 min ministrados uma vez por semana durante dois
meses e meio. O grupo foi composto de 6 integrantes (4 mulheres e 2 homens) e
administrado por dois profissionais da psicologia e um aluno em fase de concluso de curso.
Nos encontros utilizamos o formato descrito por DEl Rey(2006) e seu grupo de pesquisa,
baseado no protocolo de tratamento utilizado na Temple University por Heimberg (2002).
Nesse modelo foram integradas tcnicas de exposio, reestruturao cognitiva e treinamento
de habilidades sociais (THS), esse utilizado, direta e indiretamente na exposio ao vivo s
situaes temidas. Essa experincia pretendeu levantar as principais dificuldades e
facilitadores desse tratamento, bem como seus resultados teraputicos, porm os dados ainda
esto em processo de anlise. O objetivo principal consiste na melhoria dos sintomas, da
qualidade de vida e dos comportamentos mais adaptativos dos pacientes, os quais sero
constatados a partir das observaes clnicas e aplicao dos inventrios propostos.
Observaciones Clnicas y Sustentacin Terica Sobre el Origen, Evolucin y Tratamiento
de la Crisis de Angustia
Roberto Mainieri C.
1. Sociedad Panamea de Psicoterapia, Panam, Panama, 2. Instituto Panameo de Terapia
Cogntiva Conductual, Panam, Panama.
Abstract Central: Los trastornos de ansiedad junto a la depresin, constituyen los problemas
que con ms frecuencia se presentan en la prctica clnica; siendo capaces de generar un alto
nivel de sufrimiento personal, problemas en el funcionamiento familiar, en la pareja y en las
relaciones interpersonales. No tratado, los trastornos de ansiedad se convierten en condiciones
crnicas que pueden complicarse con depresin y enfermedades mdicas. Es importante que
el terapeuta tenga conocimientos sobre los mecanismos que subyacen en estos trastornos y

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los tratamientos eficaces para capaces de restablecer el bienestar y la productividad de las


personas, cuando hayan estado afectadas por diferentes trastornos de ansiedad durante varios
aos de sus vidas. En este trabajo se presentan diversos aspectos del origen, evolucin y
tratamiento de el Ataque de Pnico, producto de las observacin clnica de pacientes tratados
por el autor, conceptuados a travs del marco terico de la Terapia Cognitiva-Conductual. En
cuanto al tratamiento, se destaca el valor del abordaje cognitivo, los mtodos conductuales y el
valor o no de la medicacin, segn los resultados observados en los pacientes tratados,
enfatizando el hecho de que cada uno de estos elementos tiene una importancia especfica y
complementaria dentro del tratamiento. --------------------------------------------------------------------------------------------------------- Anxiety disorders together with depression, are problems that more
frequently arise in clinical practice; being able to generate a high level of personal suffering,
problems in family functioning, couples and interpersonal relationships. Untreated, anxiety
disorders become chronic conditions that can complicate with depression and medical illness. It
is important that the therapist has knowledge about the mechanisms underlying these disorders
and effective treatments capable of restoring the well-being and productivity of people, when
they have been affected by different anxiety disorders for several years of their lives. This work
presents various aspects of the origin, evolution and treatment of the panic attack, product of
the clinical observation of patients treated by the author, conceptualized through the theoretical
framework of the cognitive-behavioral therapy. Concerning the treatment, this work highlights
the value of cognitive approaches, behavioural methods, and the value or not medication,
according to the results observed in treated patients, emphasizing the fact that each of these
elements has a specific and complementary importance within the treatment.
Estresse e Ansiedade de Teste - Uma Reviso da Utilizao da Abordagem Cognitivista
Luciana Mancio Balico, Regina Margis.
Faculdade da Serra Gacha, Caxias do Sul, Brazil.
Ao tentar identificar as razes que contribuem aos bons e estudiosos alunos a serem
reprovados em seus concursos, depara-se com sintomas de ansiedade de desempenho e de
estresse, que podem resultar da falta de preparo emocional e psicolgico para realizar as
provas. O objetivo do trabalho foi revisar dados da literatura com a meta de investigar a
utilizao da terapia cognitivista e comportamental no manejo da sintomatologia de ansiedade
e estresse dos estudantes que se preparam para provas de concursos. Foi realizada uma
reviso da literatura a partir de uma busca na base de dados da PUBMED, selecionando
artigos publicados no perodo de 1981 a 2011. A busca consistiu no cruzamento das palavras
exam, test e examination com as expresses em ingls cognitive therapy, behavioral therapy,
Cognitive Behavioral Therapy (CBT) e psychotherapy, que correspondem a terapia cognitiva,
terapia comportamental, terapia cognitivo-comportamental e psicoterapia. Foram encontrados
dez artigos. A partir das informaes descritas nesses artigos foi identificado que os resultados
apresentados correspondiam a melhora do estresse e da ansiedade de teste em todas as
pesquisas aps as intervenes. Em oito artigos foi descrito uma melhora de desempenho no
teste aps interveno. O uso da Terapia cognitivo-comportamental como interveno de
tratamento para ansiedade de teste e estresse foi apresentado nos artigos revisados como
efetiva sendo proposto que tal efeito foi devido a sua ao educativa e a disponibilidade para
potencializar aes autogestoras dos alunos. Frente a relevncia e frequncia de ocorrncia de
estresse e ansiedade em situaes de testes e suas consequncias no desempenho escolar,
alm do escasso numero de pesquisas e publicaes sobre o tema, considera-se vlido,
ampliar o conhecimento no assunto.

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A Long-Term Follow Up of Completers of CBGT for Social Phobia: A Naturalistic Study


Sofi Marom1, 4, Tal Tavor4, Lev-Ari Lilach, Cfir Seifert4, Eva Gilboa-Schechtman3, Idan Aderka5,
Avraham Weizman1, 2, Haggai Hermesh1, 2.
1. Geha Mental Health Center, Kfar Saba, Israel, 2. Tel Aviv University, Tel Aviv, Israel, 3. Bar
Ilan University, Ramat Gan, Israel, 4. Rupin Academic Center, Emek Hefer, Israel, 5. Haifa
University, Haifa, Israel.
Abstract Central: RCTs have demonstrated that Social Phobia (SP) can be successfully
treated with CBT. Group CBT (CBGT) has received robust empirical support. However there is
scarce data on long follow-up (FU) studies on outcome of CBGT for SP. Moreover, there is
scarce data on long FU studies in naturalistic settings. In addition, there is unclear data as to
factors predicting maintenance of CBGT gains in naturalistic settings. The first goal of the study
was to examine whether outcome of CBGT for SP is maintained after long FU periods.
Specifically, we aimed to reach patients who completed CBGT up to 15 years prior the study.
The second goal was to examine the differential response of generalized and specific SP
individuals to CBGT at a long FU. The third goal was to examine the impact of depression on
CBGT outcome at a long FU . The fourth goal was to find predictors of long term outcome of
CBGT for SP. CBGT was conducted in an outpatient public clinic for anxiety disorders with large
groups (10-20 participants). There were 18 weekly 1.5 hour sessions, conducted by a therapist
and a co-therapist. Drop out rate was about one third of the participants. Students (MA
Psychology) contacted all completers of CBGT during 1997-2010. Questionnaires were sent
and completed electronically. Participants were 495 patients who completed CBGT. We
reached out 229 participants. Analyses included 221 participants. We are currently in the midst
of data collection. Patients were assessed before and after CBGT and at FU . Measures
included: Personal Data (Demographic: marital & employment status. Clinical: Psychotherapy
after CBGT, medications status), Liebowitz Social Anxiety Scale, Sheehan Disabilities Scale
and Beck Depression Inventory. Results: SP symptoms further improved at the long FU.
Functioning in work and social areas also improved at FU. Generalized SPis had higher scores
than specific SPis on all measures, however no Trx. X Subtype interaction was found between
termination and FU. Depression was not related to treatment outcome nor at termination neither
at FU. Conclusions: CBGT for SP in a naturalistic setting may be a beneficial treatment for longterm periods Limitations: Results are based only on partial data, thus conclusions might be
incomplete. We aim to enlarge the data in the next few weeks and present the full analysis at
the conference.
Efectos de un Programa Cognitivo - Conductual Sobre la Ansiedad Rasgo - Estado en
Estudiantes Universitarios
Renzo Martnez Munive.
Practica Privada, Lima, Peru.
Abstract Central: La investigacin tuvo como objetivo evaluar un programa cognitivo conductual de 10 sesiones, sobre la ansiedad rasgo (AR) y ansiedad estado (AE) en
estudiantes del 3 aos de la facultad de Psicologa de una universidad pblica. Se utiliz un
diseo cuasi-experimental de pre y post test con un grupo control (GC) y un grupo experimental
(GE). Utilizndose el inventario de ansiedad rasgo - estado (IDARE). La muestra estuvo
constituida por 25 alumnos (entre 19 y 24 aos) que tuvieron puntajes superiores al promedio
en AE y AR, dividindose en dos grupos (GC=12 y GE=13 alumnos). Al finalizar el programa, el
GE se redujo a 10 alumnos. Se realiz la validez y confiabilidad del instrumento para esta
poblacin con 60 alumnos. Los resultados indican que existen diferencias altamente
significativas (p<0.001) en las mediciones pre y post test en el GE, en AR y AE. Asimismo,

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existen diferencias significativas (p<0.01), en la AR y AE, en el GC y GE luego de aplicarse el


programa. Adems, al comparar las medidas previas y posteriores considerando el sexo,
encontramos que existen diferencias significativas (p<0.01) en la AR y AE en mujeres y AE en
varones, pero no en la AR. Finalmente, al comparar las medidas previas y posteriores
considerando la edad en el GE, encontramos en los dos grupos diferencias significativas
(p<0.05) en la AR y AE. Frases claves: Ansiedad rasgo - estado, Programa cognitivo conductual, Terapia cognitivo - conductual, Estudiantes universitarios The aim of this research
is to evaluate a cognitive - behavioral program of 10 sessions, on trait anxiety (TA) and state
anxiety (SA) in students of third year of the school of Psychology at one public university. Cuasiexperimental design was used pre and post test with a control group (CG) and an experimental
group (GE), using state - trait anxiety inventory (STAI). The sample was constituted by 25
students (between 19 and 24 years) who had above average scores on AR and SA, divided into
two groups (CG = 13 and EG = 12 students). At the end of the program, the EG was reduced to
10 students. The validity and reliability of the inventary was performed for this population by 60
students. The results indicated that there are highly significant differences (p <0.001) in pre and
post test measurements in the EG in TA and SA. There are also significant differences (p <0.01)
in AR and SA, in CG and EG after the program was applying. Additionally, comparing the pre
and post measures, considering sex, we found that there are significant differences (p<0.01) in
TA and SA in women and SA in men, but not in TA. Finally, when comparing pre-and post
measures, considering the age at EG, we found significant differences (p <0.05) in TA and SA
in both groups. Key words: State - trait anxiety, Cognitive - behavioral program, Cognitive behavioral therapy, College students.
Humor as an Exposure Stimuli: A Physiological Investigation of the Response to
Different Types of Humor in the Socially Anxious
Chad McCoy, Sean McMillan, Bethany Barnett, Jade Porter, Deon Hall, Caleb Lack.
University of Central Oklahoma, Edmond, OK, USA.
Numerous studies have shown that cognitive-behavioral therapy, in particular exposure and
response prevention, is the gold-standard treatment for anxiety disorders. However, there are
numerous difficulties in conducting exposures, not the least of which is obtaining the proper
triggers for a persons anxiety. As such, alternative means of provoking anxiety are often
sought. This project investigates if and how persons with high social anxiety and a control group
differ in their physiological reactivity to three different forms of video humor (uncomfortable or
awkward, gross-out, and slapstick) and a non-arousing control (boring news story). This is being
done to examine the possibility of using humorous stimuli to assist exposure therapy. Initial pilot
results on a small sample (n = 23, 11 with high levels of self-reported social anxiety and 12 with
no self-report anxiety of any kind) of subjects is promising. While no baseline differences are
being seen between groups on the control video, higher galvanic skin response and heart rate is
seen in the socially anxious group. , the two groups appear to have some differences purely
based on an examination of means. This is particularly evidence in the GSR across all videos,
where the non-anxious scores are twice the size of the anxious. There are also apparently large
differences in the HR across all videos. Due to the small sample size, however, our power
appeared to be too low to detect such differences in an ANOVA, as the only statistically
significant difference between the groups was seen on the heart rate in response to the grossout video (F (1, 31) = 4.42, p = .044). This pilot project, despite the low numbers of participants,
yielded interesting data that is being investigated further via ongoing data collection. As such,
this has to potential to help identify easily disseminated stimuli for use during exposure and
response prevention therapy, the most effective and well supported treatment for anxiety
disorders, both in session, between sessions, and in self-guided exposures. Given the

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difficulties in getting persons with social anxiety to engage in exposure and response
prevention, repeated video watching has the potential to be a useful low-level exposure and
could help prepare for more difficult in vivo tasks.
Pilot Evaluation of a New Imagery-Based Group Treatment for Social Anxiety Disorder: A
Case Series
Peter McEvoy1, 2, Lisa Saulsman1.
1. Centre for Clinical Interventions, Perth, WA, Australia, 2. University of Western Australia,
Perth, WA, Australia.
Abstract Central: OBJECTIVES: Despite a burgeoning literature suggesting that imagery is
more powerfully associated with affect than verbal-linguistic activity, most manualised,
evidence-supported cognitive behavioural protocols predominantly work within the verbal mode.
Some imagery-based techniques (e.g., video-feedback) are important components of
contemporary group and individual CBT protocols, but other imagery-based techniques (e.g.,
rescripting) have almost invariably been evaluated within individual treatment formats. The main
aim of this study was to pilot a new manualised, group CBT protocol that incorporates imagery
components throughout. METHODS: Patients (N = 15) referred to a specialist community
mental health clinic for social anxiety disorder attended an imagery-based group CBT (IB-CBT)
program. Treatment comprised of 12, 2-hour sessions plus a one-month follow-up. Symptom
measures were completed weekly. The main session components were: socialisation to the
imagery-based CBT model and imagery monitoring (session 1); imagery manipulation
techniques to challenge beliefs about the significance of negative social imagery (session 2);
psychoeducation about behavioural experiments (BE), including an in vivo BE with an imagery
component (session 3); development of individualised BE hierarchies and metaphorical coping
imagery (session 4); safety behaviours with imagery-based and in vivo components (session 5);
video-feedback to challenge negative self-imagery (session 6); a series of in vivo BEs (session
7); attention training with an imagery component (session 8); rescripting imagery from past
negative social experiences (sessions 9 and 10); constructing new, more positive core beliefs
via imagery (session 11), and relapse prevention (session 12). RESULTS: Patients were severe
and complex with many having multiple comorbidities (e.g., substance abuse, bipolar disorder).
Symptom trajectories were promising and compared favourably to historical data using a goldstandard protocol. Treatment was rated as acceptable by participants. Patients awareness of
spontaneous imagery increased from pre- to post-treatment. CONCLUSIONS: Imagery-based
group CBT for social anxiety disorder is a promising and potentially potent mode of treatment.
Differential Physiological Response to Humorous Stimuli in the Anxious
Sean McMillan, Chad McCoy, Deon Hall, Jade Porter, Bethany Barnett, Caleb Lack.
University of Central Oklahoma, Edmond, OK, USA.
This project investigates if and how persons with high levels of three types of anxiety
(generalized anxiety, social anxiety, and obsessive-compulsive symptoms) and a control group
differ in their physiological reactivity to four video stimuli: three different forms of humor
(uncomfortable or awkward, gross-out, and slapstick) and a non-arousing control (boring news
story). This was done because research regarding anxieties and their link to humor is
nonexistent in the literature, despite anecdotal reports of humor's use in the treatment of
anxiety. Researchers used the Biopac device in order to accurately measure subjects'
physiological responses, particularly galvanic skin response (GSR) and heartrate, as those are
two of the most widely used measures of physiological anxiety. It was hypothesized that 1)

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overall, the anxious participants would show higher arousal levels than controls and 2) there
would be different patterns of high responders with in the anxiety group (e.g., the socially
anxious would show more arousal during the socially uncomfortable humor). This project serves
as a basis to then explore the possible use of individually uncomfortable humor in treatment of
anxiety disorders within the framework of exposure and response prevention techniques. After
consenting to participate in the study, participants completed a demographic questionnaire, the
Penn State Worry Questionnaire (PSWQ), the Leibowitz Social Anxiety Scale (LSAS), and the
Obsessive-Compulsive Inventory - Revised (OCI-R), and a measures of functional impairment
and quality of life (Sheehan Disability Scale and WHO Quality of Life-BREF). All participants
were then attached to the Biopac and be shown a 10 minute control video (boring news story) to
obtain a baseline physiological measure of average heart beats per minute and skin
conductance, then three 10 minute videos of different types of humor (socially uncomfortable Curb Your Enthusiasm; gross-out - Jackass; and slapstick - Happy Gilmore). Finally, the
subjects rated how a) entertaining, b) humorous, and c) uncomfortable they thought each film
clip was. While data collection is ongoing, initial pilot results on a small sample (n = 33) were
intriguing. The sample was divided into anxious (scoring at the clinically significant level on at
least one of the anxiety measures - PSWQ, LSAS, or OCI-R) and non-anxious groups for
analyses, but due to the small size could not be divided into further, anxiety-specific subgroups
to test those hypotheses. Confirmatory of our first hypothesis, those who self-identified as
anxious did display a statistically significantly higher level of reactivity as assessed by heart rate
to the humor stimuli (F (1, 32) = 5.68, p = .032), but there were no differences between groups
on the control stimuli. Due to an equipment malfunction, GSR was only collected on half of the
pilot sample, and as such there were too few participants to do proper analyses on. This
research has to potential to help identify easily disseminated stimuli for use during exposure and
response prevention therapy, the most effective and well supported treatment for anxiety
disorders. These could potentially be used in session, between sessions, and in self-guided
exposures. Given the known difficulties in getting persons with anxiety to engage in exposure
and response prevention, especially for novice therapists, repeated video watching that is
tailored to a person's particular fear or worry has the potential to be a useful low-level exposure
and could help prepare for more difficult in vivo tasks.
Trait Anxiety: Better Safe Than Sorry!
Ann Meulders1, 2, Johan Vlaeyen1, 3.
1. Psychology, University of Leuven, Leuven, Belgium, 2. University of South Australia,
Adelaide, SA, Australia, 3. Maastricht University, Maastricht, Netherlands.
The ability to detect imminent threat (i.e., danger cues) fosters adaptation and survival as it
activates defensive responses such as escape and avoidance behaviors. However, the ability to
accurately detect non-threatening stimuli (i.e., safety cues) is equally important. That is, the
failure to inhibit fearful responding and avoidance to such safety cues might be detrimental for
survival as well, for example, due to depletion of resources following unnecessary escape
behaviors or missing additional resources or opportunities offered by safety cues. Previous
research has demonstrated that anxiety disorders are characterized by overgeneralized fear to
safety cues (Lissek et al., 2010). Delayed discrimination learning or prolonged generalization of
fear responses to safety cues might be a fundamental feature of what makes anxiety disorders
so impairing. Hence, spreading of fear from threat cues to safety cues may have important
implications for the understanding of chronic fear and worry in anxiety disorders, but also for
worrying that is prominent in the general healthy population, which is also impairing and costly.
Despite its evident importance, research exploring the relationship between stimulus
generalization and anxiety levels in humans is scant. An intriguing, yet uninvestigated question

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is whether successful discrimination learning is also more vulnerable in high trait anxious
individuals than in low anxious individuals. In order to answer this question, we re-analyzed the
pooled data of two experimental studies examining acquisition and extinction of fear of
movement-related pain. In both studies, participants filled in the trait portion of the State-Trait
Anxiety Inventory (Spielberger, 1983) and underwent acquisition and extinction of fear of
movement-related pain using the voluntary movement conditioning paradigm (Meulders et al.,
2011) using joystick movements as conditioned stimuli (CSs) and a painful stimulus as an
unconditioned stimulus (pain-US). During acquisition, one movement (CS+) was paired with a
pain-US, another movement was not (CS-). During extinction, the CS+ was no longer
reinforced. We tested whether trait anxiety affected fearful responding to the safety cue during
extinction. Results showed that both low and high trait anxious individuals successfully acquired
the CS+/CS- discrimination. Interestingly, at the beginning of extinction high trait anxious
individuals demonstrated significantly more fear to CS- than low trait anxious individuals. These
findings seem to suggest that safety learning is more vulnerable in people with an anxious
disposition. Under the assumption that overgeneralization and a lack of (persistent) inhibition of
fearful responding to safety cues is at least one important factor in clinical anxiety, prevention of
fear generalization to (previously) safe cues might be targeted in exposure therapy to optimize
treatment effects.
The Efficacy of Cognitive Behavior Therapy Applied to Panic Disorder - Conducting a
Clinical Case According to an Eight Session Treatment Protocol
Thas Moraes.
Instituto Conexo Ser, belo horizonte, Brazil.
This presentation reports a clinical case of a patient diagnosed with panic disorder and
agoraphobia, without the presence of a personality disorder, according to the theoretical and
applied model of Cognitive Behavior Therapy (CBT) . The patient is a 26 years old female,
social worker, presently working at the City Hall, in the city of Contagem, State of Minas Gerais,
the same city where she presently lives at. The method used was standard Cognitive Therapy
(Beck, 1979). The patient's initial scores were Beck Depression Inventory (BDI) = 16, Beck
Anxiety Inventory (BAI) = 27 and Beck Hopelessness Scale (BHS) = 08. The patient presented
complaints of agoraphobic avoidance which entailed subsequent professional and social
difficulties. These difficulties contributed to her seeing herself as "paralyzed with respect to her
life projects. In conducting the clinical case, it was possible to identify a primary schema of
inadequacy and a secondary associated schema of vulnerability. The vulnerability schema
showed up based on the belief that "something bad will happen and I will not have resources to
deal with it", and catastrophic beliefs about the threat of physiological sensations. With
reference to her inadequacy schema, it was associated to beliefs, such as "I am a failure" in
many situations, favoring the development of compensatory strategies that perpetuated her
anxiety symptoms. The intervention included psychoeducation, informing her about panic
disorder and agoraphobia and the cognitive-behavioral model for the disorders. Cognitive
strategies for anxiety management, including relaxation training, were used, along with activity
scheduling and cognitive symptoms management, such as challenging automatic thoughts,
attention to typical cognitive errors, and advantage/ disadvantage and cost/benefit inventories.
Development problem solving skills was aiming at more functional behaviors in order to achieve
her goals. On the intermediate phase of treatment, the focus was on cognitive restructuring
through questioning of dysfunctional beliefs and replacing them with alternative, more functional
beliefs. In the final phase of the treatment, we reinforced the use of strategies for managing
anxiety symptoms, establishing appropriate methods of coping with future situations of
vulnerability for relapse prevention. The patient is presently in follow-up, and treatment

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outcomes have remained effective and satisfactory, as the patient learns to manage her anxiety
symptoms, managing to avoid further panic attacks. Furthermore, it was possible to recognize
the patient's progress toward her previously outlined goals and to develop a project for her
future professional and personal life. Her present scores are BDI= 0, BAI =0 and BHS= 1.
Internet-Delivered Attention Modification Training for Social Phobia: A Randomized
Controlled Trial
Karolin Neubauer1, Maxie von Auer1, 2, Eileen Murray1, Sylvia Helbig-Lang3, Alexander Gerlach4.
1. Christoph-Dornier-Foundation of Clinical Psychology, Muenster, Germany, 2. University of
Bremen, Center for Clinical and Rehabilitation Psychology, Bremen, Germany, 3. University of
Hamburg, Department of Clinical Psychology and Psychotherapy, Hamburg, Germany, 4.
University of Cologne, Department of Psychology, Institute of Clinical Psychology and
Psychotherapy, Cologne, Germany.
Abstract Central: Attentional bias towards social threat is a mechanism which is thought to
maintain social phobia. Recently, computer-delivered trainings have been developed to modify
this bias and thereby reduce anxiety symptoms with encouraging findings. The distribution of
such attention trainings (ATs) via internet might be a promising approach in overcoming
obstacles in health care utilization. However, there is no evidence supporting the effectiveness
of internet-based ATs in clinical populations as yet. The current trial examined effects of an
internet-based AT in individuals with social phobia (N= 56). Participants were randomly
assigned to either eight sessions of an AT based on a modified dot probe paradigm or a control
condition without attention modification. After training and at a 4-month follow-up, both groups
showed small but significant reductions in self-report, behavioral and interview symptom
measures without evidence for effects of the AT condition. There were no links between
changes in biased attention and symptom change. These findings question the effectiveness of
internet-based AT in social phobia. Future studies need to investigate effective variants of
internet-delivered bias modification training before it can widely be applied.
Memory and Emotion on a Sample with Social Anxiety Disorder
Carmem Neufeld, Priscila Palma, Carolina Rossetto.
USP, Ribeiro Preto, Brazil.
Abstract Central: Mnemonic processes are responsible for keeping all human beings life
quality and stability. However, research has shown that such processes can present mistakes
and distortions which can change the course of life. False memories are recollections of events
that never happened in fact, and the current articles have showed consistently that our memory
is susceptible to distortion even when the event carries a high emotional level. Moreover, it is
known that the level of disability and emotional instability interfere for a greater number of false
memories. Anxiety is a normal adaptive response but it becomes pathologic when it is not
proportional to the triggering situation. Amongst the anxiety disorders, there is a prevalent
diagnosis called Social Anxiety Disorder (SAD). This work aimed to compare participating
adults carriers of Social Anxiety Disorder (SAD) and participating adults who do not have these
symptoms, investigating the effect that emotion has in the memory performance, for an event
witnessed. When anxiety is too intense, it tends to harm all spheres of life, and it acquires a
clinical meaning. To develop this study, a sequence of eleven slides was used, followed by two
narrative versions, one with emotional impact and the other without, besides the Subjective
Scale of Emotion, a self-test for memory. The study had 137 participants, who were divided into
four groups: individuals who do not suffer from the disorder and emotionally loaded narrative,

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individuals who do not suffer from the disorder and narrative without emotional load, individuals
who suffer from the disorder and emotionally loaded narrative, individuals who suffer from the
disorder and narrative without emotional load. Parametrical analysis was carried out using the
Variance analysis (ANOVA). All the statistical treatments used an < 0,05 for the hypothesis
test and post hoc tests with correction for Bonferroni to identify the possible differences found.
The results suggest that participants with SAD who were submitted to a version without
emotional impact had higher rates of real memories, according to attentional bias characteristic
of this population. Besides, the participants who suffer from Social Anxiety Disorder (SAD) had
higher rates of false memories who were submitted to a version without emotional impact,
suggesting that emotion acted as a protection and suggesting that the social anxiety has a
significant action over memory performance. Implications for Cognitive Behavioral Therapy and
clinical practice will be discussed.
Superao do Medo de Janela por Meio da Dessenssibilizao Sistemtica
Samira Nogueira.
Aprimore Psicologia Clnica Consultoria em Gesto de Pessoas, Palmas-TO, Brazil.
Abstract Central: O presente estudo teve por objetivo trabalhar a fobia de janela em uma
participante de 40 anos de idade, solteira, autnoma, com ensino mdio completo. Foram
utilizadas diferentes tcnicas comportamentais, com foco principal na Dessensibilizao
Sistemtica por imaginao, para diminuir o medo que a participante apresentava em diversas
situaes que envolviam o estimulo fbico. Os resultados apontaram para a eficcia da
interveno, e indicaram que a Dessensibilizao Sistemtica foi a tcnica principal para a
superao do medo que a participante tinha de janelas, uma vez que, aps sua aplicao, ela
passou a se aproximar e tocar em janelas dentro e fora do consultrio. Passou tambm a falar
sobre janelas sem as respostas de ansiedade que antes apresentava. Palavras-chaves:
Anlise do Comportamento; Dessensibilizao Sistemtica; Fobia especfica.
A Test of Expectancy Theory: Anxiety Sensitivity and Co-Occurring Psychopathology
Aaron Norr, Daniel Capron, Norman Schmidt.
Florida State University, Tallahassee, FL, USA.
Although anxiety sensitivity (AS; a fear of anxiety related sensations) has been a wellresearched risk factor for the development of psychopathology, almost no attention has been
paid to its parent theory, Reiss expectancy theory (ET). Up to this point, ET has gone largely
unexamined. One prediction of ET that has gone untested is that AS is a better predictor of
number of fears than anxiety per se. This prediction was examined using a large (N=317)
clinical sample of anxiety outpatients. Specifically, we examined whether elevated AS predicted
number of comorbid anxiety and non-anxiety disorder diagnoses in this sample. Supporting ET,
AS predicted the number of comorbid anxiety diagnoses above and beyond current anxiety.
Showing specificity, AS did not predict the number of comorbid non-anxiety diagnoses when
current anxiety symptoms were accounted for. These results provide important support for the
validity of Reiss ET, and are consistent with the growing literature suggesting that AS may be a
useful transdiagnostic treatment target.
Computer-Free Cognitive Bias Modification: The Future may Lie in the Cards
Lies Notebaert, Patrick Clarke, Benjamin Grafton, Colin MacLeod.
School of Psychology, University of Western Australia, Crawley, WA, Australia.

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Abstract Central: It is now well established that sub-clinical and clinical anxiety disorders are
associated with an attentional bias towards threatening information. Moreover, there is
encouraging evidence that changing this pattern of attentional selectivity through a procedure
known as attentional bias modification (ABM) results in reduced anxiety vulnerability and
enduring clinical benefits. The most used methodology to induce this attentional change has
been the dot-probe paradigm, in which two stimuli (one threatening, one neutral or positive) are
briefly presented on a computer screen, after which a target probe appears at the location
opposite the threatening stimulus. Through repeated exposure to this contingency participants
are encouraged to adopt a selective attentional pattern away from threat. Although effective, this
methodology has been criticized for being boring, risking high attrition rates when implemented
for treatment (Beard, 2011; Brosan et al, 2011). In addition, the dependence on computer
delivery may be counter-productive in treating some disorders (such as social anxiety) and
prohibits the implementation of the treatment in situations where a computer is not available.
The aim of the current study was to develop a game like ABM paradigm that can be delivered
without a computer and test its effectiveness in changing patterns of attentional selectivity and
emotional vulnerability to a stressor. A card game was developed based on the popular game
SNAP. Each card displayed two faces, one with an angry and one with a happy facial
expression. The task was to match the current card with the previously presented card
according to the identity of the angry person (attend threat condition) or according to the identity
of the happy person (avoid threat condition). A different response was required for match (the
people on the two cards have the same identity) versus mismatch trials (the people on the two
cards have a different identity), and participants were encouraged to complete each deck of
cards (N = 16, 24 cards per deck) as fast and accurately as possible. Change in attentional bias
was assessed using a standard dot probe paradigm and anxiety vulnerability was measured
through responses to a video stressor. Results showed that the card game was effective at
modifying attentional bias, and that participants in the avoid threat condition showed decreased
levels of anxiety vulnerability as compared to participants in the attend threat condition.
Implications for ABM implementations, especially in particular populations such as children, are
discussed.
Uma Proposta de Tratamento Individual da TCC para a Ansiedade Social
Ana Nunes, Beneria Donato.
Psicologia, Faculdade Estcio, Recife, Brazil.
Abstract Central: Uma proposta de tratamento individual da TCC para a Ansiedade Social A
abordagem cognitiva comportamental tem proposto e divulgado diversas tcnicas para o
tratamento da Fobia Social. Nosso objetivo descrever os procedimentos para tratamento da
Fobia Social, dando nfase ao treino de habilidades sociais na forma individual. A literatura
refora que, em alguns casos, a forma grupal mais eficaz, no entanto, sentimos a
necessidade de propor uma forma individual, pois, alm de tambm ser eficaz, algumas vezes
o psicoterapeuta no dispe de um grupo adequado (Donato, 2003). O Treinamento em
Habilidades Sociais (THS) tem sido utilizado para tratamento da fobia Social, por que em geral
os fbicos sociais apresentam dficits de habilidades sociais que mantm a fobia e dificultam a
exposio. Neste sentido ensinar um repertrio adequado de habilidades sociais pode facilitar a
reduo da ansiedade no confronto interpessoal e na exposio gradual. De acordo com
Caballo, (2003) o comportamento socialmente habilidoso um conjunto de comportamentos
emitidos por um indivduo, dentro de um contexto interpessoal, que expressa os sentimentos,
atitudes, desejos, opinies ou direitos desse indivduo, de um modo adequado situao,
respeitando esses comportamentos nos demais, e que geralmente resolve os problemas

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imediatos da situao enquanto minimizam a probabilidade de futuros problemas. Algumas


intervenes utilizadas na proposta individual so o ensaio comportamental, jogo de papis e
vdeo feedback. O tratamento dividido em cinco momentos: primeiro realizado a avaliao,
construo da lista de dificuldades e uma educao; posteriormente o treinamento das
habilidades no consultrio apenas com o terapeuta; em terceiro lugar o treinamento das
habilidades no consultrio com o terapeuta e o co-terapeuta; em quarto lugar o treinamento das
habilidades e exposio gradual ao vivo com o co-terapeuta; finalmente a reavaliao dos
objetivos e das dificuldades atravs do IHS-Del-Prette, Escala Fobia Social e Escala SUDS da
hierarquia de exposio. Os resultados alcanados com esta proposta de protocolo individual
nos fazem concluir, com humildade, que o treino de habilidades individual propicia repertrio
adequado exposio, permitindo ao paciente uma maior confiana para enfrentar as
situaes sociais. Entretanto, so necessrios mais estudos controlados e de seguimento que
possam demonstrar a eficcia da proposta individual de maneira mais cientfica.
Characterizing Disgust-Related Processes: Implications for Anxiety and Related
Disorders
Bunmi Olatunji1, Bethany Teachman2, Iris Engelhard3, Arne Leer3, Emma Lange3, Bunmi
Olatunji1, Peter de Jong4, Johan Verwoerd4, Ineke Wessel4, Charmaine Borg4, Peter de Jong4,
Elizabeth Mason5, Rick Richardson5, Jonathan Gaston6, Andrew Page7.
1. Vanderbilt University, Nashville, TN, USA, 2. University of Virginia, Charlottesville, VA, USA,
3. Utrecht University, Utrecht, Netherlands, 4. University of Groningen, Groningen, Netherlands,
5. University of New South Wales, Kensington, NSW, Australia, 6. Macquarie University,
Syndey, NSW, Australia, 7. University of Western Australia, Crawley, WA, Australia.
Disgust-related processes have been implicated in the etiology and maintenance of several
anxiety and related disorders (Olatunji et al., 2010). Indeed, descriptive and experimental
research has now shown that disgust at the emotional and personality level plays an important
role in some specific phobias (de Jong et al., 2002; Sawchuk et al., 2002) and contaminationrelated obsessive-compulsive disorder (OCD; Olatunji et al., 2005). More recent theoretical and
empirical developments have also begun to examine the extent to which disgust may be
associated with even more complex conditions, including sexual dysfunctions (de Jong et al.,
2009). Subsequent research aimed at better characterizing processes that may be unique to
disgust has shown that disgust is significantly associated with specific anxiety disorder
symptoms independent of various negative affective traits (Olatunji et al., 2007). In an attempt to
explain the unique association between disgust and anxiety-related psychopathology, a
disease-avoidance model is often articulated where stimuli high in contagion potency are
avoided or endured with dread due to excessive disgust reactions (Woody & Teachman, 2000).
However, a disease-avoidance model may be limited in scope given that disgust is also
implicated in anxiety disorders (i.e., height phobia) not marked by disease concerns (Davey &
Bond, 2006). Although evidence implicating disgust in various anxiety and related conditions
continues to grow, there is a clear need for more descriptive and experimental research that
more precisely characterizes basic processes unique to disgust and the implications of such
processes for anxiety and related disorders. Research along these lines may lead to the
development of interventions that more effectively target excessive disgust reactions.
The present series of papers consist of diverse methodologically sound investigations that more
clearly characterizes basic processes unique to disgust and its disorders. First, Engelhard and
colleagues will present data from two disgust conditioning studies demonstrating that while
evaluative conditioned responses do not extinguish, counterconditioning trials reduced US
expectancies to the CS+ and reduced negative valence of the CS+, as evidenced by self-report
and behavioral data. These findings suggesting that counterconditioning may be more effective

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than extinction in reducing learned disgust reaction have important treatment implications.
Olatunji will then present data from descriptive and experimental studies examining the extent to
which three distinct disgust domains are characterized by pathogen concerns. The findings
suggest that while pathogen concerns may explain individual differences in contamination
disgust, it may not fully explain individual differences in core and animal-reminder disgust. De
Jong and colleagues will then present experimental data showing that those high in symptoms
of contamination-based OCD infer risk of contamination on the basis of experienced disgust and
this finding my offer important insights into the persistent of contamination fears. Borg and de
Jong will broaden the scope by examining how sexual arousal interplays with disgust and
disgust eliciting properties in women. The findings suggest that sexual arousal may reduce
subjective disgust and increase behavioural approach of disgusting stimuli. These findings also
suggest that low sexual arousal might be a key feature of particular sexual dysfunctions. Lastly,
Mason and colleagues will outline potential strategies for treating excessive disgust responses
in the context of anxiety and related disorders. This series of talks will highlight new important
directions in processes and mechanisms that are specific to disgust and the implications of such
mechanisms for the development and treatment of anxiety and related disorders. Bethany
Teachman will serve as the discussant for this symposium.
Effects of Extinction and Counterconditioning on Learned Disgust
Although learned disgust appears to play an important role in certain anxiety disorders, much
remains unknown about how the disgust response can be effectively eliminated. Study 1 of the
present investigation examined the effects of extinction on reducing evaluative conditioned
disgust. Participants (N=40) completed acquisition trials, with a disgusting picture as the
unconditioned stimulus (US) and two neutral pictures as the conditioned stimuli (CS+, paired;
CS-; unpaired), followed by extinction trials (i.e., CS only trials; experimental condition) or a filler
task (control condition). Evaluative conditioned effects were quantified by ratings of CS valence
and an affective priming task. Acquisition trials increased US expectancies to the CS+ and
reduced US expectancies to CS-. Extinction trials reduced US expectancies to the CS+, but did
not extinguish evaluative conditioned disgust responses: the CS+ remained negative. Study 2
then examined the effects of counterconditioning on evaluative conditioned disgust. Participants
(N=50) completed acquisition trials, followed by counterconditioning trials, in which the CS+ was
paired with a pleasant US (experimental condition), or a filler task (control condition).
Counterconditioning trials reduced US expectancies to the CS+ and reduced negative valence
of the CS+, as evidenced by self-report and behavioral data. The implications of the potential
differential effects of extinction and counterconditioning on disgust for exposure-based
treatment of specific anxiety disorders are discussed.
Do Pathogen Concerns Fully Characterize All Disgust Domains?
Although core, animal-reminder, and contamination disgust are viewed as distinct types of
disgust, these three disgust domains may be commonly accounted for by pathogen concerns.
Three studies were conducted to test the assumption that a common pathogen concern is the
unifying factor underlying these three disgust domains. Confirmatory factor analysis in Study 1
(n = 2,930) provided support for the three-factor model of core, animal-reminder, and
contamination disgust and indicated that the three-factor model yielded significantly better fit
than a one-factor pathogen disgust model. Study 2 (n = 63) found that only contamination
disgust uniquely predicted behavioral avoidance in a public restroom where pathogen concerns
are salient. Lastly, unselected participants were randomized into a pathogen prevention (n = 30)
or control condition (n = 30) in Study 3. After a baseline period, participants in the pathogen
prevention condition spent one week actively engaging in an array of pathogen prevention
behaviors on a daily basis, followed by a second week-long baseline period. Participants in the
control condition monitored their normal use of pathogen prevention behaviors. Compared to

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controls, those in the pathogen prevention condition reported significantly greater increases in
contamination disgust but not core or animal-reminder disgust. These findings suggest that the
three disgust domains are distinct and while pathogen concerns may explain individual
differences in contamination disgust, it may not fully explain individual differences in core and
animal-reminder disgust.
If I feel Disgusted, It Must Be Contagious- Disgust-Based Reasoning in OCD
One of the striking features of OCD patients (washing/fear of contamination type) is their
persistence in avoiding physical contact with particular stimuli (e.g., door knobs) in the absence
of objective threat. Current models emphasise the importance of illness/contamination related
catastrophical beliefs to explain these dysfunctional behaviours. Recently it has been proposed
that perhaps also emotional reasoning might play a role in the persistence of these avoidance
behaviours.
It has already been shown that anxiety disordered patients tend use an if I feel anxious there
must be danger heuristic, that logically acts in a way to confirm the a priori threat value of
feared stimuli. Similar patterns of emotional reasoning may be elicited by the experience of
disgust: If I feel disgusted it must be contagious. This study tested whether indeed disgustbased reasoning might be involved in fear of contamination. On the basis of the Padua
Inventory (PI) we selected a group of participants high (n = 31, PI > 13 and a group of
participants low (n = 27, PI < 5) in contamination fear. Each participant was presented with a
series of scripts that systematically varied the absence/presence of objective threat of
contamination and the absence/presence of the actors disgust response. Following each script
participants rated their perceived threat of contamination/illness. In line with the hypothesis that
disgust-based reasoning might be involved in fear of contamination, specifically high
contamination fearful individuals inferred risk of becoming ill on the basis of experienced disgust
(in addition to objective threat), as was evidenced by a significant Group (high vs. low) x Threat
(yes vs. no) x Disgust response (yes vs. no) interaction. This finding might not only help to
explain the persistence of contamination fears, but also provides some fresh clues to improve
currently available treatment options.
Sexual arousal in women dampen disgust and disgust-induced avoidance
Sex and disgust are basic, evolutionary relevant functions that are often construed as
paradoxical. In general the stimuli involved in sexual encounters are, at least out of context
strongly perceived to hold high disgust qualities. Saliva, sweat, semen and body odours are
among the strongest disgust elicitors. This results in the intriguing question of how people
succeed in having pleasurable sex at all. One possible explanation could be that sexual
engagement temporarily reduces the disgust eliciting properties of particular stimuli or that
sexual engagement might weaken the hesitation to actually approach these stimuli.
Participants were healthy women (n=90) randomly allocated to one of three groups: the sexual
arousal, the non-sexual positive arousal, or the neutral control group. Video clips were used to
elicit the relevant mood state. Participants engaged in 16 behavioural tasks, involving sexrelated (e.g., lubricate the vibrator) and non-sex related (e.g., take a sip of juice with a large
insect in the cup) stimuli, to measure the impact of sexual arousal on feelings of disgust and
actual avoidance behaviour.
In this study, the sexual arousal group rated the sex-related stimuli as less disgusting compared
to the other groups. A similar tendency was evident for the non-sex disgusting stimuli. For both
the sex and non-sex related behavioural tasks the sexual arousal group showed less avoidance
behaviour (i.e., they conducted the highest percentage of tasks compared to the other groups).
This study has investigated how sexual arousal interplays with disgust and disgust eliciting
properties in women, and has demonstrated that this relationship goes beyond subjective report
by affecting the actual approach to disgusting stimuli. Hence, this could explain how we still

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manage to engage in pleasurable sexual activity. Moreover, these findings suggest that low
sexual arousal might be a key feature in the maintenance of particular sexual dysfunctions.
This above mentioned study relied exclusively on explicit self-report measures and actual
behaviour, thus the question whether these findings would also be translated to the implicit
approach tendencies towards disgusting stimuli remains unanswered. Evidence shows that the
relatively spontaneous behaviours are guided largely by the implicit/automatic associations in
memory, which is the kind of behaviour that seems critically involved in disgust induced
defensive behaviour. Therefore, in this presentation we will present an additional follow-up study
to understanding how sexual arousal interplays with approach tendencies at both the explicit but
also at the more implicit level.
Eww, yuck! Treating disgust in anxiety disorders
Anxiety disorders have traditionally been conceptualised as involving maladaptive fear
responses. However, there is growing awareness that dysfunctional disgust responses play a
key role in certain anxiety disorders, such as phobias of blood and spiders, as well as obsessive
compulsive disorder and post-traumatic stress disorder. That is, people with these disorders
arent just afraid, they also experience high levels of disgust towards feared objects and
situations. Indeed, in many cases, the disgust response is more prominent than the fear
response. We and others in the field have shown that disgust is resistant to extinction, which
suggests that exposure treatments for anxiety may not adequately target disgust reactions. This
inattention to disgust is likely to reduce the effectiveness of treatment or leave the patient
vulnerable to relapse in the future. However, very little is known about how to successfully treat
pathological disgust responses. In this talk, I will outline potential strategies for treating
excessive disgust responses, some of which are currently being explored in the context of a
group treatment program for blood-injection-injury phobia that we have recently established.
Avenues for future research will be discussed.
Group Intervention in Anxiety Disease: Craftwork as Facilitator of the Therapeutic
Process
M. Oliveira.
prtica privada, Aracaju, Brazil.
Group intervention using the cognitive-behavioral approach, to women with anxiety disease,
with or without depressive symptoms, users of mental health service, in the reference center,
located at Anlia Pinna de Assis Family Health Unit, in Aracaju, Sergipe, consists of weekly
group sessions with crafts as facilitators of the therapeutic process, which includes techniques
of: psychoeducation, cognitive restructuring, problems solving, behavioral testing, relaxation,
breathing, among others. The group is characterizes by being open, with approximately eight
women, whose intervention lasts about two hours and thirty minutes. In order to join the group,
the women go through mental health care in this same health unit, when it is detected the need
and profile for their insertion in the group. The intervention described above has shown positive
results. Out of the reports from the group members in moments of feedback sessions, as well as
reports from their relatives, can be observed reduction of anxiety, better adherence to clinical
psychiatric, better family life, social skills, problems solving skills, in addition to marked increase
in self-esteem. In discussing cases at the health unit with the psychiatrist and analysis of
records of the group participants, can be observed other also important effects such as the
insertion in the labor market and the reduction in the use of prescription drugs, antidepressants
and anxiolytics.

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Efectos de un proceso psicoteraputico Cognitivo-Conductual con intervencin de la


familia como estrategia para el tratamiento de una adolescente con Ansiedad
Generalizada (TAG). Estudio de Caso nico
Yamilena Parra Villa1, 2, Marleyn Serrano2, 1.
1. Prctica Privada, Barranquilla, Colombia, 2. Universidad del Norte, Barranquilla, Colombia.
El presente artculo, producto de una investigacin descriptiva que sigue los lineamientos de un
estudio de caso nico, expone los resultados de un proceso psicoteraputico cognitivoconductual con intervencin de la familia en una paciente adolescente con diagnostico de
Ansiedad Generalizada. El propsito era determinar el impacto de la familia en el problema,
tratamiento y el logro final de los objetivos, a partir de los informes cualitativos y los resultados
de las pruebas aplicadas en la etapa inicial y durante la intervencin, se analizaron
cualitativamente los primeros y los segundos a travs de estadstica descriptiva. Los resultados
evidencian cambios importantes durante la etapa individual, como la disminucin de temores
bsicos y de la evitacin como estrategia, sin embargo se mantenan sentimientos de tristeza y
preocupacin por la apariencia, el logro y la aceptacin social. Durante la segunda fase, la
intervencin con inclusin de la familia, se modificaron caractersticas parentales que se
reflejaron en la generalizacin de los cambios, adquisicin y dominio de mejores estrategias de
afrontamiento, autoesquemas ms positivos, disminucin de los sntomas de tristeza y menor
preocupacin por la aceptacin del grupo. Se concluye que la terapia cognitivo-conductual con
inclusin de la familia fue positiva en este caso, sin embargo, responde a las particularidades
del mismo y en este sentido, resulta importante que cada terapeuta adquiera sensibilidad para
determinar no solo que tcnicas utilizar, sino en qu procesos resulta necesaria y pertinente la
intervencin con la familia.
Resultados
Se pueden identificar dos grandes momentos de cambio en relacin a los problemas
encontrados en la paciente, para este propsito vamos a dividir el proceso en dos periodos, de
la sesin 1 a 22 en la cuales el trabajo estuvo orientado especficamente a la paciente y de la
sesin 23 a 38 en las que se realizaron intervenciones tanto con la paciente como con ambos
padres tanto de manera individual como grupal.
Como en todo proceso psicoteraputico con nios en el que se reconoce que el papel de los
padres es determinante en la configuracin de problemticas psicolgicas, si bien estos fueron
incluidos dentro de las primeras sesiones, su papel no fue protagnico y el objetivo de incluirlos
era mas de tipo psicoeducativo para la comprensin de la problemtica y lograr su participacin
en el trabajo y logro de objetivos planteados con la paciente, as mismo se pretenda
mantenerlos informados de los pormenores del proceso.
En esta etapa en la que se prioriz el trabajo a nivel emocional, conductual y cognitivo con la
joven, los logros alcanzados en relacin a la ansiedad eran importantes, la nia manejaba
mejor esta emocin, el nmero y caractersticas de las situaciones que le generaban malestar y
preocupacin haban disminuido considerablemente, al revisar las Unidades Subjetiva de
Ansiedad se puede observar que la paciente ha enfrentado con xito sus miedos ms
importantes, como el temor a ver pelculas de miedo, as mismo, el temor persistente a no estar
con sus padres y a que les suceda algo malo ha disminuido significativamente, ella misma lo
define como un temor normal que es capaz de debatir cada vez que aparece y de superar sin
contratiempos, lo ms importante es que no busca evitar sus temores ni cognitiva, ni
conductualmente. Por otra parte, puede quedarse sola en casa ya sea en la noche o en el da y
no experimenta temor ante las imgenes de santos que all se encuentran, tampoco hacia la
oscuridad.
Sin embargo, a nivel social, se mantena el malestar por la aceptacin de grupo, as mismo su
autoimagen y autoeficacia eran un poco bajas lo cual mantena los sntomas de tristeza como

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se observa en los resultados del CDI. En relacin a la medicacin, la Fluoxetina (antidepresivo)


se mantena en 5cc como al inicio, sin embargo, el Quetidin (antipsicotico) descenda en su
dosis, lo cual guarda coherencia con la evolucin de sntomas, menor ansiedad, sntomas de
tristeza y baja autoestima estables. Su sueo se encuentra completamente normalizado, aun
despus de suspendido el medicamento Quetidin para la sesin 25, Luna afirma Ahora
duermo mejor que con la pastilla aun inmediatamente despus de enfrentarse a estmulos que
antes consideraba insoportables; sin embargo, aun duerme en el cuarto con sus padres, pero
tiene que ver ms con la costumbre y el manejo que ellos le han dado a esta situacin
La intervencin directa con los padres inici en la sesin 23, siendo alternada con el refuerzo
del trabajo cognitivo con la joven a nivel de los pensamientos de incompetencia y otros
relacionados con el autoconcepto, la imagen personal y la aceptacin social. Aproximadamente
dos meses despus , cuando ya se haba realizado trabajo con los padres en relacin a las
pautas de crianza y control conductual, ya se notaban cambios cualitativos los cuales eran
expresados por la paciente y sus padres en la sesin 27 a 29, estos son descritos en la tabla
20.
Las sesiones 31 a 38, fueron importantes para la generalizacin de los logros y para el trabajo
a nivel cognitivo con la paciente, se realiz un fuerte trabajo e nivel de prevencin de recadas
para asegurar el mantenimiento de los resultados una vez finalizado el proceso
psicoteraputico, el trabajo con los padres se llevo ms al plano cognitivo con el propsito de
modificar las creencias que podan estar manteniendo la problemtica y con la madre
especficamente, en el manejo de su propia ansiedad.
Para la sesin 36, se identificaban logros importantes a nivel cuantitativo reflejados en las
puntuaciones de las pruebas descritas anteriormente, los cuales fueron respaldados por los
cambios percibidos a nivel de la paciente, los padres y la terapeuta. Se describen en la tabla
21, de forma resumida, los avances percibidos ms importantes al finalizar el tratamiento.
Para concluir este apartado, resultan evidentes los logros obtenidos en cada etapa del proceso
y es claramente identificable el papel de los padres dentro de la terapia, ya que si bien se
obtienen ganancias importantes con el trabajo individual, estas no serian generalizables y
resultara difcil mantenerlas en el tiempo sino se modificaran ciertas caractersticas a nivel
familiar que contribuyeron en su aparicin y favorecen su mantenimiento.
Discusin
Son muchas las investigaciones que respaldan estos resultados, la mayora de ellas
compararon la TCC individual a nios con ansiedad exclusivamente, con la TCC con ellos y sus
padres paralelamente, la mayora de ellas afirma que la TCC con intervencin de la familia es o
ms positiva o permite el mayor mantenimiento de los logros durante el seguimiento, Barrett
(1995), encontr que Ambos tratamientos se mostraron efectivos en la reduccin de la
ansiedad de los nios frente al grupo control, pero el tratamiento que inclua intervencin
familiar alcanz resultados significativamente superiores al que slo utilizaba terapia cognitivoconductual; posteriormente en otro estudio llego a la conclusin de que a pesar de que el grupo
que recibi intervencin familiar manifest una mejora mayor en algunas variables, las
diferencias entre ambos tratamientos no fueron significativas, (P. M. Barrett, 1998). Estos
resultados son coherentes con el caso que nos ocupa, teniendo en cuenta que se obtuvieron
logros importantes con la terapia individual, sin embargo, fue necesario intervenir a nivel
familiar teniendo en cuenta el impacto de los padres sobre su conducta, hubiese sido ms difcil
la generalizacin de los resultados, que se logr especialmente en relacin a la adquisicin y
utilizacin de estrategias de afrontamiento en situaciones generadoras de ansiedad, por el
control ambiental y el manejo de contingencias trabajado con ellos.
En este sentido otros autores sugieren con base emprica la importancia de implicar a los

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padres en el tratamiento de los problemas de ansiedad de sus hijos (Mendlowitz, et al., 1999).
La intervencin familiar potencia los efectos de efectos de la TCC (Santacruz et al., 2002),
finalmente y ms reciente, Suveg y colaboradores (2009), evaluaron la TCC individual, la TCC
basada en la familia y la Terapia familiar de apoyo y atencin para jvenes ansiosos, sus
resultados sugieren que la intervencin individual con el nio y la intervencin familiar como el
enfoque de apoyo basado en la familia, pueden resultar eficaces.
Si bien, la familia de la paciente mostraba caractersticas disfuncionales que adems
intervinieron en la aparicin del problema y lo reforzaban, posean particularidades como un
inters genuino en el bienestar de su hija y un sentimiento de unin familiar que favorecieron el
proceso, algunas investigaciones respaldan este hecho, una de ellas afirma que si bien, las
familias disfuncionales generaron mayores niveles de ansiedad, tambin desarrollaron mayor
nmero de recursos para enfrentar sus problemas (Martnez-Jimnez, et al., 2006 ). Por su
parte, Vctor y colaboradores (2007), encontraron que si bien, el estrs de los Padres y su
psicopatologa no se asociaron con los resultados del tratamiento, una mayor cohesin familiar
al inicio del estudio se asoci con disminuciones significativamente mayores en la ansiedad del
nio despus del tratamiento en los participantes que recibieron TCC. Es decir, que a pesar de
las caractersticas de disfuncionalidad y patologa paterna, la unin y el inters familiar se
convierten en factores protectores para el tratamiento de la ansiedad en nios y adolescentes.
En base a esto, podemos decir que resulta tan importante el papel de los padres, tanto que
algunas investigaciones han llegado a concluir que, si bien es mejor la intervencin individual
con inclusin de la familia, la TCC exclusiva con los padres de nios pequeos con ansiedad
pueden ser una alternativa viable de tratamiento para mejorar la accesibilidad a los
tratamientos eficaces para los nios con trastornos de ansiedad y para reducir los costos
asociados con la entrega de atencin de salud mental, (Waters, et al., 2009). Sin embargo y en
base a los resultados de este estudio de caso, esta teora se debe evaluar con rigurosidad, ya
que es posible que no resulte beneficioso para el tratamiento de adolescentes trabajar solo con
sus padres, tanto por la alta implicacin cognitiva presente en los jvenes con TAG, como por
la necesidad de empoderarlos de su propio proceso y generalizar los resultados a otras
preocupaciones o situaciones ansigenas que no estn a la vista de sus padres.
Conclusiones y recomendaciones
Teniendo en cuenta el objetivo principal de la investigacin que era determinar el impacto de un
programa de intervencin cognitivo conductual que incluy a la familia como estrategia para el
tratamiento de una adolescente con TAG a partir de la formulacin clnica y en relacin a los
resultados se formulan las siguientes conclusiones y recomendaciones:
-La ansiedad en la adolecente del presente caso, evidencia bsicamente las mismas
caractersticas planteadas por la literatura cientfica en relacin a las cualidades de la
preocupacin que en esta edad est relacionada generalmente al autoconcepto, la aceptacin
social, los logros, la apariencia fsica y la independencia; as mismo, se determina el impacto de
variables familiares como la herencia, el modelado, el refuerzo, la sobreproteccin y el
autoritarismo en la configuracin y mantenimiento de las conductas ansiosas que ha
manifestado la joven desde su infancia, caracterizada esta por temores marcados.
-De la misma forma es reconocido el marcado grado de afectacin cognitiva debida a la
instauracin de distorsiones y creencias, caracterstico del TAG y acentuado por las
preocupaciones propias de la adolescencia. As mismo, en este como en todos los casos
revisados, resulta evidente la utilizacin de la evitacin y el escape como estrategias
principales de afrontamiento y estas posibilitan el mantenimiento de los sntomas, trabajar
sobre ambas variables, nivel cognitivo y afrontamiento se logran resultados positivos en la
disminucin de la ansiedad y aumento de la autoeficacia.
-Con la TCC individual se obtienen logros importantes en el tratamiento del TAG, en este
sentido, las tcnicas expuestas en la literatura cientfica, que han sido as mismo agrupadas en

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programas de intervencin y son soportadas por la evidencia emprica, resultan eficaces para el
tratamiento de las preocupaciones, temores y conductas caractersticas de este trastorno tanto
en nios como adolescentes, sin embargo, el orden de utilizacin, es ms decidir si son o no
necesarias y/o suficientes debe ser analizado en base a la particularidad del joven y de la forma
en que se presenta la problemtica en el.
-La TCC con intervencin de la familia acta positivamente sobre el tratamiento de
adolescentes con TAG, especialmente y como en este caso, juegan un papel importante en su
gnesis y sostenimiento, tenerlos en cuenta dentro del proceso teraputico debe ir ms all de
la simple obligacin de mantenerlos informados, ya que al mismo tiempo que se pueden
convertir en limitantes para el logro de los objetivos, pueden transformarse en motivadores del
cambio, sin embargo, debe tenerse siempre presente la necesidad de mantener la confianza
terapeuta-paciente y lo lmites de su papel dentro de un proceso en el que el adolescente debe
ser el protagonista.
-Finalmente, se debe tener en cuenta la particularidad de cada caso tanto para determinar las
estrategias y su orden de aplicacin, como la necesidad de incluir a la familia dentro del
proceso, el terapeuta debe ser lo suficientemente hbil como para poder determinar en qu
caso esta intervencin resulta necesario o en su defecto, puede convertirse en un impedimento
u obstculo para el cambio.
-Para concluir, se subraya la necesidad de realizar ms investigaciones que permitan
contrastar tcnicas y programas de intervencin en adolescentes, especialmente estudios de
casos que por su particularidad permitan llegar a resultados que confirmen o debatan la
evidencia existente y que sirvan a otros terapeutas de base para actuar en su prctica clnica,
especialmente a los nuevos terapeutas que se enfrentan casos que pueden llegar a ser tan
complejos por las caractersticas del trastorno como por las variable propias de esta etapa del
desarrollo.
Protocolo de Tratamento Cognitivo-Comportamental para Tratamento do Mutismo
Seletivo
Ana Claudia Peixoto.
Departaento de Psicologia, Universidade Federal Rural do Rio de Janeiro, Nova Iguau, Brazil.
Abstract Central: O que se segue o modelo de interveno para avaliao inicial,
interveno e ps-interveno em crianas portadoras do transtorno denominado mutismo
seletivo (MS). O MS considerado um subtipo de fobia social em crianas e est associado a
um comportamento aprendido. Trata-se de um planejamento experimental before-after (antes e
depois), foram realizados atendimentos individuais com as crianas, algumas em conjunto com
pais, professores e seus pares, num total de 25 sesses. Esse tipo de trabalho se faz
necessrio para assegurar que as mudanas observadas nos comportamentos ps-interveno
podem ser atribudas interveno realizada e no a outros fatores. Participaram desse estudo
de caracterizao 24 crianas, sendo 15 do sexo feminino e 9 do sexo masculino. Os objetivos
teraputicos foram: eliciar interao verbal com outras crianas e adultos; estimular o
comportamento verbal na escola; aumentar o tempo do comportamento verbal; diminuir a
ansiedade social frente a situaes de interao sociais corriqueiras; auxiliar as crianas a
acalmar seus sintomas angustiantes; capacit-las com habilidades de enfrentamento e
autocontrole em situaes ansiognicas, e de adaptao s novas situaes; diminuir
comportamentos de apatia e isolamento. A estrutura das sesses incluiu seis componentes:
registro do humor, reviso da tarefa de casa, estabelecimento da agenda, contedo da sesso,
atribuio da tarefa de casa e evocao de feedback da criana. As escolas serviram como
locais dos atendimentos. A primeira etapa permitiu o levantamento da linha de base que
serviria como parmetro para comparao dos dados levantados no ps-teste (aps a
interveno). As sesses de avaliao foram realizadas em seis encontros compostos pela (a)

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aplicao de entrevistas e escalas estruturadas com pais e professores acerca dos sintomas,
avaliao da cognio e desempenho escolar das crianas; (b) anlise funcional das crianas
atendidas; (c) critrios da amostragem e juntamente com a diviso dos grupos de controle e
experimental; d) solicitao da autorizao para tratamento junto aos responsveis e escola
que as crianas pertenciam. A segunda fase consistiu em realizar a psicoeducao quanto ao
prprio funcionamento e o transtorno e estimular o comportamento verbal. As principais
tcnicas utilizadas foram o registro de sentimentos e pensamentos, desvanecimento do
estmulo, exposio gradual e reforamento positivo, totalizando mais sete sesses. A terceira
fase objetivou o treinamento de habilidades sociais e a resoluo de problemas, para tal foram
utilizados nove encontros para auxiliar a criana com o ensino de habilidades de enfrentamento
como identificar situaes e aes associadas aos sentimentos; falar de si; prestar ateno;
responder e fazer perguntas; identificar sentimentos; nomear sentimentos; controlar
sentimentos; conscientizar-se da importncia da amizade; fazer pedidos; iniciar conversas com
estranhos; fazer e negar pedidos; dar opinio, resolver problemas interpessoais; desenvolver
valores pessoais; e ensino de auto-verbalizaes positivas e de apresentao de
comportamento verbal em pblico. A quarta fase teve como objetivo trabalhar a preveno de
recadas e a realizao do ps-teste.
CBT Group Treatment for Social Anxiety Disorder: Development and Evaluation of a
Proposal Combining Theatre of Oppressed and Videofeedback
Maria Amlia Penido2, 1, Bernard Rang1.
1. Universidade federal do Rio de janeiro, Rio de janeiro, Brazil, 2. Universidade Veiga de
Almeida, Rio de janeiro, Brazil.
Abstract Central: Social Phobia or Social anxiety Disorder is considered to be a serious
problem, of chronic course that can lead to incapability. It is characterized by its carriers fear to
be evaluated negatively in social situations. Social phobia patients are afraid to act, behave or
demonstrate symptoms of anxiety that might be embarrassing or humiliating, trying thus to
prevent themselves from social situations or on the other hand cope with the discomfort.
Theater of Oppressed is a set of techniques, theater games and exercises, organized in
different modalities, whose main goal put the theater in the service of social change. It proposes
a transformative methodology that dialogue to reflect and seek alternatives for social and
interpersonal conflicts. One of the major interventions of CBT is cognitive restructuring that can
be developed by adapting techniques from Theater of Oppressed. This present work is a
description of the results acquired from a research that had the objective of developing a
program of structured psychological treatment for social phobia, aliening behavioral cognitive
therapy in group to techniques of Theater of Oppressed Individuals and also Videofeedback
techniques to evaluate the efficiency of this treatment in comparison to a Control group in stand
by list. It was also evaluated, specifically, the use of videofeedback in the training of the ability to
speak out in public. Thirty-five patients who participated in the treatment, and twenty-one
individuals on the stand by list, were evaluated. The evaluations occurred before the beginning
of the therapy, at the end of the therapy and after a month past the end of the therapy.
Seventeen sessions, two hours each and one, lasting four hours; referring to the evaluation of
the videofeedback in the development of social ability of speaking out to an audience were
performed. Thirty-five individuals were evaluated while participating. The sessions happened
twice a week. Instruments used in the research were: Identification slip, Brazil Criterion, Beck
Depression Inventory, Beck Anxiety Inventory; Social Phobia Anxiety Inventory (SPAI); Social
Ability Inventory (SAI); Social Phobia Scale; Fear of Negative Evaluation (FNE); Self Esteem
Scale and the results referring to the videofeedback session, evaluated by the following
instruments: Global Scale of Evaluations of accomplishment of the ability to speak out in public.;

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Scale of Anxiety Symptom Perception and Scale of Evaluation of the accomplishment of the
ability to speak out in public. The instruments of the videofeedback session were used only in
the experimental group when they were in the pre and post videofeedback. The results found
showed a significant statistical difference between the control group and the experimental
group, including the evaluation of the ability to speak out in public in the videofeedback session.
The experimental group improved in a significant way, while the control group did not. The
protocol proposed proved to be more effective than the passing of time. The videofeedback
techniques showed more effective results in the development of the social ability to speak out in
public.
Assessment of Deficits in Social Skills and Social Anxiety Levels in Brazilian Psychology
Undergraduate Students
Anderson Pereira1, Marcia Wagner3, Margareth Oliveira2.
1. Instituto de Psicologia, UFRGS, Porto Alegre, Brazil, 2. PUCRS, Porto Alegre, Brazil, 3.
IMED, Passo Fundo, Brazil.
Introduction: Social skills can be defined as a set of behaviors used to mediate interpessoal
relationships, through which we can express feelings, ideas and opinions, in an attempt to solve
current problems and prevent the occurrence of new ones. Deficits in these skills can result in
higher levels of anxiety in social relationships, which, in extreme cases, can characterize anxiety
disorders such as Social Phobia (also referred as Social Anxiety Disorder).Professions that
demand interpersonal relationship skills in their daily work require professionals to have high
levels of social skills for successful results. In this description, we use psychology as a
prototypical example, since the relationship between the psychologists and their clients is the
foundation in which changes in the clients lives occur,. The psychologist social skills mediate
this relationship. Hence both high levels of social anxiety and deficits in social skills might
account for impairments in the psychologist practice. Therefore the aim of this study was to
evaluate these factors (social anxiety and social skills) in a sample of psychology undergraduate
students . Method: A sample of 69 Brazilian psychology undergraduate students participated in
this cross-sectional study. Participants were selected from the database of the cross-cultural
adaptation study of the Social Anxiety Questionnaire for Adults (Cuestionario de Ansiedad
Social, CASO-A30) to Brazil. Social skills deficits and social anxiety were assessed by a
sociodemographic questionnaire, the Social Skills Inventory (Inventrio de Habilidades Sociais,
IHS-Del-Prette) and the CASO-A30. Results: Sixteen students (23%) presented evidences of
social phobia and 43.5% have social skills deficits in at least one of the IHS-Del-Prettes factors.
The factors in which more students showed social skills deficits were F2 (self-affirmation of
positive affect and self-esteem) and F1 (coping and self-affirmation at risk). Conclusion: The
psychologist practice is based in the relationship established between the psychologist and
his/her client. This relationship is mediated by the psychologists social skills. Social skills
deficits can harm the performance of the psychologist and client improvement. Results of this
study suggest a need for greater attention to social skills development in the psychology
courses to help students improve their social skills and prevent deficits in this area from
becoming a more severe problem in their future professional practices.
Procrastinacin Acadmica: Caracterizacin de Estudiantes Universitarios de la Ciudad
de Bogot - Colombia
Diana Melissa Quant Quintero, Dolly Gonzlez.
Cundinamarca, Universidad Catlica de Colombia, Bogota, Colombia.

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Abstract Central: La procrastinacin o dilacin es entendida como un patrn de


comportamiento que se caracteriza por aplazar voluntariamente la realizacin de actividades
que deben ser entregadas en un momento establecido (Steel, 2007). Rothblum, Solomon y
Murakami (1986) consideran que quienes presentan procrastinacin acadmica le tienen miedo
al fracaso y aversin a las tareas de tipo acadmico. Este estudio tuvo como objetivo realizar
una caracterizacin de la poblacin universitaria, de forma que se pudiese identificar si existe
relacin entre variables sociodemogrficas y los niveles de procrastinacin acadmica. En el
estudio participaron 1578 estudiantes universitarios. Para evaluar la procrastinacin se utiliz el
PASS- Espaol. Se realiz un anlisis por conglomerados donde se identificaros tres perfiles
en relacin con las razones por las cuales se procrastina; se encontr que stos perfiles tienen
una relacin significativa con variables sociodemogrficas como el sexo y la edad, resultados
que son acordes con los hallazgos de otras investigaciones donde se encontr que se hay
mayor nivel de procrastinacin en el gnero masculino, y que existe una disminucin del patrn
procrastinador a medida que incrementa la edad. Se plantea la necesidad de realizar estudios
con poblacin colombiana que puedan dar cuenta de las variables que pueden predecir la
procrastinacin crnica, de manera que se cuente con elementos suficientes para comenzar a
disear programas de intervencin ajustados a las necesidades del pas.
Transdiagnostic CBT for Depression and Anxiety: A Systematic Review and Metaanalyses
Sanjay Rao1, Christopher Rae2, Kirstine Postma3.
1. Psychiatry, Dalhousie University, Halifax, NS, Canada, 2. Tees Esk Valley NSH Trust,
DURHAM, United Kingdom, 3. Lesley Hartman & Associates, Halifax, NS, Canada.
Abstract Central: Introduction: Transdiagnostic approach is an emerging trend in CBT practice.
We did a systematic review of RCTs using this approach for the treatment of anxiety and
depressive disorders. Methods: We performed systematic literature searches using databases
Pubmed, Psychinfo, Psychlit, Web of Science, Embase, Cochrane library and Clinicaltrials.gov
with search terms transdiagnostic, cognitive , behav*, therapy. Only trials addressing
depression or anxiety disorders, with formal diagnostic assessments were selected. Selected
references were hand searched for previous studies. 10 trials met the above criteria and all,
except one, addressed a range of anxiety disorders only. The trials were divided into TCBT
interventions using the internet (3 studies), group TCBT (5 studies) and individual TCBT (2
studies). 1 study from group TCBT was removed from the analyses due to large baseline
difference between treatment and control groups. RevMan 5.1 software was used for metaanalyses of effect sizes. Results: Separate analyses were done for internet, group and
individual TCBT interventions. Standardised mean difference scores were used to pool effect
sizes. All internet TCBT studies were devised by one investigator group with a total of 283
subjects. The sample sizes were small but the quality ratings of the studies were high. However
due to considerable heterogeneity, a random effects model was applied. The effect sizes (SMD)
were in favour of the active treatment vs waiting list (WL) controls in terms of anxiety ( 0.81, CI:
0.27 to 1.35), depression (0.63, CI: 0.37 to 0.90), disability (0.63, CI: 0.37 to 0.90). Group TCBT
interventions were not subjected to a meta-analysis as due to variable trial design and
heterogeneity across the studies. In one of the two studies using waiting list controls, the
outcome of active treatment and control groups did not differ in terms of anxiety (-0.67 CI: -5.95
to + 4.61), depression (-0.08 CI -0.5 to + 0.35), and disability (0.03 CI: -0.46 to +0.40) if
treatment dropouts were taken into account. In the second study with lower risk of bias, the
active intervention showed strong effect sizes (5.11, CI: 4.25 to 5.97) in comparison to WL
controls. The authors of two studies using active control conditions groups- TCBT vs relaxation
and group TCBT vs diagnosis specific group CBT- stated non inferiority between the conditions.

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We did not carry out an effect size analyses due to attrition biases inherent in these two studies.
Data from the 2 individual TCBT study trials were pooled to yield 59 subjects. Active intervention
vs waiting list control yielded a modest to strong effect sizes for anxiety (0.70 CI: 0.14 to 1.25)
and depression (1.50, CI: 0.59 to 2.41), with wide confidence intervals. Conclusion: Anxiety
disorders have been the main focus of TCBT research. Studies of a single internet based
package of TBCT shows promise but requires replication with larger sample sizes. Group TCBT
data comes from a wide range of approaches, designs and due to the variable quality of studies,
they cannot be recommended in routine clinical practice. Individual TCBT of anxiety and
depression, despite better trial design, has only 2 small studies published, which limits it
application to practice.
Associations Between Parental Anxiety, Distress Tolerance and Behaviors During
Interactions with Youth with Anxiety Disorders
Cara Remmes, Emily Bilek, Jill Ehrenreich-May.
University of Miami, Coral Gables, FL, USA.
Observational findings with parents experiencing anxiety disorders suggest that they may
display less warmth, less granting of autonomy, and more criticism during interactions with their
children than parents without anxiety disorders (e.g. Whaley, Pinto, & Sigman, 1999). However,
research in this area is complicated by youth anxiety status. For example, Drake and Ginsburg
(2011) examined parenting behavior in parents of youth without anxiety and found that maternal
anxiety was not predictive of parental overcontrol, criticism, or modeling of anxiety when
interacting with youth without clinical levels of anxiety. Therefore, the relationship between child
internalizing symptoms and problematic parenting behaviors appears to be cyclical; as youth
internalizing distress may work to elicit inconsistent or ineffective parenting behaviors, especially
in parents who have difficulty regulating their own emotions. Given the many challenges
associated with raising a child with high levels of negative affect, parental distress tolerance is
expected to influence behaviors in the parenting context. Distress tolerance refers to ones
ability to experience and endure negative emotional states (Schmidt & Cook, 1999) and is
theorized to influence ones perception of negative emotional states. Therefore, those with low
distress tolerance are expected to be more reactive to stress associated with parenting, as well
as to their childs and to their own negative affective states. However, the association between
parental distress tolerance and behaviors in the parenting context has not been previously
examined. This investigation will examine the role of parental distress tolerance as a mediator
between parent anxiety and specific parenting behaviors, such as overcontrol and modeling of
anxiety in parents of youth ages 7-12 with clinical levels of anxiety. Thirty-four parents and their
children were recruited, completed questionnaires and participated in a behavior observation
task during an intake assessment at a University-based research clinic. Distress tolerance was
measured using the Distress Tolerance Scale (DTS; Simons and Gaher 2005) and parental
anxiety was measured using the Penn State Worry Questionnaire (PSWQ; Meyer, Miller,
Metzger, Borkovec, 1990). Parental behaviors were observed during an observational task and
will be coded according to a previously developed coding scheme (Ginsburg & Grover, 2006).
Preliminary results suggested a negative relationship between parental distress tolerance and
worry, such that low scores on the DTS (M =59.7, SD = 13.3) were related to high scores on the
PSWQ (M =51.1, SD = 11.3), r (33) = -0.58, p < 0.01. It is hypothesized that parental anxiety will
be related to observed parental overcontrol and modeling of anxiety during the interaction task,
and that this relationship will be partially mediated by parental distress tolerance. Results of this
investigation will clarify specific processes that occur between anxious youth and their parents.
This increased understanding will aid in the development of parent-directed prevention and
early intervention strategies for youth anxiety.

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Pilot Study using Looming Vulnerability Reduction on College Students with Probable
GAD
John Riskind, Evan Kleiman, Karen Shaefer.
Psychology, George Mason University, Fairfax, VA, USA.
Abstract Central: According to the looming vulnerability model, anxious individuals tend to
have a threat overestimation style that leads them to generate exaggerated perceptions, mental
simulations, and expectations of rapidly rising risk and approaching danger. For example, an
anxious person might notice slight or hear an odd engine noise and visualize threats as rapidly
heading towards negative outcomes. These dynamic perceptions of changes in threats are
assumed to have a greater impact on anxiety than constant or stable threat situations.
Perception of escalating threat instigate fear, interfere with processing and selection of coping
responses, and create worry about the need for finding ways to have control, prevent, or escape
from the perceived escalating risk or danger. Research has shown that self-report measures of
looming cognitive styles represent a distinct component of threat that differ from estimates of the
probability of occurrence of negative events (Riskind et al., 2000), as well as anxiety sensitivity
(Elwood et al. 2011; Reardon & Williams, 2007),and intolerance of uncertainty (Riskind et
al.,2007) and are elevated in Generalzed Anxiety Disorder. Riskind, Rector and Taylor (2012)
recently proposed a set of looming reduction procedures to address distorted perceptions of
looming vulnerability and suggested that they could enhance treatment outcomes. Interventions
that reduce these looming distortions would be expected to reduce anxiety and worry as well
as increase perceptions of control. In other words, picturing threats as making slow gains would
be less threatening than picturing them as making rapid gains. The present pilot study tested
the effects of looming reduction strategies in 21 college students with probable diagnoses of
Generalized Anxiety Disorder. Study participants were selected with the GADQ-IV. Participants
visualized an event or situation which caused them worry and rated their level of worry on a 100
point scale. They also rated their perceived level of control over the sequence in the worry
situation. After listening to two audiotapes of guided looming vulnerability reduction imagery
exercises using techniques (e.g., freeze frame) described by Riskind et al (2012), they
repeated these ratings. Two weeks later the participants returned and the process was repeated
with two different guided imagery looming reduction exercises. Repeated measures analyses of
variance on the ratings over both sessions produced a significant main effect on worry ratings
(p< .001). Looming reduction decreased worry ratings at the first session. They had climbed
back up two weeks later but again decreased after the further guided imagery exercises. A
strong similar trend was found for ratings of perceived control. These pilot results suggest
looming reduction exercises may prove help assist individuals with GAD manage their worries.
Homework practice may be needed to boost these effects.
Social Anxiety and the Processing of Ambiguous Facial Expressions
Beata Robins.
School of Psychology, The University of New South Wales, Sydney, NSW, Australia.
High anxious individuals show a greater attentional capture by threat stimuli and a greater
tendency to interpret ambiguous emotional facial expressions (e.g., neutral faces) in a
threatening manner compared to low anxious individuals (e.g., MacLeod, et al., 2002; Mathews
& MacLeod, 2002). It has been suggested that these processing biases are not only symptoms
of anxiety but are also implicated in the maintenance, and possibly the aetiology of anxiety
disorders (e.g., MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002; Mathews &

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MacLeod, 2002). However the underlying mechanisms involved in such biases are complex
from a visuo-cognitive perspective, and remain underexplored in the clinical literature. There is
evidence to suggest that the viewing of emotional facial expressions (EFEs), particularly fearful
faces, modulates both early perceptual (e.g., contrast sensitivity) and attentional mechanisms
(e.g., Phelps et al., 2006). There are major points of contention relating to whether this
emotional modulation of visual processing is based on level of threat or level of ambiguity of that
threat. It has been proposed that an increase in sensitivity of visual mechanisms in response to
fearful faces compared to other EFEs would be largely based on ambiguity (relating to the
sources of threat in the case of fear), not primarily on threat per se (e.g., Whalen et al., 1998). It
is thought that the modulation of vision and attention in response to ambiguous stimuli facilitates
subsequent information gathering in the service of disambiguating such stimuli. Two major
issues remain underexplored in the clinical literature: Firstly, whether anxiety-related processing
biases are primarily driven by threat or the ambiguity of that threat; Secondly, whether anxietyrelated processing biases are associated with primarily top-down attentional control deficits or
bottom-up mechanisms associated with increased visual sensitivity. Visual attention paradigms
used within the clinical literature (e.g., eye-tracking, visual search) do not disentangle bottom-up
and top down processes involved in attentional capture. The aim of the current experiments is to
examine whether high and low social anxiety individuals differ in the emotional and attentional
modulation of contrast sensitivity in response to ambiguous (e.g., fear, surprise, neutral) and
unambiguous (e.g., happy, sad, angry) EFEs. The way in which anxious individuals process
ambiguous stimuli is an important area of research given that clinically speaking a defining
feature of anxiety is an inability to tolerate uncertainty. My research attempts to explore whether
the socially anxious process ambiguous EFEs such as neutral and fearful faces differently, and
in a way that may lead to a greater likelihood that their concerns will be confirmed. This has
implications for the understanding of the phenomenology of anxiety disorders such as Social
Anxiety, and the application of attentional training techniques in clinical practice.
Terapia Cognitivo-Comportamental como Estratgia de Next-Step para Pacientes
Resistentes Farmacoterapia: Uma Reviso Sistemtica
Helga Rodrigues, Raquel Gonalves, Tnia Macedo, Ivan Figueira, Paula Ventura.
Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Existem evidncias consistentes sobre a eficcia da terapia cognitivo-comportamental (TCC) e
farmacoterapia no tratamento dos transtornos de ansiedade. A TCC considerada o
tratamento de primeira linha para alguns transtornos de ansiedade. A no remisso ao
tratamento farmacolgico nos transtornos de ansiedade est relacionada a altas taxas de
recada, diminuio da qualidade de vida e maior comprometimento funcional do paciente. O
objetivo da presente reviso foi investigar a eficcia da terapia cognitivo-comportamental como
estratgia de next-step no tratamento de pacientes com transtornos de ansiedade que no
remitiram aps uma interveno farmacolgica. Para tal, foi realizada uma reviso sistemtica
nas bases eletrnicas ISI/Web of knowledge, PubMed e PsycINFO / PsychLit. Foram
considerados pacientes resistentes aqueles que no responderam (no remitiram
completamente) a uma adequada interveno farmacolgica e ainda apresentavam sintomas
residuais do transtorno de ansiedade. Foram identificadas 603 referncias em nossa pesquisa,
das quais 17 foram includas: oito sobre o transtorno obsessivo-compulsivo, cinco sobre o
transtorno de pnico, e quatro sobre o transtorno de estresse ps-traumtico. No foram
localizados estudos no transtorno de ansiedade social e no transtorno de ansiedade
generalizada. Observou-se uma falta de padronizao da terminologia e das definies de
resistncia, o que torna difcil a comparao de resultados. Finalmente, todos os estudos
mostraram benefcios identificados a partir da adio de TCC como estratgia de next-step. A

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TCC parece ser uma estratgia de next-step promissora para pacientes com transtornos de
ansiedade que no remitem aos tratamentos farmacolgicos usuais. Entretanto, novos ensaios
clnicos com desenhos metodolgicos mais fortes so necessrios para estabelecer
definitivamente a sua eficcia nesta populao.
Anxiety Reactivity and Anxiety Perseveration Represent Dissociable Underlying
Dimensions of Anxiety Vulnerability
Daniel Rudaizky, Colin MacLeod.
University of Western Australia, Perth, WA, Australia.
Trait anxiety is a personality dimension reflecting an individuals general tendency to experience
anxious mood state and is typically measured using questionnaires such as the Spielberger
Trait Anxiety Inventory (STAI-T). While trait anxiety has commonly been considered a unitary
construct the present research conceptually distinguishes, and independently assesses, two
hypothetical dimensions of anxiety vulnerability which, it is argued, could plausibly make
independent contributions to variance in trait anxiety scores. These dimensions are anxiety
reactivity, reflecting individual differences in the intensity of an anxious reaction to a stressor,
and anxiety perseveration, reflecting individual differences in the persistence of anxious
symptoms after exposure to a stressor. We present evidence from both questionnaire
instruments and in-vivo measures that these two dimensions of trait anxiety each account for
independent variance in the determination of trait anxiety scores.
Alleviating Anxiety Vulnerability Through Attentional Bias Modification: A Translational
Research Approach
Daniel Rudaizky1, Ben Grafton1, Philip Enock2, Richard McNally2, Colin MacLeod1.
1. University of Western Australia, Perth, WA, Australia, 2. Harvard University, Cambridge, MA,
USA.
Compelling evidence has been found to support cognitive models of anxiety disorders that
propose selective attention to negative information plays a pivotal role in the development of the
elevated levels of anxiety vulnerability that precipitate anxiety pathology. In order to directly test
this theoretical position, and to exploit its therapeutic implications, researchers have developed
attentional training tasks, designed to modify attentional bias to negative information. This
typically involves using PC technology to expose participants to single or multiple sessions of
the training task within a laboratory setting, which has been configured to directly attenuate
attentional bias to threat. Research has confirmed that when this laboratory based atentional
training is successful, this reduction in attentional bias to threat serves to also attenuate anxiety
reactions to laboratory stressors and to reduce the severity of real life anxiety symptoms.
However, in order to fully realize the therapeutic potential of these attentional training tasks they
need to be brought out of the laboratory and decoupled from PC delivery in order that they can
be conveniently and repeatedly delivered in the naturalistic settings where attentional bias
impacts on real-life anxiety. In the current study we compare the efficacy of one attentional
training task, a training version of the dot-probe task, when delivered on both PC and iPhone
platforms in order to determine if mobile devices such as the iPhone are able to produce the
same attentional training effects as typically found when this task is delivered on a PC. The
results have the potential to inform researchers about the viability and validity of conducting
attentional training tasks on mobile devices.

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Differences in Body Vigilance Among Patients with Irritable Bowel Syndrome, Functional
Dyspepsia, and an Overlap of the Two
Tatsuo Saigo1, Jun Tayama1, Tadaaki Tomiie2, Naoki Nakaya3, Toyohiro Hamaguchi4, Susumu
Shirabe1, Yuji Sakano2, Shin Fukudo5.
1. Center for Health & Community Medicine Nagasaki University, Nagasaki-shi, Japan, 2.
School of Psychological Science Health Sciences University of Hokkaido, Sapporo-shi, Japan,
3. Tohoku Medical Megabank Organization, Sendai-shi, Japan, 4. Department of Occupational
Therapy Saitama Prefectural University, Koshigayashi-shi, Japan, 5. Department of Behavioral
Medicine Tohoku University Graduates School of Medicine, Sendai-shi, Japan.
[Aim]A high rate of overlap between functional dyspepsia (FD) and irritable bowel syndrome
(IBS) has been consistently reported (Ford et al., 2009). Patients with this overlap have been
shown to have more severe gastrointestinal (GI) symptoms (Corsetti et al., 2004) and
depressive symptoms (Lee et al., 2010), and poorer health-related QOL (Piacentino et al., 2011)
than do patients with IBS alone. The pathophysiological characteristics of IBS and FD are
dysmotility of the gastrointestinal tract, visceral hypersensitivity, and psychological disturbance.
IBS and FD are important to understand dysregulation of the brain-gut interaction. A previous
study revealed that body vigilance (BV), which is excessive attention to internal body sensations
(Abramowitz & Braddock, 2006), can predict the severity of GI symptoms. However, differences
in BV have not yet been examined between persons with FD alone, IBS alone and IBS-FD
overlap. To fill this gap, the present study attempts to describe differences in BV in patients with
such disorders diagnosed on the basis of the Rome II criteria. [Method] Participants of this
cross-sectional study were 1135 Japanese college students (62% male; mean age = 19 years;
SD = 1). They completed a validated self-report questionnaire containing items on demographic
details and Japanese versions of the Rome II Modular Questionnaire (RIIMQ) (Shinozaki et al.,
2006), the Gastrointestinal Symptoms Rating Scale (GSRS) (Hongo et al., 1999), and the Body
Vigilance Scale (BVS) (Schmidt et al., 1999). The reliability of the RIIMQ for epidemiological
surveys has been confirmed. The Japanese version of the RIIMQ can be used for the diagnosis
of both IBS and FD. The GSRS is a disease-specific QOL instrument of 15 items combined into
five symptom clusters: reflux, abdominal pain, indigestion, diarrhea, and constipation. The BVS
assesses conscious attendance to internal bodily cues. Data were analyzed using one-way
ANOVAs with post-hoc Bonferroni tests. SPSS version 20.0 was used for the statistical
analyses. The study was approved by the Ethics Committee of Nagasaki University, which
confirmed that the study was in accordance with the Declaration of Helsinki. [Results]ANOVAs
showed significant differences in mean BV scores among the four groups (FD alone, IBS alone,
IBS-FD overlap, and healthy subjects) [F (3, 1066) = 20.17, P < 0.01]. Bonferroni post hoc tests
showed that patients with IBS-FD overlap had significantly higher BV scores than patients with
IBS alone (P < 0.01) and healthy subjects (P < 0.01). However, mean BV scores did not
significantly differ between patients with IBS-FD overlap and those with FD alone (P = 0.67).
[Conclusion] Patients with IBS-FD overlap and those with FD alone have greater activation in
the prefrontal cortex, which controls BV, than do patients with IBS alone. Physical and
psychological stress activates the prefrontal cortex and exacerbates gastrointestinal symptoms
through the hypothalamic-pituitary-adrenal axis. GI symptoms of patients with IBS-FD overlap
increase BV. Thus, a vicious cycle is formed. Modification of BV through cognitive behavior
therapy may improve gastrointestinal symptoms.
DIFERENTES POSSIBILIDADES DE AVALIAO E INTERVENO COMPORTAMENTAL
NOS TRANSTORNOS DE ANSIEDADE
Thiago Sampaio2, 1, Denis Zamignani3, 4, Roberto Banaco3, 5, Rodrigo Sampaio2.

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1. Instituto de Psiquiatria, Universidade de So Paulo, So Paulo, Brazil, 2. Episteme


Psicologia, So Paulo, Brazil, 3. Ncleo Paradigma, So Paulo, Brazil, 4. Universidade
Anhembi Morumbi, So Paulo, Brazil, 5. Pontifcia Universidade Catlica, So Paulo, Brazil.
As estratgias teraputicas mais amplamente estudadas para o tratamento dos transtornos de
ansiedade so aquelas que envolvem, de algum modo, a exposio sistemtica ao estmulo
ansiognico (e.g. dessensibilizao sistemtica, exposio in vivo, exposio na imaginao,
exposio interoceptiva, exposio com preveno de resposta, inundao, e exposio
macia no gradual). A brevidade, objetividade e simplicidade de procedimento da chamada
terapia comportamental baseada em exposio, bem como sua adequao aos mtodos
utilizados nas pesquisas clnicas psiquitricas (ensaios clnicos controlados), parecem ter
favorecido o seu estudo, promovendo um acmulo de evidncias de sua eficcia na remisso
dos sintomas desses transtornos. Entretanto, a despeito dessa estratgia de interveno ter
sido designada como padro ouro de tratamento dos transtornos ansiosos em geral (com
exceo do transtorno de ansiedade generalizada) e das fobias em particular, ela ainda
apresenta efeitos indesejveis, como as relativamente altas taxas de abandono e recada. A
associao de tcnicas cognitivas foi uma estratgia amplamente empregada a partir da
dcada de 70, quando emergiu a terapia cognitivo-comportamental (TCC), representando um
pequeno e inconclusivo avano nesses dados, sendo mais ou menos efetiva a depender do
quadro clnico ansioso especfico estudado. Uma crtica importante a essa abordagem aponta a
utilizao de uma anlise superficial ou incompleta das relaes funcionais que mantm o
problema. A perspectiva analtico-comportamental dos transtornos de ansiedade prope uma
abordagem ideogrfica e experimental desse fenmeno e a translao dos resultados obtidos
em pesquisas de laboratrio para o contexto clnico. O conhecimento mais amplo das inmeras
possibilidades de relaes comportamentais existentes, incluindo diversas topografias e
variveis de controle, favoreceria a especificao segura de outras variveis que
potencialmente estariam envolvidas nos padres comportamentais apresentados pelas
pessoas que recebem esse diagnstico, para alm da caracterstica esquiva fbica. Alm
disso, uma avaliao mais ampla do repertrio comportamental do indivduo, incluindo seus
sintomas ansiosos, possibilitaria a utilizao de estratgias menos aversivas, aumentando a
aderncia e efetividade da terapia. Outro ponto crtico se refere inconsistncia tericometodolgica do terapeuta que utiliza os modelos comportamental e cognitivo na prtica da
TCC. Um dos trabalhos desta mesa prope uma possibilidade de compreenso
comportamental do modelo cognitivo do transtorno de pnico e uma discusso das vantagens e
limites da utilizao dessa compreenso como base para a avaliao e a interveno.
ANSIEDADE: ASPECTOS EXPERIMENTAIS, NEUROBIOLGICOS E CLNICOS DAS
TERAPIAS COMPORTAMENTAL E COGNITIVA
Thiago Sampaio1, 2, Mariliz Vascolcelos1, Luiz Guilherme Guerra3, Mariangela Savoia1, 3.
1. Instituto de Psiquiatria, Universidade de So Paulo, So Paulo, Brazil, 2. Episteme
Psicologia, So Paulo, Brazil, 3. Conscientia, So Paulo, Brazil.
Conforme a quarta edio do Manual Estatstico e Diagnstico dos Transtornos Mentais (DSMIV) os transtornos que apresentam a ansiedade, medo ou pnico como condio patolgica
primria, esto dentro da ampla categoria dos transtornos de ansiedade. Entretanto, as teorias
neuropsicolgicas atuais entendem a ansiedade como uma resposta emocional de defesa que
guarda distines neuroanatmicas e funcionais importantes de outras emoes
tradicionalmente a ela relacionadas como o medo e o pnico. Embora essas diferenas
favoream uma explicao neurobiolgica para o sucesso diferencial da psicoterapia em
relao psicofarmacologia em alguns quadros de ansiedade (especialmente nas fobias), a

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literatura cientfica apresenta as terapias cognitiva e comportamental e a psicofarmacoterapia


como os tratamentos mais eficazes para os transtornos de ansiedade em geral. Essas duas
abordagens psicoteraputicas, apesar de apresentarem divergncias terico-filosficas
importantes entre si, compartilham o objetivo de promover, de algum modo, mudanas
consistentes e duradouras nas relaes que a pessoa atendida estabelece com seu ambiente.
No caso dos transtornos de ansiedade, o foco est fundamentalmente nas contingncias
aversivas (e seus respectivos comportamentos de esquiva), nas prprias relaes
respondentes presentes na experincia afetiva, e nas crenas e regras que, de algum modo,
tomam parte na manuteno da ansiedade patolgica. Em termos comportamentais, essas
relaes podem ser operantes ou respondentes, abertas ou encobertas, e incluem os aspectos
cognitivo, afetivo, comportamental (motor e glandular) e fisiolgico. Essas categorias
descrevem diferentes nveis de anlise dessas relaes. Uma anlise completa das relaes
organismo-ambiente no deve desconsiderar nenhum desses aspectos. O arsenal tcnico das
duas abordagens vem sendo estudado h anos, e o conhecimento dos processos fisiolgicos
(e mais especificamente os neurobiolgicos) subjacentes resposta clnica s intervenes
cognitivas e comportamentais em indivduos com diagnstico de transtornos de ansiedade
apontam para uma convergncia anatmico-funcional. Os estudos apresentados indicam que
esses processos so, em ambos os casos, semelhantes aos responsveis pela resposta clnica
psicofarmacoterapia, envolvendo as mesmas estruturas e circuitos e o mesmo tipo de
alterao/normalizao neurofuncional. Dados de pesquisas bsica e aplicada sobre os
processos neurobiolgicos subjacentes ansiedade patolgica e aos seus trs principais tipos
de tratamentos sero analisados em conjunto, numa tentativa de articulao dos modelos
cognitivo, comportamental e neurobiolgico dos transtornos de ansiedade e de sua teraputica,
considerando o papel central de estruturas especficas do sistema cerebral de defesa nas
respostas de ansiedade, medo e pnico e do crtex pr-frontal na produo dos efeitos
teraputicos.
Differences in Mechanism Between the Word Repeating Technique and Exposure to
Verbal Stimuli
Tomoya Sato1, Rui Hashimoto1, 2, Takahiro Yokoyama1, Shunta Maeda1, Kyoko Nagano1, Kohji
Minosaki1, 2, Hironori Shimada3.
1. Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan, 2. Research
Fellow of Japan Society for the Promotion of Science, Tokorozawa, Japan, 3. Faculty of Human
Sciences, Waseda University, Tokorozawa, Japan.
A method used in Acceptance and Commitment Therapy (ACT) is the Word Repeating
Technique (WRT; Hayes et al., 1999). WRT is designed to facilitate the perception of the
arbitrariness of verbal stimuli by repeating a word or short phrase aloud quickly. Many studies
have shown the effectiveness of WRT (e.g., Masuda et al., 2010). However, there are two
limitations of WRT studies. First, the protocol for an effective WRT procedure is still unclear. For
example, it is important to use neutral verbal stimuli in WRT (e.g., lemon; Bach & Moran, 2008).
On the other hand, it is also important to use negative verbal stimuli in WRT (e.g., idiot; Masuda
et al., 2010). Therefore, there is confusion over which type of verbal stimuli to use. Second, the
effect of WRT may include the effect of exposure. There may be the effect of decrease of
anxiety by exposure because WRT contains the procedure that same stimuli were exposed a lot
of times. We should thus examine whether additional effects would result from the control of
exposure effects. Sato et al. (2012) examined the effectiveness of WRT and the differences
between the underlying mechanisms of WRT and exposure while controlling for the effect of
exposure. The authors demonstrated the effectiveness of WRT by using both neutral verbal
stimuli and negative verbal stimuli. However, the duration of the WRT procedure was unequal

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across conditions in that experiment. Therefore, the present study examined these effects while
controlling for the duration of the exercises. Twenty undergraduate and graduate students (eight
women, mean age = 21.0 years, SD = 3.1) were randomly assigned to four groups. The
conditions were: (a) Both-WRT, in which participants repeated both neutral verbal stimuli (e.g.,
lemon) and negative verbal stimuli (e.g., failure), (b) Neutral-WRT, in which they repeated only
neutral verbal stimuli, (c) Negative-WRT, in which they repeated only negative verbal stimuli,
and (d) Verbal-EXP, in which they were exposed to negative verbal stimuli. Participants also
completed the Japanese versions of the Social Phobia Scale (SPS; Kanai et al., 2004), the
Social Interaction Anxiety Scale (SIAS; Kanai et al., 2004), the Acceptance and Action
Questionnaire-II (AAQ-II; Kishita et al., 2008), the degree of emotional discomfort and the
believability of the verbal stimuli, and the Go/No-go Association Task (GNAT). The GNAT was
used to measure the function of verbal stimuli on avoidance. The results suggested that
participants in the Neutral-WRT condition showed a decrease in verbal function on avoidance,
as compared to those in the Negative-WRT condition. We also found that participants in the
Verbal-EXP condition showed a decrease in experimental avoidance, as compared to those in
the Negative-WRT and Neutral-WRT conditions. These results indicate that using neutral verbal
stimuli in the WRT decreased experimental avoidance after the effects of exposure and
exposure to verbal events were controlled for. Therefore, using negative verbal stimuli in the
WRT may function as an avoidance strategy to decrease their discomfort. On the other hand,
using neutral verbal stimuli in the WRT may facilitate the perception of the arbitrariness of verbal
stimuli.
MODELO PSICOBIOLGICO DE PERSONALIDADE DE CLONINGER E SUA RELAO
COM TRANSTORNOS DE ANSIEDADE
Mariangela Savoia1, 2, Marcio Bernik2.
1. AMBAN - Conscientia, Sao Paulo, Brazil, 2. Programa Ansiedade, So Paulo, Brazil.
H uma relao estreita entre personalidade e transtornos psiquitricos. Tal relao pode ser
complexa e, alm dos transtornos da prpria personalidade, relaes entre caractersticas de
personalidade (com ou sem transtorno) e os chamados transtornos psiquitricos do eixo I tm
sido observadas quanto a gravidade, risco de ocorrncia e refratariedade ao tratamento do
transtorno em questo. Entretanto, alm da determinao gentica, a personalidade formada
tambm por componentes aprendidos. Isso quer dizer que tais traos extremos de
temperamento so passveis de modificao e/ou controle atravs do desenvolvimento de
repertrio comportamental para lidar com eles. O modelo de personalidade psicobiolgico de
Cloninger descreve sete dimenses de personalidade. Quatro delas seriam respostas
imediatas de seres humanos s formas bsicas de estimulao, quais sejam, recompensa,
novidade e punio; as outras trs seriam caractersticas desenvolvidas ao longo da vida e
influenciariam a expresso das quatro primeiras caractersticas. Essas dimenses foram
chamadas de Busca por Novidade (Novelty Seeking, NS), Esquiva ao Dano (Harm Avoidance,
HM) e Dependncia de Gratificao (Reward Dependence, RD), Persistncia (Persistence, P),
Auto-direcionamento (Self-directedness, SD), Cooperao (Cooperativeness, C) e autotranscendncia (Self-Transcendence, ST). Sero apresentados estudos desenvolvidos pelo
grupo sobre a relao entre o modelo psicobiolgico de Cloninger, medido por meio do TCI, e
os transtornos de ansiedade, particularmente Transtorno de pnico, Transtorno de Estresse
Ps traumtico, Fobia social e Transtorno Obsessivo Compulsivo
Fobia Social - Possibilidades de tratamento
Mariangela Savoia, Tito Barros Neto, Cristiane Gebara.

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AMBAN - Conscientia, Sao Paulo, Brazil.


Diversas tcnicas comportamentais e cognitivas foram propostas e divulgadas como eficazes
para o tratamento da fobia social. Das tcnicas propostas, a exposio ao vivo s situaes
temidas a tcnica mais largamente reconhecida como central e eficaz na reduo das
reaes de ansiedade fbica, A exposio mais difcil de se realizar em pacientes com fobia
social do que em outros transtornos ansiosos porque as situaes sociais so variveis e
imprevisveis, o tempo limitado de algumas situaes sociais no proporciona habituao e
ausncia de habilidades sociais para uma exposio adequada. . A exposio ao vivo pode ser
maximizada com terapia de grupo e exposio virtual. A principal vantagem da terapia em
grupo em relao individual para o fbico social que o grupo funciona como uma situao
social vivida pelo paciente e observada pelo terapeuta. Nos grupos, o paciente poder exercitar
tarefas comportamentais com outros pacientes sob observao do terapeuta, de forma a
sedimentar as cognies recm-adquiridas na prpria sesso, alm de submeter-se a
exerccios de exposio a situaes sociais temidas intra-sesso. As tarefas podem ser
ensaiadas no grupo, com os membros desempenhando um papel ou servindo de audincia. As
situaes temidas e evitadas so recriadas no grupo. J o tratamento por realidade virtual tem
se mostrado melhor que imaginao, com relao a custos financeiros, de tempo, e esforos
, portanto, uma possibilidade com resultados indicando a efetividade desta interveno. O nvel
de coneco que os indivduos sentem com o ambiente virtual multidimensional, que envolve
trs fatores primrios, presena espacial, envolvimento com a situao e o realismo da mesma.
O tratamento farmacolgico uma possibilidade a ser investigada neste tratamento, aplicado
de forma isolada ou em combinao com terapia cognitivo comportamental. Mais ainda, devese identificar que fatores interferem na adeso ao tratamento e que pacientes podem se
beneficiar mais deste ou daquele tratamento. Esta mesa tem a proposta de apresentar estudos
desenvolvidos no Programa Ansiedade da Universidade de So Paulo que tratam destas
questes, avaliar a eficcia da adio dos tratamentos farmacolgicos com ISRS ( Inibidor de
recaptao de serotonina) e tratamento psicoterpico comportamental cognitivo em grupo, um
estudo piloto do tratamento de exposio feito atravs de imagens em 3D e follow-up de uma
amostra de pacientes com diagnstico de fobia social e ainda fatores de adeso a estes
tratamentos.
Psychobiological Cloninger`s model of personality and its relationship with anxiety
disorders
Mariangela Savoia, Marcio Bernik.
AMBAN - Conscientia, Sao Paulo, Brazil.
There is a close relationship between personality and psychiatric disorders. This relationship
can be complex and beyond the personality disorders, relationships between personality traits
(with or without disorder) and so-called axis I psychiatric disorders have been observed as the
severity, and risk of resistance to treatment of the disorder in question. However, besides the
genetic, personality is formed by components also learned. This means that such extremes of
temperament traits are modifiable and / or control by developing behavioral repertoire to deal
with them. The psychobiological model of personality Cloninger describes seven dimensions of
personality. Four of them were immediate responses of humans to the basic forms of
stimulation, namely, reward, punishment and novelty, the other three features would be
developed throughout life and influence the expression of the first four features. These
dimensions were called Novelty Seeking, NS, Harm Avoidance, HM, Reward Dependence, RD,
Persistence,P, Self Directedness, SD, Cooperativeness, C and Self Transcendence, ST). Will
be presented studies conducted by the group about the relationship between Cloninger's

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psychobiological model, measured by the TCI, and anxiety disorders, particularly panic disorder,
Post Traumatic Stress Disorder, Social Phobia, and Obsessive Compulsive Disorder
Between Flesh and Brain: Subjective Experience of Body Signals and Interoception in
Anxiety Spectrum Disorders
Lucas Sedeo1, 3, Margherita Melloni1, 3, Blas Couto1, 4, Marcelo Cetkovich2, 3, Liliana Traiber2, 3,
Pablo Lpez2, 3, Emillio Compte2, 3, Fernando Torrente2, 3, Rafael Kichic2, 3, Agustin Ibanez1, 4.
1. Laboratory of Experimental Psychology and Neuroscience-INECO, Buenos Aires, Argentina,
2. Anxiety Clinic - INECO, Buenos Aires, Argentina, 3. Institute of Cognitive Neurology (INECO),
Buenos Aires, Argentina, 4. National Scientific and Technical Research Council (CONICET),
Buenos Aires, Argentina.
BACKGROUNDS: Interoception, the perception of body and visceral sensations, has been
proposed as a core element in psychological models of panic attacks [Ehlers & Breuer, 1992, J
Abnorm Psychol]. These models suggest that panic attacks are triggered by the awareness of
somatic sensations accompanying physiological arousal, followed by the interpretation of these
somatic sensations as a medical or psychological threat [Barlow, 1988, Guildford Press].
Besides, interoception is related to emotional processing. Recent studies have found positive
significant correlations between interoceptive accuracy and the experience of positive and
negative emotions [Critchley, 2009, Int J Psychophysiol; Weins et al., 2000, Cogn. Emot].
OBJECTIVE: To determine whether there are systematic differences in interoception between
anxiety patients with infrequent panic attacks (experienced at least one panic attack during
lifetime, named infrequent panickers), obsessive compulsive disorder (OCD) patients and
controls. METHODS: All experimental groups performed a behavioral interoceptive task
(heartbeat detection task), in which participants were told to follow their heartbeats without
feedback in four conditions, with a feedback condition in the middle. Besides, we included two
social cognition tasks: emotional recognition of morphed faces (Emotional Morphing) and
reading the mind in the eyes (RMET). All subjects also underwent three body signals
questionnaires: Body Perception Questionnaire (BPQ) -assessing the awareness of body
perception-; Body Sensation Questionnaires (BSQ) -evaluating the degree to which patients
fear somatic symptoms- and the Anxiety Control Questionnaire (ACQ) -assessing an individuals
perceived level of control over anxiety related events. PRELIMINARY RESULTS: Although,
there were no significant differences in the heartbeat detection task between infrequent
panickers and controls, OCD patients showed significantly better interoceptive accuracy when
compared to the others groups. Furthermore, results in the accuracy and reaction times (RT) of
emotion recognition and in the RMET showed no differences between groups. All groups
showed similar ratings in the BPQ. Nevertheless, infrequent panickers obtained higher in the
BSQ and in the ACQ. DISCUSSION: Higher accuracy in OCD in the heartbeat detection task
was expected, as they could not inhibit their motor tapping responses, leading to more
responses than actual heartbeats and hence better mean accuracy. Despite the preliminary
negative results in social cognition task, a different analysis showed that patients who had
suffered panic events five days before assessment, presented more difficulties to recognize fear
and reduced RT in the recognition of all emotions. Furthermore, BSQ and ACQ showed that
infrequent panickers were more afraid of somatic symptoms and perceived lower level of control
over anxiety events suggesting that they tend to view interoceptive sensations as dangerous
and threatening. Taken together, those results might imply that the subjective interpretation of
somatic sensation is more related to infrequent panic attacks than interoception. However, it is
to note that, infrequent panickers group merge together patients with at least one panic attack
along with patients that have suffered several of these events. This highlights the need of

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evaluate specific group of patients with diagnose of panic disorder in order to unravel the roll of
interoception and its relationship to biased interpretations of somatic sensations.
Relacin Entre Ansiedad y Estilos de Personalidad en Estudiantes de Psicologa de una
Universidad Colombiana
Elsa Siabato Macias, Ingrid Forero Mendoza.
Boyac, Universidad pedaggica y tecnolgica de Colombia, Tunja, Colombia.
El presente estudio no experimental de tipo correlacional se realiz con el objetivo de
establecer y analizar la relacin entre ansiedad y estilos de personalidad en estudiantes de
Psicologa de una universidad colombiana, mediante la aplicacin del Inventario de ansiedad
Rasgo-Estado (IDARE) y el Inventario Millon de Estilos de Personalidad (MIPS) en su
adaptacin espaola, a 121 estudiantes (34 hombres y 87 mujeres), con edades comprendidas
entre 18 y 33 aos, seleccionados mediante un muestreo estratificado simple. El anlisis de
datos, se realiz mediante el coeficiente de correlacin de Pearson. En el estudio se encontr
que existe relacin positiva entre ansiedad y los estilos de personalidad Preservacin,
Adecuacin, Introversin, Intuicin, Sentimiento, Retraimiento, Indecisin, Discrepancia,
Sumisin y Descontento; y correlacin negativa con los estilos Expansin, Modificacin,
Extraversin, Sociabilidad, Decisin y Dominio.
Mindfulness Teraputica Para Reduo Do Estresse
Luiz Silva, Isabella Gelli.
FASE, Petrpolis, Brazil.
Abstract Central: O presente trabalho, realizado atravs de levantamento bibliogrfico, tem
como foco o tratamento do estresse atravs do uso da mindfulness em sua verso teraputica
desenvolvida pelo Professor Jon Kabat-Zinn, PhD, e implementada por ele e seus associados
na University of Masachussets Medical School, no projeto que se denominou inicialmente
Stress Reduction Therapy (SRT). O interesse pelo tema aqui explorado decorreu do empenho
dos autores em pesquisar a aplicao teraputica da Mindfulness e seus resultados, na
expectativa de aperfeioar sua prtica clnica, maximizando-se, assim, a eficcia dos
tratamentos a seu cargo. Tal interesse justifica-se pelo j empiricamente constatado sucesso
da Mindfulness Teraputica e por sua rpida expanso na Amrica do Norte e no Reino Unido,
apresentando resultados de excelncia incontestvel e perspectivas cada vez mais
promissoras. O fenmeno denominado estresse comeou a ter destaque e relevncia para a
comunidade cuidadora da sade humana a partir da obra de Hans Selye (1956), que
apresentava o estresse atravs de um enfoque predominantemente biolgico, focalizando as
respostas fisiolgicas aos estressores. As perspectivas holsticas oferecidas por Goldstein
(1995), Bertalanffy (1977) e Perls (1977) conduziram a uma concepo menos reducionista, ou
mais abrangente, do estresse, descrevendo-o como um fenmeno que se processa
sistemicamente. Essa concepo constitui um dos principais fundamentos que vieram a
conferir sustentao tcnico-cientfica Mindfulness Teraputica. Inspirado nos ensinamentos
de Buda sem a eles se vincular, Jon Kabat-Zinn (1990) inaugurou formalmente o uso
teraputico da mindfulness revestindo-a de uma configurao secular, ou seja, isenta de
crenas e feies religiosas. No estado de mindfulness, destaca-se a concentrao no aqui-eagora, sem julgamentos, autocrticas ou crticas relativas ao outro, superando-se a tendncia
do indivduo a permanecer continuamente revivendo o passado e temendo ansiosamente o
futuro, deixando de viver plenamente o presente a seu alcance imediato. Est comprovado
empiricamente que com o uso regular da prtica mindfulness, reduzem-se o estresse, a

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ansiedade e a depresso, provavelmente porque se passa a ter uma viso mais realista e mais
produtiva de si prprio. O mtodo usado no treinamento da mindfulness teraputica consiste
basicamente em o praticante manter a ateno plenamente focada em suas experincias aquie-agora. Durante a prtica em consultrio e nos exerccios regulares executados nos intervalos
entre sesses, os pensamentos que se insinuam na mente no so banidos. So, entretanto,
despidos de julgamento, avaliao e interpretao e evita-se dar-lhes continuidade. Depois de
algum tempo, alm de tornar-se tecnicamente apto a concentrar-se corretamente, o indivduo
se habitua a praticar a concentrao naturalmente em cada momento do seu dia-a-dia. Dessa
forma, constata-se que para quem pratica assiduamente a mindfulness, a civilizao pode ser
desconfortvel, mas no tem que inevitavelmente ser insuportvel.
Shy Bladder Syndrome (Paruresis): What Every Clinician Should Know About It
Steven Soifer.
University of Memphis, Memphis, TN, USA.
Abstract Central: Paruresis, a discrete social phobia better known as shy bladder syndrome, is
an anxiety disorder that affects, in some form or another, about 20 million people in the United
States and Canada, and 220 million people worldwide. Rarely spoken about in public, few
people suffering from this problem have sought treatment due to the shame, embarrassment,
and avoidance associated with it. Sufferers with paruresis can be mildly, moderately, or severely
afflicted by this anxiety disorder. While those who suffer mildly may hardly think twice about it
(for example, freezing up at a ball game or when the boss walks into the bathroom), those who
suffer moderately to severely have a much more difficult time. These sufferers often find that
paruresis will interfere significantly in their lives, affecting job considerations, travel, social
situations, dating and other activities. A typical paruretic will think or obsess about his or her
condition throughout the day, wondering where he or she may find the next safe bathroom. In
the worst case scenario, a severe paruretic will functionally be agoraphobic. Over the last 80
years, approximately 75 journal articles have been written on this subject. Some of these have
appeared in medical journals, while others have appeared in various psychological and
psychiatric publications. Starting in the 1960s, a number of articles appeared utilizing various
behavioral techniques to treat paruresis. However, it is fair to say that very few clinicians know
how to effectively treat paruresis. But our work indicates that with graduated exposure therapy
and some cognitive restructuring exercises, 80 - 90 percent of those suffering from paruresis
can realize significant improvement in just 8-12 sessions, or in a weekend workshop format. Dr.
Soifer has run well over a hundred workshops for paruretics across the world, treating over
1000 clients in the process. In this talk, the author will briefly describe the etiology, assessment
techniques, relevant clinical research, and various treatment approaches. Then, the author will
describe the successful treatment model they have developed. Set within a cognitive-behavioral
framework, the graduated exposure procedure the authors use is very effective for most
paruretics. The model involved having the client work with a same-sex therapist. Utilizing in vivo
desensitization methods, the client learns that is it safe to urinate in the presence of others.
Beginning with the least fearful situation, the therapist works with the client, progressing up the
latters behavioral hierarchy of feared situations. Eventually, the therapist and client proceed to
real life public situations. Paruresis is where social phobia, panic disorder, and other kinds of
anxiety disorders were about 30 years ago. There is very little public awareness about it, and
few treatment providers are educated, must less available, to help those suffering from
paruresis. That is why the International Paruresis Association (IPA), Inc. was set up in 1996. In
addition to his other responsibilities, Dr. Soifer is the CEO of IPA, Inc.

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A Randomised Controlled Trial of Acceptance and Commitment Therapy and Cognitive


Behaviour Therapy in the Treatment of Anxiety Disorders among Children
Jessica Swain2, 1, Karen Hancock1, 2, Angela Dixon1, Karen Munro1, Siew Koo1, Cassandra
Hainsworth1, Jennifer Bowman2.
1. The Children's Hospital Westmead, Westmead, NSW, Australia, 2. The University of
Newcastle, Newcastle, NSW, Australia.
Abstract Central: Anxiety disorders affect approximately 10-20% of children, can be enduring if
left untreated, and have been associated with psychopathology in later life. Despite this, there is
a paucity of empirical research to assist clinicians in determining appropriate treatment options.
Cognitive Behaviour Therapy (CBT) is currently the gold-standard evidence-based intervention,
however there is a lack of evidence for its efficacy among child populations as well as for the
comparative effectiveness of alternative interventions. In the past decade, Acceptance and
Commitment Therapy (ACT) has sparked increasing interest among clinicians and researchers.
Several reviews and meta-analyses have consistently found ACT is efficacious in the treatment
of an array of psychological disorders among adults, including anxiety. Preliminary research
evidence also supports the use of ACT among children with other problems such as anorexia
and chronic pain. However, the utility of ACT in the treatment of anxiety disorders in children
remains untested. Furthermore, whilst literature reviews have broadly concluded ACT is more
effective than control conditions, they have also consistently identified that more research is
required to establish its effectiveness relative to alternative interventions. This paper will present
the main findings of a randomised controlled trial underway at The Childrens Hospital
Westmead, Sydney, Australia. Two-hundred-and-thirty-seven children and their
parent/caregivers were recruited, assessed and block randomised to one of three conditions
(ACT, CBT or waitlist control). Seventy-seven were deemed to be ineligible in accordance with
pre-determined study inclusion/exclusion criteria. One-hundred-and-sixty commenced treatment
(ACT=59; CBT=57; Control=44). Participants in the ACT and CBT groups received a 10-week
group-therapy manualised treatment program, in accordance with the relevant therapy,
delivered by psychologists. Controls completed the CBT program after 10 weeks waitlisted.
Repeated measures were taken immediately post-therapy and at three months after therapy
cessation. To the researchers' knowledge, this study is the largest trial of ACT in the treatment
of children and young people undertaken to date. In addition to outcome data on the
effectiveness of ACT for anxious children, it will also provide additional evidence for the utility of
CBT in this population and illustrate the comparative effectiveness of these two interventions,
which are currently implemented widely in postmodern clinical practice. This trial offers the
potential to provide an evidence-base to support alternative treatment for anxiety in young
people, particularly for those who do not benefit from standard treatments. It will allow for
greater flexibility in the approaches available to clinicians and thereby facilitate optimising
clinical outcomes for children with anxiety disorders.
Mechanisms for Change - The Core Components of Acceptance and Commitment
Therapy in Optimising Clinical Outcomes for Anxious Adolescents: Findings from a
Randomised Controlled Trial
Jessica Swain2, 1, Karen Hancock1, 2.
1. The Children's Hospital Westmead, Westmead, NSW, Australia, 2. The University of
Newcastle, Callaghan, NSW, Australia.
Abstract Central: Clinical research has typically focused on assessing the efficacy of
interventions. However, this approach does not assist in determining the specific techniques
that are empirically effective or conversely, those that are contraindicated. Identification of these

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mechanisms of change within a specific treatment could support clinical practice via enabling
interventions to be tailored to meet individual client needs and potentially optimising therapeutic
processes, thereby reducing treatment times. Acceptance and Commitment Therapy (ACT) has
been found to be effective in the treatment of a wide range of psychological concerns. Whilst the
ACT literature on the treatment of anxiety is in its infancy, preliminary research demonstrates its
efficacy in the treatment of the range of DSM-IV anxiety disorders. Despite this, the
mechanisms of change underpinning its success remain less clear. The ACT model
incorporates six core processes that are purported to increase psychological flexibility, or the
dynamics of maintaining/altering behavioural patterns to achieve alignment with personal values
for living. These processes - acceptance, cognitive defusion, values clarification, committed
action, contact with the present moment (mindfulness), and self-as-context - are hypothesised
to be the elements key to its effectiveness. Emerging research supports the role of defusion,
acceptance and provides some evidence for the role of values clarification and committed action
in reducing psychopathology. However, in the main, these studies are preliminary and subject to
several methodological limitations including measures that lack psychometric evaluation,
reliance on self-report measures alone and the use of measures that concentrate on a small
number of core processes, leaving other parts of the ACT model untested. This paper will
present a review of the ACT literature with respect to mechanisms of change in the treatment of
anxiety. Outcomes on these mechanisms from a randomised controlled trial of ACT for the
treatment of adolescents with a DSM-IV anxiety disorder - currently underway at The Childrens
Hospital Westmead, Sydney, Australia - will be discussed. Eighty-two adolescents and their
parent/caregivers were recruited and completed an assessment battery, including measures of
acceptance, mindfulness, cognitive defusion, and valued living. Participants were block
randomised to one of three conditions (ACT, Cognitive Behaviour Therapy [CBT] or waitlist
control). Eleven were deemed to be ineligible in accordance with pre-determined study
exclusion criteria. Seventy-one commenced treatment (ACT=27; CBT=21; Control=23). Those
in the ACT and CBT groups completed a 10-week group-therapy program, in accordance with
the relevant therapy. Controls received CBT after 10 weeks waitlisted. Repeated measures
were taken post-therapy and at three months after therapy cessation. In addition to outcome
data on the mechanisms of change for ACT in the treatment of adolescent anxiety, this paper
will explore whether these are unique to ACT. This research offers the potential to provide an
evidence-base for more specific intervention for young people with anxiety, maximising
therapeutic processes and optimising clinical outcomes.
The Use of Technology in the Treatment of Selective Mutism: A Proposed Mobile
Application
Sarah Tabbarah, Robert Friedberg, Rosa Poggesi, Nathan Chow.
Palo Alto University, Palo Alto, CA, USA.
Treating selective mutism is challenging. In many instances, anxiety disorders are treated
successfully with traditional in-person cognitive behavioral therapy (CBT). Currently, innovations
in technological adaptations of conventional CBT are drawing increased interest (Khanna &
Kendall, 2008; Kendall, Khanna, Edson, Cummings, & Harris, 2011). Technology based
interventions are cost effective, accessible, familiar and highly engaging to children (Elkins,
McHugh, Santucci, Barlow 2011). Although some computer programs exist for assisting therapy
(e.g. Camp Cope-A-Lot), only two CBT apps are available in the Apple App store and a few
were found in the Android Market. Undoubtedly, there is a gap that needs to be filled.
Technology based interventions for children diagnosed with SM represent a graduated task.
The mobile application may serve a proxy function paving the way for verbal interaction with
others. This poster proposes an outline for a mobile app tailored specifically for SM. The app

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features are firmly rooted in CBT and include modular core elements such as Psychoeducation,
self-monitoring, cognitive restructuring, and behavioral experiments/practice (Chorpita, 2006,
Friedberg, McClure & Garcia, 2009). More specifically, the proposed model program includes
behavioral interventions where the child practices learned skills interactively using the
application and then progresses to practicing them in-vivo. Before beginning to play, the childs
hierarchy of feared speaking is inputted as levels of the game. The child then navigates through
the different levels of the game. The child advances through the levels by accomplishing the
levels goals. A preliminary level, for example, could be the child asking his interactive sibling for
a piece of candy. A more advanced level would be asking the store clerk for something off the
shelf. When completing a level rewards the interactive character, the child is also rewarded invivo. As the child advances in levels, he/she is expected practice in-vivo experiments in order to
collect additional points. Finally, the therapist is able to monitor treatment, almost in real-time as
he/she would be receiving automatic notification that the child completed a level.
Epoch Analysis in Eye Tracking During Exposure to Aversive Pictures and Words
Minoru Takahashi.
Faculty of Human Sciences, Mejiro University, Tokyo, Japan.
PURPOSE: Attentional processing of threatening information is one of the important factors in
the development and maintenance of anxiety disorders. Attentional process research can be
divided into two types: the orienting of attention and the continued engagement of attention to
threatening cues (Armstrong et al., 2010). The latter type of research is especially important in
enhancing the effectiveness of CBT, and exposure techniques in particular. Exposure
techniques are useful in the treatment of anxiety and phobia, and the method is being improved
based on these research (Antony & Barlow, 2002; Craske & Mystkowski, 2006). For example, in
recent studies, words and languages are used as a stimulus to boost the effectiveness of
exposure therapy. For example, Tabibnia et al.(2008) examined whether exposure to aversive
image with words would lead to reduction in autonomic reactivity. Also, Hayes et al.(1999)
proposed a new type of exposure, the words repeating technique, in Acceptance and
Commitment Therapy. It has been shown that subjective pain decreased when the process of
exposure was accompanied with words (Deyoung et al.2010; Masuda et al. 2008). The purpose
of this study is to explore the change of visual attention in the epoch-related analysis during a
30 sec. exposure to aversive pictures and words. METHODS: 1) Participants: Participants were
13 young adults (2 male and 11 female) between the age of 18 and 27 (Mean = 23.62). They
were paid 500 Yen (about $6) for their participation in a 30-min experimental session. 2)
Materials and apparatus: 6 pictures and 6 words were used. The pictures were selected from
International Affective Pictures Sets (IAPS; Center for the Study of Emotion and Attention,
1999). It included 3 negative and 3 positive pictures depicting animals or insects. In addition, 3
negative and 3 positive words were chosen for this experiment. The words were comprised of 2
Chinese characters (i.e. kanji), which represented suffering or sadness in the negative
condition, and pleasantness or comfort in the positive condition. Eye tracking was recorded with
QG-PLUS. 3) Procedure: Participants were instructed of the procedure of the experiment and
how to evaluate the stimulus. During the experiment, pairs of opposite-valence pictures (or
words) were randomly shown for 30 seconds. There were 12 trials in total, and each picture or
word was shown twice. RESULTS and DISCUSSION: Subjective unpleasantness of the
aversive stimulus were analyzed using a 22 ANOVA with the type of stimuli (pictures or words)
and valence (unpleasant or pleasant) as within-subject factors. Significant main effects of the
type of stimuli (F(1,12)=6.08, p<.05) and valence (F(1,12)=169.74, p<.05), as well as a
significant interaction between type and valence (F(1,12)=17.69, p<.05) were found.Thus,
further analysis using gaze duration was done separately for each type of stimuli(i.e.

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picuture/word). The effects of valence of stimuli(unpleasant or pleasant) and interval(0-10sec.,


10-20sec., or 20-30sec.) on glance duration was evaluated using a 23 ANOVA. As a result,
mean gaze duration in the picture condition showed no main effect of valence (F(1,12)=.78,
n.s.) and interval (F(1,12)=.81, n.s.), but interaction between valence and intervals was
marginally significant(F(1,12)=4.68, p<.51). As for the word condition, the main effect of valence
was significant(F(1,12)=5.63, p<.05). However the no main effect of intervals( F(1,12)=.54,
n.s.)and interactions(F(1,12)=1.57, n.s.) did not reach significance. It was suggested that the
change of visual attention to threating is different by a kind of the stimulus.
Cognitive behavioral treatment of children with anxiety disorders: Efficacy, effectiveness
and clinical implications of treatments of different intensity and in different settings
Mikael Thastum1, Kristian Arendt1, Lisbeth Jrgensen1, Esben Hougaard1, Signe SchneevoigtMatthiesen1, Mikael Thastum1, Ron Rapee2, Irene Lundkvist-Houndoumadi1, Signe
Schneevoigt-Matthiesen1, Lisbeth Jrgensen1, Mikael Thastum1, Mikael Thastum1, Lisbeth
Jrgensen1, Signe Schneevoigt-Matthiesen1, Tina Clausen1, Tine Vadgaard1, Irene LundkvistHoundoumadi1, Kristian Arendt1, Hjalti Jonsson1, Lisbeth Jrgensen1, Signe SchneevoigtMatthiesen1, Mikael Thastum1, Lisbeth Jrgensen1, Hjalti Jonsson1, Signe SchneevoigtMatthiesen1, Mikael Thastum1.
1. Aarhus University, Aarhus, Denmark, 2. Centre for Emotional Health, Department of
Psychology, Macquary University, Sydney, NSW, Australia.
Although anxiety disorders are highly prevalent among children and adolescents, and cognitive
behavioral treatment has proven to be effective, still many children with anxiety disorders do not
retrieve adequate treatment. Thus, there is need for developing, and testing evidence based
treatment programs of different formats and intensities, that could satisfy the needs of different
clinical settings. More research of the effectiveness and implementation of evidence based
treatments within ordinary clinical community practice are also needed. At this symposium
results from cognitive behavioral treatment of children with anxiety disorders of different formats
and intensity and within different settings will be presented. This includes presentations of:
Therapist assisted low cost bibliotherapy; group treatment with inclusion of the parents,
treatment of non-responders to the group treatment, and implementation of group treatment in
clinical practice.
The Cool Kids/Chilled Adolescents Anxiety Program: Results of a randomized wait-list
controlled trial
Introduction: The Cool Kids/Chilled Adolescents Anxiety Program is a manualized CBT program
for treating anxiety disorders in children and adolescents, developed and evaluated at
Macquarie University, Australia (Hudson et al., 2009). The program was translated and
implemented at the Youth Anxiety Clinic at the Department of Psychology, Aarhus University,
Denmark, in 2009.
Objectives: The objective of the study is to evaluate The Cool Kids/Chilled Adolescents Anxiety
Program in a Danish context, and thereby as the first study independently replicate the original
Australian evaluation study (Hudson et al., 2009).
Method: The study is a randomized wait-list controlled trial including a total of 110 participants
(aged 7-15 years) with an anxiety diagnosis as the primary diagnosis. Participants were
randomly allocated into either a 3 month wait-list control condition or a treatment condition. The
treatment consisted of 10 2-hour group sessions with 6 children and their parents. Results were
measured by independent diagnostic interviews with the children and their parents at posttreatment and at 3-month follow-up, ADIS-C/P (Albano & Silverman, 1996), as well as by self-

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report child and parent scales pre- and post-treatment, and at 3- and 12-month follow-up.
Results: Results from pre-post treatment and follow-ups will be presented at the conference.
Do children with anxiety disorders who do not respond to manualized CBT improve with
a subsequent case-based approach?
Introduction: In a recent meta-analysis the overall effect size for generic Cognitive Behavioral
Therapy (CBT) of anxiety disorders in children and/or young people was found to be moderate
(Reynolds, S., Wilson, C., Austin, J. & Hooper, 2012). Even though the majority of children with
anxiety disorders respond to CBT treatment, there are children who show minimal or no
improvement.
Objective: The aim of the present study was to investigate the effectiveness of a case-specific
CBT intervention for children, who have shown minimal improvement to manualized CBT.
Design: In the context of a Randomised Controlled Trial conducted at the Anxiety Disorder
Clinic for Children and Adolescents at Aarhus University, a manualized group treatment (Cool
Kids/Chilled Program) was offered to 110 children with anxiety disorders. Approximately 20 % of
the sample was found not to have responded adequately when measured three months after
the end of treatment by the Clinical Global Impression-Improvement of Anxiety scale. Those
non-responders were subsequently offered additional CBT case-based treatment targeting
problem-sustaining factors.
Methodology: Clinicians ratings on diagnostic interviews (ADIS-IV-C/P) and Childrens Global
Assessment Scale were used in order to evaluate the degree of response to the manualized
and the subsequent case-based intervention. Self-reports of parents and youth: Spence
Childrens Anxiety Scale (SCAS-c/p), Childrens Anxiety Life Interference Scale (CALIS), SelfEfficacy Questionnaire for Children (SEQ-C), Childrens Automatic Thought Scale (CATS) and
Depression Anxiety Stress Scales (DASS) at pre-, post-, and 3-, months after the end of both
interventions provided comparative information on changes in children and parents.
Results: At the time of the conference we expect to be able to present findings from all identified
non-responders, who subsequently received an additional case-based intervention.
Therapist assisted bibliotherapy for children with anxiety disorders: preliminary results
of a randomized controlled trial
Introduction: Only a small proportion of children with anxiety disorders receive treatment,
despite evidence of the efficacy of cognitive-behavioural therapy for treating children with
anxiety disorders. Bibliotherapy is a low cost therapy with minimal therapist assistance, which in
a few studies have been shown to result in favourable outcomes compared to waitlist and
outcomes comparable to face-to-face treatment.
Objectives: The current study examined the efficacy of therapist supported group bibliotherapy
compared with face-to-face group treatment in a randomized controlled design.
Methodology: Children (aged 8-12, n = 80) with a principal diagnosis of an anxiety disorder are
randomly allocated to bibliotherapy or group treatment. In the bibliotherapy condition parents
are provided with a book and a workbook to the children. Parents meet in groups of five families
four times of 1 hour with a therapist to problem-solve application of skills learned and
clarification of concepts from the book. Group treatment is based on the Cool Kids Program, a
ten-session cognitive- behavioral program for the management of childhood anxiety disorders.
Children and parents meet with a therapist for weekly two hours session. Treatment credibility is
assessed after the first session. Group session ratings are assessed after each session.
Attrition rates, diagnostic change and self-report questionnaires are assessed post treatment.
Results: At the time of the conference we expect to present pre-post results from 60
participants, 30 in each condition.

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Effectiveness of group cognitive-behavioral treatment for childhood anxiety disorders in


community clinics: clinical significance and benchmarking against efficacy
Background: The efficacy of a group cognitive behavioural therapy program (Cool Kids) of
childhood anxiety has been demonstrated in a university-clinic setting in Australia (Hudson et
al., 2009) and preliminary findings from a randomized controlled trial (RCT) at a University-clinic
supports its efficacy in Denmark (Arendt & Thastum, 2012).
Objective: To evaluate the outcomes of evidence based, manualized group cognitivebehavioural treatment (CBT) for children and adolescent with anxiety disorders, when delivered
in an outpatient Child and Adolescent Psychiatry or in a community based School Counselling
Service in Denmark.
Method: Psychologists and psychiatrists from three Child and Adolescent Psychiatry clinics and
four community bases School Counselling Services are trained and supervised in a manualized
group CBT treatment program (Cool Kids) for Childhood anxiety. Ninety-six children with anxiety
disorders aged between 7 - 14 are expected to be included, equally divided between Psychiatric
clinics (n = 48) and School Counselling services (n =48). The treatment consists of 10 2-hour
group sessions with 5-6 children and their parents. Results are measured by independent
diagnostic interviews with the children and their parents at pre- and post-treatment and at 3month follow-up (ADIS-C/P: Silverman & Nelles, 1988), as well as by self-report child and
parent scales pre- and post-treatment, and at 3- and 12 month follow-ups. Parents symptoms of
anxiety and depression are also measured.
Results: At the time of the conference, we expect to be able to present post-treatment and 3
month follow up data for all participants. Furthermore, pre-post changes, as well as percent of
post-treatment diagnosis and pre-treatment severity will be benchmarked against efficacy data
from a Danish RCT from the University-clinic.
Discussion: Implications of the findings for the use of the Cool Kids program in a community
based and/or psychiatric clinical practice in Denmark will be discussed.
Evidence based practice in a community setting: How do therapists experience the
implementation of a manulized Cognitive Behaviour therapy program for childhood
anxiety disorders?
Introduction: Dozens of studies have supported the potency of cognitive behavioral treatments
(CBTs) for child anxiety disorders in efficacy studies. Research on treatment of childhood
anxiety disorders has clearly reached a point at which effectiveness research is needed to
examine how CBT programs performs across different settings, with different providers, and
consumers.
The process of moving efficacious treatments to clinical settings is complex and may require
adaptations of treatments, settings, and service systems. To ensure the effectiveness of
treatments within clinical settings, it is important to identify potential obstacles in the
implementation of evidence based practices into clinical practice. Obstacles within the clinical
setting may be found at the patient level (e.g. more comorbid and severe cases); therapist level
(e.g. negative beliefs and criticism of treatment manuals, inadequate training) and at an
organizational level (e.g. unsupportive organizational climates, lack of funding, too much case
load). Effectiveness studies of CBT programs within childhood anxiety disorders have mainly
evaluated the treatment effects, and patient characteristics, while therapist beliefs and
experiences have gotten little attention.
Objectives: The aim of this study is to evaluate therapists experiences and beliefs about the
implementation of a manualized CBT program in their clinical setting.
Methods: The effect of a CBT group therapy program (The Cool Kids program) for childhood
anxiety disorders was evaluated within seven different community settings (psychiatric
departments and school based services). Prior to the study, fifteen therapists (psychiatrist and
psychologists) with different amount of clinical experience and qualifications received two-day

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training in the Cool Kids manual. All therapists received three 1 hour group supervision
sessions during the 10 session treatment course. At post-treatment, a questionnaire measuring
the therapists beliefs and experience with the program was collected. Furthermore, different
key-concerns were noted during the supervision.
Results: Data collection will be completed at the time of the conference. This exploratory data
will be used to look for any potential obstacles at the therapist level, which may affect the
implementation of an evidence based practice within a clinical setting.
Discussion: The findings will be discussed in terms of whether validated treatment protocols and
community practice settings may have to be modified so that effective treatments can be
delivered in clinical settings.
Phobia in School Evaluation: An Intervention Focused on Interconnection of
Psychopedagogy and Psychotherapy
Nidia Valdez1, Maria Helena Favero2.
1. Ethos-Espao da Psicologia, Brasilia, Brazil, 2. Universidade de Brasilia, Brasilia, Brazil.
Abstract Central: This work approaches a specific situation of anxiety disorder: phobia in
situations of mathematics evaluation at school. It is based on the studies of three research lines
used interconnectedly: studies about anxiety; studies focused on math conceptions and their
interconnections with gender roles; studies intended to intervene to create new conceptions
about that knowledge area, about personal interaction with it, and the construction of selfesteem associated to it. We describe a psychotherapeutic and psychopedagogical procedure
with a 14-year-old female adolescent, a student at her first year in a private high school in
Braslia, DF, Brazil. She complained of anxiety characterizing the specific phobia: strong and
consistent fear in situations of school evaluation, with anxiety-related responses such as
insomnia, digestion disorders, lack of appetite, which marked anxious anticipation and suffering
in the feared situation - the math test - which significantly interfered in her personal and school
life. She felt high anxiety in math classes, which disarranged her cognitive formulations,
predisposed her to the aforementioned organic symptoms, inhibited her learning, and kept her
locked in a vicious circle that engendered her low self-esteem. Our intervention focused on the
development of new conceptual competences considering that they lead to conscious
awareness about the relationship between competences and difficulties, so that new meanings
could be attributed to that relationship, and thus favour anxiety control and construction of
positive self-esteem. Considering that all human activity is mediated and signified in the
relationship with the other, we systematized our intervention according to three distinct yet
related activities: assessment of R.s math competences and difficulties; planning of
psychopedagogical activities based on that assessment; thorough analysis of the development
of those activities, regarding the tools used and the procedure adopted for its mediation, which
presupposes to consider not only the math-related contents, but also the meanings connected
to them. Therefore, each intervention session was planned according to data showed in the
previous one. Results obtained showed the relevance of our approach: as R. developed the
required math competences, her performance in school evaluations gradually changed
positively and her self-esteem was reconstructed. The process engendered: re-signification of
her experiences and conceptions about mathematics; a new perception about her competence,
and the disappearance of her anxiety.
Generalization of Fear Over Stimuli Through Symbolic and Functional Relations
Ellen Vervoort, Bram Vervliet, Frank Baeyens.
KULeuven, Leuven, Belgium.

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It is well known that fear develops through a conditioning process in which a neutral stimulus
(for example, a dog) is consistently followed by an aversive event (being bitten by the dog). As a
result, this stimulus will become threatening itself. However, a core feature of clinical fear is that
it tends to generalize to other stimuli than the original stimulus. In our example, people who are
bitten by a dog, often develop fear of all dogs, instead of only the one dog that actually bit them.
This phenomenon of fear generalization is mostly investigated at a perceptual level: stimuli
that are perceptually similar to the threatening stimulus will evoke similar fear responding. Two
recently initiated research lines in our lab investigate an alternative form of generalization: nonperceptual generalization, or symbolic generalization based on concepts or semantic groups
of stimuli. In such instances, generalization of fear is observed between stimuli that do not share
perceptual features, but rather have (1) a symbolic or (2) a functional relation. We investigated
the first type of relation in our first experiment. Using a Matching-To-Sample training, we created
two four-member equivalence classes, consisting of abstract figures. Within class transfer of
conditioned fear proved to be greater than between class transfer. The second research line
focuses on functional equivalence or acquired equivalence/distinctiveness, which is based on
common outcomes or antecedents. The first experiment demonstrated more generalization
between stimuli that shared a common outcome in a previous phase, compared with stimuli that
were followed by a different outcome. In summary, both types of equivalence training, MatchingTo-Sample and common outcomes, appear to support generalization of fear within classes of
stimuli. Stimulus classes or concepts may therefore play an important role in the expansion of
conditioned fear over different stimuli.
Cognitive Behavior Therapy in Adolescents with Social Phobia: What are the Evidences?
Bruno Vieira1, 2, Ana Maria Martins Serra2.
1. Universidade Federal de Uberlndia, Uberlndia, Brazil, 2. Instituto de Terapia Cognitiva,
So Paulo, Brazil.
Abstract Central: BACKGROUND: Studies have shown that anxiety disorders response to
pharmacotherapy for youth is not as good as for adults. Researches with Cognitive Behavioral
Therapy (CBT) have demonstrated relevant efficacy using that approach. The Social Phobia
(SP) is a peculiar form of anxiety disorder. Its the fear of being badly evaluated. Its the anxiety
for performance. Frequently, adolescents are included with children in the approaches. In such
case, the adolescents are not considered the singularity of their age group. METHODS: A
research was done in the internet sites Medline, Cochrane, Lilacs and Scopus, by using the key
words: Social, phobia, adolescents and CBT. At Scopus we used some filters because of the
large number of references. It is hard to find studies that only adolescents with SP were
grouped. In any way, those studies showing adolescents with other groups were considered as
social phobia with other anxiety disorders as well. RESULTS: A total of 152 references were
found and after a careful examination of abstracts considering well-designed studies, 21 were
selected as the aim of this current approach. Among them, there were 6 controlled trials, 5
control groups, 3 review articles, 2 prospective-observe studies, 1 cohort study, 1 prospectivecomparative, 1 multisite clinical trial, 1 meta-analysis and 1 long term follow-up study. Most of
them (13) refer to mixed anxiety disorders. Some other, 9 articles, refer to SP only. Two studies
have considered just adolescents but not involving just SP. Only 2 approaches were for social
phobic adolescent. All of them have shown some symptomatic improving using CBT, although
they usually were watchful about the needs of enhancing the quality of techniques and protocols
as finding new approaches as well. Some studies mentioned the additional gain when the
parents were treated, even though the parents resistance was evident. CONCLUSION: The
studies including adolescents with SP are still insufficient. Well-designed studies indicate that
CBT is effective on treating anxiety and SP in youth, but technical improving is necessary.

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Finally, more researches to show the techniques that work better and involve new approaches
may improve treatment outcome.
Understanding and Treatment of Anxiety and Depression in Older Adults
Viviana Wuthrich1, Viviana Wuthrich1, Viviana Wuthrich1, Viviana Wuthrich1, Ron Rapee1, Ron
Rapee1, Ron Rapee1, Carly Johnco1, Dusanka Tadic1, Kenneth Laidlaw2, Junwen Chen3.
1. Macquarie University, Sydney, NSW, Australia, 2. University of Edinburgh, Edinburgh, United
Kingdom, 3. Flinders University, Adelaide, SA, Australia.
This symposium will focus on psychological issues related to understanding and treating of
anxiety and depression in older adults. Research indicates that anxiety and depression present
differently in older adults, and that some modifications are needed in the therapy of older adults.
The first paper examines some of the cognitive and emotional reactivity differences between
younger and older clinical and community samples, and discusses how they might impact on
our understanding of anxiety and depression. The second paper focuses on understanding
differences in cognitive flexibility in community dwelling and clinical older adult samples and how
this relates to anxiety and depression symptoms, and how it specifically relates to the ability to
learn cognitive restructuring skills. Implications for these findings on treatment with older adults
will be discussed. The third paper reports on the preliminary results of a randomised controlled
trial comparing cognitive behavioural therapy to an active control condition (discussion group)
for treatment of comorbid anxiety and depression in older adults. The final paper reviews
psychological treatment trials for geriatric depression, and considers what further changes are
needed to further improve outcomes in this population.
Age differences in emotion regulation in anxiety and depression: a multimodal
investigation.
Adaptive emotion regulation strategies have been postulated as the mechanisms underlying the
robust finding that older adults experience a high level of well-being, despite declines in
cognition, physiology and social networks. However, while most older adults experience high
well-being, not all do. Difficulties in emotion regulation are considered a critical factor in the
development and maintenance of anxiety and depression. This research aims to investigate age
differences in spontaneous emotion regulation across discrete emotions in both healthy and
clinical samples. Older (60 years +) and younger (18-25 years) participants with clinical and
non-clinical levels of anxiety and depression completed self-report measures of anxiety,
depression, and general functioning. Participants also completed cognitive tasks designed to
assess interpretation bias and the use of reappraisal as an emotion regulation strategy.
Participants completed a series of mood inductions (happy, sad and anxious) during which
continuous self report ratings of mood and physiological responses (skin conductance) were
recorded to assess emotion intensity and rate of recovery. The use of spontaneous emotion
regulation was assessed. Results will be discussed in light of the existing evidence for age
differences in emotion regulation. The results will also contribute to our understanding of the
role emotion regulation plays in maintaining lower levels of anxiety and depression in older
adults.
The role of cognitive flexibility on older adults ability to learn cognitive restructuring
skills.
There is evidence to suggest that those with high levels of anxiety and depression demonstrate
poorer performance on measures of executive functioning compared with controls. In addition,
executive functioning skills are found to decrease during normal ageing processes. While there
is consistent evidence that cognitive behavioural therapy (CBT) is effective with older people,

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there remains a clinical debate about the extent to which cognitive therapy components,
including cognitive restructuring, may need to be adapted or eliminated with older clients due to
age-related decline in cognitive functions. Cognitive flexibility includes the ability to produce
diverse ideas, consider response alternatives, and modify behaviours in response to changing
circumstances, and these skills appear to be important abilities for implementing cognitive
restructuring, where negative thoughts are identified, evidence that supports and refutes the
thought is generated, and a more realistic and adaptive interpretation is produced. This
research investigated the impact of cognitive flexibility on older adults ability to learn cognitive
restructuring. In particular, we assessed whether the combination of older age and clinical
anxiety and depression had a synergistic effect on impairments in cognitive flexibility and on the
ability to learn cognitive restructuring. 40 treatment-seeking clinical participants with comorbid
anxiety and depressive symptoms were compared with 53 non-clinical control participants on a
range of neuropsychological measures of cognitive flexibility, and on the quality of their
cognitive restructuring skill acquisition. The preliminary findings will be presented and the
implications for using cognitive restructuring techniques with older adults will be discussed.
Randomized Controlled Trial of Cognitive Behavioural Therapy Compared to a
Discussion Group for Older Adults with Comorbid Anxiety and Depression: Preliminary
Findings.
Despite the ageing of the population, research on the best psychological treatment for comorbid
anxiety and depression in older adults is still under developed. Some research suggests that
older adults with anxiety or depression can benefit from cognitive behaviour therapy (CBT);
however, CBT has not always been shown to be superior in older adults with anxiety disorders,
and generally the effect sizes for therapy are smaller than in younger adults. Current gaps in the
literature include a lack of knowledge about the effectiveness of psychological treatments for
older adults with comorbid anxiety and depression, and the impact of pre-treatment cognitive
ability on treatment outcomes in large scale trials. In this study we compared group CBT to a
discussion group for older adults with comorbid anxiety and depression in a large randomized
controlled trial. Participants were assessed on the Anxiety Disorders Interview Schedule, and
were randomly allocated to group treatment. Participants were excluded if they experienced
bipolar disorder, psychosis, substance abuse, or were a suicide risk. Participants also
completed symptom measures of anxiety, depression, general functioning, and cognitive ability
at pre-treatment, post-treatment and 6 months post-treatment. Preliminary findings regarding
the effectiveness of the two treatment conditions, as well as the impact of cognitive ability on
treatment outcome will be discussed.
Augmenting CBT with gerontology for chronic/complex late life depression and anxiety.
A recent randomized controlled trial (Laidlaw et al., 2008) has demonstrated that CBT on its
own can be an effective treatment for late life depression. The evidence for this clinical trial is
briefly reviewed as is the outcome evidence from other clinical trials and systematic reviews.
The evidence is considered critically and the case for developing a conceptual approach to
augmentation of outcome is outlined. Depression is a relapsing and remitting condition and
anxiety (especially Generalized Anxiety Disorder) rarely spontaneously remits. A final
consideration of this paper is the long term outcome of CBT with older people and how CBT
may be optimised to fit the needs of clients with chronic and complex histories and
presentations.
A Feasibility Study of Individual Cognitive Behavior Therapy for Social Anxiety Disorder
in Japanese Clinical Settings

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Naoki Yoshinaga1, 2, Fumiyo Ohshima1, Satoshi Matsuki1, Mari Tanaka1, Tomomi Kobayashi1,
Hanae Ibuki1, Kenichi Asano1, Osamu Kobori1, Tetsuya Shiraishi1, EmI Ito1, Michiko Nakazato1,
Akiko Nakagawa1, Masaomi Iyo1, Eiji Shimizu1.
1. Chiba University, Chiba, Japan, 2. Japan Society for the Promotion of Science, Tokyo, Japan.
Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for social anxiety
disorder (SAD) in Europe and North America. CBT was introduced into Japanese psychiatry in
the late 1980s, and awareness of the effectiveness of CBT has spread, not only among
professionals and academics but also among the general public. Nevertheless, the number of
facilities offering CBT is still limited; as of 2012, SSRIs (fluvoxamine and paroxetine) are the
only treatments covered by insurance for Japanese patients with SAD. It is possible for CBT to
be acceptable and effective for patients with SAD even in non-Western cultures; therefore, we
conducted a feasibility study of CBT for SAD in Japanese clinical settings. After enrolling in the
study, patients were placed on a 2-week waiting period to establish the baseline stability of their
symptoms. At the end of the waiting period, patients received a CBT intervention for 14 weeks.
Concomitant medications were permitted if the dose had been stable for at least 4 weeks prior
to study entry and remained stable throughout the study. Patients were assessed by the selfrated Liebowitz Social Anxiety Scale at baseline (week 0), pre-CBT (before session 1/week 2),
mid-CBT (after session 7/week 9) and post-CBT (after session 14/week 16) time points. Of the
19 subjects screened, 15 were eligible for the study and completed the outcome measures at all
assessment points. Receiving CBT led to significant improvements in primary SAD severity. The
mean total score on the Liebowitz Social Anxiety Scale improved from 91.8 to 51.7 (pre-CBT to
post-CBT), and the within-group effect size at the end-point assessment was large (Cohens d =
1.71). After CBT, 73% of participants were judged to be treatment responders, and 40% met the
criteria for remission. Despite several limitations, our treatmentwhich comprises a 14-week,
individual CBT programseems feasible and may achieve favorable treatment outcomes for
SAD in Japanese clinical settings. Currently, our research team is running a randomized control
trial for SSRI-resistant SAD in order to address the limitations of this study (trial number:
UMIN000007552).
The Effects of Mindfulness - Based Cognitive Therapy on Depression and Anxiety of
Adult with Type 2 Diabetic
Khatereh Zabihi.
Rahnemood counselling center, SARI, Islamic Republic of Iran.
Abstract Central: The effects of mindfulness - based cognitive therapy on depression and
anxiety of adult with type 2 diabetic Khatereh Zabihi Maryam Mansurian, Bahram Mirzaian,
Ramzan Hasanzade Abstract Background: The prevalence of anxiety and depression
symptoms in patients with diabetes is considerably higher than in general population. People
with diabetes are at greater risk for depression. Depression is associated with a 60% increased
risk of type 2 diabetes. Objectives: The objective of this study was to examine the effectiveness
of group mindfulness-based cognitive therapy (MBCT) on depression and anxiety for patients
suffering from type II diabetes. Methods: Thirty diabetic II patients (mean age 37 years, SD 10)
were randomized into a group receiving MBCT or a waiting-list control group. Before and after
the intervention period questioners (Beck depression Inventory) and Spielberger state-trait
anxiety inventory)) were completed. Results: Repeated measures multiple analysis of variance
(MANCOVAs) showed that, compared with the control group, the intervention resulted in
significantly stronger reductions of depression and state-trait anxiety. Conclusion: Recognition
and understanding the MBCT can be used and might be helpful as a part of comprehensive
care for diabetic patients and decreases the decreases the psychological problems of type II

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diabetic patients. Keywords: mindfulness - based cognitive therapy. anxiety. depression. type II
diabetes. . Corresponding Author: Rahnemud counseling center, Sari, Iran. Email:
khaterehzabihi@gmail.com Phone Number: +981519123253078
Anlisis de Caso: Tratamiento cognitivo conductual de un caso de Trastorno de Panico
sin agorafobia
Sonia Zambrano Hernndez.
Facultad de Psicologia, Universidad Catlica de Colombia, Bogota, Colombia.
Los ataques de pnico se refieren a una inesperada respuesta de miedo o malestar intensos
acompaados de una serie de sntomas fsicos y cognitivos que en ocasiones limitan la
actuacin de quienes la padecen (Barlow, 2002). Se presenta la intervencin cognitivo
conductual basndose en los protocolos de Roca, E. & Roca, B. (1999), Bados (2000) y
Moreno & Martin (2008) para un caso de un hombre de 30 aos, que solicita una intervencin
psicolgica argumentando crisis de ansiedad, que limitan su vida profesional y personal. Hace
6 meses empieza tratamiento farmacolgico sin mejora significativa de los sntomas
fisiolgicos. Presenta ocasionales ataques de pnico asociados principalmente a situaciones
laborales, se desempea como escolta de personas del gobierno por lo que se expone a
situaciones de riesgo con frecuencia, como el manejo de armas, vuelos nacionales e
internacionales, situaciones de riesgo para el protegido, etc. El tratamiento se planteo como
metas clnicas: (1) Lograr eliminar los ataques de pnico mediante el uso de estrategias de
prevencin de respuesta, (2) Retirar el tratamiento farmacolgico, (3) Lograr que el paciente se
enfrente a las situaciones ansiogenas, (4) Disminuir los niveles de ansiedad y depresin
iniciales. Se lograron alcanzar y mantener los objetivos planteados sin sufrir recadas. Por
ltimo, se muestran los resultados obtenidos de la evaluacin pre y post tratamiento mediante
el empleo de varios instrumentos de evaluacin debidamente adaptados para la poblacin
colombiana. Palabras clave: ataques de pnico, , tratamiento cognitivo-conductual, sesgos
cognitivos, experimento de caso nico. Barlow, D. H. (1988). Anxiety and its disorders. The
nature and treatment of anxiety and panic. Nueva York: Guilford Press. Barlow, D. H. (2002).
Anxiety and its disorders. The nature and treatment of anxiety and panic (2nd ed.), Nueva York:
Guilford Press. Bados, A. (2000). Agorafobia y ataques de pnico. Madrid: Pirmide. Moreno,
P. J. y Martn, J. C. (2008). Tratamiento psicolgico del trastorno de pnico y de la agorafobia:
manual para terapeutas. Bilbao: Descle de Brouwer. Roca, E. y Roca, B. (1999). Cmo tratar
con xito el pnico (con o sin agorafobia) (2a ed.). Valencia: Ediciones ACDE.
Modulao do Neurocircuito do Medo a Partir de Intervenes CognitivoComportamentais
Marcele de Carvalho.
Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
Abstract Central: O esclarecimento sobre as vias neuroanatmicas responsveis por
processos relevantes ao medo e ansiedade em humanos vem aumentando graas aos atuais
avanos em neurocincias e em tcnicas de neuroimagem. proposto que o circuito cerebral
relacionado ao Transtorno de Pnico (TP) envolve as vias relacionadas ao medo condicionado.
Diferentes reas cerebrais e suas projees parecem estar envolvidas neste neurocircuito,
como, por exemplo, a amgdala, o hipocampo e o crtex pr-frontal. Como o neurocircuito do
medo envolve primordialmente regies subcorticais - que so responsveis por mediar e eliciar
respostas autonmicas, endcrinas e comportamentais - o propsito do tratamento manter
estas reaes sob controle. Diversos estudos demonstram que a terapia cognitivo-

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comportamental (TCC) eficaz no tratamento do TP. A terapia cognitiva atinge seus objetivos
primordialmente por modificar pensamentos disfuncionais sobre sensaes corporais. A terapia
comportamental usa a exposio como interveno para provocar habituao e extino de
respostas ansiosas e agorafbicas. Responder como o crebro funciona aps estas
intervenes psicoteraputicas uma questo instigante para a neurocincia. Foi realizada
uma reviso sistemtica, cujos objetivos principais foram citar as principais funes das
estruturas neuroanatmicas mais importantes do neurocircuito do medo e levantar hipteses
sobre como a TCC pode influenciar na modulao do mesmo. A busca bibliogrfica foi
realizada na base de dados PubMed, usando as palavras-chave: panic disorder, fear,
neurobiology, neuroanatomy, neurocircuitry, neuropsychology. A busca no se limitou data de
publicao dos artigos. Apenas artigos em ingls foram selecionados. As referncias dos
artigos selecionados foram utilizadas como fontes para a busca. Foram encontrados diversos
estudos sobre diferentes regies cerebrais que participam do neurocircuito do medo e da
ansiedade e as mesmas foram citadas com a descrio de sua funcionalidade no circuito. Os
estudos pesquisados demonstraram que a TCC opera por mecanismo top-down, modulando a
ativao da amgdala, exercendo efeitos inibitrios em uma variedade de respostas aprendidas.
A pesquisa sobre as modificaes do neurocircuito do medo a partir de intervenes cognitivocomportamentais deve se concentrar na investigao do crtex pr-frontal e das principais
estruturas que interagem com o mesmo, j que o crtex pr-frontal est envolvido no
processamento de informaes e na regulao da extino da memria de longo prazo. So
necessrios estudos em neuroimagem que investiguem a fundo esta questo, com metodologia
mais uniforme, para que melhor se compreenda o medo e a ansiedade normais e patolgicos,
visando aperfeioar as possibilidades de tratamento.
Social Threat Thoughts Predict Change in State Anxiety During an Impromptu Speech
Task
Rianne van Niekerk1, 2, Anke Klein1, Esther Allart2, Mike Rinck1, Eni Becker1.
1. Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands, 2. Pro
Persona, Nijmegen, Netherlands.
The goal of this study was to investigate the predictive value of social threat thoughts and trait
anxiety on state anxiety during an impromptu speech task. In total 141 children varying in
degrees of social anxiety were asked to perform a two-minute speech in front of a camera. They
also filled out self-reports about their trait anxiety and the social threat thoughts they
experienced during the speech task. Furthermore, the children filled out state anxiety selfreports before and after the speech task. Results showed that state anxiety prior to the speech
task was significantly predicted by trait anxiety. Social threat thoughts and trait anxiety both
accounted for a unique proportion of the variance in state anxiety after the speech task. The
change in state anxiety was only significantly predicted by social threat thoughts. This finding
supports the idea that social threat thoughts play an important role in the increase of selfreported state anxiety during a socially challenging task.
Treating Young Anxious Children (aged 4-7 years), via the Parents or via the Children?
Cathy van der Sluis, Susan Bgels.
Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.
Parent- or family focused interventions for treating child anxiety disorders have thus far not
proven to be more effective than child-based interventions. However, most research focused on
children aged 8-18 years, whereas parents may be more influential in younger aged children.

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This study will examine: 1) whether the child group CBT or parent group CBT is more effective
in treating anxiety disorders in young children; and 2) whether the efficacy of the treatments
depends on a) the primary anxiety disorder of the child (i.e. separation anxiety more effectively
treated with parent training and social anxiety with child training) and b) the level of self-reported
anxiety of the parents. The parent group CBT is an adaptation of the Confident Kids! Program
(Brechman-Toussaint & Anderson, 2003), which is efficacious (van der Sluis, van der Bruggen,
Brechman-Toussaint, Thissen, & Bgels, 2012). The child group CBT is a newly developed
program and is currently being piloted. In this study, 128 families of children aged 4-7 years,
referred for severe anxiety problems, will be randomised to either parent group CBT (64
families) or child group CBT (64 families). In order to compare the effects of both interventions
to the effects of time and assessment only, 30 families are first randomised for waitlist, and rerandomised for one of the two interventions after waitlist. Child anxiety will be measured at
pretest, posttest, 8 weeks follow up and 1 year follow up. Treatment integrity of both treatment
conditions will be check by audiotaped group session ratings by independent observers. This
study will contribute to the knowledge of the treatment of anxiety disorders in young children.
Correspondence and Discrepancy between Father, Mother, Teacher, and Child Report of
Anxiety in Clinically Anxious and Control Children aged 4-7 years
Cathy van der Sluis1, Helen Dodd2, Susan Bgels1.
1. Child Development and Education, University of Amsterdam, Amsterdam, Netherlands, 2.
University of East Anglia, Norwich, United Kingdom.
Abstract Central: To gain a better understanding of the assessment of anxiety reports in young
children, who cannot yet read and write, this study examined the correspondence and
discrepancy between mother, father, teacher and child report of child anxiety. In addition, the
effects of parental anxiety/depression, child clinical status, child age and child gender on reports
of informants were examined. Participants were 61 children from the normal population and 43
clinically referred anxious children aged 4 to 7 years, their parents and their teachers. All
participants completed questionnaire measures of child anxiety. Correlations between child selfreports and reports by others (mothers, fathers and teachers) were low. Clinically anxious
children reported higher levels of anxiety on the Picture Anxiety Test than normal controls. For
mothers, higher levels of maternal anxiety/depression, a younger child age and a child who had
been clinically referred were significantly related to higher reports of child anxiety. For fathers,
only child clinical status was related to higher reports of child anxiety. Results indicate that
young children may be able to provide informative self-reports on their anxiety.
Assessment & Measurement/ Evaluacin y Medicin/ Avaliao e Mensurao
Assessment of Children with Emotional Disorders: Psychologists Perceptions and
Practices
Ryan Allen1, Timothy Hanchon2, Scott Decker3, Cesar Merino4.
1. Educational & Allied Studies, John Carroll University, University Heights, OH, USA, 2. The
Citadel, Charleston, SC, USA, 3. University of South Carolina, Columbia, SC, USA, 4. University
of San Martin De Porres, Lima, Peru.
Abstract Central: INTRODUCTION: In the United States, all children with disabilities are
guaranteed an Individualized Education Plan (IEP) from the age of 3 to 21 years of age. For
students diagnosed with various forms of child psychopathology, access to the counseling
services included within IEPs is provided through the broad Emotional Disturbance (ED)

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disability category, which is outlined in the Individuals with Disabilities in Education Act (IDEA).
The eligibility criteria for ED were written into this federal law in 1975, and remain virtually
unchanged nearly four decades later. Unlike other comprehensive diagnostic codes (e.g., DSMIV, ICD-10), which provide detailed criteria for a range of mental disorders, IDEA offers only one
brief definition of ED. Over the years since the federal law was enacted, there has been nearly
universal criticism of the federal criteria as vague, ambiguous, outdated, and without any
scientific merit or validity. As a result of this problematic set of criteria, ED identification is often
left to the subjective assessment and diagnostic approaches of individual psychologists, rather
than the application of an empirically validated set of diagnostic criteria and assessment
practices. Not surprisingly, diagnostic practices vary widely among psychologists (Hanchon &
Allen, in press). The purpose of our study was to examine the specific diagnostic and
assessment practices of psychologists working in school-based settings. METHOD: Through a
survey, our sample (N=214) of psychologists was asked to provide data regarding assessment
methods (e.g., clinical interviews, classroom observation, projective measures, behavior rating
scales), specific instrument use (e.g., BASC-2, Achenbach, CDI, BDI, HTP), and inclusion of
other professionals in the ED diagnostic process (e.g., physicians, psychiatrists, counselors,
teachers). In each case, participants reported the frequency of their use of each
method/instrument and how often other professional contributed to the diagnosis of children
being considered for the ED category. The consistency with which each psychologist utilized a
comprehensive approach to assessment and diagnosis was also examined. RESULTS: The
results suggest that although psychologists understand the importance of utilizing a variety of
assessment tools and sources of data, actual practice is less consistent. The majority of school
psychologists (>50%) meet the expectation of conducting comprehensive ED evaluations, as
indicated by the inclusion of common assessment techniques (e.g., interviews, behavior ratings
scales, observations) in all diagnostic situations involving ED. However, we found that nearly 1
in 5 respondents failed to include several important components of a comprehensive evaluation
in greater than 10% of their ED evaluations. Even when considering the logistical issues often
associated with conducting school-based evaluations (e.g., scheduling interviews, forms being
returned, student absences), it is difficult to explain such limited use of teacher interviews and
classroom observations. Even more concerning is the infrequent inclusion of parent and child
interviews by a relatively large percentage of our sample.
CAD-20 E BFP: Um Estudo Correlacional em Estudantes de Escola Pblica da Paraba/br
Carmen Amorim-Gaudncio, Jessica Oliveira, Lucas F. Braz, Josemberg Andrade, Nilse
Chiapetti.
Universidade Federal da Paraba, Joo Pessoa, Brazil.
Abstract Central: A emisso de comportamentos antissociais e delitivos tem-se propagado
nos diversos contextos da nossa sociedade. Atualmente dentre as formas de violncia, uma
das mais visveis na sociedade a chamada violncia escolar, assim denominada por ser
cometida por jovens, dentro e/ou nas proximidades do ambiente escolar. Com isso acentua-se
cada vez mais a necessidade de se buscar explicaes para tais comportamentos, bem como
maneiras de prevenir e intervir na forma de comportar-se. Essa problemtica social reconhece
a necessidade e utilizao da psicologia para que sejam determinadas medidas de preveno
e promoo de comportamentos socialmente ajustados. Neste sentido, o estudo buscou
conhecer a relao entre os fatores Antissocial e Delitivo com os cinco grandes fatores da
Personalidade (Extroverso, Neuroticismo, Abertura a mudana, Amabilidade,
Conscienciosidade) dos estudantes da rede pblica de ensino do Estado da Paraba. Para isso,
utilizou-se o Questionrio de Condutas Antissociais e Delitivas (CAD-20) juntamente com a
Bateria Fatorial de Personalidade (BFP). Participaram 330 alunos de Ensino Fundamental II e

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Ensino Mdio com idades entre 10 e 21 anos (M=13; DP=2,08) e maioria do sexo feminino
(65%). Para a anlise dos dados foi utilizado o software PASW, verso 18. Os resultados
indicaram que o fator Condutas Delitivas obteve correlao significativa negativa com o fator
Conscienciosidade (r = -0,13; p < 0,05). Por sua vez, o fator Condutas Antissociais obteve
correlao significativa negativa com os fatores Amabilidade (r = -0,20; p < 0,01) e
Conscienciosidade (r = -0,20; p < 0,01) e correlao significativa positiva com o fator
Neuroticismo (r = 0,15; p < 0,01). De acordo com a literatura, indivduos conscienciosos so
geralmente cautelosos, dignos de confiana, organizados e responsveis. Indivduos com alta
pontuao em Amabilidade so agradveis, amveis, cooperativos e afetuosos e indivduos
neurticos so geralmente nervosos, altamente sensveis, tensos e preocupados. Com base
nos resultados observa-se que indivduos amveis e conscienciosos tendem a emitir
comportamentos socialmente ajustados. J os indivduos neurticos esto mais propensos a
emitirem comportamentos violentos. Nesse caso, o estudo apontou evidencias de que os
comportamentos antissociais e delitivos se relacionam com alguns fatores da personalidade
apresentados pelos sujeitos. de grande importncia o desenvolvimento de pesquisas mais
aprofundadas na rea que contribuam para a elaborao de uma poltica preventiva efetiva
levando em considerao o perfil dos nossos adolescentes.
Cuestionario de Autoesquemas Desadaptativos en Fobia Social: Propiedades
Psicomtricas Preliminares
Hugo Arias Lpez, Ronald Toro, Yonatan Rojas, Diana Quant Quintero.
Fundacin Ser, Bogot, Colombia.
Abstract Central: Se presentan los resultados preliminares de la validacin del CAD-FS
(Cuestionario de Autoesquemas Desadaptativos en la Fobia Social), un instrumento diseado
para la identificacin de contenidos cognitivos de la fobia social: yo social inferior, necesitado y
dbil; valoraciones crticas y amenazantes de los dems; desaprobacin; estndares de
desempeo social; y la ansiedad y sus efectos (Clark & Beck, 2010). Se aplic a una poblacin
con edad M=28,35 aos y DT = 12,4 aos. Para el diseo se realizaron dos pilotajes previos y
una pre-validacin de constructo con 3 jueces expertos. En el anlisis se eliminaron 2 factores
cuyos tems pasaron a los factores Estndares de desempeo social y Ansiedad y sus
efectos, siguiendo el modelo terico utilizado como base del diseo y conservando sus
propiedades psicomtricas; as la versin final est constituida por 22 tems con cargas
factoriales entre .512 y .786, 4 factores con alfa de Cronbach entre .666 y .758, los cuales
explican el 55.8% de la varianza total acumulada, y un alfa de Cronbach general de .817. Sobre
la versin final, se realiz un anlisis segn la teora de la respuesta al tem TRI, a partir de la
cual se observa que este instrumento cuenta con un error moderadamente bajo estimado en
0,18 mostrando una precisin moderada en la medicin del constructo; sobre el ajuste prximo,
se puede apreciar que el CAD-FS discrimina adecuadamente en los niveles bajos de acuerdo
al intervalo propuesto en Linacre y Wright (2004) con valores entre 0,5 y 1,5 ajustndose
adecuadamente al modelo. Respecto a las caractersticas del OUTFIT, se encontr que los
tems tienen buen ajuste al modelo en los casos atpicos de RASGO. Estos anlisis permitieron
estimar un ndice de confiabilidad de 0,98 que demuestra la homogeneidad del instrumento; en
la actualidad se est realizando la recoleccin de datos para obtener informacin sobre la
validez concurrente. Se demuestran las propiedades psicomtricas del CAD-FS y su
pertinencia para brindar una representacin general de los autoesquemas desadaptativos de la
fobia social, segn el modelo cognitivo de Clark, Beck y otros autores representativos (Clark &
Beck, 2010; Clark & Wells, 1995; Beck & Clark, 1988; Beck, Emery & Greenberg, 1985).

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Un Modelo Social Cognitivo del Rendimiento Acadmico


Silvia Aylln1, 2, Daniel Mas1, 3.
1. FUNDACIN SEMAS, Crdoba, Argentina, 2. Universidad Empresarial Siglo 21, Crdoba,
Argentina, 3. Universidad Nacional de Crdoba, Crdoba, Argentina.
Abstract Central: Silvia Aylln, Daniel Mas El rendimiento acadmico en el aprendizaje es
una variable compleja. Se consideran tres variables psicolgicas relevantes que contribuyen a
determinarlo: rasgos de personalidad, habilidades cognitivas y creencias de autoeficacia. Las
preguntas centrales planteadas son : En qu medida participan estas variables en la
determinacin del rendimiento? Es posible hacer predicciones sobre el rendimiento en base a
ellas? El marco terico se construy con la Teora Social Cognitiva, la Teora Social Cognitiva
de Carrera, la Teora de los Cinco Grandes Factores y la Teora de las Inteligencias Mltiples.
Hiptesis: La autoeficacia, las habilidades objetivas y ciertos rasgos de personalidad,
contribuyen de manera significativa a explicar el rendimiento acadmico Objetivo general:
Verificar la capacidad explicativa del modelo. Especficos: Valorar la contribucin de cada una
de las variables independientes, determinar la utilidad predictiva del modelo y verificar los
instrumentos utilizados. La metodologa es descriptiva correlacional, la muestra es accidental
de 176 alumnos de 6to. Ao polimodal de la ciudad de Crdoba, Argentina. Los instrumentos
son: Test DAT-5 de habilidades cognitivas, Inventario IAMI de autoeficacia e Inventario de
Personalidad 16PF. Se confeccion una matriz en la que se cargaron los puntajes en los tests y
el rendimiento acadmico de cada alumno en Lengua, Matemtica y el promedio total. Para
arribar a los resultados del presente trabajo, se elaboraron tablas con datos descriptivos y con
correlaciones bivariadas entre predictores y rendimiento acadmico desarrollando tres modelos
de regresin mltiple jerrquica. En el primero la variable criterio fue el puntaje total, en el
segundo el rendimiento en matemtica y en el tercero el rendimiento en lengua. En el primer
modelo se observa que las tres variables predictoras que contribuyen significativamente a
explicar el Promedio Total son las puntuaciones en Responsabilidad ( 0.305), Razonamiento
Numrico ( 0.186) y Razonamiento Verbal ( 0.215). En conjunto el modelo explica un 24 %
de la variable Rendimiento Acadmico (F 3,127 = 5,833, p < 0.000). En el segundo modelo,
donde la variable criterio fue el promedio de calificaciones en Matemtica, las tres variables
predictoras que explicaron significativamente el rendimiento en Matemtica fueron:
Razonamiento Numrico ( 0,295), Razonamiento Verbal ( 0.174) y Lgico-Matemtico (
0.206). En conjunto el modelo explica un 25 % de la variable Rendimiento Acadmico (F 3,127
= 6,199, p < 0.000). En el ltimo modelo, donde la variable criterio fue el promedio de
calificaciones anual en Lengua, se puede observar que las cuatro variables predictoras que
contribuyen significativamente son las puntuaciones de Amabilidad ( 0.185), Responsabilidad
( 0.237), Razonamiento Numrico ( 0.238) y Lingstica ( 0.165) En conjunto el modelo
explica un 26% de la variable Rendimiento Acadmico (F 3,127 = 6,423, p < 0.000).
Conclusiones: a) Las tres variables contribuyen de una manera significativa a explicar el
rendimiento, con una capacidad predictiva moderada. b) El mejor predictor del modelo son las
escalas de habilidades. c) Los resultados obtenidos refrendan el modelo social cognitivo de
rendimiento.
Questionrio de Impulso, Auto-Dano e Ideao Suicida na Adolescncia (QIAIS-A):
Estudos de Validao
Clia Barreto Carvalho1, 2, Carolina Nunes1, Paula Castilho2, Jos Pinto Gouveia2.
1. Science Education, University of Azores, Ponta Delgada, Portugal, 2. College of Psychology
and Sc. Ed., University of Coimbra, Coimbra, Portugal.

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Abstract Central: O auto-dano e a ideao suicida entre os jovens constituem-se como um


problema srio e um foco importante de poltica social e prtica profissional nos pases
ocidentais (Glassman, Weierich, Hooley, Deliberto & Nock, 2007), sendo que, a nvel mundial,
as taxas destes comportamentos em adolescentes tm aumentado (Williams & Bydalek, 2007),
despertando um interesse crescente na investigao sobre esta temtica, que alerta, assim,
para o impacto destes na vida do indivduo (Pelios, Morren, Tesch & Axelrod, 1999; Duque &
Neves, 2004). Stheneur (2006) chega mesmo a apontar o suicdio como a segunda causa de
morte na adolescncia, nos pases ocidentais, logo seguida dos acidentes rodovirios. A
presente investigao estuda os comportamentos auto-lesivos nos adolescentes. Esta faixa
etria foi escolhida em virtude de estes adolescente serem cognitivamente mais capazes de
planear e realizar uma tentativa de suicdio de forma mais eficaz, ou seja, letal, do que
indivduos mais jovens, por outro lado tm menos superviso dos pais e mais autonomia, o que
pode aumentar o risco de oportunidade de suicdio (Brigde, Goldstein & Brent 2006). Com este
objectivo, foi desenvolvido e validado o Questionrio de Impulso, Auto-Dano e Ideao Suicida
na Adolescncia (QIAIS-A- Castilho, P., Barreto Carvalho C., Nunes C. & Pinto-Gouveia J.2012), numa amostra de adolescentes (n =1605). A escala revelou bons indicadores
psicomtricos. Em termos de validade, tanto o total (=.90), como as dimenses (Impulso
=.77; Auto-dano =.88; Funes do auto-dano =.94; Ideao suicida =.82) da escala,
apresentam bons indicadores de consistncia interna. A estrutura factorial encontrada para
todas as dimenses da escala consistente com o modelo terico. Do ponto de vista
psicomtrico este instrumento revela ser bastante adequado para avaliar comportamentos de
auto-dano e ideao suicida na adolescncia. Abstract: We develop and validate the Impulse,
Self-Harm and Suicidal Ideation Questionnaire - Adolescents (QIAIS-A- Castilho, P., Barreto
Carvalho C., Nunes C. & Pinto-Gouveia J.- 2012), that assesses the degree of impulsivity, the
presence of self-harm behaviors and their functions, as well as the presence of suicidal ideation
in adolescents. This new 64-itens self report questionnaire was completed by 1605 adolescents
between 14 and 16 years. The questionnaire showed good psychometric indicators. In terms of
validity, both total ( = .90), and dimensions (=.77 Impulse; Self-harm =.88; self- harm
functions =.94-harm, suicidal ideation =.82) of the questionnaire exhibit good internal
reliability. The factor structure foud for all the dimensions are consistente with the theoretical
model. From the psychometric viewpoint, this tool turns out to be quite appropriate for
evaluating behaviors of self-harm and suicidal ideation in adolescentes.
Stress and Academic Performance of Psychology Students in interior of So Paulo,
Brazil
Andressa Becker da Silva, Luiz Gonzaga, Snia Enumo.
Psychology, Catholic University of Campinas, Campinas, Brazil.
Abstract Central: Stress is a biopsychosocial imbalance that leads psychophysiological
responses, such as changes in memory, concentration and attention that can generate learning
difficulties at any age. The aim of this study was to determine the level of stress and what its
predominance (physical or psychological) in Psychology undergraduate students in a University
of So Paulo, Brazil. Fifteen participants were female, aged between 22 and 56 years (median
= 28.3), sixth semester of the course, in a sample of convenience, answered a subjective
questionnaire on academic performance and the Inventory of Stress Symptoms for Adults Lipp
(ISSL), after signing the Instrument of Consent. For data analysis, we used the Friedman test
and Spearman correlation through SPSS 18.0, assuming a significance level of p <.05. The
results show that 9 of the 15 participants were stressed, with 6 at the Resistance phase, 2 at the
Near-exhaustion phase and 1 at the exhaustion phase, with predominantly psychological
symptoms (n = 6). The average grade that a student must achieve to be approved at this

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institution was 7.0 (on a scale of 0 to 10). Of the fifteen students interviewed, 9 had a 7.0
average, 3 had a mean 8.0; 2 took 5.0 average and a 6.0 average. Thus, almost all students
were within the average. Most of them, 93.3% believed that stress impairs academic
performance by interfering with concentration and motivation to learn. There was significant
difference between the stress level and academic performance, X2 = 13.0 (p = 0.00), as well as
to the type of stressor (physical or psychological), X2 = 9.0 (p = 0.003). When calculated the
correlation between stress level and academic performance, a non-significance was perceived,
= -0.126 (p = 0.65), but draws attention to the value of the correlation was negative, showing
an indirectly proportional relationship. These results show that stress significantly affects the
performance of these students, and that, being inversely, higher stress, lower academic
performance. It is questionable if these students use coping strategies to reverse the negative
effects of stressors and to what extent they are suitable or not. Therefore, it is suggested for
future research, a functional analysis of the coping strategies used by academics, improving or
not their academic performance.
Psychometric Properties of the Young Schema Questionnaire Short Form Version 3
(YSQ-S3)
Martine Bouvard, Anne Denis.
university of Savoie, Chambry, France.
The Young Schema Questionnaire short form version 3 (YSQ-S3) is a 90-item questionnaire
that was designed to assess the 18 Early Maladaptive Schema: emotional deprivation,
abandonment, mistrust/abuse, social isolation, defectiveness /shame (domain A); failure,
dependence/incompetence, vulnerability to harm or illness, enmeshment/ undeveloped self
(domain B); entitlement/grandiosity, insufficient self-control/ self-discipline (domain C);
subjugation, self-sacrifice, approval-seeking/ recognition-seeking (domain D); emotional
inhibition, unrelenting standards, negativity/pessimism, punitiveness (domain E). Each of the
items of the YSQ-SF is rated on a 6-point scale (1= completely untrue of me to 6= describes me
perfectly). Higher scores indicate a greater presence of the maladaptive schema for the
respondent. Two groups of students answered the YSQ-S3. The first group of subjects allowed
us to carry out an exploratory factor analysis on each of the five domains of the questionnaire.
The second group of subjects allowed us to carry out confirmatory factor analyses. A subgroup
also filled a questionnaire on parental attitudes (the short Egna Minnen Betraffande Uppfostran)
and the Eysenck Personality Questionnaire Revised-Abbreviated (EPQ-RA). We looked for the
links between maladaptive schemas and parental attitudes on one hand, and between
maladaptive schemas and personality dimensions on the other hand.
Translation and Adaptation of the Mini-Social Phobia Inventory (Mini-SPIN): Preliminary
Results in Mexican Population
Marcelo Archibaldo Bravo Caldern, Isabel Reyes Lagunes.
Universidad Nacional Autonma de Mxico, Distito Federal, Mexico.
Social phobia (also known as social anxiety disorder) comprises a marked and persistent fear of
one or more social or performance situations (American Psychiatric Association, 2000).
According to various studies (Acarturk, Ron de Graaf, van Straten, ten Have y Cuijpers, 2008;
Chartier, Walker y Stein, 2003; Furmark, 2002; Simon et al., 2002; Stein, Torgrud y Walker,
2000; Torgrud et al., 2004), this disorder show a high comorbidity, is associated with loss in
quality of life, with a low social support, and with educational, occupational and social difficulties.
It is estimated that in Mexico, only 9.1% of people with social phobia seek treatment (Medina-

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Mora et al., 2003). Therefore, it is of great importance to have reliable and valid instruments to
assess social phobia, and this way to make the early detection of disorder. The Mini-Social
Phobia Inventory (Mini-SPIN; Connor, Kobak, Churchill, Katzelnick y Davidson, 2001) is a selfadministered screening tool, and has demonstrated that it is able to quickly and easily detect the
presence of social phobia. The findings suggest that Mini-SPIN (despite having only three
items) is able to discriminate adequately between patients with social phobia and those without
the disorder (Connor et al., 2001; DEl Rey y Matos, 2009; Osrio et al., 2007; Osrio et al.,
2010; Ranta et al., 2012; Seeley-Wait et al., 2009; Weeks et al., 2007). In the original study
(Connor et al, 2001) is indicated that using a cut-off score of 6, the Mini-SPIN show a diagnostic
efficiency of 90%. The aim of the present paper is to show preliminary results about the Mexican
version of the Mini-SPIN. The following activities were performed: 1) To translate of items to
Mexican Spanish; and 2) To carry out a pilot study. Translation of items. Each item of the
original version of Mini-SPIN (Connor et al., 2001) was translated from English into Mexican
Spanish, by a translator with mastery of both languages, and with knowledge of construct of
social phobia. A second person translated the items back to English. Finally, a third independent
translator compared the two versions in English of Mini-SPIN (original and back-translated), with
the intention of making sure that they were linguistically equivalent. Pilot study. The number of
participants was 120 university students from Faculty of Psychology of the National
Autonomous University of Mexico (UNAM). They filled in group the Mini-Social Phobia Inventory
(Mini-SPIN). It was emphasized to students that they are free to express any doubt, question or
suggestion about the inventory. Taking in account the commentaries of participants, we
obtained the final Mexican version of the Mini-SPIN. As additional information, in this pilot study
the Mini-SPIN mean score was 2.25 (SD = 2.09). The internal consistency was also studied,
having a Cronbachs alpha within acceptable limits. It is necessary to follow evaluating the
psychometric properties of the Mini-SPIN in both clinical and non-clinical samples. This way to
check if the Mini-SPIN is a reliable and valid measure, and if is able to detect effectively the
social phobia in Mexican population.
Satisfaccin, bienestar y autoeficacia sexual
Jos Britos1, Oswaldo Rodriguez2, Pablo Vera3, Itor Finotelli2.
1. Psicologa, Universidad Catlica de Asuncin, Asuncin, Paraguay, 2. Instituto Paulista de
Sexualidad, Sao Pulo, Brazil, 3. Universidad Santiago de Chile, Santiago, Chile.
Se analizan y discuten 4 estudios que involucran la satisfaccin sexual, el bienestar subjetivo y
la comparacin de la autoeficacia sexual de la pareja. La informacin a discutir provienen de
experiencias de Brasil, Chile y Paraguay. Itor Finotelli (Brasil) hace una comparacin de la
autoeficacia sexual en parejas atendidas en una clnica privada de psicoterapia de Sao Paulo.
El 51% de los hombres y 14% de las mujeres tenan quejas de disfuncin sexual, en los dems,
ambos tenan quejas de disfuncin sexual. Se utilizaron la Escala de Autoeficacia SexualFuncin Erctil (SSES-E) y la Escala de Autoeficacia Sexual Femenina (SSES-F). Se considera
los ndices encontrados entre bajo y medio, adems de significativos para p=0,05 y 0,01. La
percepcin del funcionamiento sexual varia segn las dimensiones de los instrumentos, segn
el tiempo de relacionamiento y cuando las disfunciones sexuales ocurren en el hombre o en
ambos. Jos Britos (Paraguay) presenta las cualidades psicomtricas de la escala sobre
Satisfaccin Sexual para parejas heterosexuales. El instrumento con 40 reactivos, utiliza una
escala visual analgica y contiene tems relacionados a las fases de la respuesta sexual,
teniendo como soporte terico al Conductismo Social de Staats. En el estudio se compar
poblaciones clnicas y no clnicas entre 20 y 50 aos, de la ciudad de Asuncin, encontrndose
sensibilidad en la prueba para identificar fases de la respuesta sexual afectadas ya sea por
disfunciones o por problemas no clnicos que merecen tratamiento. Oswaldo M. Rodrigues Jr.

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(Brasil) describe estudios sobre la Satisfaccin sexual y reporta que, en 1996 una investigacin
con 110 estudiantes universitarios uno de los hallazgos ms importantes fue la asociacin entre
orgasmo y satisfaccin sexual. La satisfaccin sexual fue referida por el 86% de las mujeres,
aunque el 15% no estaran satisfechas siempre. En el 2010, mediante la Escala de Satisfaccin
Sexual para Mujeres, describe 5 factores: conformidad, comunicacin, compatibilidad,
preocupacin relacional y preocupacin personal. El estudio presenta datos preliminares sobre
una escala reducida, con una muestra clnica de 20 mujeres sin quejas sexuales, que estn en
proceso de psicoterapia con edades medias de 33 aos. El instrumento presenta relaciones
significativas entre los tems con los factores y los factores con la puntuacin total. Finalmente,
la Satisfaccin Sexual puede ser una medida que permite reevaluar los procesos de
psicoterapia focalizados en la sexualidad. El estudio que presenta Pablo Vera (Chile) propuso
evaluar la relacin entre los indicadores del comportamiento sexual y emocional y el bienestar
sexual subjetivo. Trabaj con una muestra de 862 personas chilenas, las cuales se
distribuyeron homogneamente en cuanto a sexo y estado civil. Se administr el cuestionario
de Bienestar Sexual Subjetivo de Laumman et .al (2006). Tambin, se administraron
cuestionarios psicolgicos y de comportamientos sexuales. Se verific un modelo predictivo del
bienestar sexual subjetivo. Las principales variables predictoras fueron, las caricias sexuales,
frecuencia sexual y juegos sexuales.
Personal Agency in Children: The Psychometric Properties of a Clinical Tool for
Assessing Childrens Coping Self-Efficacy in the Context of Parental Conflict
Heidi Brummert Lennings, Kay Bussey.
Psychology, Macquarie University, Sydney, NSW, Australia.
This study investigates childrens personal agency to deal with parental conflict through their
coping self-efficacy beliefs (Bandura, 1986;1990;1994). Coping self-efficacy is an individuals
perceived ability to access cognitive resources and perform the actions required to take control
of stressful situations (Benight & Bandura, 2004; Singh & Bussey, 2010). Individuals who
believe in their ability to cope are more likely to face stressful situations by controlling their
negative thoughts and taking action to lessen the negative consequences (Bandura, 1997). It
has been shown that children who live in a collaborative, and respectful family unit are likely to
have prosocial tendencies, whereas children who are exposed to parental conflict are at risk of
experiencing psychological maladjustment (Cummings & Davis, 2002; Grych & Fincham,1990).
It is therefore proposed that children exposed to parental conflict and who strongly believe in
their ability to cope may have better psychological outcomes than children with low levels of
coping self-efficacy. However, there are presently no established instruments to assess
childrens personal agency in the context of parental conflict. Aim: To establish the psychometric
properties of a new clinical tool, The Coping Self-Efficacy Beliefs Measure for Parental Conflict.
Participants: Independent school students from New South Wales, Australia participated in the
study (N=672). Participants were primarily from middle class backgrounds and were in Grades 5
and 7. The sample was 66% White, 18% Asian, 3% Middle-Eastern, and 13% from other ethnic
groups. Design: The measures were administered in a self-report questionnaire that took
approximately 50 minutes to complete. Research assistants, the investigator and
schoolteachers supervised the students in sessions consisting of about 20 students per group.
The supervisors asked the students not to interact with each other during the questionnaires.
Results: A Confirmatory Factor Analysis in AMOS confirmed an adequate measurement model
for The Coping Self-Efficacy Beliefs Measure for Parental Conflict, 2 (7)=13.240, p=.066,
TLI=.968, CFI=.989 and RMSEA =.054. As per the recommendations of Cole, Ciesla, and
Steiger (2007) some of the subscales of the instrument were allowed to covary. For example,
the subscales of Internalising and Distancing were allowed to covary as they measure opposite

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extremes of avoidance. The Coping Self-Efficacy Beliefs Measure for Parental Conflict had a
Cronbachs alpha of .808. Furthermore, Structural Equation Modelling in AMOS provided
support for the measures construct validity as there was a negative path from coping self
efficacy to psychological maladjustment, as measured by the Strengths and Difficulties
Questionnaire, 2 (31)=43.607, p=.066, TLI=.984, CFI=.991 and RMSEA =.036. Conclusion:
The Coping Self-Efficacy Beliefs Measure for Parental Conflict has good psychometric
properties for children between the ages of 10 and 13. It is a promising clinical tool that can be
utilised even when limited details of the parental conflict are known. Finally, it demonstrates
construct validity as children with high coping self efficacy scored lower on psychological
maladjustment.
Evaluacin Transcultural del Acoso Escolar por Medio del Cuestionario Multimodal de
Interaccin Escolar"
Vicente Caballo1, Marta Calderero1, Isabel Salazar1, Benito Arias2, Mara Irurtia2, Antonella
Galli3, Research Team Ciso-A1.
1. Faculty of Psychology, University of Granada, Granada, Spain, 2. Universidad de Valladolid,
Valladolid, Spain, 3. Clnica Ricardo Palma, Lima, Peru.
Abstract Central: El acoso escolar es un tema de gran actualidad y tiene una presencia
constante en los medios de comunicacin de masas, especialmente cuando el desenlace de
una situacin de acoso acaba en tragedia. Aunque existe toda una serie de instrumentos de
autoinforme dirigidos a la evaluacin del acoso escolar, decidimos construir uno nuevo debido
principalmente a las carencias que sufren muchos de ellos. El presente trabajo concluye la
investigacin que se inici hace varios aos para el desarrollo de una nueva medida del acoso
escolar y muestra la versin final del Cuestionario multimodal de interaccin escolar (CMIEIV), compuesto por 36 tems y cinco factores (Caballo et al., 2012). Han participado en esta
investigacin 12 pases latinoamericanos y Espaa, con una muestra de 12.801 sujetos con
edades comprendidas entre 9 y 15 aos y distribuidos aproximadamente al 50% para cada
sexo. El anlisis factorial confirma la estructura de cinco factores del cuestionario, que explican
el 51,81% de la varianza y que se concretan en los siguientes: a) Comportamientos
intimidatorios (acosador), b) Victimizacin recibida (acosado), c) Observador activo en defensa
del acosado, d) Acoso extremo/Ciberacoso y e) Observador pasivo. La correlacin entre los
distintos factores va de -0,14 a 0,46, lo que seala que hay muy poco solapamiento entre las
reas que est evaluando. El alfa de Cronbach es de 0,91, indicando una elevada consistencia
interna del cuestionario. Se presentan igualmente otras propiedades psicomtricas de esta
medida de autoinforme, que muestran la solidez del CMIE-IV. Esperamos que este nuevo
autoinforme sirva para avanzar un poco ms en este campo tan de actualidad y tan complicado
de abordar.
Process of Development and Validation of Community Integration Scale-Psychiatric
Disorder
Joana Cabral, Clia Barreto Carvalho.
Cincias da Educao, Universidade dos Aores, Ponta Delgada, Portugal.
Abstract Central: A recuperao de pessoas com doena mental envolve, no s factores
internos mas, tambm, factores externos, como a interaco com o ambiente. Ao longo de
muitos anos ignorou-se a importncia da vida social dos indivduos com doena mental,
mantendo-os em instituies ou ambientes protegidos. Actualmente comea-se a valorizar a
importncia e os benefcios da integrao comunitria de pessoas com doena mental (Wong,

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Matejkowski & Lee, 2011). Ainda existem poucos estudos e instrumentos que avaliem a
integrao comunitria de pessoas com doena mental. O presente estudo apresenta o
processo de desenvolvimento e validao de uma escala que avalia o nvel de integrao
comunitria de indivduos com doena mental, a Escala de Integrao ComunitriaPerturbao Psiquitrica (EIC-PP, Carvalho & Cabral, 2012). Esta escala foi criada com base
num modelo que conceptualiza a integrao comunitria como multidimensional, visto que
defende que a integrao comunitria se divide em trs dimenses: a integrao fsica, a
integrao social e a integrao psicologia (Aubry & Myner, 1996 and Wong & Salomon, 2002).
s dimenses anteriormente referidas acrescentou-se a independncia (Gulcur, et al., 2007),
visto ser uma varivel tida como constituinte da integrao.
Anlise Factorial Confirmatria da Verso Portuguesa da "Perceived Threat Scale" (PTS)
do "Deployment Risk and Resilience Inventory" (DRRI)
Teresa Carvalho1, 2, Marina Cunha1, 2, Jos Pinto-Gouveia1.
1. CINEICC - Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra,
Portugal, 2. Higher Institute Miguel Torga, Coimbra, Portugal.
A Perceived Threat Scale (PTS) do Deployment Risk and Resilience Inventory (DRRI) um
instrumento de auto-resposta destinado a avaliar a percepo de ameaa (medo pela
segurana e bem-estar pessoais) durante a exposio zona de guerra. Esta varivel tem
demonstrado ser um relevante factor de risco associado psicopatologia desenvolvida por
veteranos de guerra. Objectivos: este estudo analisou a estrutura latente da verso
Portuguesa da PTS, composta por 2 factores (Ameaas de Combate e Ameaas de No
Combate) previamente obtidos atravs da Anlise Factorial Exploratria (AFE). Analisou
tambm a consistncia interna e capacidade discriminante deste instrumento na amostra do
presente estudo. Participantes e Mtodo: 310 homens da populao geral de combatentes da
Guerra Colonial Portuguesa completaram a PTS, a PTSD Checklist-Military Version (PCL-M), o
Beck Depression Inventory (BDI) e as Escalas de Ansiedade e Stress do DASS-21.
Resultados: a Anlise Factorial Confirmatria (AFC) sugere que o modelo bi-factorial de
primeira ordem rectificado possui um bom ajustamento aos dados (GFI = .92; TLI = .93; CFI =
.94; RMSEA = .06; PCFI = .79) e uma adequada validade factorial. Obteve-se igualmente para
a PTS uma adequada consistncia interna (alphas de Cronbach: Ameaas de Combate = .82;
Ameaas de No Combate = .83; Escala Global = .86) e uma boa capacidade discriminante
relativamente aos sintomas da PTSD, depressivos, ansiosos e de stress. Discusso: os
resultados da AFC, pioneiros em Portugal, corroboram a estrutura bi-factorial da verso
Portuguesa da PTS, previamente obtida pelos autores. Os resultados confirma igualmente que
a escala internamente consistente e apresenta uma boa capacidade discriminante. Estudos
futuros devero ser efectuados afim de confirmarem a estrutura latente da verso Portuguesa
da PTS.
Validacin Estadstica y Prevalencia del Sndrome de Fatiga Crnica en Estudiantes
Mexicanos
Norma Coffin1, Leonard Jason2, Constanza Miralrio1, Mara de Lourdes Jimnez1, Monica
Alvarez1, Clara Bejar1, Francisca Bejar1.
1. Psicologa, Universidad nacional Autnoma de Mxico, Tlalnepantla, Mexico, 2. De Paul
University, Chicago, IL, USA.
El Sndrome de Fatiga Crnica (SFC) es una enfermedad que se caracteriza por una fatiga
persistente e inexplicada, y que resulta claramente discapacitante en el funcionamiento

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personal, social y ocupacional para la persona que la padece, ya que suele acompaarse de
procesos inflamatorios, dolorosos, con alteraciones del sueo (Friedberg y Jason, 2002). El
propsito de este trabajo es presentar un instrumento validado para poblacin mexicana, con el
fin de facilitar el diagnstico correcto del SFC. Se llev a cabo con una muestra conformada de
245 estudiantes de Medicina y Psicologa en tres regiones de Mxico. Se tradujo al espaol el
Cuestionario de fatiga crnica (Chronic Fatigue Questionnaire; Hawk, Jason y Torres-Harding,
2006), una medida de autoinforme, formado por 35 tems, que puede ser aplicado de manera
grupal o individual. Se clasific a la poblacin en tres grupos: Muestra Total (100%), Fatiga
(43.98%) y No Fatiga (56.02%). En el anlisis factorial, la matriz de componentes muestra una
correlacin estadstica de cero entre los factores fsico emocional y cognitivo. Estos resultados
muestran validez interna del instrumento, ya que los factores son independientes entre s. Se
llev a cabo una rotacin ortogonal Varimax, encontrando que el factor fsico es el ms
representativo dentro de los sntomas de la fatiga crnica (75.34%). A partir de ocho tems
crticos (Fukuda, et al. 1994), se estandarizaron las puntuaciones Z tomando los valores 0
(cero), como 0,1. De esta forma, los participantes se ubicaron en cuatro niveles de fatiga, con
una desviacin estndar de 1: normal (hasta 0,54); leve (hasta 4,33); moderado (hasta 9,20)
o crnico (9,20 o ms). El nivel de consistencia interna (alpha de Cronbach) del cuestionario
fue de 0,96, siendo de 0,82 para el factor fsico, 0, 86 para el factor emocional y 0, 92 para el
factor cognitivo. Este estudio aporta un instrumento que aumenta la posibilidad de realizar un
diagnstico y tratamiento adecuados del SFC en poblacin mexicana.
WCBCT - Peru Conversation Hour with the Master Clinician
Frank Dattilio.
Psychiatry, Harvard Medical School, Allentown, PA, USA.
This conversation hour will offer participants an opportunity to experience an open dialogue
hour with one of the masters in the field of cognitive-behavior therapy. Topic areas of discussion
include, but are not limited to, case conceptualization of a wide range of clinical cases,
treatment techniques with difficult cases, as well as successful aspects of the therapeutic
relationships. Participants are encouraged to present challenging case situations for dialogue.
This session can be set for one or two hours. Presenter: Dr. Frank M. Dattilio Harvard Medical
School
Title of symposium: Developments in Technology and Clinical Cognitive Science: The
4th wave in CBT?
Oana David, Daniel David, David Opris, Silviu Matu, Anca Dobrean, Simona Stefan, Cristina
Mogoase.
Professor Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University
(BBU) Cluj-Napoca, Cluj-Napoca, Romania.
Cognitive-behavioral therapy (CBT) has evolved through so-called three waves: (1) first wave
(behavioral), second wave (cognitive-behavioral), and third wave (mindfulness/acceptanceenhanced cognitive-behavioral). Based on the integration of new advances in (1) clinical
cognitive sciences (e.g. implicit processes, embodied cognitions) and (2) technological
developments (e.g., virtual realities, online and computer-based interventions), we think that a
new (r)evolution in CBT is prefigured in the form of a 4th wave CBT. In this symposium,
integrations and implications of these discoveries and evolutions in clinical cognitive sciences
and technology in CBT theory and practice are discussed. The first presentation will offer a
comprehensive perspective on the integration of technology and discoveries in fundamental

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cognitive sciences research into the CBT framework. The second presentation will be focused
on the use of virtual reality technology in CBT for various mental conditions. The third
presentation will describe the state of the art in internet delivered CBT (iCBT) and mobile
delivered CBT. The forth paper will present results from a controlled trial on the efficacy of a
one-session CBT intervention delivered face-to-face versus videoconference systems (classic
and EON Holopodium). The following presentations will refer to a new CBT app developed
based on the emotion-regulation paradigm, and will present pilot data on the efficacy of CBT
delivered by a new robot (RETMAN) promoting emotional resilience in children. The final paper
of the symposium is concerned with CBT interventions based on the cognitive bias modification
paradigm (i.e., attention and memory biases modifications). The symposium concludes with a
general discussion of future research directions in what we have called the 4th wave in CBT.
Cross-Cultural Adaptation and Confirmatory Factor Analysis of the Spence Children's
Anxiety Scale in a Brazilian Community Sample
Diogo DeSousa, Circe Petersen, Silvia Koller.
Institute of Psychology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Background: The Spence Children's Anxiety Scale (SCAS) is a childhood anxiety measurement
instrument that presents evidences of adequate reliability and validity internationally. It consists
of 38 items related to anxiety symptoms originally divided into six dimensions: generalized
anxiety; social phobia; separation anxiety; panic/agoraphobia; obsessive-compulsive; and fear
of physical injuries. The SCAS has been adapted to many languages, countries, and cultures.
However it has not yet been adapted to use in Brazil. Also, international adaptations and
psychometric investigations have shown that different theoretical models of anxiety dimensions
provided good fit to the factor structure of the SCAS. Hence the aims of this study were: 1) to
cross-culturally adapt the SCAS to Brazil; and 2) to investigate, by means of Confirmatory
Factor Analysis (CFA), the theoretical model that best fits the SCAS in a Brazilian community
sample. Method: The SCAS was cross-culturally adapted to Brazil following recognized
procedures based on specialized literature and on the International Test Commission
Guidelines for Translating and Adapting Tests. The sample of the empirical study consisted of
712 youths (53.1% girls) aged 7-17 years old (M = 11.52, SD = 2.11). CFA was conducted
employing the unweighted least squares estimation method. We tested five theoretical models:
(M1) one factor; (M2) six uncorrelated factors; (M3) six correlated factors; (M4) six correlated
factors loading into one higher-order factor; and (M5) five correlated factors loading into one
higher-order factor which also accounts for the generalized anxiety dimension. Results: The
Brazilian adapted version of the SCAS is very similar to the original version in terms of
conceptual, item, semantic, and operational equivalences. The six correlated factor model (M3)
presented the best fit to the data (GFI: .952; AGFI: .945; RMR: .050; SRMR: .056), with factor
loadings ranging from .254 to .642 (M = .483; SD = .09; two items below .35). Nonetheless, both
higher-order models (M4 and M5) also presented acceptable fit, not significantly differing
between themselves, although significantly lower than the fit of M3. In M4, the factor loading
from the generalized anxiety first-order factor to the higher-order factor was .920, while the other
first-order to higher-order factor loadings ranged from .725 (fear of physical injuries) to .846
(panic/agoraphobia). In M5, first-order to higher-order factor loadings ranged from .721 (fear of
physical injuries) to .841 (panic/agoraphobia). Conclusions: The cross-cultural adaptation and
CFA results suggest the Brazilian version of the SCAS is very similar to its original version, with
a theoretical six correlated factor structure, indicating that future cross-cultural studies may
benefit from Brazilian findings using the instrument. Also a new measure is now available for the
assessment of childhood anxiety symptoms in Brazil. Finally, results from the CFA regarding the
two higher-order factor models give support to the theoretical conceptualization that generalized

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anxiety might be interpreted as a basic anxiety dimension, being part of a higher-order


dimension of anxiety in itself; instead of a separate dimension as, for instance, social phobia or
panic.
Construccin de una Escala para Medir Autoeficacia Percibida en Cuidadores Primarios
Informales de Enfermos Crnicos
Xochitl Espinosa Cortes.
Psicologa, Universidad Nacional Autnoma de Mxico, Mxico, Mexico.
En la actualidad, la familia es considerada como la principal proveedora de cuidados de salud y
en ocasiones constituye la nica red de apoyo para las personas que lo necesitan. Sin
embargo, el cuidar a otros es un ejemplo de situacin en que las personas implicadas se
encuentran sometidas a estrs crnico. De acuerdo con Bandura (1997), la Autoeficacia (AE)
es considerada un atributo psicolgico importante para el manejo de las implicaciones del
cuidado. El objetivo de este trabajo fue desarrollar una escala apropiada para la poblacin
mexicana que mida Autoeficacia Percibida en Cuidadores Primarios Informales de Enfermos
Crnicos. Para fines de esta investigacin, se defini a la AE como las creencias de los
cuidadores en sus propias habilidades y/o capacidades para resolver las demandas que implica
el cuidar de una persona enferma o con discapacidad. Se elabor un plan de prueba tomando
en cuenta las dimensiones afectiva, cognoscitiva y conductual de la AE, con dos reas de
incidencia personal: relaciones interpersonales y autocuidado. Se realiz un estudio
exploratorio, con una muestra no probabilstica de Cuidadores Primarios Informales de
enfermos crnicos de diferentes instituciones de Salud Pblica de Mxico (N=230). Para el
anlisis de los datos se realizaron anlisis de frecuencia, de media y sesgo, pruebas T de
Student para muestras independientes, se identific la congruencia en la direccionalidad de los
reactivos, generndose tablas de contingencias y se emple la rotacin ortogonal en cada uno
de los anlisis factoriales de tipo exploratorio. La escala qued conformada por 26 tems,
divididos en las subescalas cognitiva, afectiva y conductual con una confiabilidad de = .95.
The Beck Depression Inventory in Patients with Sexual Dysfunction: Validity Evidences
Based on the Structure
Itor Finotelli Jr.3, 1, Oswaldo Rodrigues2, 1, Diego Viviani1, 2.
1. Grupo de Estudos e Pesquisas do Instituto Paulista de Sexualidade (GEPIPS), Campinas,
Brazil, 2. Instituto Paulista de Sexualidade, So Paulo, Brazil, 3. Universidade So Francisco,
Itatiba, Brazil.
The Beck Depression Inventory (BDI-2) is described today as a major clinical instruments to
identify depressive symptoms. Since its last review, the validity studies grew progressively using
different populations. Aiming to contribute to the instrument development, the present study has
investigated validity evidences based on internal structure of the BDI-2 in a sample of patients
with sexual dysfunctions. The sample consists of 362 patients (60% men and 40% women) from
a clinic specialized in sexual dysfunctions treatments, whose ages ranged between 18 and 67
years (M=33.8, SD=10.48). Applications occurred individually in the initial care compliments of
ethical criteria required in the research. The collected data were subjected to a full information
factor analysis, a method that works with item response vectors, recommended for categorical
data and analysis of internal consistency. The factorial analysis with promax rotation extracted
two dimensions being able to explain 60% of the variance; criterias for the extraction were
eigenvalues> 1.0 and retaining items with loads greater than or equal to 0.4. It was observed
that the items, Loss of Pleasure and Loss of Energy have fit with significant factor loadings on

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the two factors in addition, the items Indecisiveness and Worthlessness have grouped in
opposing factors, differing in comparison with other studies. The two structures (strongly and
positively correlated) correlated strongly positive (0.72). According to the one indicated by the
literature, the one and three models factors were evaluated, but have not met the expected
criteria. The structure was also evaluated through sex, however, did not show different
groupings. The internal consistency analysis by Kuder-Richardson estimated the accuracy of
the instrument in 0.92. It was concluded that the results were satisfactory and similar to other
studies which have evaluated the structure on other populations. For the mentioned grouping
differences of four items, they were consistent according to the characteristics of patients with
sexual dysfunctions. We suggest further studies with other Brazilian samples to expand the
discussion of the instrument, so restricted to the international literature.
Construccin y Validacin de una Escala para Medir Estilos de Comunicacin en la
Relacin Paciente-Mdico
Alejandra Garcia Arista, Isabel Reyes Lagunes.
Psicologia, UNAM, Distrito Federal, Mexico.
Garca Arista Alejandra y Reyes Lagunes Isabel Universidad Nacional Autnoma de Mxico,
Ciudad de Mxico, Mxico. RESUMEN. En los ltimos aos, se han desarrollado mltiples
escalas para la medicin de la asertividad en diversos escenarios, sin embargo se ha detectado
que existe un dficit en el diseo de escalas que valoren el estilo de comunicacin asertivo
dentro de un ambiente hospitalario, es por ello que el presente estudio tiene como objetivo la
construccin y validacin de un instrumento que midiera los estilos de comunicacin de
pacientes con el personal mdico; ya que se ha evidenciado que la relacin paciente-mdico
influye ampliamente en la adhesin al tratamiento que una persona pueda tener (OMS, 2004),
siendo parte importante de la relacin, la comunicacin asertiva (Gobo, 2011; Nuez, 2010;
Shelton & Burton, 2004;), pues permite al paciente realizar preguntas al mdico que aclaren y
le hagan comprender de una mejor forma su enfermedad y tratamiento. La base para el
desarrollo del instrumento fue un estudio exploratorio previo de preguntas abiertas. En este
trabajo se busco obtener la validacin de esta medida, para ello, 216 pacientes con
enfermedades crnico-degenerativas del Hospital Jurez de Mxico, respondieron un
cuestionario de auto reporte con escala de respuesta tipo Likert pictrica. Se llevo a cabo el
anlisis de reactivos (Reyes-Lagunes & Garca y Barragn, 2008), con la finalidad de obtener
un instrumento confiable, valido y culturalmente relevante, verificndose que las opciones de
respuesta fueran atractivas, el sesgo de la distribucin fuera el esperado (tpico), evaluando la
discriminacin y direccionalidad de los reactivos, eliminndose aquellos que no cumplan con
los criterios establecidos. Los reactivos resultantes de estas etapas permitieron realizar el
clculo de la consistencia interna mediante un Alpha de Cronbach y ejecutndose un anlisis
factorial se obtuvieron 4 factores (No asertividad-pasividad, No asertividad-Inseguridad,
Asertividad y Agresividad), distribuidos en 21 reactivos finales con un alfa total de .816. El
instrumento propuesto se considera una til y valiosa contribucin en la prctica clnica para
detectar estilos de comunicacin as como para realizar intervenciones psicolgicas cognitivo
conductuales, dirigidas a mejorar la comunicacin especficamente mediante un entrenamiento
asertivo. Palabras clave: estilos de comunicacin, asertividad, pasividad, validacin
psicomtrica.
Estandarizacin y Validacin del Inventario y Situaciones de Respuestas de Ansiedad
(ISRA) a Republica Dominicana
Zoilo Garcia Batista.

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1. Pontificia Universidad Catolica Madre y Maestra, Santiago, Dominican Republic, 2.


Universidad Complutense de Madrid, Madrid, Spain.
Abstract Central: El objetivo del presente estudio es la estandarizacin y validacin del
Inventario de Situaciones y Respuestas de Ansiedad -ISRA (Miguel-Tobal y Cano-Vindel, 2002)
en poblacin de Repblica Dominicana. La muestra total estuvo conformada por 1074 sujetos,
679 mujeres y 395 hombres, a su vez formada por 986 individuos sanos y 88 individuos con
asma bronquial. Se aplic el Inventario de Situaciones y Respuestas de Ansiedad-ISRA
(Miguel-Tobal y Cano-Vindel, 2002), que posibilita la evaluacin de los tres sistemas de
respuesta (cognitivo, fisiolgico y motor), el nivel general de ansiedad y cuatro reas
situacionales (evaluacin, interpersonal, fbica y de la vida cotidiana). Los resultados del
ANOVA de dos vas, muestran que existen diferencias significativas entre los niveles de
ansiedad de ambos grupos, (asmticos y sanos, as como en hombres y mujeres). Los anlisis
factoriales exploratorios confirman la existencia de tres sistemas de respuestas (cognitivo,
fisiolgico y motor) y 4 reas situacionales (evaluacin, interpersonal, fbica y de la vida
cotidiana). La consistencia interna y el test-retest fue adecuado. Por otro lado se obtuvieron
correlaciones positivas y significativas entre el ISRA y el STAI.Finalmente se encontraron
caractersticas psicomtricas del ISRA dominicano similares a las obtenidas en la versin
espaola original, la versin brasilea, la costarricense, etc. Por lo que se concluye que el ISRA
es un instrumento fiable y vlido para evaluar la ansiedad en los tres sistemas de respuestas,
as como en los cuatro rasgos especficos o reas situacionales de ansiedad concordando con
los modelos tericos que lo fundamentan (Lang, 1968; Endler, 1981). Finalmente la deteccin
de niveles mayores de ansiedad en el gnero femenino coincide con la literatura universal.
Palabras Claves: Ansiedad, ISRA, Estandarizacin.
Relationships Between Psychopathology and Personality Dimensions of the New
HEXACO Personality Model
Gemma Garcia-Soriano, Mara Roncero, Gertrudis Forns, Amparo Belloch.
Universitat de Valencia, Valencia, Spain.
Introduction. A new lexically-based personality model called HEXACO (Ashton & Lee, Europ J
Personality, 2001, 15, 327-353) proposes that personality is better explained across six
dimensions instead of the five proposed by the most commonly-accepted lexically-based
personality model. The six dimensions are called Honesty-Humility (H), Emotionality (E),
eXtraversion (X), Agreeableness (A), Conscientiousness (C) and Openness to experience (O),
each one including 4 subscales or facets. Aim. To analyze the relationship between personality
traits, measured by the HEXACO model, and several psychopathology indicators: depression,
anxiety, sensitivity to anxiety, and Obsessive-Compulsive. Participants. A total of 346 individuals
from the general population (64% women) with a mean age of 33.9 years (SD=14; range: 18-79
years) participated in the study. Measures. HEXACO-Personality Inventory-Revised (HEXACOPI-R), with 100 items; Beck Depression Inventory-II (BDI-II); Beck Anxiety Inventory (BAI);
Clark-Beck Obsessive-Compulsive Inventory (C-BOCI); Anxiety Sensitivity Inventory (ASI-3).
Results. The highest number of significant associations (Pearson correlations) was found
between psychopathology measures and the Emotionality and Extraversion domains, followed
by Agreeableness. The Honesty-Humility domain was only associated with the social aspect of
ASI-3. Weak associations were found between psychopathology measures and the
Conscientiousness and Openness to experience factors. Results from regression analyses
showed that Extraversion, Emotionality, and Conscientiousness predicted scores on depressive
symptoms, explaining 21% of the BDI- II variance. Regarding the anxiety symptoms,
Emotionality and Extraversion explained 17% of the BAI scores, and Extraversion,

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Agreeableness and Emotionality explained 20% of O-C symptoms. For the ASI-Somatic factor,
Extraversion and Agreeableness explained 13% of the variance, whereas Emotionality and
Extraversion predicted 8% of the Cognitive ASI factor variance. Finally, Extraversion, HonestyHumility, Emotionality, Agreeableness and Openness predicted 22% of the Social ASI-3 factor.
Discussion. Associations between Honesty-Humility, the most novel contribution of the
HEXACO model, and psychopathology measures were scarce and low. This factor was only
significantly associated with Social-ASI, but not with depressive, anxiety or obsessivecompulsive symptoms, indicating that this domain is not related to negative emotionality.
Regarding Emotionality and Extraversion domains, our results indicate that both were the most
relevant in predicting psychopathology symptoms, coherent with studies carried out with other
personality measures. Agreeableness and its facets showed a pattern characterized by small
but significant associations with almost all psychopathology measures, as found in other
studies. The Conscientiousness and Openness domains only show a weak, although significant,
association with depression. Acknowledgements. Study supported by Grant PSI2010-18340
(Spanish Ministerio de Ciencia y Competitividad).
Construccin y Validacin Psicomtrica de una Escala Breve de Percepcin de la
Relacin Entre Dieta y Salud
Carmen Mercedes Gutierrez Perez.
Universidad Nacional Autnoma de Mxico (UNAM), Distrito Federal, Mexico.
Para lograr y mantener una buena salud es necesario mantener una dieta adecuada que
incluya toda una variedad de alimentos (Araya & Lutz ,2003). Sin embargo se sabe que cuando
se padece una enfermedad crnica es necesario tomar en cuenta los dos pilares principales del
tratamiento que son el medicamento y la dieta (Mendoza et al., 2000). Por ello el presente
trabajo tuvo como objetivo la construccin y validacin de una escala que midiera la percepcin
de la relacin entre dieta y salud. Los participantes fueron n=190 enfermos crnicos
degenerativos pacientes de un hospital publico de la ciudad de Mxico, las mujeres
conformaron el (57%) y los hombres el (43%). La edad se distribuy entre 18 y 70 aos (M=
44.23, DE=16.39). La escala est conformada por cinco reactivos y mide la percepcin de la
relacin dieta-salud con una confiabilidad de .80 (5 reactivos), esta categora se define como la
percepcin de la relacin que existe entre seguir un rgimen alimenticio adecuado
generalmente recomendado por el mdico y el mejoramiento de la salud fsica principalmente
cuando se presenta una enfermedad crnica. Se sugiere aumentar el nmero de participantes y
probar la escala en poblacin general para mejorar los niveles de confiabilidad.
The BAT-Back: Development and Validation of a Behavioral Test Assessing FearAvoidance in Chronic Low Back Pain
Sebastian Holzapfel, Jenny Riecke, Winfried Rief, Julia Glombiewski.
University of Marburg, Marburg, Germany.
Background: The fear-avoidance model is well established in chronic pain research. One core
element of this model is avoidance of physical activity (bending forward, lifting). There are
different self-rating instruments assessing fear-avoidance (e.g. Tampa Scale for Kinesiophobia).
However, these measures do not sufficiently correlate with actual avoidance behavior. A crucial
aspect of tailored treatments in chronic low back pain (e.g. graded exposure in vivo) is a valid
identification of chronic low back pain (CLBP) patients who avoid physical activity. Therefore a
behavioral test assessing actual avoidance behavior in patients with CLBP was evaluated.
Methods: n=102 patients were asked to perform the recently developed BAT-Back, a sequence

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of three movements (1. bend forward, 2. lift a water box, 3. rotate) without using safety-behavior
(e.g. going to the knees). Before execution of the movements subjects were asked to rate the
intensity of fear-avoidance related cognitions and emotions. Afterwards subjects executed the
movements while their behavior was monitored and rated. Convergent and divergent validity
was assessed via associations of the BAT-Back avoidance score with the self-rating measures
Tampa Scale for Kinesiophobia (TSK), Pain and Activity Relations Questionnaire (PARQ),
Behavioral Responses to Illness Questionnaire (BRIQ), Hospital Anxiety and Depression Scale
(HADS), Numeric Rating Scale - Pain (NRS-P), Pain Disability Index (PDI), Quebec Back Pain
Disability Scale (QBPDS) and demographic variables (gender, age, Body-Mass-Index (BMI)).
Results: 69% of subjects were female. The mean age was 52 (SD 5.5) years. The subjects
mean pain duration was 14.75 (SD 9) years. The average performance duration of the test was
7 minutes. Convergent validity showed significant correlations with TSK (r=.430, p<.05) and
avoidance scales derived from BRIQ (r=.317, p<.05) and PARQ (r=.301, p<.05) as well as
measures of disability like PDI (r=.474, p<.05) and QBPDS (r=.623, p<.05). Concerning
divergent validity no significant correlations with the subscales anxiety (r=.058, p>.05) and
depression (r -.132, p>.05) of the HADS were found. No significant associations of the BATBack avoidance score with demographic variables like age (r=.173, p>.05) and BMI (r=.169,
p>.05) were observed. Gender differences with female patients scoring higher on the BAT-Back
(T=2.225, p<.05) were found. Significant correlations were observed with NRS-Pain (r=.439, p
<.05). Conclusion: The BAT-Back represents a new behavioral approach in measuring (fear)avoidance in CLBP in an economical, naturalistic and standardized manner. Results indicate
that the BAT-Back is a valid measure of avoidance behavior because it is correlated with selfrating measures of avoidance behavior, but independent from age, BMI as well as from general
anxiety and depression. Group differences between male and female patients might be due to
gender role expectations. In a large-scale Randomized Controlled Trial, we are currently
investigating whether the BAT-Back can identify those patients benefiting most from graded
exposure in vivo, compared to interventions based on other psychological techniques. First
results about the role of tailored interventions in CLBP will be reported.
Aproximaciones del Constructo Muerte para el Mexicano
Maira Hurtado Abril.
Universidad Nacional Autonoma de Mxico, Mxico, Mexico.
El tema de la muerte, sin duda, ha tenido un lugar destacado en la literatura, en el arte, en la
religin y en la Filosofa. Sin embargo, en la vida cotidiana la muerte es un tema que nadie
desea conversar, constituyendo un fenmeno el cual se busca poner distancia siendo
banalizando (Rovaletti, 2002). Especficamente en la cultura occidental, los conceptos ms
comunes en relacin al tema de la muerte, se operacionalizan como un hecho biolgico por el
que atraviesa todo ser humano, un rito de traspaso, algo inevitable, un hecho natural, un
castigo, la realizacin de la voluntad de Dios, entre otros (Huesca, 2008). Constructos que no
involucran lo que la persona vive desde su sistema de creencias y emociones. En conjugacin
con lo anterior, se gener un instrumento con el objetivo de identificar el constructo de muerte
para los mexicanos. Se recolectaron 252 instrumentos sobre la percepcin de muerte en
poblacin general. Por gnero, el 64% de las evaluaciones le corresponda al gnero femenino
y el 35% del gnero masculino, con una media de edad de 26 aos. Para la seleccin de los
reactivos se utilizo la tcnica de redes semnticas, con la finalidad de identificar la estructura y
orden de la interpretacin del trmino para un conjunto de sujetos (mexicanos).Se
seleccionaron 51 reactivos, los cuales conforman 3 dimensiones Mi muerte es con 18
reactivos, La muerte de un ser querido (amigo o familiar) es con 19 reactivos y la muerte es
con 14 reactivos, presentados en este orden indicando el grado de proxema que existe con el

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trmino. Para la validacin del instrumento se realizaron los siguientes pasos recomendados
por Reyes & Garca (2008): identificar si las opciones de respuestas cuentan con frecuencias
mayores a cero, comprobar la distribucin normal de cada variable, identificar la fuerza de la
asociacin, anlisis de consistencia interna entre los reactivos, anlisis de conglomerados
jerrquico y anlisis de confiabilidad por dimensin. Mediante este procedimiento se eliminaron
18 reactivos y el grado de confiabilidad final fue del 82%. Los datos permiten concluir que
innegablemente se observan las diferencias existentes en la definicin de muerte para el
mexicano dependiendo de la cercana que tenga con el evento. El mexicano cree que se
dirigir a otro lugar, la creencia religiosa de llegar al paraso al lado de Dios o la reencarnacin
se encuentran en su ente cognitivo, debido a que tambin fue concebida la propia muerte como
un cambio y una transicin. En cambio, la muerte de un ser querido es indeseable e inesperada
pero a la vez existe raciocinio al considerarla como inevitable e irremediable. La connotacin
sigue en la lnea emocional porque es definida como deprimente, fea, amarga y terrible. Por
ltimo, al considerar la muerte como un suceso lejano, se define como un proceso natural,
normal e inevitable, contradiciendo a la muerte de un ser querido lo cual no resulto natural y
fueron involucrados con mayor incidencia los reactivos emocionales. Sin embargo, esto ayuda
a entender como el mexicano puede observar tantas muertes lejanas a l o ella en su vida
cotidiana afrontndolo de una manera funcional dejando en segundo lugar una afectacin
emocional lo que permite soportarlo da a da y seguir adelante.
Development of Measure of Metacognitive Insight: Examination of Validity with
Mindfulness Intervention
Yoshinori Ito1, Sakino Takeichi2.
1. Faculty of Education, University of the Ryukyus, Nishihara-Cho, Japan, 2. University of the
Ryukyus, Nishihara-Cho, Japan.
Decentering is described as the capacity to take a present-focused, nonjudgmental stance in
regard to thoughts and feelings, and to accept them. Teasdale, Moore, Hayhurst, Pope,
Williams, & Segal (2002) developed a measure of metacognitive awareness which reflects
decentered awareness (MACAM). And by using this measure, they have demonstrated that
reduction relapse rate of depression resulting from the cognitive therapy and mindfulness-based
cognitive therapy is mediated by metacognitive awareness. Japanese version of MACAM was
also developed (Katsukura, Ito, & Nedate, 2011) and its reliability and validity were examined.
However, we could point out two problems in MACAM. One is ambiguity of rating criterion, and
another is difficulty of rating. So we developed a new measure of metacognitive insight (MoMI)
which is more convenient in clinical situation (Ito & Takeichi, 2012). MoMI adopt interviewing
method. Interview sessions are divided into two phases; 1) clarifying participants ABC model
and identifying their schema by downward arrow technique, and 2) inquiring insight to that
schema. The answer of the phase 2 is classified whether P got a metacognitive insight or not by
experimenter and two independent rater. In the previous study, it was indicated that MoMI has
very high reliability and construct validity. The aim of the present study was to examine whether
the score of MOMI could be predict the effect of mindfulness training sessions. High depressive
and ruminative 14 undergraduate students were screened as participants (F=8, M=20.10,
SD=1.21). They participated in 2 weeks 3 sessions mindfulness training sessions. Results
showed that mindfulness training improved FFMQ, ASQ, and MOMI. Furthermore, the people
who acquainted more metacognitive awareness more improved than the people who not in
ASQ. These results indicate that the change of MOMI can predicts the effect of mindfulness
training, which suggest that the construct validity of MOMI.

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Terapia cognitivo comportamental com idosos institucionalizados portadores de


sintomas depressivos: padres cognitivos e estratgias
Spencer Jnior, Giliane Gomes.
Universidade de Pernambuco, Recife, Brazil.
O envelhecimento um processo fisiolgico gradual, que se associa a declnios fsicos e
cognitivos, exigindo o aprendizado de novos comportamentos para manuteno da qualidade
de vida (Nordon et al., 2009). Da decorre que a institucionalizao do idoso deve atuar como
facilitadora do processo de envelhecimento, minimizando as perdas de autonomia e identidade
(Tomasini & Alves, 2007). Entretanto esse perfil ideal da instituio de longa permanncia para
idosos (ILPI) no corresponde realidade brasileira, de tal forma que a depresso torna-se
queixa prevalente no contexto das ILPI. Na depresso os sintomas cognitivos e afetivos so
entendidos, segundo Costa Maia (1999) como uma perturbao do pensamento . Pensamento
de auto-desvalorizao, de auto-culpabilizao, rejeio e abandono so alguns dos que
surgem muito frequentemente. Aaron t. Beck (1991) apud Costa Maia (1999) foi
particularmente preciso ao fazer o retrato cognitivo dos deprimidos, descrevendo-os como
percebendo no s a si prprios, como ao mundo e ao futuro com base em lentes
sistematicamente negativas. O objetivo desta pesquisa determinar o percentual de
depresso, entender os padres cognitivos e a adequao da Terapia CognitivoComportamental neste cenrio social. O recurso metodolgico usado foi o estudo descritivo,
transversal, observacional, com comparao de grupos, realizado incluindo 96 idosos, com 65
anos ou mais de idade, residindo em uma dentre nove instituies de longa permanncia,
sendo sete localizadas no Recife e duas em Jaboato dos Guararapes, Pernambuco, Brasil, no
perodo de maio a julho de 2011. Os instrumentos de coleta permitiram investigar
caractersticas sociodemogrficas e da instituio, triar depresso (Escala de Depresso
Geritrica), perdas cognitivas (Mini-Exame do Estado Mental - MEEM e Teste de Desenho do
Relgio - TDR) e (re)pensar as prticas psicolgicas, adaptando-as a essa nova realidade.
Havia depresso em 63,5% dos idosos na Escala de Depresso Geritrica e em 59,4%, no Mini
5.0. As perdas cognitivas estavam presentes no MEEM de 65,6% dos idosos e no TDR de
72,9%. Considerando que na Terapia Cognitiva Comportamental, o paciente levado a relatar
os acontecimentos tristes da sua vida, mas frequentemente colocando uma nfase sobre as
alteraes comportamentais e atribuindo as variveis cognitivas um papel mediador na forma
como o sujeito concebe a realidade, conceitualiza-se que a diminuio do ritmo
comportamental que caracteriza a depresso como decorrente do decrscimo dos reforos
recebidos pelo individuo deprimido. Portanto, dada alta incidncia sintomatolgica, e a
premncia de intervenes no mbito da sade mental, nota-se que os postulados
epistemolgicos behavioristas correspondem s carncias apresentadas na ILPI. Segundo
Carvalho e Fernandes (1996) a Terapia Cognitiva Comportamental tem sido para muitos idosos
um local para expressar suas angstias onde respostas assertivas so reforadas, tais como
expresso de afeto. Por fim, a institucionalizao de idosos, no Nordeste Brasileiro, ainda
uma deciso social a requerer detalhamento, e estudos transversais, associados descries,
que podem elucidar aspectos determinantes ou modificadores das institucionalizaes (Bonita,
Beaglehole & Kjellstrm, 2006).
Idosos Demenciais Institucionalizados e a Terapia Cognitivo Comportamental:
Entendendo a Reabilitao Cognitiva de Abrangncia Bio-Psicossocial
Spencer Jnior, Giliane Gomes.
Universidade de Pernambuco, Recife, Brazil.

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Abstract Central: O envelhecimento da populao um fenmeno mundial e determinadas


condies patolgicas, cuja incidncia maior na populao idosa, tornaram-se evidentes,
como o caso das demncias. Segundo RAMOS et al (2009), o quadro demencial pode ser
definido como o comprometimento adquirido da memria associado a um prejuzo em pelo
menos uma das outras funes cognitivas da linguagem, gnosias, praxias ou funes
executivas, que interferem na capacidade funcional. Com isso, os indivduos acometidos pelas
demncias geralmente apresentam dificuldade no controle das emoes, na resoluo de
problemas, podem apresentar mudanas na personalidade e problemas de comportamento.
Buscou-se inicialmente pesquisar/rastrear a prevalncia dos quadros demenciais em
Instituies de Longa Permanncia para Idosos (ILPI) e instigar discusses neste mbito
apontando tcnicas eficazes baseadas na Terapia Cognitivo Comportamental (TCC) para uma
melhora na qualidade de vida dos idosos. O recurso metodolgico usado foi o estudo
descritivo, transversal, observacional, com comparao de grupos, realizado incluindo 96
idosos, com 65 anos ou mais de idade, residindo em uma dentre nove instituies de longa
permanncia, sendo sete localizadas no Recife e duas em Jaboato dos Guararapes,
Pernambuco, Brasil, no perodo de maio a julho de 2011. Os instrumentos de coleta usados
foram o Mini-Exame do Estado Mental (MEEM) e Teste de Desenho do Relgio (TDR) que
permitiram investigar caractersticas sociodemogrficas, institucionais e triar as perdas
cognitivas caractersticas da demncia. Os resultados pontuaram que as perdas cognitivas
estavam presentes no MEEM de 65,6% dos idosos e no TDR de 72,9%. De posse deste
percentual sintomatolgico foi realizado uma reviso sistemtica de estudos controlados que
avaliaram a eficcia das TCC na reduo do transtorno demencial, como tambm discusses a
este respeito dentro da ILPI. Segundo Camara et al (2009) h uma abordagem teraputica
pioneira testada em ambulatrios desde 1987, que vem apresentando respostas satisfatrias
quanto eficcia, denominada de reabilitao cognitiva de abrangncia bio-psicossocial, tem
por finalidade a estimulao de comportamentos, da memria, da orientao e da realidade. A
dinmica se constitui com: 1) Tcnicas Comportamentais; 2) Terapia de Orientao para a
Realidade; 3) Estimulao Cognitiva; 4) Terapia de Reminiscncias; e 5) Teoria de Validao.
Vislumbrando o aumento da emisso de comportamentos assertivos. Por fim, entendendo que
segundo Goffman (2008) toda instituio tem tendncia ao fechamento, preciso atuar dentro
da realidade institucional para que esta no esteja propiciando o surgimento dos sintomas
demenciais.Com isso, v-se a necessidade de quantificar e qualificar a prevalncia dos
quadros demenciais encontrados em ILPIs e de lanar um alerta sobre a negligncia com a
Sade Mental nesta esfera.
Propiedades Psicomtricas de la CES-D/IS en Poblacin Universitaria de la Ciudad de
Durango, Mxico
Angelica Lechuga-Quiones, Sergio Estrada Martnez, Jaime Salvador Moysn, Yolanda
Martinez Lpez, Osmel La- Llave-Len.
psicosocial, Instituto de Investigacin Cientfica Universidad Juarez del Estado de Durango,
Durango, Mexico.
Introduccin: La depresin es un aspecto que constantemente se ha relacionado con la
conducta suicida. La sintomatologa depresiva principalmente, ha sido evidenciada en varios
estudios en donde ha estado presente en adolescentes y jvenes con pensamientos e intentos
de suicidio. Por esta razn es de suma prioridad e inters el contar con un instrumento vlido y
confiable, para la identificacin como para la medicin de caractersticas relacionadas con la
conducta autodestructiva en estudiantes universitarios. Objetivo: Evaluar las propiedades
psicomtricas de la CES-D/IS, mediante su aplicacin a estudiantes de nivel licenciatura de la
Universidad Jurez del Estado de Durango (UJED). Material y Mtodos: El estudio incluy a

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943 estudiantes de 13 unidades acadmicas durante el periodo escolarizado de 2008. Se


aplic la escala CES-D/IS. Se solicit a los participantes el consentimiento informado y se les
asegur el manejo confidencial de los datos. Para medir la validez del instrumento se utiliz el
anlisis factorial exploratorio, se evalu la consistencia interna mediante el coeficiente alfa de
Cronbach, se emplearon estadsticos descriptivos, t de Student y U de Mann-Whitney para
inferencias al O.05. Los datos se procesaron con los paquetes estadsticos SPSS v15 y R v
2.7.2. Resultados: La escala present una consistencia interna de =0.89. El ndice result
homogneo cuando se analiz por rea de estudio, edad y sexo. El anlisis factorial mostr
cuatro factores con el 45.5% de la varianza explicada. Conclusiones: La escala CES-D/IS,
present buenas propiedades tanto en su confiabilidad como en su validez.
Anlisis Factorial Confirmatorio del Cuestionario de Esquemas YSQ (Version
Colombiana)
Mariantonia Lemos, Lina Saldarriaga, Diana Agudelo, Yvonne Gmez Gmez Maquet.
Universidad de los Andes, Bogota, Colombia.
Se llev a cabo un Anlisis Factorial Confirmatorio (AFC) para evaluar la estructura interna de
la prueba de esquemas maladaptativos tempranos (YSQ) desarrollada por Young y Brown en
1990 y validada en Colombia por Castrilln et al (2005). A partir de un anlisis factorial
exploratorio, Castrilln et al (2005) lleg a una prueba de 45 tems ( = 0.90). En este estudio el
AFC se llev a cabo usando un modelo de ecuaciones estructurales con los datos obtenidos de
303 estudiantes universitarios (51.2% mujeres; edad promedio: 18 aos, D.E. 1.4 aos). Para
los anlisis se utiliz el mtodo de estimacin robusto de mxima verosimilitud usando el
programa MPlus versin 5.5. En el AFC se evaluaron tres modelos. El primero prob la
existencia de los once esquemas propuestos por Castrilln et al (2005) a partir de la teora de
Young, Klosko y Weishar (2003); adems de correlaciones entre tems similares del mismo
esquema. Este modelo mostr ndices de ajuste parcialmente adecuados (X2 (881, n=303) =
1922.26, p<.05; TLI = .957; CFI = .962.; SRMSR = 0.025; RMSEA = .062). El segundo modelo
evalu la presencia de un factor de segundo orden general, concebido como vulnerabilidad
para la psicopatologa, adicional a las correlaciones entre esquemas del mismo dominio y entre
los tems de un mismo esquema (Kriston et al, 2012). Los ndices de ajuste para este modelo
fueron X2 (917, n=303) = 1975.36, p<.05; TLI = .958; CFI = .961.; SRMSR = 0.025; RMSEA =
.062. Finalmente el tercer modelo consider de la existencia de 5 dominios con correlaciones
entre los tems similares (Soygut et al, 2009). Los resultados mostraron un mejor ajuste de este
modelo debido a su parsimoniosidad y congruencia con la teora(X2 (914, n=303) = 1957.07,
p<.05; TLI = .958; CFI = .961.; SRMSR = 0.025; RMSEA = .062). En general se encontr que la
versin colombiana del YSQ tiene una estructura interna slida de cinco factores de segundo
orden: desconexin, autonoma deteriorada, limites insuficientes, orientacin hacia el otro y
estndares inflexibles.
The Prevalence of State Anger and Trait Anger Within Psychiatric Outpatients
Marien Lievaart1, Elke Geraerts1, Ingmar Franken1, Hans Hovens1, 2.
1. Erasmus University Rotterdam, Rotterdam, Netherlands, 2. The Delta Psychiatric Hospital,
Poortugaal, Netherlands.
Anger is a clinically relevant emotion. Within individuals with social anxiety disorder anger is
associated with less satisfaction about their cognitive behavioral treatment and with premature
termination from treatment (Erwin, Heimberg, Schneider, & Liebowitz, 2003). Similarly, patients
meeting criteria for Post-Traumatic Stress Disorder with high levels of anger before treatment

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benefited less from exposure therapy. Furthermore, anger presumably interferes with common
therapy factors, such as a strong therapeutic alliance (DiGiuseppe & Tafrate, 2010), motivation
in treatment, resistance to change and less collaboration in goal setting (Hubble, Duncan, &
Miller, 2004). Therefore, it may be valuable to enquire about anger difficulties in patients. This
poster presents information about the prevalence of anger in psychiatric outpatients.
Implications for therapy will be discussed. Literature: DiGiuseppe, R., & Tafrate, R. (2010).
Understanding Anger Disorders. New York, NY: Oxford University Press. Erwin, B.A.,
Heimberg, R.G., Schneier, F.R., & Liebowitz, M.R. (2003). Anger experience and expression in
social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitivebehavioral treatment. Behavior Therapy, 34 (3), 331-350. Hubble, M.A., Duncan, B.L., & Miller,
S.D. (2004). The heart and soul of change: What works in therapy. Washington, DC: American
Psychological Association.
Translation and Transculturally Adaptation of Scales for Children and Adolescent
Posttraumatic Reactions into Brazilian Portuguese
Beatriz Lobo, Alice Brunnet, Thiago Silva, Rodrigo Grassi-Oliveira, Adriane Arteche, Christian
Kristensen.
PUCRS, Porto Alegre, Brazil.
It is estimated that 25% of children will experience a potentially traumatic event until they are 16
years old. These events are a risk factor for the development of some psychopathologies such
as Posttraumatic Stress Disorder (PTSD). Previous studies show that childs trauma appraisals
can play a prominent role in the development or maintenance of the disorder. Thus it is
important to evaluate the posttraumatic symptomatology and the subjective response to
understand the traumatic event impact on a childs life. Given the scarcity of psychometrically
valid instruments to assess posttraumatic reactions in Brazilian population, the aim of this study
is to translate and transculturally adapt two scales to evaluate child and adolescents
posttraumatic reactions for use in the Brazilian language and culture. Considering that most of
the questionnaires are developed in English-speakers countries, and researchers also need to
use these instruments in populations that dont have English as mother language, the process
of translation must be conducted with a methodological rigor and include a cross-cultural
adaptation looking at both linguistic and cultural adaptation issues. These methods must include
objective measures of content validity to guarantee the instruments quality. The Trauma
Symptom Checklist for Children (TSCC; Briere, 1996) is an internationally used instrument to
assess posttraumatic and associated symptoms in children and adolescents aged 8 to 16. The
Child Post-traumatic Cognitions Inventory (cPTCI; Meiser-Stedman et al., 2009) is a version of
the Post-traumatic Cognitions Inventory (PTCI; Foa, Ehlers, Clark, Tolin, & Orsillo, 1999)
adapted for children, which aimed to assess negative post-traumatic appraisals for children and
adolescents aged 6 to 17. Method: The translation procedure was based in previously literature
and included: translation, back-translation, linguistic expert evaluation and expert committee.
The index of content validity (CVI) was based in literature proposals described previously, and
was obtained through judges evaluations on each dimension of the CVI: (a) clarity of language,
which measures how much the items are comprehensive in the target population; (b) pertinence
in practice, which measures how much each item is adequate to evaluate the target population;
and (c) theory relevance, which measures how much the items are in agreement with the
construct theory. Results: The items with less than 0.8 in content validity index (CVI) were
modified and re-evaluated by the same judges. A good rate on total content validity index (CVIt)
scores was found (for all dimensions was found after two judges evaluations and one
reformulation. The total CVI of TSCC was: (a) clarity of language = 0.896, (b) pertinence in
practice = 0.942 and (c) theory relevance = 0.932. The total CVI of cPTCI was: (a) clarity of

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language = 0.914, (b) pertinence in practice = 0.927 and (c) theory relevance = 0.919.
Moreover, the back translation of the final version also showed that the Portuguese TSCC and
cPTCI maintained the same meanings of the original in English. Conclusion: The good rate on
final total CVI scores and the maintenance of meaning after the translation demonstrated that
the TSCC and cPTCI were adequately translated and culturally adapted. This method provided
a quantitative data to evaluate the adequacy of the adaptated itens of TSCC and cPTCI,
enabling objective reformulations, specifically focusing in clarity of language, practice pertinence
and theory relevance. Ongoing work is being performed to conduct the pilot testing and to
examine the reliability, the factorial and concurrent validity of the scales.
Escala de Adiccin a la Tecnologa
Leticia Luque1, 2, Emanuel Aramburu2.
1. Unidad Estudios Epidemiologicos en Salud Mental, Facultad de Psicologia, Universidad
Nacional de Crdoba, Cordoba capital, Argentina, 2. Universidad Morn, sede Rio Tercero, Rio
Tercero, Argentina.
Abstract Central: El potencial adictivo de las tecnologas de informacin y comunicacin (TIC)
no puede seguir estudindose sin considerar la convergencia meditica y la hibridacin que
han sufrido. En funcin de esto se determinan algunas propiedades psicomtricas de una
escala de adiccin a la tecnologa, construida a partir de la escala de dependencia a la
tecnologa de Luque y Gmez (2010). Evala usos abusivos y patolgicos de la tecnologa en
sentido genrico, e incluye los usos problemticos de computadoras, internet, televisin,
telfonos mviles, y videojuegos. El anlisis factorial exploratorio (sobre N= 989) arroja cinco
factores: Adiccin a computadoras-Internet, a videojuegos, a telfono mvil y a televisin, y
Bsqueda de novedades tecnolgicas. Se determina la existencia de un factor de segundo
grado, denominado Adiccin a la tecnologa o tecno-dependencia. La consistencia interna de
cada subescala es aceptable, siendo fuerte para la escala completa (=.929, 37 items). La
escala debe estudiarse con sujetos de distintas edades para el establecimiento de criterios
diferenciales, y en distintos contextos por la posible incidencia de factores como la accesibilidad
y la disponibilidad ambiental.
Evaluating Measurement Equivalence: Adaptation and Validation of the Cognitive Triad
Inventory (CTI-C) for Children in Puerto Rican Adolescents
Cybelle Lpez-Valentn, ngel Nuez-Mndez, Nicole Ryan-Nolla, Giovanni Tirado-Santiago.
University of Puerto Rico, San Juan, USA.
Background: Early adolescence is a critical developmental stage in the onset of depression.
During this period formal operational thought consolidates, allowing the building of cognitive
schemas (Kessler et al., 2001). Depression is characterized by the existence of negative
schemas that according to Becks theory (Beck et al., 1979) contain dysfunctional attitudes
about the self, the world, and the future, named the Cognitive Triad. Negative cognitive styles
associated with depression are established in early adolescence and remain relatively stable
into mid-adolescence (Kuyken et al., 2006). Adolescent depression is linked with a series of
immediate and long-term psychosocial impairments, making them significantly more vulnerable
to experience a depressive episode in adulthood (Auerbach et al., 2010; Davey et al., 2008).
The early detection of these negative cognitive schemes is crucial for identifying adolescents at
risk and reducing depression rates in youth. To measure the factors of the Cognitive Triad in
Latino adolescents, here we translated, adapted and validated the Cognitive Triad Inventory for
Children (CTI-C; Kaslow et al., 1992) in a population of Spanish-speaking Puerto Rican

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adolescents (13-17 years-old). The CTI-C was developed for children, but it has also been used
in adolescents (Greening et al., 2005). Method: The CTI-C consists of 36 items divided into
three subscales that measure views about the self, the surrounding environment, and the
participants future. For each item, a participant is given three choices (Yes=2, Maybe=1, No=0)
to answer whether he or she is currently thinking about the thought expressed on the item. For
each subscale, half of the items were positively worded and half negatively. For analysis
purposes, negatively worded items required recoding in a manner that higher scores mean
more adaptive responses. After an English to Spanish translation, we administered the scale to
a sample of 33 adolescents. Focus groups were conducted and the language of the scale was
modified and administered to a sample of 252 adolescents (mean age 14.84, SD=1.26) of
schools of the San Juan Metropolitan Area. Results: Exploratory factor analysis with Varimax
rotation failed to find the three factors of the cognitive triad in the original instrument. Instead,
we found that the scale showed two factors with 16 items each. Four items were discarded
because they were complex items with factor loadings in more than one factor. The first factor,
for items worded in a positive direction, showed strong internal consistency with a Cronbachs
of 0.84, and factor loadings ranging from .33-.70. The second factor, for items worded in a
negative direction, showed a strong internal consistency with a Cronbachs of 0.88 and factor
loadings ranging from .33-.75. The mean total score of the sample was 48.97 (SD=5.44), which
contrasts with Greening et al. (2005) results in which non-depressed Caucasian and AfricanAmerican adolescents showed mean scores of 56.90 and 61.03, respectively. Conclusion: Our
results are consistent with other studies that fail to confirm the three-factor structure of the CTIC. The discrepancies in total scores between our and Greenings study may be due to cultural
and linguistic variables.
Evidencias de Validez de Tres Inventarios Estado/Rasgo en Nios y Adolescentes de
Lima
Eduardo Manzanares Medina, Gustavo Calderon De la Cruz, Lizeth Vilcherrez Pizarro, Reyna
Concha Curay, Cesar Merino.
Universidad de San Martin de Porres, Lima, Peru.
An con el reconocimiento del impacto sobre la salud mental de la experiencia emocional y de
su expresin en nios y adolescentes, no existe numerosa informacin cientfica publicada en
el Per sobre instrumentos de medicin que sirvan para describirla formalmente. El proceso de
validacin y/o adaptacin de estos instrumentos es importante para fines prcticos y cientficos,
y ocurren dentro de un proceso de investigacin psicomtrica. Por tal razn, el presente estudio
reporta evidencias de validez de tres instrumentos de evaluacin psicolgica que evalan la
ansiedad, depresin y clera en nios y adolescentes. Estos instrumentos usan el auto-reporte
para cuantificar la experiencia emocional relacionada con el bienestar y adaptacin social; los
instrumentos son: Inventario de Ansiedad Estado Rasgo (IDARE; Spielberger, Gorsuch y
Lushene, 1983) Inventario de Depresin Estado/Rasgo (IDER; Spielberger, Agudelo y BuelaCasal, 2008); Inventario Multicultural de Expresin de la Clera Rasgo-Estado (ML-STAXI;
Moscoso y Spielberger, 1999). Aunque el IDER ha sido validado recientemente en una muestra
peruana (Merino & Pflucker, en prensa) con buenos resultados, no ha sido reportado la
exploracin conjunta de estas medidas en nios y adolescentes. Las experiencia de la
ansiedad, depresin y clera evaluadas por estos instrumentos se hacen dentro del marco
Estado-Rasgo, que es un modelo para diferenciar la vivencia emocional en adultos y en nios y
adolescentes. Este marco se refiere a identificar las emociones situacionalmente o vinculadas
con momentos especficos, o como atributos o tendencias estables en la personalidad. Para
esta investigacin exploratoria, los instrumentos se aplicaron en una muestra de 113 escolares,
varones y mujeres entre 4to de primaria y 5to de secundaria, de un colegio pblico Lima

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Metropolitana. Se contrastaran hiptesis sobre la consistencia interna y sobre varios aspectos


de la validez psicomtrica interna y externa, as como la relacin con el sexo y la edad de los
participantes. Se explorar tambin la estructura interna mediante un anlisis factorial
confirmatorio. Se discuten las implicancias de las propiedades psicomtricas obtenidas en los
tres inventarios, adems de resaltar su importancia en la evaluacin psicolgica de nios y
adolescentes en el mbito escolar.
Evaluacin de los Signos Vitales Emocionales en Adolescentes
Eduardo Manzanares Medina, Gustavo Calderon De la Cruz, Reyna Concha Curay, Lizeth
Vilcherrez Pizarro, Cesar Merino.
Universidad de San Martin de Porres, Lima, Peru.
Abstract Central: La ansiedad, la ira y la depresin son los principales indicadores de malestar
psicolgico y requieren una evaluacin cuidadosa para el diagnstico y el tratamiento, pues
permiten vincularlos directamente con los eventos que dan lugar a las mismas. Para la
conceptualizacin e instrumentacin sobre la ansiedad, la ira y la depresin, fue Charles D.
Spielberger, quien proporcion un modelo explicativo de estos fenmenos dentro del marco
Estado-Rasgo, que es un modelo para diferenciar la vivencia emocional en adultos y en nios y
adolescentes. Dentro de este marco, Spielberger desarroll varios instrumentos: el Inventario
de Ansiedad Estado-Rasgo (STAI), el Inventario de Expresin de la Ira Estado-Rasgo (STAXI),
y el Inventario de Depresin Estado-Rasgo (STDI). An con el reconocimiento del impacto
sobre la salud mental de la experiencia emocional y de su expresin en nios y adolescentes,
no existe numerosa informacin cientfica publicada en el Per sobre instrumentos de medicin
que sirvan para describirla estandarizadamente. El proceso de validacin y/o adaptacin de
estos instrumentos es importante para fines prcticos y cientficos, y ocurren dentro de un
proceso de investigacin psicomtrica. Por tal razn, el presente estudio reporta evidencias de
validez de tres instrumentos de evaluacin psicolgica que evalan la ansiedad, depresin y
clera en nios y adolescentes. Otro objetivo del estudio es reducir el STAI utilizando aquellos
tems que discriminen mejor su uso en poblacin infantil y adolescente. Para esta investigacin
exploratoria, los instrumentos se aplicaron en una muestra de 113 escolares, varones y
mujeres entre 4to de primaria y 5to de secundaria, de un colegio pblico Lima Metropolitana.
Los resultados fueron favorables respecto a la estructura interna de cada instrumento evaluada
por en anlisis factorial confirmatorio, con pocas errores correlacionados; la confiabilidad fue
tambin satisfactoria. Las correlaciones entre los puntajes estuvieron de acuerdo a la teora.
Para la versin abreviada del STAI, se detectaron tems con buena validez discriminativa
respecto a los otros constructos. Se discuten las implicancias de las propiedades psicomtricas
obtenidas en los tres inventarios, adems de resaltar su importancia en la evaluacin
psicolgica de nios y adolescentes en el mbito clnico.
The Diagnostic Interview Kiddie-SADS-PL: Validity and Reliability Studies in a
Portuguese Sample
Ana Paula Matos, Cristiana Marques, Snia Cherpe, Ceu Salvador.
CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra,
Portugal.
Abstract Central: To screen and to assess mental health among children and adolescents
through diagnostic instruments provides objective diagnoses and enhance clinical practice.
Diagnostic interviews represent one of the most reliable, valid and clinically useful instruments
for diagnostic, treatment planning and assessment (Grills-Taquechel & Ollendick, 2008),

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because of their format which determines how long the child has been having the problem, the
temporal sequence of behaviours and the estimation of the degree of impairment associated
with emotional or behaviour problems (Frick, Barry, & Kamphaus, 2010). One of the most widely
diagnostic interviews used with children and adolescents is Schedule for Affective Disorders
and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL;
Kaufman, Birmaher, Brent, Rao & Ryan, 1996). Studies on its validity and reliability have shown
good results. This interview assesses the presence or absence of symptomatology, and
subsequently, generates diagnoses. As there were no studies about the K-SADS-PL in
Portugal, the aims of this work were to translate K-SADS-PL, to present descriptive data, to
study the convergent, divergent, and consensual validity, as the interrater and test-retest
reliability. The sample was constituted by children and adolescents, from 10 to 18 years, and
includes a clinical group and a general population group. The assessment protocol includes the
K-SADS-PL-PT, the Child Depression Inventory (CDI), the Multidimensional Anxiety Scale for
Children (MASC), Brief Symptom Inventory (BSI) and the Children Behavior Checklist (CBCL).
The results showed that the validity and reliability of K-SADS-PL-PT are good and therefore this
clinical interview is a valid and reliable tool to assess and diagnose child and adolescent
psychiatric disorders.
Emocin Expresada y Estrs Desde el Punto de Vista de los Pacientes: Nuevas Escalas
para su Evaluacin (BDSEE y PSEE)
Cristina Medina-Pradas1, 2, Steven R. Lpez3, J. Blas Navarro2.
1. Universidad Autnoma de Madrid, Madrid, Spain, 2. Universidad Autnoma de Barcelona,
Barcelona, Spain, 3. University of Southern California, Los Angeles, CA, USA.
Abstract Central: La Emocin Expresada (EE) dirigida hacia los pacientes con trastorno
mental grave, por ejemplo psicosis o trastornos de la conducta alimentaria, es un predictor de
recadas ampliamente estudiado. Sin embargo, poco se ha tenido en cuenta que las actitudes
de la EE se asocian con ciclos de interaccin bidireccionales y mutuamente influyentes entre
los pacientes y sus familiares. Asimismo, pocas veces se ha preguntado directamente a los
pacientes por cmo perciben esa EE por parte de sus familiares, a pesar de suponerse que les
estresa y que por eso recaen. En tercer lugar, ninguna escala de EE ha tenido en cuenta las
emociones positivas (en concreto, la calidez) anteriormente y se empiezan a tener datos de su
poder protector. Por ello, es fundamental enfocar el estudio y el tratamiento de la EE hacia y
desde una visin didica, tanto en investigacin como en intervencin, e incluir la calidez de
cara a una psicologa ms positiva. Para ello, primero necesitamos nuevos instrumentos de
evaluacin que consideren este enfoque. Se presentarn dos nuevas escalas para la
evaluacin de la EE desde el punto de vista de los pacientes: la Escala Didica Breve de EE
(BDSEE) y la Escala de Estrs Percibido por la EE (PSEE). Ambas han demostrado ser vlidas
y fiables, han sido traducidas a diversos idiomas y estn siendo usadas por diversos grupos
punteros a nivel mundial.
Adaptacin de una Medida de Auto-Reporte para la Experiencia de Burnout en
Adolescentes
Cesar Merino, Raquel Caballero, Alejandra Delgadillo, Dora Pflcker.
Universidad Cientfica del Sur, Lima, Peru.
Abstract Central: El burnout ha sido estudiado en contextos laborales, pero los estudios
empricos sobre el tema en adolescentes se iniciaron en Finlandia, donde se construy un
instrumento para adolescentes (School Burnout Inventory, SBI; Salmela-Aro et al., 2009). Esta

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investigacin evala la adaptacin del SBI, iniciada en Espaa y Colombia. En Per, estudios
previos concluyeron que los tems del cuestionario estn conceptualmente relacionados con las
experiencias auto-reportadas de ansiedad y depresin (Merino et al., 2012). En el presente
estudio, participaron 1126 adolescentes provenientes de un colegio estatal, en Lima. Se aplic
el SBI con medidas de ansiedad y depresin, e indicadores de autoestima y rendimiento
escolar. Se evalu la estructura interna mediante un anlisis factorial confirmatorio. Los
resultados indican que la estructura de tres dimensiones (Agotamiento Emocional, Cinismo y
Prdida de Eficacia) representa mejor las respuestas de los adolescentes. Este modelo
tridimensional tambin es coherente con las adaptaciones hispanas previas y con el modelo
original propuesto por Salmela-Aro. La confiabilidad es adecuada para el puntaje total y para
sus componentes. Las correlaciones positivas con ansiedad y depresin estuvieron en orden
de las hiptesis planteadas, sugiriendo diferenciacin conceptual entre ellas. Tambin, se
cumplieron las hiptesis de validez sobre las correlaciones con los indicadores de autoestima
(correlacin negativa), e indicadores de rendimiento (correlacin negativa). En conjunto, los
resultados indican que la adaptacin del instrumento en su conjunto es adecuado y parece
responder a las demandas de evaluacin psicolgica en adolescentes, respecto a las
experiencias de estrs extremo. Burnout has been studied in work contexts, but in adolescents,
empirical studies on the subject began in Finland, where there is a tool for adolescents (School
Burnout Inventory, SBI; Salmela-Aro et al., 2009). This research evaluate the adaptation of the
SBI to Per, originally adapted in Spain and Colombia. In Peru, previous studies concluded that
the items are conceptually related to anxiety and depression (Merino et al., 2012). In the present
study, we get a sample of 1126 adolescents from a public school in Lima. SBI was applied with
measures of anxiety and depression; and indicators of self-esteem and school performance.
Internal structure was assessed using confirmatory factor analysis. The results indicate that the
three-dimensional structure (emotional exhaustion, cynicism and loss of efficacy) best
represents the adolescents responses. This three-dimensional model is also consistent with
previous Hispanic and adaptations to the original model proposed by Salmela-Aro. The
reliability is adequate for the total score and its components. The positive correlations with
anxiety and depression were in order of the hypotheses, suggesting the conceptual distinction.
Also, were met validity hypothesis on correlations with measures of self-esteem (negative
correlation), and performance indicators (negative correlation). Overall, the results indicate that
the adaptation of the whole instrument is appropriate and seems to meet the demands of
psychological assessment in adolescents, about the experiences of extreme stress.
EPQR-BV: Validacin Hispana de una Versin Muy Breve del EQPR
Cesar Merino.
Instituto de Investigacion de Psicologia, Universidad de San Martin de Porres, Surquillo, Peru.
Abstract Central: En el contexto profesional-clnico, y de investigacin, el EPQR es una
medida importante para acercarse a la descripcin nomottica y emic de la personalidad. Pero
estudios preliminares en Per con esta medida (Merino, 2011) mostraron que el fraseo de
algunos de los tems provenientes de su espaola, no es satisfactoria para el contexto peruano
y, posiblemente, para el internacional hispano (Merino, en prensa). Recientemente, apareci
una versin inglesa modificada del EPQR (EPQR-BV; Sato, 2005), que presenta tems
ordinales y nicamente evala los factores E y N, considerando los problemas de las escalas P
y L. Su primera adaptacin hispana mediante un anlisis factorial confirmatorio de su estructura
configuracional mostr un adecuado modelo bidimensional, y consistencia interna superior a
0.80. La presente investigacin evala la estructura interna desde usando metodologa SEM.
Participaron 300 sujetos, estudiantes de psicologa y de la comunidad (muestreo bola de
nieve). Se verific un modelo bidimensional. Los resultados fueron satisfactorios respecto a la

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estructura bidimensional para los factores N y E, pero se agregaron covariaciones de error


tericamente razonables en algunos tems de ambas escalas. Las cargas de los tems fueron
superiores a 0.45. La consistencia interna vari entre 0.80 y 0.86 en las submuestras y muestra
total. Se exploraron diferencias entre varones y mujeres, hallndose diferencias coherentes con
lo que reporta la literatura. Los resultados en general muestran una potencial medida para la
prctica clnica, confiable e internamente vlida. In the professional and clinical context, and
research, the EPQR is an important measure for the closer nomothetic and emic description of
personality. But preliminary studies in Peru with this measure (Merino, 2011) showed that the
phrasing of some items from the Spaniard version is not satisfactory to the Peruvian context and
possibly for the Hispanic international (Merino, in press). Recently, there appeared a EPQR
modified English version (EPQR-BV; Sato, 2005), which presents items ordinal and only
evaluates the factors E and N, considering the problems of the scales P and L. The first
Hispanic adaptation using confirmatory factor analysis of configurational structure showed an
adequate two-dimensional model, and internal consistency greater than 0.80. This research
evaluates the internal structure from using SEM methodology. 300 subjects participated,
students and community psychology (snowball sampling). Dimensional model was verified. The
results were satisfactory with respect to the two-dimensional structure for the factors N and E,
but were added theoretically reasonable error covariances in some items of both scales. The
loads of the above items were 0.45. Internal consistency ranged between 0.80 and 0.86 in the
total sample and subsamples. The differences between men and women were consistent with
differences reported by the literature. The overall results show a potential measure for clinical
practice, reliable and internally valid.
Coping Strategy Indicator (CSI): Validacin Estructural en Adolescentes de Lima (Per)
Cesar Merino, Eduardo Manzanares Medina, Gustavo Calderon De la Cruz.
Instituto de Investigacion de Psicologia, Universidad de San Martin de Porres, Surquillo, Peru.
Abstract Central: Aunque la capacidad de afrontamiento al estrs en adolescentes es
importante para su exitosa adaptacin social, ha sido infrecuentemente investigado en habla
hispana, posiblemente por las pocas propuestas de medicin psicolgica en el rea clnica. La
metodologa del auto-reporte de las estrategias de afrontamiento ha probado ser un medio
eficiente en la investigacin y en la prctica profesional, y el Indicador de Estrategias de
Afrontamiento (Copyng Strategy Indicator, CSI; Amirkhan, 1990) es una propuesta para su uso
en adolescentes. El presente estudio evala la dimensionalidad del CSI aplicado a 283
adolescentes (160, mujeres) en Lima entre 12 y 19 aos. Este instrumento fue originalmente
creado para adultos, y evala estrategias generales de Solucin de Problemas, Bsqueda de
Apoyo y Evitacin. El CSI ha recibido respaldo emprico en adultos y adolescentes de habla
inglesa, pero an no ha sido investigado en adolescentes hispanos. Usando la metodologa de
ecuaciones estructurales, se probaron varios modelos: un factor general, dos factores
(ortogonales y oblcuos), tres factores (ortogonales y oblcuos), y cuatro factores (dos factores
derivados de Evitacin). Los resultados indican que la consistencia fue adecuada (alfa > 0.80)
excepto para Evitacin. El modelo con mejor ajuste fue de tres factores oblicuos, con
covariacin de errores entre algunos tems. Las correlaciones interfactoriales ocurrieron en la
direccin predicha, indicando moderada divergencia entre las estrategias. Los resultados dan
soporte a la aproximacin multicultural de la estructura del CSI en adolescentes
latinoamericanos, y es de potencial valor tambin para grupos interculturales locales.
Assessing the Contents of Worry: Cross-cultural Adaptation, Validity Evidence and
Correlations to Mental Disorders Variables of the Anxious Thoughts Inventory

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Andr Moreno, William Gomes, Gustavo Gauer.


Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Worry is an important cognitive constituent of anxiety, characterized by the presence of intrusive
repetitive negative thoughts about a future event. Assessment instruments of worry are useful to
research on this variable and for allowing the measurement of this factor in the clinical treatment
of anxiety. Assessment of the contents of worry allows for specifying the phenomenology of
worry expressions in various mental disorders, given its specific presence in anxiety disorders.
This communication presents the adaptation of an instrument for measuring the contents of
worry processes to Brazilian context, the Anxious Thoughts Inventory (ANTI). Moreover, it
presents validity evidence of the Brazilian version of the instrument and correlations of this
version to important variables for assessing mental disorders. Cross-cultural adaptation of the
ANTI followed the following steps: prior contact with the original author of the instrument in order
to permit adaptation to the Brazilian context; two translations by bilingual experts; agreement
between translations, leading to a single translated version; back-translation version by a
bilingual expert; evaluation of the translated version by a committee of experts, evaluation of
back-translation by the original author; pilot study with 12 undergraduates to ensure
comprehension of the items of the translated version. After performing these steps for crosscultural adaptation, we obtained as a result the Brazilian version of ANTI, called Inventrio de
Pensamentos Ansiosos (IPAN). In order to assess the psychometric properties of IPAN, 276
Brazilian college students answered to the instrument. The results indicated that IPAN
demonstrated good internal consistency, with Cronbach's alpha coefficient of 0.85. The
relationship between IPAN and other psychological variables of interest in mental disorders was
probed by correlating it to instruments that assess frequency of worry (PSWQ), anxiety (BAI),
depression (BDI) and reflexivity and repetitive thoughts (QRR). The IPAN showed strong
correlation with PSWQ and moderate correlation with other variables. The good internal
consistency of IPAN and its strong correlation to frequency of worry as measured by the PSWQ
recommends it as a good option for assessing worry in clinical and research settings. The
moderate correlation with BAI can be explained by the fact that, while BAI assesses
predominantly physiological features of anxiety, IPAN assesses worry, a primarily cognitive
factor and thus representational feature of anxiety. The moderate correlation with BDI and QRR
may be explained by the high levels of co-morbidity between anxiety disorders and others
mental disorders. We conclude that IPAN presents a potentially useful contribution to the
assessment of the contents of worry and the assessment of anxiety disorders in the Brazilian
context. New studies are encouraged in the line of further evaluating the psychometric qualities
of the instrument, as well as its correlations with other personality variables, self-regulation
mechanisms and metacognitive processes relevant to mental disorders.
The Reliability And Validity Of The Malay Version Of The Catastrophic Cognitions
Questionnaire-Modified In A University Student Sample
Firdaus Mukhtar1, Jamilah Hanum Abdul Khaiyom2, Normala Ibrahim1, Sherina M Sidik1, Tian
Oei3.
1. Universiti Putra Malaysia, Serdang, Malaysia, 2. International Islamic University Malaysia,
Gombak, Malaysia, 3. University of Queensland, Brisbane, QLD, Australia.
Abstract Central: Objective. This study investigated the reliability and validity of the CCQ-M in
a sample of 290 Malay university students in a public university Malaysia. Method: The reliability
of the CCQ-M was measured using internal consistency (Cronbachs alpha), split-half reliability
and test-retest reliability. Principal axis factoring was performed to assess construct validity.
Results: The Malay CCQ-M revealed good internal consistency, split-half reliability and test-

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retest reliability. Exploratory factor analysis revealed four factors if compared to the three factors
in the original version. Conclusion: It was hoped that with this type of cross-cultural information,
the differences of the constructs in the Malay version of CCQ-M could be further studied and
confirmed.
The Reliability and Validity of the Bahasa Malaysia Version of the Automatic Thought
Questionnaire-Positive (ATQ-P)
Firdaus Mukhtar1, Jia Low1, Normala Ibrahim1, Sherina M Sidik1, Tian Oei2, 1.
1. Universiti Putra Malaysia, Serdang, Malaysia, 2. University of Queensland, Brisbane, QLD,
Australia.
Abstract Central: The aim of the current study was to investigate the reliability and validity of
the Bahasa Malaysia (BM) version of the Positive Automatic Thought Questionnaire (ATQP-BM)
in clinical and non-clinical populations for use in a Malaysian populace. The ATQP is a
derivation from the original Automatic Thoughts Questionnaire which instead, aims to assess an
individuals positive and functional thoughts. The ATQP-BM was administered to 200 members
of the general population and a further 200 to university students with administration to clinical
population currently in progress. Analysis conducted show that ATQP-BM has good internal
reliability, and good test-retest reliability when conducted on university students. Preliminary
exploratory factor analysis showed a three factor model for the ATQ-BM. Discriminant validity
will be conducted, comparing the results of both measures between the general population and
student population against the clinical population. Preliminary results show ATQP-BM has the
potential to have good psychometric properties for use as cognitives measures within Malaysian
culture.
Validation Data of the Spider Phobia Beliefs Questionnaire Adapted for Cockroach
Phobia in General and Clinical Spanish Populations
Sara Nebot1, Soledad Quero1, 2, Juani Bretn-Lpez1, 2, Maria Angeles Perez-Ara1, Mar Mols1,
Cristina Botella1, 2.
1. Universitat Jaume I, Castelln, Spain, 2. CIBER de Fisiopatologa de la Obesidad y Nutricin
(CIBEROBN), Santiago de Compostela, Spain.
Introduction. With the increasing interest in the identification and dissemination of evidencebased treatments for psychological problems (Nathan and Gorman, 1998, 2007), the need for
evidence-based assessment strategies is greater than ever before. It is crucial to develop
assessment instruments with good psychometric properties resulting in a reliable evaluation.
Specific phobias have a high prevalence rate and can be very disabling for many people
(Magee et al., 1996). The most investigated animal phobias have been spider phobia
(ODonohue & Szymanski, 1993) and snake phobia (Klieger & Siejack, 1997). Currently, we
have have at our disposal empirically validated measures for these phobias in English speaking
population (Anthony et al., 2001). The aim of this study is to provide preliminary validation data
of an adaptation of the Spider Phobia Beliefs Questionnaire (SBQ; Arntz et al., 1993) in general
and clinical Spanish population. Method. The general sample consisted of 250 participants and
the clinical sample included 64 patients. The SBQ is a 78-items questionnaire that assesses the
strength of fearful beliefs regarding spiders on a 0 ("I do not believe at all) to 100% ("I
absolutely believe it") point scale. It includes 2 scales: beliefs regarding spiders (items 1-42) and
beliefs about ones reaction to encountering a spider (items 33-78). The back translation
procedure was conducted for the original version of the SBQ and the word spider was
substituted by the word cockroach. The SBQ was administered together with the Fear of Spider

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Questionnaire (FSQ: Szymanski y ODonohue, 1995) adapted for cockroaches (Nebot et al.,
2012) and the Spanish version of the Disgust Scale (DPSS-R; Propensity and Sensitivity
ScaleRevised; Sandn et al., 2008). Results. The average score of the scale of beliefs
regarding cockroaches in the general population was 14.08 (SD = 11.67) and 3.54 (SD = 7.25)
in the scale of beliefs about ones reaction to encountering a cockroach. The clinical population
obtained a mean score of 50.93 (SD = 15.98) in the first scale and 39.44 (SD = 19.68) in the
second one. Internal consistency for both scales in both populations showed excellent
Cronbach coefficients (ranging from 0.94 to 0.95). In addition, significant differences in both
SBQ scales between the two groups and between men and women in the general population
were found. Moreover, also found significant differences in both scales for men and women
from the general population. Finally, both SBQ scales correlated positively and significantly with
the other measures included in the study (ranging from 0.278 to 0.728). Conclusions. The
results obtained show that the SBQ, adapted for cockroaches phobia, has an excellent internal
consistency in Spanish population. It was also effective in differentiating between clinical
population with a diagnosis of cockroach phobia and the general population. In addition a good
convergent validity between the SBQ and related measures was found. These data are in line
with the results obtained by Arntz et al. (1993), although the validation is still in process since it
is necessary to enlarge the sample in order to obtain firmer results.
Adaptacin y Validacin Psicomtrica del Inventario de Autoeficacia de Rechazo de
Alcohol Versin Revisada para Adolecentes
Luis Perez-Romero.
Universidad Nacional Autonoma de Mxico, Ciuda de Mexico, DF, Mexico.
El consumo de sustancias adictivas en especial de las legales como el tabaco y el alcohol es
un problema de salud publica debido a las mltiples consecuencias asociadas a su consumo,
una de las poblaciones que en particular se ve afectada es la poblacin adolescentes, en los
ltimos tres aos se ha observado un incremento tanto en la prevalencia como en la proporcin
de personas que inicia a edad temprana el consumo de alcohol, de acuerdo con la Encuesta
Nacional de Adicciones 2008 (ENA) ms del 50% de la poblacin consumidora de drogas inici
antes de los 17 aos y de estas personas la gran mayora inicio consumiendo alcohol o tabaco
(ENA, 2008), aquellos adolescentes que consumen este tipo de sustancias antes de la mayora
de edad tienen mayores probabilidades de consumir algn otro tipo de droga ilegal en el futuro.
La adolescencia tambin ha sido sealada por la literatura como un periodo crtico en que se
puede desarrollar la conducta adictiva, pues es en este momento del desarrollo que comprende
de los 12 a los 20 aos de edad, donde se da el proceso de prueba de drogas y posible abuso
y dependencia (Becoa, 2007; Espada, Grifffin, Botvin & Mndez; 2003; Olivari & Barra, 2005)
tambin el inicio del consumo de alcohol a edades tempranas como en la adolescencia se
asocia con el desarrollo de desordenes por el uso del alcohol en la vida adulta (abuso y
dependencia) (Flory, Lynam, Milich, Leukefeld & Clayton, 2004; Young, Hasking, Oei &
Loveday, 2007) y con otros problemas asociados tales como: accidentes automovilsticos, uso
de tabaco y otras drogas, conductas sexuales de riesgo, embarazos en adolescentes,
transmisin de enfermedades sexuales, violencia depresin, suicidio y desarrollo de
sintomatologa del sndrome de de dependencia o abuso de sustancias (Grant & Dowson,
1997), tomando en consideracin lo antes expuesto es claro que se debe de contar con
tratamientos, programas preventivos e instrumentos que sirvan para evaluar su tratamiento, es
en este sentido que el objetivo del presente trabajo fue adaptar y validar un inventario que
evala la Autoeficacia de rechazo en adolecentes, dicho constructo se refiere a la percepcin
que tiene un individuo sobre su habilidad para rechazar o resistir beber alcohol, este constructo
se desprende de la Teora del Aprendizaje Social de Albert Bandura (Oei & Balwin, 1994; Oei,

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Hasking & Young, 2005; Young, Hasking, Oei & Loveday, 2007), este instrumento fue
originalmente desarrollado por: Young, Hasking, Oei y Loveday (2007). El estudio estuvo divido
en dos etapas; en la primera se llevo a cabo la adaptacin del instrumento original, atraves del
proceso de traduccin - retraduccin por jueces expertos en el rea de psicologa de las
adicciones y el pilotaje, en la segunda etapa se valido la versin final obtenida del proceso de
adaptacin, para ello participaron 126 estudiantes de nivel medio superior pertenecientes a
instituciones de educacin pblicas. Los resultados arrojan 2 factores: autoeficacia de rechazo
en situaciones de alivio emocional y autoeficacia de rechazo en situaciones oportunistas, la
escala explica el 65.69 % de la varianza, con un alpha de Cronbach global de .91. Se confirman
parcialmente dos de los factores originales de la prueba.
Validacin de Contenido de un Sistema Experto para la Deteccin de TDA/H Basado en
Lgica Difusa
Jonnathan Pinilla, Jazmine EScobar, Juan Avila, Nancy Martinez.
Bogot, Universidad El Bosque, Bogot, Colombia.
Abstract Central: El TDA/H es un trastorno de elevada prevalencia, y es vital contar con
herramientas eficaces para su diagnstico. Sin embargo, dada la complejidad del trastorno, los
sistemas categoriales como el DSM IV tienen dificultades para diagnosticarlo, pues no toman
en consideracin las diferencias en la capacidad diagnstica de los criterios que incluyen. Con
el fin de formular un modelo multi-informante y multimodal que permita un diagnstico ms
preciso, en un trabajo anterior diseamos un sistema experto para la deteccin de TDA/H
basado en lgica difusa, capaz de trabajar con diferentes incertidumbres en cada criterio y con
variables lingsticas y cuantitativas, y que arroja resultados satisfactorios. El objetivo de la
presente investigacin es realizar una validacin de contenido de las variables de entrada del
sistema por medio de jueces expertos. Los jueces, que fueron seleccionados teniendo como
criterio su formacin y experiencia en el rea, clasificaron las variables de entrada y las
puntuaron, lo que sirvi de insumo para un anlisis multidimensional y un anlisis de
conglomerados que devel la estructura subyacente de las variables implicadas en el
diagnstico del TDA/H. Este anlisis permiti reducir el nmero de variables de entrada del
sistema experto basado en lgica difusa y aumentar su precisin para el diagnstico del
TDA/H.
Explicit and implicit cognition in violent offenders: Therapy, change and reoffending
outcomes
Devon Polaschek1, Sue Calvert1, Melanie Takarangi2, Rebecca Bell1, Sue Calvert1, Devon
Polaschek1, Rebecca Bell1, Melanie Takarangi2, Devon Polaschek1, Morgan Sissons1, Devon
Polaschek1.
1. School of Psychology, Victoria University of Wellington, Wellington, New Zealand, 2. Flinders
University, Adelaide, SA, Australia.
In this symposium we examine new assessment approaches for the measurement of explicit
and implicit cognition in violent offenders. In the first presentation, we examine self-presentation
bias in self-reported psychopathology profiles of high risk violent offenders. In the second
presentation we compare implicit and explicit measures of offender cognition in the assessment
of treatment progress and risk. Finally in the third presentation we examine whether the Implicit
Association Test can be used to differentiate violent offenders undertaking treatment from
untreated violent offenders, and lower risk offenders.

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Can Self-reported Psychopathology Profiles Help with identifying whose self-report is


predictive of criminal behaviour?
The validity of self-reported psychopathology symptoms has far-reaching relevance: from
assessing criminal culpability in the courtroom to determining which candidate is suitable in a
job interview. But there are widespread concerns about invalidity of self-report responding in
criminal offenders. Is this scepticism warranted?
Using data collected from high-risk violent offenders in an intensive rehabilitation programme,
the current research analyses self-reported psychopathology profiles in conjunction with indices
of self-presentation bias. The results provide a better understanding of the types of selfpresentation bias that enhance and are detrimental in predicting criminal recidivism from
offenders self-reported cognitions in treatment.
Do violent prisoners in treatment show parallel patterns of change in explicit and implicit
cognition?
The successful assessment and treatment of violent criminals gives a central role to the
offender cognition, both as a treatment target and as an indicator of ongoing criminal risk.
However, most research uses only explicit attitudinal self-report measures which may not be the
best indices of treatment progress. This paper presents analyses of self-report questionnaire
data and implicit association tests containing violence-related concepts before and after
treatment, and compares results with dynamic measures of criminal risk and progress in
treatment.
Implicit associations with violence, and treatment attendance in violent and non-violent
offender
If implicit association measures are valid indicators of a form of cognition associated with
violence risk, then IAT performance should differ between violent offenders undertaking
treatment , untreated violent offenders, and lower risk offenders in prison for non-violent
offences. This study addresses this question by comparing IAT data across treated and
untreated offenders, both before and after intensive cognitive-behavioural treatment.
El Sindrome del 'Burnout' en Grupos de Choferes de Servicio Pblico, Privado y
Particulares de Lima Metropolitana
Carlos Ponce.
Psicologia, UNMSM, Lima, Peru.
Abstract Central: El presente estudio de tipo descriptivo comparativo est orientado a
diagnosticar la presencia del sndrome del Burnout, a nivel intergrupos e intragrupos, en una
muestra de 898 choferes varones que conducen vehculos de servicio pblico, privado y
particulares, en Lima Metropolitana. El instrumento utilizado ha sido el Inventario Burnout de
Maslach y Jackson (MBI), compuesto por 22 temes que miden: cansancio emocional,
despersonalizacin, y realizacin personal. Entre las conclusiones ms importantes tenemos
que aproximadamente el 40% de conductores examinados se encuentra en la fase aguda del
Burnout; que los choferes de servicio pblico revelan, no slo, mayor cansancio emocional que
los particulares, sino una elevada despersonalizacin en contraste con los de servicio privado.
Asimismo, los mototaxistas, los microbuseros, y los choferes de mnibus urbanos, presentan
un mayor cansancio emocional; una elevada despersonalizacin; y, una baja realizacin
personal en relacin a los otros tipos de conductores. Palabras claves: Sndrome de Burnout,
estrs laboral, trfico y seguridad vial, validez, confiabilidad, choferes de servicio pblico,
privado, y particulares.

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Razonamiento Inductivo en Nios/as con Parlisis Cerebral: Respuesta Motora y


Aspectos Perceptuales como Efectos de Interferencia en el Test de Matrices Progresivas
de Raven
Claudia Prez-Salas.
Universidad de Concepcin, Chile, Concepcin, Chile.
Abstract Central: La Parlisis Cerebral (PC) incluye una serie de trastornos del movimiento y
de la postura corporal que afectan la actividad de la persona que la posee. El trastorno motor
severo, frecuentemente, se presenta junto a otras alteraciones, como impedimentos visoperceptuales y del habla. Debido a la dificultad de evaluar a personas que no hablan ni
controlan el movimiento, muy pocas investigaciones han analizado su funcionamiento cognitivo,
no existiendo informacin concluyente respecto a su rendimiento en tareas de esta ndole.
Adems, las escasas investigaciones que incluyen a este tipo de poblacin utilizan pruebas
convencionales y no analizan la necesidad de acomodarlas para evaluar de manera precisa las
habilidades cognitivas en este grupo. El objetivo general de esta investigacin fue evaluar el
razonamiento inductivo de nios/as y jvenes con PC severa mediante el test de Raven y
dispositivos de acceso adaptado al computador para luego analizar el efecto que aspectos
perceptuales y contextuales presentes en dicha prueba tienen sobre el rendimiento de estos
menores. La investigacin, de tipo experimental, analiz el efecto de las acomodaciones
realizadas a la prueba de Raven para la evaluacin de los participantes con PC en
comparacin a los participantes sin discapacidades. Participaron un total de 6 nios con
trastorno motor severo entre 8 y 14 aos (M= 12; DE= 2,76), la mayora con PC tetraparsica y
ausencia de habla y 9 nios/as y jvenes sin ningn tipo de discapacidad, entre 8 y 12 aos de
edad (M = 10,22; DE = 1,3). Dos sets se tems fueron usados en este estudio. El set estndar
consisti en las primeras 10 matrices de la serie E de las Matrices Progresivas de Raven y el
set contextual, correspondi a 10 tems anlogos a los anteriores en cuanto a reglas lgicas
subyacentes, pero situados en un contexto familiar (e.g. personas realizando alguna accin).
Los resultados indicaron que los nios/as y jvenes con PC son capaces de desempearse
significativamente mejor ante temes de razonamiento inductivo acomodados en comparacin a
los estndares, dando cuenta de un mejor nivel cognitivo que el detectado mediante pruebas
estandarizadas. El efecto de las acomodaciones slo fue significativo para los participantes con
PC, pero no para los participantes sin discapacidades. Se concluye respecto a la necesidad de
realizar una evaluacin acomodada en personas con trastorno motor severo para evaluar su
potencial de rendimiento.
Construccin de la Escala Optimismo-Pesimismo en Enfermos Crnicos
Jorge Rosas Medina.
Universidad Nacional Autnoma de Mxico, Mxico D.F., Mexico.
La Psicologa Positiva ha generado importante evidencia cientfica sobre los recursos
psicolgicos que favorecen un estado de salud fsica y mental, entre ellos el optimismo.
Abramson, Seligman & Teasdale, en 1978, conceptualizan al optimismo a partir de un estilo
explicativo, es decir, la explicacin del motivo y la falta de control sobre nuestros fracasos.
Existe dos estilos explicativos: optimismo y pesimismo, el primero de ellos se caracteriza por
utilizar dimensiones de externalidad, temporal y especificidad, mientras el segundo utiliza las
dimensiones de internalidad, permanente y globalidad. Adicional a la definicin conceptual de
un constructo, es importante obtener formas exactas de medicin, incluyendo el desarrollo de
instrumentos, as Scheier y Carver, en 1985 el Life Orientation Test, con consistencia interna de
0.75. Por su parte, Reivich (1995) desarroll el Cuestionario del Estilo Atributivo, el cual reporta
un 0.73 de confiabilidad. Sin embargo, en frecuentes ocasiones, la adaptacin de dichos

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instrumentos no corresponden a la cultura y caractersticas de otra poblacin o sectores


especficos de esta, la cual tambin requiere ser evaluada y atendida de forma adecuada. Por
ello, el objetivo del presente estudio fue elaborar y validar un cuestionario en escala tipo Likert,
para medir optimismo-pesimismo, basado en perspectiva de los estilos explicativos.
Participaron 180 pacientes con enfermedad crnica degenerativa, 59.4% mujeres y 40.6%
hombres, con un promedio de edad de 46.85 aos, 67% con educacin bsica, los cuales
fueron atendidos de un hospital de alta especialidad de la Ciudad de Mxico. El instrumento se
elabor en tres fases: I. Construccin, comprendi por un lado, un plan de prueba que incluy
las dimensiones y reas de incidencia; y por otro, la obtencin de reactivos con la tcnica de
redes semnticas naturales modificadas (Reyes-Lagunes, 1993) para que el instrumento fuera
relevante culturalmente, contrabalanceados por dimensin/rea, y enlistados en el cuestionario
al azar para evitar sesgos. En la fase II. Validacin del instrumento, se llevaron a cabo los
siguientes pasos: 1. Constatar si la cantidad de opciones de respuesta era adecuada, 2.
Comprobar que el sesgo de la distribucin de cada variable fuera el esperado; 3. Verificar que
cada variable tuviera capacidad de discriminacin, entre quienes haban puntuado alto y bajo,
para verificar esto se aplic la prueba t de Student para muestras independientes; 4. Evaluar la
congruencia en la direccionalidad de los reactivos; 5. Calcular la confiabilidad de la escala
mediante el alfa de Cronbach; 6. Efectuar un anlisis factorial, obteniendo los factores e
indicadores de la escala; y 7. Calcular la confiabilidad final para la escala, factores e
indicadores. En la fase III. Presentacin del cuestionario, conformado por 13 reactivos, dividido
en dos factores y dos indicadores (Factor 1. Atribucin pesimista al tratamiento, Factor 2.
Atribucin pesimista a la enfermedad, Indicador 1. Atribucin optimista general e Indicador 2.
Atribucin optimista al tratamiento) con confiabilidad interna de 0.74, la cual es muy similar a la
obtenida en otros instrumentos, por ejemplo Scheier y Carver, en 1985 y Reivich, en 1995. Al
trmino de este estudio se concluy que ste es un instrumento breve, con congruencia terica
y conceptual, ajustado a las caractersticas de la poblacin; que permite identificar variables
cognitivas susceptibles de intervencin y puede ser aplicado por todo el personal de salud.
Dado que el presente trabajo es un estudio exploratorio, se recomienda continuar mejorando
las caractersticas psicomtricas del instrumento.
Assessing Event-Specific Repetitive Thought: A Subtype-Level, Transdiagnostic
Measure
Suraj Samtani, Michelle Moulds.
The University of New South Wales, Sydney, NSW, Australia.
The construct of Repetitive Thought has come about recently in the literature as rumination,
worry, and similar constructs have been grouped under this broader umbrella term (Watkins,
2008). Examining repetitive thinking in a transdiagnostic manner allows us to examine the
causes and consequences of this cognitive process beyond the boundaries of major depression
and the anxiety disorders (e.g., in eating disorders, Axis II disorders). Current models of
Repetitive Thought divide the construct into two subtypes: an analytical (maladaptive) subtype
and an experiential (relatively adaptive) subtype. Existing scales of Repetitive Thought only
assess the analytical subtype, and also confound repetitive thinking with symptoms of various
disorders. This project is aimed at creating a self-report measure (the RTS) that is
transdiagnostic, assesses both subtypes, and is content valid. Two parallel versions of this
scale have been developed: a trait- and a state-version. The state-version has been developed
given the potential clinical utility of a scale that assesses repetitive thinking in relation to a past
or upcoming traumatic or stressful event. Exploratory Factor Analyses (N = 595) of the stateversion revealed that a seven-factor solution resulted in a model with good fit. The seven
subscales extracted were: Analysing Behaviour, Experiencing Emotions, Experiential Vivid

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Recall; Experiential Reliving; Experiencing Physical Sensations; Analysing Implications; and


Analysing Causes. A confirmatory factor analysis (N = 410) revealed that the subscales could
be grouped under higher-order Analytical and Experiential Repetitive Thought factors. Thus, the
scale measures the two subtypes suggested by the literature
Can We Differentiate ADHD from Normal Children Based on the Theta/Beta Pattern?
Mateu Servera1, 2, Pascal Aggeinsteiner1, 2, Jacobo Picardo1, 2, Victoria Meisel1, 2, Gloria GarcaBanda1, 2.
1. University of Balearic Islands, Palma, Spain, 2. Institute of Health Sciences Research
(IUNICS), Palma, Spain.
Attention deficit-hyperactivity disorder (ADHD) is one of the most common child psychiatric
disorders. The ADHD diagnosis is essentially clinical. However many procedures are used
(interviews, parent and teacher scales, neuropsychological tests, etc.). Recently, interest has
focused on quantitative EEG, although the results are controversial. One of the simplest
procedures for evaluating the electrical activity of the brain comes from Neurofeedback (NFB)
treatment protocols. These protocols can be used not only for the intervention but also for
evaluation. Our aim is to analyze whether the NFB protocol based on the Theta/Beta ratio is
useful in differentiating ADHD (or related problems) from normal children. The Theta/Beta ratio
was evaluated in a sample of 29 clinical children (ADHD or related disorders) and a normal
sample of 98 children (from 8 to 11 years old) using four different tasks according to Lubar et
alia classical protocol (1995). As was hypothesized, the ADHD sample showed a global
Theta/Beta ratio significantly higher than the normal sample (2.91 vs 2.47), without controlling
the age factor. The differences between the two samples were statistically significant in all
tasks. We also observe an overall effect of maturation on Theta/Beta ratio. As expected, as age
increases the ratio decreases in the normal sample. The significant difference was among the
group of children 8 years and the other groups. However, this difference is not attributable
equally to Theta and Beta waves. While Theta wave, as expected, decreased significantly with
age, Beta was quite stable and did not increase as expected. Similarly, the differences observed
between the clinical and normal samples on Theta/Beta ratio must primarily be attributed to the
higher power of the Theta wave, since the Beta power is quite similar between the two groups.
In conclusion, the results of our work are in the same direction of previous work and highlights
the trend that children with ADHD or related problems may present a Theta/Beta pattern
different from normal children. However, we must bear in mind that the age factor seems to play
a major role, that Theta dysfunction appears to be superior to Beta, and that although the
differences are statistically significant effect size may be limited.
Can the Sluggish Cognitive Tempo influence the assessment of Attention Deficit
Hyperactivity Disorder?
Mateu Servera, Maria Bernad, Victoria Meisel, Gloria Grases, Gloria Garca-Banda.
Psychology, University of Balearic Islands, Palma, Spain.
The term Sluggish Cognitive Tempo (SCT) refers to a controversial psychological and
psychopathological dimension that describes a state of irregular and underaroused orientation
and poor alertness to the context. SCT children seem "drowsy", "apathetic", "confused",
"unmotivated", and with tendency to "daydream". The SCT has always been associated with
ADHD, sometimes as a distinct subtype and sometimes likened to predominantly inattentive
subtype. But controversy persists whether the SCT may be a clinical entity or not. The aim of
this paper is to analyze whether the measure of SCT in the context of a general

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psychopathological assessment of children with suspected ADHD may influence the diagnosis
of the disorder. Participants in the study were 76 children referred to a clinical unit for being
suspected of having ADHD or related problems. Among other measures, all children were
assessed with the parent version of CBCL. From this scale was obtained the SCT score (sum of
items 13, 17, 80 and 102) and T-scores of Withdrawn/Depression (W/D), Anxiety/Depression
(A/D), Somatic Complaints (SC), Social Problems (SP), Thought Problems (TP), Attention
Problems (AP), Antisocial Behavior (AB), and aggressiveness (A). It is important to note that
three of the SCT items also belong to AP. From previous studies it was hypothesized that the
SCT would present higher correlations with W/D and A/D (beside obviously AP scale) and lower
with AB and A. The pattern of correlations supported our predictions largely: The highest
correlations were with W/D (.55), SC (.51), and A/D (.47) and the lowest with A (.18) and AB
(.02). Subsequently, the sample was divided into two groups based on the SCT score: those
subjects which fell one standard deviation above the mean (high SCT, n = 11) and the rest (Low
SCT, n = 65). T-test comparisons were statistically significant on all scales except AB and A.
The effect size in those scales that showed significant differences was always greater than 1
(large) and in this order: W/D, SP, AP, SC, A/D, and TP. In conclusion, the SCT dimension may
affect the ADHD because subjects with high scores tend to have more problems with social
withdrawal, anxiety and depression than typical behavioral problems associated with ADHD
children. This work has been supported by a research grant from the Spanish Government
(PSI2011-23254)
Reliability and Validity of an Sluggish Cognitive Tempo Measure for Parents: Preliminary
Results from an Spanish Sample
Mateu Servera1, George Burns2, Victoria Meisel1, Jesus Carrillo3, Susana Collado4, Maria
Bernad1.
1. Psychology, University of Balearic Islands, Palma, Spain, 2. Washington State University,
Pullman, WA, USA, 3. Universidad Complutense de Madrid, Madrid, Spain, 4. Universidad Rey
Juan Carlos, Madrid, Spain.
The question about the different subtypes of Attention Deficit and Hyperactivity Disorder
(ADHD) have been controversial for some time. In particular it has been argued about the
subtype "inattentive" (ADHD-IN). Some authors suggest that ADHD is a unique disorder and
that inattention, impulsivity and hyperactivity problems are highly related. Other authors defend
an inattentive subtype versus a combined subtype, although they believe that both share the
same attentional problems. Finally, others have argued for the existence of the Sluggish
Cognitive Tempo (SCT) dimension to identify a type of child-related ADHD IN but with different
characteristics. The aim of this paper is to analyze a SCT measure versus ADHD-IN scale
based on the DSM-IV. Specifically, it aims to provide data on the reliability and validity of the
SCT measure for mothers and father. A sample of Spanish children 6 years old was assessed
both by mothers (n = 723) as parents (n = 603) on a SCT measure and other measures:
inattention (ADHD-IN) and hyperactivity/impulsivity (ADHD-HI) scales based on DSM-IV; two
ODD scales (ODD-P, peers-, and ODD-A, adults-); an anxiety/depression scale (A/D); and
Academic and Social Impairment measures. The SCT measure consisted of 10 items adapted
from Penny et al. (2009) scale. This measure was adequately translated into Spanish. The
results indicate that the SCT reliability was acceptable (reliability coefficients for parents and
mothers were about .81, inter-rater reliability .71 and test-retest reliability for fathers and
mothers was about .73). Factor analysis showed that five from 10 items loaded properly on SCT
factor and differed from the ADHD-IN factor. The pattern of correlations supported our
predictions: SCT showed a weaker relationship with ADH-HI and the two ODD variables than
ADHD-IN. On the other hand, SCT was equally correlated with Academic and Social Impairment

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and A/D, as ADHD-IN. We believe that these preliminary results are positive and support the
idea of further work to develop a measure for assess the SCT dimension with items other than
those currently used to assess ADHD-IN. This work has been supported by a research grant
from the Spanish Government (PSI2011-23254)
Momentos de Mudana e Tcnica Psicoterpica em Terapia Cognitivo-Comportamental e
Psicanlise
Fernanda Souza, Paula Cassel, Paula Campezatto, Maria Lucia Tiellet, Margareth Oliveira.
Pontficia Universidade Catlica do Rio Grande do Sul, Porto Alegre, Brazil.
Para pesquisas de processo psicoteraputico, o objetivo essencial compreender como as
mudanas ocorrem ao longo do tratamento, buscando identificar os mecanismos de ao
teraputica. Para isso, mtodos quantitativos e qualitativos podem ser utilizados para analisar
padres de interao e comunicao entre a dupla terapeuta e paciente no decorrer de
sesses de psicoterapia, de modo a relacionar esses padres de interao e de conversao
associados mudana clnica. Nesse sentido, a aliana teraputica, a estrutura da situao
teraputica, a funo do terapeuta, a forma de interao entre a dupla teraputica nas sesses,
a forma em que se organiza e se transmite os contedos teraputicos e a capacidade do
paciente em se ajudar so fatores considerados como comuns a todas as psicoterapias,
denominados fatores inespecficos. Tais fatores se constituem em elementos fundamentais na
explicao dos resultados da psicoterapia. J os elementos especficos das psicoterapias so
aqueles de carter tcnico, isto , so os que distinguem especficos tipos de psicoterapia.
Estudos tm demonstrado que os elementos inespecficos so preditores de resultados
psicoteraputicos em diferentes tipos de psicoterapias, contudo no h produo cientfica
satisfatria para elucidar de que forma estes fatores colaboram na mudana em psicoterapia.
Posto isto, apresentaremos a anlise do processo de duas sesses de psicoterapia, a saber,
uma de Terapia Cognitivo-Comportamental e outra de Psicoterapia Psicanaltica, as
abordagens tericas mais utilizadas no Brasil e em muitos outros pases. Nosso objetivo foi
verificar como a mudana ocorreu em cada processo e de que forma o psicoterapeuta
desenvolveu seu papel, tendo em vista que cada teoria possui diferentes tcnicas de
interveno. Para tanto, utilizamos o instrumento denominado Therapeutic Cycles Model (TCM,
Modelo dos Ciclos Teraputicos), o qual identifica momentos de mudana em psicoterapia
atravs da anlise de textos pelo computador. O TCM aplicado a transcries de sesses de
psicoterapia, independente de linha terica, permitindo identificar momentos-chave do processo
psicoteraputico (ciclos teraputicos). Um momento-chave contm a idia de progresso
teraputico e identificado atravs da presena de marcadores verbais de emoes e de
processos de pensamentos. A anlise das sesses demonstra que o terapeuta da TCC
apresenta postura mais ativa previamente e no decorrer dos ciclos apresentados, sugerindo e
motivando o paciente. J o terapeuta psicanaltico realizou intervenes de discriminao e
clarificao, fazendo-o de forma mais breve e pontual. Embora sejam distintas, ambos os tipos
de tcnicas utilizadas pelos terapeutas apresentaram resultados positivos (facilitao de
momentos de mudana). Assim, entende-se que a teoria e a tcnica utilizada no so
determinantes para a ocorrncia de mudana, sugerindo que os fatores inespecficos, como a
aliana teraputica, possuem papel decisivo no progresso psicoteraputico.
A Importncia Da Avaliao Psicolgica Em Pacientes Com Leso Medular Traumtica
Julia Tavares, Leopoldo Barbosa.
NAAP - Ncleo de Avaliao e Acompanhamento Psicolgico, Campina Grande - PB, Brazil.

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A Leso Medular (LM) uma condio com significativas manifestaes clnicas incapacitantes
e permanentes geradas por insuficincia parcial ou total do funcionamento da medula espinhal,
decorrente de uma leso que afeta a integridade anatmica deste rgo (Fechio, Pacheco,
Kaihami e Alves, 2009). A leso medular traz inmeras limitaes para a pessoa, no mbito
familiar e em suas relaes amistosas. A mudana sbita de uma vida ativa, independente,
para uma dependente, provoca custos emocionais e cria a necessidade de um novo estilo de
vida. Entende-se que as consequncias de uma leso medular no se limitam esfera motora,
assim a pesquisa visa investigar aspectos ligados a vulnerabilidade, desajustamento
psicossocial, ansiedade e depresso em pacientes ps leso medular traumtica. Seus efeitos
estendem-se praticamente a todas as funes vitais do indivduo, assim, estudos de avaliao
psicolgica utilizando instrumentos e protocolos especficos podem ser significativos no
rastreamento dessas implicaes. Nesse sentido, a experincia emocional desempenha um
papel adaptativo aos elementos do funcionamento humano, assim tanto o organismo biolgico
como as emoes podem ser considerada importante no impacto desses eventos. Isso implica
dizer que, a emoo tem uma funo imprescindvel nos processos esquemticos e
concepes de nvel superior, para sentir, pensar e atuar de forma integrada.
Translation and Psychometrics Properties of the Cognitive Triad Inventory in a Brazilian
Sample
Maycoln Teodoro.
Psychology, UFMG, Belo Horizonte, MG, Brazil.
The Cognitive Triad Inventory (CTI) is used to identify cognitions in the three areas proposed by
Beck (self, world and future), which are the three major standards that guide the individual to
consider their experiences in a particular way. The evaluation of cognitive triad can be done in
several ways, including psychometrics scales. The aim of this study was to investigate the factor
structure of the Portuguese version of the Cognitive Triad Inventory in a Brazilian sample. The
study included 404 adolescents and adults, 280 women (69.3%) and 123 men (30.4%). Age
ranged from 17 to 50 years (mean = 25.14, SD = 8.53 years). Participants completed the CTI, a
seven-point-Likert scale (ranging from strongly agree to strongly disagree) composed of 36
questions that represent the three dimensions of the Becks cognitive triad. Original version of
CTI was translated in to Portuguese by three experts in cognitive therapy. Subsequently, a
committee analyzed each item and did the first Portuguese version. This version was translated
in to English and compared with the original by a professional. Data were analyzed using
confirmatory factor analysis (LISREL 8.8). According to previous studies, solutions were tested
with three (according to the theory Beck), five and six factors (according statistical data).
Results showed that the model with six factors had the best solution (X2 = 922.67; GL = 390;
X2/GL = 2.36). The fit indices were satisfactory and evaluated by the Root Mean Square Error
of approximation (0.05), Goodness of Fit Index (0.87), Comparative Fit Index (0.94) and
Adjusted Goodness of Fit Index (0, 84). Compared with the other models, the six-factors model
showed the lowest Akaike Information Criterion (1072.67). Internal consistence analysis showed
Cronbachs alpha of 0.66 for the positive view of self, 0.75 for negative self, 0.64 for positive
world, 0.61 for negative world, 0.68 for positive future, 64 for negative future. Psychometrics
properties of Portuguese version of CTI showed a six-factors model, which items were divided
in functional and dysfunctional beliefs. These results show that functional beliefs belong to a
specific factor and should be interpreted separately from dysfunctional beliefs. New studies
which investigated CTI in clinical groups are needed.

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Adaptation and Validation of the Leiden Index of Depression Sensitivity Scale-Revised


with Spanish-speaking Puerto Rican Adolescents
Giovanni Tirado-Santiago, Nicole Ryan-Nolla, ngel Nuez-Mndez, Cybelle Lpez-Valentn,
Coral Rosado-Santiago, Lydia Rodrguez-Corcelles.
University of Puerto Rico, San Juan, USA.
Background: Major depression is characterized by a systematic cognitive bias toward negative
information. In non-clinical populations, detection of a difficulty in supressing maladaptive
cognitions might help to identify individuals at risk for depression. Cognitive reactivity, a
measure of the degree to which maladaptive cognitions promote mild changes in mood (Van der
Does, 2005), is considered a vulnerability factor for depression. This process may well begin
during middle childhood and early adolescence, when abstract thinking as well as cognitive
systems for control and inhibition start to stabilize. Maladaptive cognitions in youth at risk might
affect the stabilization of cognitive inhibition and increase cognitive reactivity. A measure of
cognitive reactivity thus may indicate a vulnerability to depression. Objective: To adapt and
validate the Leiden Index of Depression Sensitivity-Revised (LEIDS-R; Van der Does &
Williams, 2003), which measures cognitive reactivity to negative information, in a population of
Spanish-speaking Puerto Rican adolescents (13-17 years-old). Since the LEIDS-R was
developed with adults, we adapted the language of the scale for an adolescent population.
Method: The LEIDS-R consists of six subscales with a total of 34 items that measure potential
changes in thought processes that occur during sad mood. Before rating items, participants are
asked to take a moment and think about the last time on which they felt somewhat sad using a
0-10 scale (0=not at all sad; 10=extremely sad; 3 to 4=somewhat sad). After this, using a 0-4
scale, participants rate how much they agree with items. Each item states what they might think
whenever they are in a sad mood. After the Spanish version of the LEIDS-R was revised and
adapted by a panel of experts, we administered the scale and conducted focus groups with a
sample of 33 adolescents. The language of the scale was then modified and administered to
252 adolescents (mean age 14.84, SD=1.26) in schools of the San Juan Metropolitan Area.
Results: The scale showed strong internal consistency, with a Cronbachs of 0.89. The mean
total score of the sample was 93.83 (SD=20.37). Exploratory factor analysis with Varimax
rotation showed six factors that explained 52.7% of the scale items variance: aggression
(AGG,10 items; factor loading: .46-.69), hopelessness/suicidality (HOP, 4 items; factor loading:
.59-.79), acceptance/coping (ACC, 5 items; factor loading: .45-.65), control/perfectionism (CP, 5
items; factor loading: .51-.69), risk aversion (RAV, 5 items; factor loading: .42-.68), and
rumination (RUM, 5 items; factor loading: .40-.60). All LEIDS-R subscales showed moderate to
very strong internal reliability with the whole scale: ACC (r=.54, p<.001), CP (r=.68, p<.001),
HOP (r=.73, p<.001), RAV (r=.75, p<.001), AGG (r=.77, p<.001), and RUM (r=.82, p<.001).
Conclusion: Detection of cognitive reactivity to sad mood in adolescents may contribute to the
early identification of individuals vulnerable to depression. Because the LEIDS-R is a self-report
measure that can be administered quickly by minimally trained personnel in a school setting, it
may be a valuable tool for the early detection of risk factors for depression.
Development of a Specific Questionnaire for the Assessment of Dysfunctional Behavioral
Strategies in Adults with ADHD: Rationale, Item Generation, and Content Validity Process
Fernando Torrente1, 2, Pablo Lpez1, 2, Dolores Alvarez Prado1, 2, Andrea Viggiano1, 2, Rafael
Kichic1, 2, Alicia Lischinsky1, 2.
1. INECO (Institute of Cognitive Neurology), Buenos Aires, Argentina, 2. Institute of
Neurosciences, Favaloro University, Buenos Aires, Argentina.

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CBT model assumes that the clinical course of ADHD in adulthood worsens with the
development of negative cognitions about the self and with the adoption of dysfunctional
compensatory behavioral strategies. Avoidance behaviors, such as procrastination, continuous
task-shifting, or focusing on low-priority tasks, are some of the common dysfunctional strategies
reported in clinical accounts of adults with ADHD, when they are faced with difficult tasks or
when they are overwhelmed in their processing capacity. In a recent study (Torrente et al.,
J.Atten Disord, 2012) we tested empirically the different theoretical components of the CBT
model for adults with ADHD. Regarding the behavioral component of the model, participants
with ADHD presented elevated scores in avoidant coping strategies. However, obtained
dysfunctional strategies appeared to be restricted in their nature and diversity, in comparison
with clinical observations, and relatively isolated from cognitive and emotional components of
the model. These results could be attributed to the lack of an instrument for the assessment of
disease-specific strategies acquired by people with ADHD for coping with difficulties related with
the disorder. Hence, in this poster we will describe the initial phases of the development process
of an ADHD-specific measure of maladaptive behavioral strategies. Firstly, we will outline the
rationale for the development of this instrument, together with its assumed theoretical structure.
Secondly, we will portray the item generation process, involving qualitative data gathered from
patients and experts. Thirdly, we will show results from content validity evaluation made by
experts. Finally, examples extracted from the pool of items generated for the questionnaire will
be presented.
Relao Entre Resilincia e Depresso em Adolescentes Brasileiros
Sara Ucha, Estefnea lida da Silva Gusmo, Mayara Fernandes Alves Silva, Kren Maria
Rodrigues da Costa, Laurentino Gonalo Ferreira, Gabriela Queiroz Galvo.
UFPI, Parnaba, Brazil.
A resilincia um tema recentemente incorporado rea da sade, estando em fase de
construo, debate e discusso, especialmente por ainda no existir um consenso em relao
definio do termo. Grotberg (2005) define resilincia como sendo a capacidade humana
para enfrentar, vencer e ser fortalecido ou transformado por experincias de adversidade. Com
o contemporneo movimento pela promoo de sade, a resilincia torna-se importante na
rea de conhecimento humano, sobretudo no campo da infncia e adolescncia, devido ao
crescente aumento das responsabilidades sociais e familiares, alm de acentuadas mudanas
biolgicas e hormonais que proporcionam muitas vezes dvidas, inquietao e mudanas de
comportamento em relao aos pares sociais (amigos) e famlia. O construto emerge como
importante na promoo e preveno da depresso. Portanto, o objetivo desta pesquisa foi
verificar a correlao entre os construtos resilincia e depresso em adolescentes. Para tanto,
contou-se com uma amostra acidental estratificada composta por estudantes (n = 150), sendo
60 de escolas pblicas e 90 de escolas particulares de Parnaba-PI-Brasil. A mesma foi
composta por adolescentes com uma mdia de idade de 16,2 anos (DP = 1,47; amplitude de
11 a 18). A maioria cursava o segundo (32,7%) e terceiro ano do ensino mdio (34,7%). Destes
51,3% era do sexo feminino. Foram utilizados dois instrumentos: Questionrio de Sade Geral
(QSG-12) (Pasquali, Gouveia, Andriola, Miranda & Ramos, 1994) e a Escala de Resilincia,
desenvolvida por Wagnild e Young (1993), assim como um questionrio com informaes
scio-demogrficas. Para a tabulao e anlise de dados utilizou-se o Pacote Estatstico para
as Cincias Sociais (SPSS) para Windows, verso 20.0. Quanto aos resultados verificou-se a
relao entre resilincia e depresso estatisticamente significativa e inversamente proporcional
depresso, como esperado (r = -0,51, p<0,01). Assim, os resultados apontam que pessoas
consideradas mais resilientes estaro menos predispostas a terem depresso. A correlao

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inversa dos resultados do presente estudo pode sinalizar para a importncia de uma mudana
na abordagem do adolescente, ou seja, o aumento da valorizao das qualidades do indivduo.
Correlao Entre Crenas Disfuncionais e Bem-Estar Subjetivo
Sara Ucha, Estefnea lida da Silva Gusmo, Roberta Ramona Portela de Mesquita, Hysla
Magalhes de Moura, Bruna da Silva Nascimento, Renan Pereira Monteiro, Elba Celestina do
Nascimento S.
UFPI, Parnaba, Brazil.
Sabe-se, atualmente, que a Terapia Cognitivo-Comportamental (TCC) vem sendo indicada no
tratamento para diversos transtornos mentais por ser um tratamento empiricamente validado
(Butler, Chapman, Forman, & Beck, 2006; Wright, Basco, & Thase, 2008). Este modelo
psicoterpico centra-se na cognio para tratamento dos problemas psicolgicos, porm
reconhece a importncia da interao recproca entre pensamentos, estados de humor e
reaes fsicas, bem como fatores advindos do ambiente (Greenberger, & Padesky,1999). No
que tange ao bem-estar subjetivo Giacomoni (2004) afirma que as perspectivas atuais
definem-no como uma ampla categoria de fenmenos que inclui as respostas emocionais das
pessoas, domnios de satisfao e os julgamentos globais de satisfao de vida. (p.43).
Segundo este autor, o bem-estar subjetivo pode sofrer a influncia de diversas variveis, como
cultura, gnero, idade e status socioeconmico, sendo que o aspecto cognitivo do bem-estar,
est diretamente ligado s crenas que se estabelecem com o mundo, com o futuro e consigo
mesmo. O presente estudo tem por pretenso verificar a relao estabelecida entre o as
crenas centrais e o bem-estar subjetivo. Para tanto, fez-se uso dos seguintes instrumentos:
questionrio scio-demogrfico, escala de bem-estar subjetivo (QSG-12) e a escala de crenas
irracionais (ECI). A anlise de dados foi realizada a partir do pacote estatstico SPSSWIN
(Statistical Package for the Social Science), em sua verso 20.0, onde se realizou a anlise rho
de Spearman. A amostra foi constituda por 48 participantes do Piau-Brasil. Os respondentes
apresentaram uma mdia de idade de 32,72 anos (dp = 10,371; amplitude de 19 - 64), sendo a
maioria do sexo feminino (53,3%) e solteiro (54,2%). A partir das anlises pde-se verificar que
as variveis crenas irracionais e sade geral apresentaram correlao estatisticamente
significativa entre si (rho de Spearman = 0,65, p < 0,01), demonstrando que o nvel de sade
geral/ bem-estar subjetivo do indivduo est relacionado com os tipos de crenas do mesmo
(racionais ou irracionais). Assim, destacam-se os estudos de Matta et al. (2009), ao relatar que
as crenas irracionais esto ensartadas na dimenso cognitiva do bem-estar subjetivo e,
portanto, podem influenci-lo determinando a percepo dos sujeitos. Desta forma, este
trabalho tem por pretenso colaborar na compreenso no mbito clnico, fomentando assim,
discusses acerca da temtica em questo.
Basic Processes/ Procesos Bsicos/ Processos bsicos
Importancia de los Niveles de Interaccin Social con las Personas en una Tarea de
Resolucin de Problemas: Comparacin de Perros de Refugio y de Familia
Gabriela Barrera1, 2, Yamila Giamal1, Jesica Fagnani1, Caterina Barison1, Luciana Crespi1,
Guillermo Ursini1, Juan Fernandez1, Alba Mustaca1, Mariana Bentosela1.
1. Grupo de Investigacin del Comportamiento en cnidos. IDIM- CONICET, Buenos Aires,
Argentina, 2. Facultad de Ciencias Veterinarias Universidad Nacional del Litoral, Santa Fe,
Argentina.

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El proceso de domesticacin, que lleva alrededor de 15000 aos, junto con la estrecha
convivencia cotidiana, han convertido a los perros domsticos en una especie privilegiada en el
vnculo con las personas. Diversas evidencias muestran que las situaciones de aislamiento o
baja interaccin social con la gente producen alteraciones en el comportamiento de los perros y
en sus habilidades comunicativas interespecficas. En el presente trabajo evaluamos a 13
perros que viven en un refugio canino con escasa interaccin cotidiana con personas y 13
perros que viven en casas de familia como mascotas, en una tarea de resolucin de problemas.
La tarea consista en aprender a remover nueve huesos de plstico que estaban encastrados
en un disco, para obtener el alimento que estaba all escondido. Se realizaron tres fases
consecutivas: adquisicin, extincin y readquisicin. Los resultados muestran que los perros de
familia interactan durante ms tiempo con el aparato que los de refugio en todas las fases,
mostrando una mayor persistencia de su respuesta. Este resultado es similar al observado
durante la extincin de una respuesta comunicativa. Por otro lado, los perros de refugio
presentan un mayor tiempo en contacto y una duracin mayor de la mirada hacia la persona
durante la extincin. Esto coincide con estudios previos que muestran que, en una prueba de
sociabilidad, los perros de refugio pasan ms tiempo cerca de la persona que los de familia. En
conclusin, estos resultados revelan diferencias en el aprendizaje de una tarea de resolucin
de problemas entre perros de refugio y de familia, poniendo en evidencia la importancia de los
niveles de interaccin social entre ambas especies.
Cognition Versus Contingencies: The Final Debate
Roberto Bueno.
Universidad Nacional Federico Villarreal, Lima, Peru.
Abstract Central: El conductismo forma parte de la visin filosfica fundamental de las
ciencias naturales que busca la explicacin de los eventos naturales en funcin de otros
eventos naturales. El concepto de lo cognitivo, sin embargo, regres a la psicologa por dos
caminos. Uno, el del cognitivismo, segn el cual lo mental forma parte de los eventos naturales
que pueden explicar la conducta. El otro camino fue el de la atencin que los propios
conductistas pusieron sobre la mediacin verbal de la conducta, ya sea en la investigacin
bsica o en la prctica clnica. Por tanto, en primer lugar, mientras el conductismo reduce la
explicacin psicolgica a factores ambientales y biolgicos especficos, el cognitivismo ampla
el modelo explicativo hacia entidades funcionales que colectivamente constituiran lo mental y
que ostentan como rasgo esencial su carcter genrico o abstracto, sin relacin con
desempeos especficos (i.e. esquemas, reglas, competencias, etc.) y, adems, en algunos
casos, basados en entidades ms abstractas de carcter innato o relativamente no modificable
por la experiencia. Por tanto, el debate actual entre conductismo y cognitivismo es el debate
acerca de si es posible o no explicar la conducta en funcin completamente de los factores
especficos ambientales o biolgicos que son materia de la investigacin conductista. Ciertos
estudios originados en la propia psicologa cognitiva apuntan hacia la posible inexistencia de
esquemas o reglas abstractas (aprendidas o innatas) que expliquen el desempeo en
determinadas tareas. Tales resultados parecen avalar la posicin conductista. En segundo
lugar, la mediacin lingstica de la conducta usualmente se interpreta como un caso de control
de la conducta por reglas abstractas expresadas verbalmente (aunque adquiridas), como
cuando se dice que el individuo responde al estmulo de acuerdo a como lo interpreta. Pero tal
esquema explicativo debe considerarse tan solamente un modo sencillo y no tcnico de
explicacin. La conducta mediada lingsticamente no es en realidad una forma de respuesta
mediada, y debe tratarse ms bien como una forma compleja de conducta, cualitativamente
distinta de la conducta que se considera no mediada lingsticamente (i. e. la conducta
operante animal).

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An Experimental Study on Nociceptive Perception in Men Complaining of Depression


Magna Cruz.
PSICOLOGIA, UNIVERSIDADE FEDERAL DE MINAS GERAIS, Belo Horizonte, Brazil.
This study has used Cold Pressor Test to evaluate experimental pain perception in depressed
patients. Patients imersed their right hand up to one third of their forearm in water at 3C with a
variation of one centigrade degree more or less. The participants were requested to inform the
experimenter about the moment of pain detection and to take off their hand when the stimulation
became unbearable. Both timings were registrated. McGill Pain Questionnaire was used to rate
painful experience while Mini International Neuropsychiatric Interview (M.I.N.I.) and Beck
Depression Inventory were used to rate the presence of depression. Results pointed out that
experimental groups rate Intensity of Present Pain (IPP) significantly lower then the healthy
groups. They also tolerate the nociceptive stimulation for a longer time. These data sugest that
disfunctional cognitive and emotional processing characteristic of depression influence
perception of pain in a distinct manner. Further studies about the relation between varied pain
perception and altered emotional processing in depression would be of great utility to the
understanding of the interaction between pain and emotion. Keywords: Experimental Pain,
Depression, Cold Pressor Test, McGill Pain Questionnaire, Beck Depression Inventory.
The Effects of Intrapersonal Differentiation and Interpersonal Integration on the
Construal of Relational Models
Ilker Dalgar1, Guler Alpaslan Dalgar2.
1. Psychology, Middle East Technical University, Ankara, Turkey, 2. Baskent University Faculty
of Medicine, Ankara, Turkey.
Abstract Central: This study aims to investigate how implementation rules for relationship
models differed with regard to self-orientation dimensions. Fiske (1992) proposed four distinct
elementary models for social relations that motivate, generate, organize, coordinate, and
evaluate almost all social relations: communal sharing, authority ranking, equality matching, and
market pricing. The self-orientations of the participants were categorized with regard to the
Balanced Integration and Differentiation model (Imamoglu, 1995) which proposed two selforientation dimensions: intrapersonal differentiation (individualization vs. normative patterning)
and interpersonal integration (relatedness vs. separateness). Past research associated the
changes in the implementation patterns of relational models and some personality disorders. It
was also asserted that the balance between intrapersonal differentiation and interpersonal
integration was linked to wellbeing outcomes. We hypothesized that the implementation
patterns of relational models would differ with regard to self-orientation dimensions. The
participants (N = 154) evaluated fifteen of their relationships on the Modes of Relationship
Questionnaire and they completed the Balanced Integration-Differentiation Scale. The
hypotheses were tested by conducting a 2 (intrapersonal differentiation) x 2 (interpersonal
integration) x 4 (relational models) mixed design ANOVA with repeated measures on the last
factor. There were significant interactions between intrapersonal differentiation and relational
models and between interpersonal integration and relational models. The pairwise comparisons
after Bonferoni correction indicated that normative patterning participants implemented authority
ranking rules to their relationships more than individualized participants. However, for both
normative patterning and individualized participants equality matching was the most
implemented model, which was followed by communal sharing, market pricing, and authority
ranking, respectively. Considering interpersonal integration - relational models interaction,

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pairwise comparisons revealed that when the participants highlighted relatedness, they
implemented communal sharing and equality matching more than separated participants.
Besides that, separated participants equally emphasized communal sharing and market pricing
rules in their relationships, whereas related participants implemented communal sharing more
than market pricing when interacting with others. The results were in the expected direction. The
social relationship patterns of participants differed depending on their self-orientations. The
implications of findings concerning optimal inter-personal interaction and well-being will be
discussed.
The Role of Laboratory-Generated Rumination in Cognitive Tasks
Nikolett Eisenbeck, Carmen Luciano Soriano, Juan Lpez, Adrin Barbero-Rubio.
Departamento de Psicologa, Universidad de Almera, Almera, Spain.
Abstract Central: In cognitive psychology, the rumination is understood as a maladaptive
response style. The individual repetitively and passively focuses on the symptoms of distress
and on its possible causes and consequences, without taking action (Nolen-Hoeksema, 1991).
Although the phenomena was first described in relation of the depression, years of correlational
and experimental analysis show that the rumination can be found in almost all psychological
disorders and can exacerbate and prolong any type of distress by numerous mechanisms
(Nolen-Hoeksema,Wisco & Lyubomirsky, 2008). Studies conducted with the laboratory
rumination manipulation (e.g. Nolen-Hoeksma & Morrow, 1993) show that it increases
significantly the dysphoric mood in dysphoric participants but not in nondysphoric subjects. The
aim of the present study is (1) to develop a general rumination induction protocol that is effective
in normal population and (2) to demonstrate its correlates with cognitive tasks and different
questionnaires. In order to analyze the effect of the rumination induction, 40 participants were
randomly assigned in two groups (Rumination and Control). First, all participants had to realize
various cognitive tasks (attention and memory). The tasks included aversive stimulation and
numerous distracters. Then, the Rumination group received a 15 minutes rumination induction
protocol, while the Control group did not receive any intervention. In the last phase, participants
of both groups repeated the same cognitive tasks. Results show that after receiving the
rumination induction protocol, subjects in the Rumination group had lower performance
compared to their previous performance and they also had poorer performance than the
participants of the Control group had. Results are discussed in terms of etiology of mental
disorders, maladaptive effects of rumination and possible methods of response style change in
therapy. In addition, an alternative, contextual-behavioral interpretation of data is presented.
Existential CBT: Back to the Future
Jacqueline Feather.
Psychology, AUT University, Auckland, New Zealand.
Abstract Central: Cognition comes from the Latin word cognoscere and is about meaning
making. CBT explicitly targets cognition as the key medium for change. At its inception, CBT
supplemented purely behavioural approaches. Beck cited existential-phenomenological thinkers
such as Heidegger, Husserl and Binswanger. However, these philosophical existential
influences appear to have been largely forgotten with the privileging of CBTs Modernist roots in
scientific empiricism and reason and logic. More recently CBT has seen a transformation from a
change-based approach to more acceptance-based approaches. These fit nicely under the
umbrella of CBT because they are also engaged with cognition, albeit in a different way: to
foster the ability to observe and let go unhelpful thinking. This paper argues for an expanding of

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CBTs engagement with cognition to embrace a third position: co-creation of meaning.


Essentially this involves a re-claiming and deepening of CBTs implicit existential roots. It has
emerged in response to clients bringing existential crises to CBT therapists-in-training in AUT
Universitys Counselling Psychology Clinic. Cases illustrating this newly developing model will
be presented.
Pueden los Perros Discriminar Reacciones Emocionales Humanas?
Esteban Freidin, Natalia Putrino, Maria D Orazio, Julia Helbling, Carolina Shimabukuro, Sandra
Tognetti, Alba Mustaca, Mariana Bentosela.
Grupo de Investigacin del Comportamiento en Cnidos. IDIM- CONICET, Buenos Aires,
Argentina.
Los perros domsticos ocupan un lugar privilegiado en las sociedades humanas, no slo
prestando diversos servicios como bsqueda y rescate o asistencia a discapacitados, sino
tambin como animal de compaa. En las ltimas dcadas se ha acumulado evidencia acerca
de las notables capacidades comunicativas que los perros despliegan en las interacciones con
las personas. Una parte esencial de la comunicacin es el poder discriminar ciertas claves
conductuales indicadoras de estados emocionales de los otros individuos. En el presente
trabajo se evaluaron 72 perros en su habilidad para discriminar una reaccin emocional positiva
(satisfaccin) en comparacin con una negativa (insatisfaccin) de una persona, producidas en
una situacin de interaccin social. Para ello un perro observaba una situacin en la que un
individuo que denominamos el pedigeo solicitaba comida a otras dos personas que
denominamos los dadores, tres veces a cada uno en forma semi-aleatoria. En un caso,
cuando uno de los dadores le daba la comida, el pedigeo deca <\#193>Que rico! y coma
mientras permaneca orientado hacia l. En cambio, cuando el otro dador le daba comida, el
pedigeo deca <\#193>Que feo!, volva a dejar la comida en el plato y se pona de espaldas
al mismo. Luego el pedigeo dejaba la sala y se dejaba suelto al perro para que eligiese a que
dador dirigirse para pedir comida. Se meda el dador al que el perro se acercaba por primera
vez. Los resultados indican que los perros presentaron una preferencia por el dador asociado a
la reaccin de satisfaccin del pedigeo, a pesar de que el comportamiento de ambos
dadores era el mismo y de que el pedigeo estaba ausente en el momento en que el perro
realizaba la eleccin. El segundo objetivo fue evaluar que claves eran las ms importantes para
realizar esta discriminacin. Para ello se evaluaron otros dos grupos de perros, en uno slo se
presentaba el componente gestual de la interaccin y en el otro, slo el componente verbal. Los
resultados muestran que en estos grupos los animales eligieron al azar entre los dadores. Sin
embargo, el 37,5% del total de los perros evaluados no realizaron ninguna conducta de
eleccin. En conclusin, estos hallazgos indicaran que los perros poseen procesos de
deteccin de emociones humanas, y utilizan esta informacin para tomar decisiones. Sin
embargo, parecen requerir de varias claves simultneas para desempearse adecuadamente
en la tarea.
Hot Thoughts and Hot Emotions: A Focus on Transference and Countertransference
Kenneth Fung1, 2, Diana Kljenak1, Kenneth Fung1, 2, Diana Kljenak1, Kenneth Fung1, 2, Ted Lo2.
1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada, 2. Hong Fook Mental
Health Association, Toronto, ON, Canada.
In any psychotherapy, powerful thoughts and feelings can be evoked both in the patient
regarding the therapist (transference) and in the therapist regarding the patient
(countertransference). These concepts are conventionally tied to psychodynamic

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psychotherapy, and yet, they can still be useful and relevant in most psychotherapies. In this
symposium, we will explore these reactions clinically from a CBT and an ACT perspective, as
well as how to address them in clinical supervision. Finally, we will also explore how
considerations of cultural issues can add another dimension towards understanding and
managing these phenomena.
A CBT Approach to Transference and Countertransference
Traditionally, the cognitive model and its standard therapeutic techniques and tools are heavily
emphasized as the essential therapeutic components in CBT. While certain aspects of the
therapeutic relationship are also described, such as the ideal of collaborative empiricism, there
has been relatively less attention focused on the automatic thoughts and emotions of the
therapist. This is in contrast to the importance accorded to the concepts of transference and
countertransference in psychodynamic psychotherapy. In this presentation, participants will
learn to reflect on, identify, and conceptualize transference and countertransference through the
CBT lens. De-centering and use of the CBT framework will be discussed as effective ways to
manage emotionally charged clinical situations that evoke strong countertransference, which
otherwise may lead to therapeutic impasse. This will be especially useful in dealing with
complex challenging cases and patients with personality disorders.
An ACT Approach to Transference and Countertransference
Acceptance and Commitment Therapy (ACT) is one of the third wave behavioral interventions
that are increasingly being applied to multiple clinical populations, including chronic mood and
anxiety disorders, pain disorders, and personality disorders. Its six core therapeutic processes
include: Acceptance, Defusion, Present Moment, Self-as-Context, Values, and Committed
Action. In furthering these therapeutic processes, a variety of techniques may be employed,
including the use of metaphors and experiential exercises. Sessions can become emotionally
charged, evoking strong internal emotions and thoughts in both the patient and the therapist.
This can occur in both individual sessions as well as group therapy. This presentation will
identify some of the common reactions that occur in ACT; formulate these processes from an
ACT perspective; and discuss ACT-consistent interventions to work with these thoughts and
feelings that arise in the course of therapy.
Addressing interpersonal processes in cognitive-behavioral therapy supervision
Introduction: Substantial empirical support for cognitive behavioral therapy (CBT) effectiveness
in the treatment of various psychiatric disorders has been demonstrated. Essential part of the
training in CBT is a clinical supervision. Adequate training in CBT results in improved therapist
competence and patient outcomes. Among essential CBT competences that need to be taught
are the ability to build and maintain therapeutic relationship as well as attending to interpersonal
processes (transference and countertransference). Unaddressed interpersonal processes will
likely present as obstacles to successful therapy and supervision. Teaching the trainee CBT
strategies to address countertransference is important in preventing poor outcomes in therapy
and supervision.
Objectives: At the end of the presentation participants will be able to describe techniques for
effectively addressing interpersonal processes in CBT supervision.
Methods: This case based presentation will illustrate strategies for addressing interpersonal
processes in CBT supervision.
Conclusions: Review of strategies of approaching interpersonal processes in CBT supervision
creates platform for reflection on the supervisory methods used by the participants and will
enhance their ability to provide effective CBT supervision.
Transference and Countertransference from a Cultural Competent Perspective

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To effective conduct psychotherapy cross-culturally, cultural issues must be taken into account.
Transference and countertransference often arise from cultural differences as well as
differences in power and social status, and yet, this is often neglected or ignored. In this
presentation, an essential cultural competent framework will be presented, as well as an
approach towards understanding these interpersonal reactions from a cultural perspective.
While this will be relevant in all types of psychotherapy, we will especially focus on CBT and
ACT consistent approaches towards dealing with these cultural issues.
Pavlov and Pain: A Systematic Review
Daniel Harvie1, Ann Meulders2, 1, Susan Hillier1, Grant Moseley1.
1. University of South Australia, Adelaide, SA, Australia, 2. University of Leuven, Belgium,
Belgium.
Abstract Central: Background: The role of classical conditioning in the origins of anxiety
disorders is well established. Several models of chronic pain (i.e. the fear-avoidance model)
also assign a significant role to classical conditioning in the development and maintenance of
chronic pain disability. During a painful episode, associations may be formed between neutral
stimuli (i.e. movements) and noxious stimuli emanating from the injury. By virtue of its
association with pain neutral stimuli may become conditioned to independently elicit responses
related to the threat of injury (i.e. fear, muscle guarding, and withdrawal). Learning theory further
suggests that such conditioned responses can be reduced by extinction-based treatments such
as exposure in vivo which may be optimized through understanding why some people develop
maladaptive responses. This systematic review investigates the hypothesis that learning deficits
exist in chronic pain populations that might underlie maladaptive conditioned responding.
Methods: A systematic literature review was undertaken in October 2012. Eight major
databases were searched using key words and MeSH headings synonymous with classical
conditioning AND pain. This was supplemented by a manual search of reference lists of key
articles. The final pool was screened for inclusion by two reviewers. Methodological and
experimental data were extracted relating to; 1. study and participant characteristics and 2.
study results of interest. Results: Three studies satisfied the inclusion criteria. A total of 61
chronic pain patients were compared to 57 controls. Conditions represented were spinal pain,
headache and fibromyalgia. All studies employed a differential conditioning paradigm using
noxious thermal/electrical unconditioned stimuli and visual or auditory conditioned stimuli.
Learning outcomes related to (1) muscular responses, (2) contingency awareness (3) anxiety
and (4) cardiac response. Meta-analysis was possible for muscular and cardiac conditioned
responding (two studies each). The combined data showed no overall change in conditioned
muscular response relative to a control stimulus in either group. Two studies reported deficits in
contingency learning in chronic pain groups which were less manifest in people with rheumatoid
arthritis relative to those with fibromyalgia. No groups showed significant cardiac conditioning.
Conclusion: Despite the assumed role of classical conditioning in the aetiology and of chronic
pain, there is a paucity of research investigating underlying learning deficits. Current evidence
questions the role of conditioned muscular responses in chronic pain, though the lack of
conditioning effects in other variables (i.e. heart rate) questions the validity of the conditioning
procedures. Two studies provided some support for the learning deficit hypothesis, showing
patient-control differences in contingency learning. Given that people with rheumatoid arthritis (a
painful conditioned not associated with psychopathology) showed significantly less impaired
contingency learning, it can be argued that deficits predate the onset of pain. The presence and
nature of learning deficits has importance for the development of cognitive-behavioural
treatments targeting maladaptive learning.

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Novedad y Memoria de la Frustracin


Nadia Justel1, Ricardo Pautassi2, Alba Mustaca1.
1. Laboratorio de Psicologia Experimental y Aplicada, IDIM, CONICET, UBA, Buenos Aires,
Argentina, 2. Instituto de Investigacin Mdica M. y M. Ferreyra (INIMEC) CONICET-UNC,
Cordoba, Argentina.
Abstract Central: Al exponer a los sujetos a una situacin novedosa, como la exploracin de
un campo abierto, previamente al entrenamiento o a la prueba de un determinado aprendizaje,
se modula el recuerdo del mismo. Por otro lado, la respuesta de los animales depende de su
experiencia previa con distintos valores de refuerzo. Una forma de estudiar este fenmeno es
mediante la devaluacin del incentivo. En el presente artculo se evala si la presentacin de
un estmulo novedoso afecta la devaluacin del incentivo. Para ello se expuso a ratas macho a
una solucin al 32% y luego la misma fue devaluada al 4%. Previo a ello los animales
exploraron un campo abierto. Se hall que la novedad interfiere con la memoria aversiva de la
devaluacin al ser presentada una hora antes del entrenamiento, alterando el desempeo de
los sujetos. Este efecto se da tanto si la huella de memoria apetitiva, o si la discrepancia entre
huella apetitiva y aversiva, es dbil como fuerte. Adems, se observa el mismo fenmeno tanto
con la exposicin nica como reiterada de la exploracin del campo. Se discuten los resultados
en base a los posibles mecanismos de accin involucrados. A nivel terico se busca
comprender los procesos neurobiolgicos implicados en la memoria emocional. Las
implicancias para la ciencia aplicada son aportar datos para lograr mejores intervenciones
hacia sujetos vulnerables a situaciones de prdida o de decepciones, tan frecuentes en la vida
diaria.
The Importance of the Present Moment in the Mindfulness
Shunya Karaki1, Hirohiko Chiba2, Yoshinori Ito1.
1. University of the Ryukyus, Okinawa, Japan, 2. Shukutoku University, Chiba, Japan.
The definition of Mindfulness includes paying attention to the present moment. This definition
suggests that mental health is brought by paying attention not to past and future but to the
present moment. In fact, most of mindfulness training do not mention the past and the future
event, but make much of repeating exercise which continues controlling attention at the present
(Segal et al., 2002). By contrast, the time perspective research has suggested that mental
health is brought by having the overall positive perspective of the past, the present, and the
future. Although both positions are discrepant apparently, how is the relationship of both in
practice? In this study, we aimed at investigating the relations between the two perspectives.
The hypothesis was as follows; 1) mindfulness was positive correlate with Self-fullness which
reflect the perspective of the present moment, 2) mindfulness was negative correlate with
Acceptance of past which reflect the perspective of the past, 3) mindfulness was negative
correlate with Goal-directedness and Hopefulness which reflect the perspective of the future. A
total of 299 healthy undergraduate students completed two measures. One of the measures
was the Refraining from Catastrophic Thinking Scale (Sugiura, Sugiura & Umaoka, 2008)
developed for measure distancing skill which is core component of mindfulness. And another
was the Experiential Time Perspective Scale (Shirai, 1994) which consists of four factors
including Acceptance of past, Self-fullness, Goal-directedness, and Hopefulness. Every factor
could reflect the level of positive perspective to each time perspective of the past, the present,
and the future. The results of some analysis did not support our hypotheses. However, the
results showed that weak positive correlation between distancing and each factors of
Experiential Time Perspective Scale. That is, regardless of time period, positive time
perspective was positively related to decentering skill. So the new possibility that people can

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more distance themselves from a negative feeling and thought when he can have more positive
time perspective or people can have more positive time perspective when he can more distance
themselves from a negative feeling and thought was suggested. Although focusing to the
present moment is emphasized in the mindfulness, it was not necessarily mean ignoring the
past and the future. These suggestions are significant because these connect mindfulness and
the time perspective research. Because there was not Japanese standardized measure that
could measure the whole component of mindfulness, We indirectly investigated the relationship
between mindfulness and the time perspective by use of the Refraining from Catastrophic
Thinking Scale that is used widely as a measure that reflect mindfulness in Japan. Future
research is necessary to investigate the relationship between mindfulness and the time
perspective by use of the standardized measure that can measure the whole component of
mindfulness.
La Influencia Moduladora de la Msica Sobre la Conducta Creativa
Rosa Lacasella.
Instituto de Psicologa, Universidad Central de Venezuela, Caracas, Venezuela.
Abstract Central: La creatividad ha sido estudiada como evento psicolgico desde mltiples
perspectivas. Se han explorado distintos eventos con los que puede estar asociada la conducta
creativa, encontrndose a la msica como uno de los factores de contexto que pueden
modularla. Esta investigacin tiene como objetivo primordial la evaluacin de los efectos
diferenciales de varios gneros o estilos musicales sobre el comportamiento creativo en la
actividad de collage realizada por nios en etapa escolar. Igualmente se estudiaron procesos
de generalizacin y transferencia de aprendizaje entre contextos y entre tareas. La muestra
estuvo conformada por 30 nios (17 nias y 13 nios), con edades comprendidas entre los 7 y
8 aos, cursantes todos del primer ao de educacin bsica. Se tomaron como indicadores de
las variables de respuesta factores asociados a la creatividad: Fluidez, Originalidad y
Elaboracin. La variable de contexto manejada fue la msica (Barroca y Rock). Se emple un
diseo cuasi-experimental de la forma grupo control-grupo experimental combinado con un
diseo intra-sujeto de la forma AB con medidas iniciales y finales. Los resultados ms
importantes se resumen de la siguiente manera: 1.- El uso del Reforzamiento DescriptivoSocial o del Reforzamiento Social sobre el factor Fluidez de la conducta creativa en la actividad
del collage realizada por nios en etapa escolar, no garantiza la modificacin del factor sobre el
cual fue aplicado. 2.- El entrenamiento en Fluidez no evidenci efectos de generalizacin sobre
otro factor no entrenado de la conducta creativa (Originalidad). Cabe destacar que en el Grupo
Msica Barroca y Reforzamiento Descriptivo-Social, se observa un efecto de generalizacin,
aun cuando la diferencia no es significativa desde el punto de vista estadstico. 3.- No se
observ transferencia del entrenamiento en Fluidez de un contexto entrenado (saln de clases
experimental) a un contexto no entrenado (saln de clases habitual). 4.- La transferencia de
aprendizaje de una tarea entrenada (collage) a una tarea no entrenada (tangram) fue ms
variable y no se puede establecer un efecto contundente. 5.- Se puede sealar con limitaciones
metodolgicas que la Msica tiene efectos facilitadores sobre la conducta creativa en la
elaboracin de collage, en especial si se refiere al gnero Msica Barroca.
Generalization of Conditioned (Fear) Responding: Effects of Autobiographical Memory
Specificity
Bert Lenaert, Bram Vervliet, Dirk Hermans.
Psychology, University of Leuven, Leuven, Belgium.

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Generalization of acquired responses appears to be a crucial, yet underinvestigated process in


emotional disorders. Generalization occurs when a conditioned response is elicited by a
stimulus different from the original conditioned stimulus. The expansion of complaints often
seen in emotional disorders is at least in part due to processes of generalization, for instance
when a fear response to a certain stimulus or situation involved in an aversive learning
experience generalizes to similar but different stimuli or situations. In the present study,
generalization is approached from a memory perspective. It is hypothesized that generalization
of conditioned responding is associated with autobiographical memory specificity. Higher levels
of generalization are predicted for people who are characterized by limited memory specificity. A
first proof of principle study showed that memory specificity was significantly associated with the
extent of generalization in a human contingency learning procedure. Participants low in
autobiographical memory specificity exhibited significantly stronger conditioned responses to
generalization stimuli as compared to participants high in autobiographical memory specificity.
Further, data of a human fear conditioning study will be presented. Again, higher levels of (fear)
generalization are predicted for people who are characterized by limited memory specificity.
Effectiveness of a Protocol Based on Perspective Taking on the Cognitive Tasks
Juan Lpez, Carmen Luciano Soriano, Nikolett Eisenbeck.
Psicologa, Universidad de Almera, Espaa, Almera, Spain.
In order to be able to distinguish the self from the thoughts, feelings and/or memories (from now
on: private events) and not simply regulate the behavior based on them, taking perspective is a
core element. The Acceptance and Commitment Therapy (ACT) promotes this type of
distancing through so called Defusion exercises. By the implementation of these exercises, the
individual acquires perspective taking and strengthens a sense of self called self as context
from where, independently from the content of the private events, can choose. According to the
recent literature, it is necessary to analyze the interactions which compose the Defusion
exercises for the purpose of determine which elements facilitate and ensure its efficacy. The
aim of the present study is to analyze different processes involved in the Defusion exercises
and the role of the perspective taking skills in the performance of cognitive tasks. For this, in the
first phase, 20 participants performed two cognitive tasks in the presence of visual and auditory
distracters. In the second phase, the participants received a protocol based on the condition to
which they were assigned. Participants of the Defusion Condition performed exercises in order
to acquire flexibility and fluency in perspective taking with their private events. Participants of
the Control Condition performed the same exercises as subjects who were assigned to the
Defusion Condition, but in a descontextualized way. Finally, in the third phase, both groups
performed the two cognitive exercises again. Among the results, the improvement in the
performance of the tasks is evaluated and the two different Defusion methods are compared.
Conclusions of the present study focus on the interactions involved in processes of Defusion
that ensure its efficacy reflected in an improved performance.
Constructing a Self Protected Against Shame: The Importance of Warmth and Safeness
Memories and Feelings on the Association between Shame Memories and Depression
Marcela Matos, Jos Pinto-Gouveia, Cristiana Duarte.
Cognitive and Behavioral Research Centre, University of Coimbra, Coimbra, Portugal.
Abstract Central: Introduction: Positive and negative affiliative experiences in early life have a
major impact on affect regulation and vulnerability to psychopathology. However, while shame
memories have been linked to psychopathology, the protective effects of affiliative experiences

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against/on this relationship were never explored. Objectives and Methodology: This study
examines two moderator models of early memories of warmth and safeness on the association
between shame memories and depressive symptoms. A mediator model of currents feelings of
social safeness on these linkages is further tested. Student participants (N=181) described a
early shame experience and completed a set of self-report measures assessing the centrality
and traumatic characteristics of the shame memory, early memories of warmth and safeness,
current social safeness and connectedness and depressive symptoms. Results: Path analyses
results showed that early memories of warmth and safeness moderated the relationship
between centrality of shame memory and depression, by attenuating its impact. No moderator
effect was found for the relation between shame traumatic memory and depression.
Furthermore, feelings of social safeness totally mediated the effect of early affiliative memories
on depression, and partially mediated the effect of centrality of shame memories on depression.
Conclusion: Affiliative relationships may engender the source of safeness and warmth that
buffers the effects of early shame experiences on negative affect. The quality of early
experiences may either fuel or damage ones ability to generate warmth and feel safe with
others, using them to soothe ones distress which, in turn, determines the vulnerability to
depressive symptoms. Clinical implications are discussed and limitations and directions for
future research presented. Keywords: Shame memory; Positive affiliative memories; Social
safeness; Depression; Path analysis; Moderator effect; Mediator effect
Novel Applications of Distress Tolerance: Development, Conceptualization, and
Treatment Implications
R. Kathryn McHugh1, 2, Stacey Daughters3, Stephanie Gorka4, Helena Rutherford5, Linda
Mayes5, Heather Murray6, Allison Borges6, Shannon Sauer6, Michael Otto6, Jesse Cougle7,
Richard Macatee7, Dan Capron7, Norman Schmidt7, R. Kathryn McHugh1, 2, Michael Otto6,
Richard Macatee7, Dan Capron7, Norman Schmidt7, Jesse Cougle7, Meghan Butryn8.
1. McLean Hospital, Belmont, MA, USA, 2. Harvard Medical School, Boston, MA, USA, 3.
University of North Carolina, Chapel Hill, Chapel Hill, NC, USA, 4. University of Illinois at
Chicago, Chicago, IL, USA, 5. Yale School of Medicine, New Haven, CT, USA, 6. Boston
University, Boston, MA, USA, 7. Florida State University, Tallahassee, FL, USA, 8. Drexel
University, Philadelphia, PA, USA.
A large body of evidence supports the role of distress tolerance (DT) as an important
transdiagnostic vulnerability factor that is associated with a range of psychological disorders and
behavioral health outcomes. Specifically, it appears that low DT may serve as a risk factor by
motivating maladaptive avoidance and escape behaviors that are relevant to any of a number of
symptoms and disorders (e.g., addiction, anxiety). However, despite many recent advances in
the application of DT across disorders, much remains to be understood about its development
and the mechanisms by which it confers risk. This series of talks will include novel applications
and recent advances in the transdiagnostic study of DT. An enduring theme across these talks
is enhancing our understanding of DT through the study of its applicability across a range of
disorders as well as the influence of developmental and contextual factors.
Presenters will take a range of perspectives on the study of DT with the overarching aim to
provide a multi-level analysis of this important construct. Dr. Daughters will present a study from
the developmental perspective, examining the association between parent and child DT. Dr.
Murray will focus on a contextual state influences on DT, examining the impact of shame on
both performance and persistence in the context of distress. Dr. Cougle and colleagues will
present a series of studies on the application of DT in obsessive-compulsive disorder, including
examination of disorder- and symptom-level associations with DT. Dr. McHugh will discuss
results from a study examining DT in heroin-dependent individuals, with a focus on a

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conceptualization of DT as a construct that is variable across types of distress (e.g., pain,


anger) and the implications of this conceptualization for both assessment and treatment of this
construct. Finally, Mr. Macatee will examine the related, but distinct constructs of emotion
regulation and DT in relation to generalized anxiety disorder. These studies contribute novel
information about the way in which DT may serve as a common risk factor as well as ways in
which it may be uniquely related to certain disorders and symptoms. Furthering our
understanding of DT will allow for enhancement of strategies aimed to reduce this risk factor in
both preventative and treatment interventions.
The Relationship between Maternal and Adolescent Distress Tolerance: The Moderating
Role of Gender
Low distress tolerance, defined as the inability to persist in goal directed activity when
experiencing emotional distress, is an established risk factor for substance use problems among
both adolescents and adults (e.g., Leyro et al., 2010). However, little empirical attention has
been conducted examining the mechanisms underlying the development of low distress
tolerance. Given evidence that children may imitate or internalize their parents ways of
regulating emotions via means of modeling or social referencing (Bridges et al., 2004; Morris et
al., 2007), the current study aimed to examine the association between maternal and
adolescent distress tolerance, with the hypothesis that maternal and adolescent distress
tolerance would be significantly related. A sample of 156 mother-adolescent dyads (Mother M
age = 45.7, SD = 5.9; Adolescent M age = 16.1, SD = 1.0; 46.8% Female adolescents; 31.4%
Caucasian, 60.8% African American) attended an afternoon assessment session where both
completed a behavioral measure of distress tolerance, the Computerized Paced Auditory Serial
Addition Test (PASAT-C; Lejuez et al., 2003). To examine maternal and adolescent substance
use and mood variables as potential covariates, mothers also completed the Brief Symptom
Inventory (BSI; Derogatis & Melisaratos, 1993), Alcohol Use Disorders Identification Test
(AUDIT; Babor et al., 2001), a measure of maternal drug use frequency, and the Child Behavior
Checklist (CBCL; Achenbach, 1992). Low distress tolerance, defined as quitting a psychological
stress task, was evidenced among 36.5% (n = 57) of adolescents and 21.8% (n = 34) of
mothers. Controlling for the effect of maternal alcohol use problems, findings from logistic
regression analyses indicated a significant interaction between maternal distress tolerance and
adolescent gender (b = -2.18, p < .01) in predicting adolescent distress tolerance [Model fit
x2(4) = 10.71, p < .05]. The interaction was probed using methods outlined by Hayes & Matthes
(2009), with results indicating a significant positive relationship between maternal and
adolescent female (b = 1.83, p < .01), but not male (b = -.24, p > .05), distress tolerance. Among
a sample of ethnically diverse adolescents, maternal distress tolerance was a significant
predictor of their daughters, but not sons, distress tolerance. This finding is in line with previous
work suggesting the association between maternal-adolescent emotion regulation strategies
(Bariola, Hughes, & Gullone, 2012), and may provide important first steps in identifying the
mechanism underlying the development of distress tolerance and addiction. Implications for
substance use prevention will be discussed.
Distress Tolerance and Shame
A large body of evidence suggests that those low in distress tolerance exhibit difficulty persisting
toward goals in a variety of emotional states and contexts. However, much of the research to
date has focused on a limited range of emotions (primarily anger/frustration and anxiety) and
thus little is known about other negative emotions, such as shame. Shame plays an important
role in a number of psychological disorders, including those for which distress tolerance is a
core feature (e.g., borderline personality disorder). Shame can potentiate emotional responses
to stressors and thus may influence both performance and persistence on goal-oriented tasks.
In this presentation, we will report data from an experimental study testing the hypothesis that

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shame would negatively impact both performance and persistence (distress tolerance) on a
challenging task. We hypothesized that participants undergoing a shame induction would exhibit
decreased performance (more errors) and shorter time to terminate a difficult behavioral task
(lower distress tolerance) compared to participants receiving a neutral mood induction.
Undergraduate students (N = 53, 87% female) completed self-report measures assessing
positive and negative affect prior to the seven minute mood induction exercise. Students were
randomly assigned to either a shame induction, which included writing about a time when they
experienced shame, or a neutral mood induction, entailing writing a detailed description of a
room. All participants then completed the Paced Auditory Serial Task (PASAT), a difficult
mathematical computerize behavioral task that is commonly used as a measure of distress
tolerance. Performance and persistence were measured. The hypothesis that participants
assigned to the shame induction would make more errors on the PASAT compared to
participants in the neutral induction was supported; however participants showed no difference
in time to terminate the PASAT task as expected (mean difference =14 seconds, p = .83 ). A
mood induction designed to increase shame impaired performance, but not persistence on a
behavioral distress tolerance task. Given recent evidence that the type of distress is a critical
component of distress tolerance, understanding the relationship between specific negative
emotional states and distress tolerance is important to better identify potential strategies to cope
with such emotional experiences.
Further Evidence for the Role of Distress Tolerance in Obsessions
Recent evidence suggests an important role for low distress tolerance (DT) in obsessions
(Cougle et al., 2011, 2012). We will present data from three separate studies exploring this
relationship. In Study 1, a treatment-seeking sample diagnosed with OCD (n = 22) was
compared to a healthy control group with no current diagnoses (n = 37) on a self-report
measure of DT (Simons & Gaher, 2005). When controlling for age, gender, and depression
diagnosis, the OCD group (M = 2.65) reported significantly lower DT than the control group (M =
3.69; F = 10.23, p = .002, partial 2= .16) Additionally, among the whole sample, lower DT was
associated with greater obsessions ( = -.45, p < .05, sr2 = .08) but not other OC symptom
dimensions, after controlling for depressive symptoms.
In Study 2, an unselected student sample (N = 167) was administered a battery of self-report
measures and shown emotional films associated with fear, disgust, sadness, and anger.
Tolerance and mood ratings were assessed via self-report for each film. Additionally,
participants completed a mirror tracing persistence task, a behavioral index of DT. Participants
with high obsessions scores reported poorer tolerance for the sad film, F (1, 77) = 6.80, p < .02,
2 = .08, and lower persistence on the behavioral DT assessment, F (1,76) = 4.79, p <.05, 2 =
.06, than a low obsession scores group, after controlling for a range of covariates. Obsessions
scores were unrelated to emotional reactivity and to tolerance for other emotional films.
In Study 3, an unselected student sample (N = 102) completed self-report measures of DT and
negative affect at baseline and daily assessments of OC symptoms and negative life events
twice-weekly for one month. Hierarchical linear modeling indicated that, after controlling for
baseline negative affect, baseline DT interacted with daily life stressors in predicting daily
obsessions scores (t = -1.95, p = .052). Baseline DT and daily stressors did not interact in
predicting other OC symptom dimensions. Follow-up tests indicated that at low levels of DT,
there was a significant positive relationship between daily stressors and daily obsessions,
though this relationship was absent at high levels of DT. Overall, these data add uniquely to the
emerging literature linking DT specifically to obsessions.
Intolerance of Distress in Heroin-Dependent and Matched Comparison Groups
Distress intolerance has been identified as a potential risk and maintaining factor for misuse of a
range of substances, such as nicotine, alcohol, and cocaine. However, it remains unclear

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whether intolerance of distress is unique to substance use disorders or whether this association
is due to the co-occurrence of mood disturbance in these populations. In this study, individuals
(N=55) diagnosed with heroin dependence were matched to a comparison group based on
gender and the presence of an affective disorder. Participants were administered a range of
behavioral and self-report distress intolerance measures, including measures of intolerance of
pain, respiratory discomfort, sadness, and frustration. Results indicated that heroin-dependent
patients had elevated distress intolerance relative to the comparison group, but that this was
only the case for intolerance of frustration. Exploratory analyses examining participants with
both heroin dependence and affective disorders indicated trends for the highest intolerance of
distress in this group. Distress intolerance appears to be an important vulnerability factor in
heroin dependence, even when controlling for affective disorders. Intolerance may vary across
domains of distress, highlighting the importance of measurement strategies that account for the
type of distress. Domain-specific and domain-general approaches to the measurement of
distress intolerance will be discussed, and a recently-validated brief self-report measure of
distress intolerance will be available to attendees in both English and Spanish translations.
Implications for the study and treatment of distress intolerance in those with substance use
disorders will be discussed.
Emotion Dysregulation and Generalized Anxiety: The Role of Distress Tolerance
Recent research has studied Generalized Anxiety Disorder (GAD) from an emotion regulation
perspective (Mennin et al., 2003; Mennin et al., 2005). A number of studies have linked
heightened emotional reactivity and poor tolerance of negative emotions to generalized anxiety
symptoms (Mennin et al., 2007; Turk et al., 2005). However, the specificity of DT to GAD
symptoms and its non-redundancy with heightened emotional intensity has been given little
attention. We will present data from two studies exploring the specificity of DT to GAD and its
role, independent of negative emotional reactivity, in the prediction of worry over time. In Study
1, a treatment-seeking sample with a primary GAD diagnosis (n = 19) was compared to a
control group with no current diagnoses (n = 37) on a self-report measure of DT (Simons &
Gaher, 2005). When controlling for age, gender, MDD diagnosis, and SAD diagnosis, the GAD
group (M = 2.71) reported significantly lower DT than the control group (M = 3.65; F = 7.93, p =
.007, partial 2= .14), suggesting that the association between low DT and GAD is not
accounted for by common covariates.
In Study 2, an unselected student sample (N=102) completed self-report measures of DT,
negative affect, and GAD symptoms at baseline and daily assessments of worry, negative
affect, and stressful life events twice weekly for one month. Hierarchical linear modeling (HLM)
indicated that baseline GAD symptoms, but not trait anxiety, depressive or social anxiety
symptoms, interacted with daily life stressors to predict daily negative affect (t = 2.94, p < .01),
providing support for models implicating heightened emotional reactivity as a salient feature in
GAD. Results also indicated that after controlling for trait negative affect, daily negative affect,
and daily life stressors, lower baseline DT significantly predicted greater daily worry (t = -2.15, p
< .05). However, DT did not interact with daily stressful events to predict daily worry, suggesting
that it acts as a context insensitive vulnerability factor in the development of GAD symptoms
above and beyond negative emotional reactivity.
Rumination and Intrusive Memories: Understanding the Basic Processes Underlying
these Transdiagnostic Phenomena in Clinical Disorders
Michelle Moulds1, Julie Krans1, Jessica Cheung1, Richard Bryant1, Kim Felmingham2, Ben
Garber1, Jacinta Wassell1, Richard Bryant1, Ian Clark3, Clare Mackay3, Emily Holmes4, Jens
VanLier5, Bram Vervliet5, Filip Raes5.
1. Psychology, The University of NSW, Sydney, NSW, Australia, 2. The University of Tasmania,
Hobart, TAS, Australia, 3. The University of Oxford, Oxford, United Kingdom, 4. MRC Cognition

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and Brain Sciences Unit, Cambridge, United Kingdom, 5. University of Leuven, Leuven,
Belgium.
It is well-established that the tendency to engage in rumination and the experience of recurrent
intrusive memories are reported by individuals across the spectrum of psychological disorders.
Furthermore, the literature has documented a bi-directional relationship between rumination and
intrusions such that there is evidence that rumination following negative events can increase the
likelihood and frequency of intrusions, and also that intrusive memories can serve to fuel
rumination. The experiments that will be presented in this symposium were conducted with the
goal of better understanding the mechanisms that underlie the development and maintenance of
these cognitive processes, as well as their consequences, across clinical disorders. Each
presenter will report the findings of recent laboratory-based studies in which they applied a
range of experimental methodologies to answer basic science questions about intrusive and
ruminative processes in psychopathology. The presenters will discuss the implications of their
findings for theoretical understanding of anxiety and depressive disorders, and explore the ways
in which their results have scope to inform the management of clinical conditions.
In the first paper, Jessica Cheung will present the findings of two experiments in which she
examined the impact of stress hormones and arousal on the development and maintenance of
intrusive memories. The second paper by Jacinta Wassell will present the findings of an
experiment in which she investigated the interplay of hormone levels and the capacity to
generate mental imagery in influencing the likelihood of intrusive memories following exposure
to negative stimuli. Next, Ian Clark will describe the findings of research in which he (i)
investigated predictors of flashbacks following viewing a trauma film, and (ii) explored the brain
regions that were activated during viewing aspects of a trauma film that were later experienced
as flashbacks. In the final paper, Jens Van Lier will describe the results of two experiments in
which he investigated the impact of abstract ruminative thought on generalization. Finally,
Michelle Moulds will draw the findings of this exciting series of experiments together and reflect
on the implications for theory and clinical practice.
The Influence of Arousal on the Emergence and Maintenance of Intrusive Memories
Intrusive memories are spontaneous recollections of past events which are typically
experienced as highly vivid, emotional and perceptually detailed. In clinical disorders, intrusive
memories may lead to significant levels of distress and prompt avoidance or rumination
strategies which contribute to the maintenance of the disorder. This study presents the findings
of two studies that investigated the role of arousal in the development and maintenance of
intrusive memories. Study 1 indexed stress and sex hormones in healthy participants who
underwent a stressor or control during encoding of aversive images. Estrogen levels predicted
subsequent intrusions of aversive images in women. Study 2 administered a stressor or control
to participants after memories of an aversive event were reactivated; reactivation of the memory
in combination with a stressor led to greater intrusions, whereas reactivation alone or stress
alone did not. These findings are discussed in terms of prevailing models of posttraumatic
stress and the role of sex and stress hormones in ongoing intrusions following trauma.
Role of Arousal, Imagery, and Stress Hormones in the Development of Intrusive
Memories
Females are twice as likely to develop PTSD as males. Females are also more likely possess
superior memory for emotional events relative to males. Independent lines of enquiry indicate
that hormonal levels and mental imagery may play a role in enhancing emotional memory. This
study integrates these lines of research to investigate their interactive contributions to intrusions
in males and females. Participants (N = 64) were divided into three menstrual groups (late
follicular females, mid luteal females, and males), and ovarian hormones were measured via

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salivary analysis. Measures of mental imagery ability were obtained. Following this, participants
were exposed to neutral and negative images. Surprise recall and occurrence of subsequent
intrusions were tested two days later. Emotional memory did not differ between menstrual
groups, however participants in the mid-luteal phase had more intrusions than others. Mental
imagery was greater in mid-luteal participants, and associated with higher progesterone levels.
These findings suggest that progesterone may enhance imagery ability, and this may contribute
to increased intrusions in females in the mid-luteal period. The implications of these results are
discussed in terms of their bearing on sex differences in clinical disorders.
Using cognitive neuroscience to understand the aetiology of flashbacks
Traumatic events happen to most people. Prevalence rates for full-blown posttraumatic stress
disorder (PTSD) are estimated at 10-20%, however, a larger percentage (50-97%) will
experience flashbacks. Flashbacks are distressing, image-based involuntary autobiographical
memories of trauma which hijack attention(1), and are predictive of later PTSD. We are
interested in experimentally understanding how flashbacks are formed and what factors are
protective against flashback formation. Psychological processing at the time of trauma
(peritraumatic) has consistently been found to be important for the development of flashbacks
and PTSD. However, it is difficult to prospectively study peritraumatic reactions to actual
trauma. The trauma film paradigm (2) has therefore been used extensively as an analogue
trauma to investigate flashback development. The trauma film paradigm also offers an
opportunity to investigate factors that may be protective against flashback development.
Combining data from the control conditions of 16 studies we investigated whether peritraumatic
emotional reactions, trait demographic and psychopathology factors, or voluntary memory would
predict the absence of analogue flashbacks to a traumatic film. Binary regression (no flashbacks
vs. flashbacks) found that the best predictor of an absence of flashbacks was a low level of
peritraumatic emotional reaction. Further, we have recently combined the trauma film paradigm
with fMRI to investigate the brain regions involved in flashback development (3). Results
suggest differences in brain activation for film scenes that subsequently occurred as flashbacks,
compared to equally traumatic scenes that did not flash back. These results further implicate the
importance of peritraumatic encoding in the development of analogue flashbacks.
Understanding the aetiology of flashbacks using cognitive neuroscience will help focus
preventative treatments for flashbacks and PTSD, hopefully reducing the distressing effects of
this costly disorder.
1. Clark, I. A., Holmes, E. A., & Mackay, C. E. in Phenomenological Neuropsychiatry: The
Patient's Experience, Bridging Clinic with Clinical Neuroscience (in press).
2. Holmes, E.A. & Bourne, C. (2008). Acta Psychologica, 127(3), 553-566.
3. Bourne, C., Holmes, E.A., & Mackay, C. E. (in press). Psychological Medicine.
The Effect of Rumination on Generalization
Many psychological problems are characterized by a gradual broadening of complaints over
stimuli, contexts, and behaviors. This expansion of complaints over stimuli, contexts, and
behaviors is known as generalization. Recently, abstract repetitive thought (A.RT) has been
proposed to be a transdiagnostic marker in several Axis-I disorders (e.g., worry in anxiety;
rumination in depression; Watkins, 2008; Ehring & Watkins, 2008). The present studies examine
the impact of A.RT (compared to a more concrete repetitive thought, C.RT) as an important
mechanism underlying generalization. In Experiment 1 student participants are trained in either
a ruminative/abstract or a non-ruminative/concrete processing mode, followed by a learning
phase and finally a generalization test phase. Results show that students with higher depression
scores display more negative generalization in the ruminative/abstract group compared to the
non-ruminative/concrete group. In Experiment 2, student participants learn that angry faces are
paired with their self and happy faces with others. They are instructed to adopt either a

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ruminative/abstract or a non-ruminative/concrete processing mode about the faces they have


seen. In the next phase, participants are asked to indicate whether the person was paired with
their self, the other or it was a new face. Crucially, we included faces where the expression had
changed and new angry/happy faces. Results show that participants in the abstract/ruminative
thought condition generalize more angry faces to the self. Interestingly, we also notice a trend
towards more generalization for the happy faces to the other person. This shows that
abstract/ruminative thought can lead to over- generalization of bad/failure feelings toward the
self (Everyone is always angry at me) but also of good feelings towards other people
(Everyone is always nicer to other people) that is often seen in social anxiety and depression.
The findings of both studies implicate that a ruminative/abstract processing style is of
transdiagnostic value through the effect this processing style has on generalization.
Relationship Between Anger Rumination and Characteristics of Autobiographical
Memory
Azumi Nakai.
Department of Psychology, Meijigakuin University, Tokyo, Japan.
Introduction: Anger rumination is defined as unintentional and recurrent cognitive processes
that emerge during and continue after an episode of anger experience. (Sukhodolsky, Golub, &
Cromwell, 2001). Rumination has been considered as a factor for maintaining and aggravating
depression, while current studies suggest that the rumination is applicable to the context of
angry moods as a cognitive bias toward anger episodes. But in Japan, the anger rumination has
not been investigated ever and there is no tool to measure the anger rumination. Then, Nakai,
Masuda, & Nedate (2004) developed the Anger Rumination Questionnaire (ARQ) for Japanese
and found the 4 factors, i.e., Sustained thoughts of revenge, Positive rumination, Counterfactual
thinking and Uncontrollability. Furthermore, authors attempted to make clear the relationship
between anger rumination, and anger duration and intensity in an experimental setting. High
anger ruminations (HR) group scored higher anger trait (AT) than low anger ruminations (LR)
group did toward the same level of anger arousal. The effect of anger rumination was shown for
anger intensity, but was not shown for anger duration. Next, Nakai, Masuda, & Nedate (2007)
were examined the influence of anger rumination on anger duration in daily life. HR tended to
hold anger longer, more, and stronger than middle anger ruminator (MR) in everyday life. The
effects of anger rumination on anger duration and intensity in daily life were shown. It was also
indicated that there was discrepancy in between HRs twice recollection of same anger arousal
event than MRs one. Relationship between anger rumination and overgeneral autobiographical
memory was suggested. The purpose of this study is to investigate relationship between anger
rumination and characteristics autobiographical memory for anger arousal event. Method:
Participants were 389 undergraduate students (90 men, mean age: 19.56, SD=1.40, and 296
women, mean age: 19.33, SD=.79) enrolled in two introductory psychology courses. Students
were administered ARQ and Memory Characteristics Questionnaire (Takahashi & Shimizu,
2007: MCQ). Participants were instructed for MCQ to remember one provoked episode and
answer about it. Results: The scores of ARQ were converted into Z scores for normalizing
gender difference. The points of MCQ were summed up. The means, SD, and the Pearson
product-moment correlation coefficients were calculated. Sixty five high anger ruminators Z
scores were from 60 to70 (HR) and 136 middle anger ruminators Z cores were from 45 to 55
(MR) were selected. Means of their points of MCQ factors that had correlation with ARQ factors
were tested by ANOVA. HR scored higher than MR on Clarity (F(1,199)=12.66), Retrospective
recollection (F(1,199)=15.70), Time information (F(1,199)=4.90) and Spatial information
(F(1,199)=4.31)( ps<.05). Sensory experiences and Events before and after had no differences.
Discussion: Relationship between anger rumination and autobiographical memory
characteristics of anger arousal event was investigated. Results showed that all ARQ factors

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had relationship with one factor or plural factors of MCQ. Among eight factors of MCQ, six
factors were week or middle positively correlated with ARQ factors. It was shown that high
anger rumination participants got higher scores of four MCQ factors than middle ruminators, i.e.,
Clarity, Retrospective recollection, Time information, and Spatial information. It was suggested
that overgeneral autobiographical memory in ruminative anger was related to these four
memory characteristics. Experimental study for investigating influence of anger rumination on
autobiographical memory will be required.
The Effect of Expectation to Anger Expression to The Closely Rerated Person
Mihoko Nakamine, Munenaga Koda, Yoshinori Ito.
The University of the Ryukyus, Naha city Torihori tyou, Japan.
[Purpose] Expressing own anger might be the primary cause for eroding peoples
relationship(Yukawa & Hibino,2003). People express their anger easier to familiar person
(Kino,2003). This study examines the hypothesis that people have expectation to the closely
related person, and when they feel this expectation is violated their feeling of anger arouse to
that person. [Method] The cooperators were requested to bring their friends as the participants
of the experiment. The participants were divided to high intimate group and middle intimate
group, thereafter each group was divided to experiment condition and neutral condition. To
induce the feeling of being violated the participants expectation, the quiz task was conducted.
The cooperators were asked to intentionally mistake the quiz which is related to the participants
characteristics such as their birthday or hobby. The participants expect that the cooperators are
able to answer to the quiz very easily. After that, experimenter went out of the room to leave the
cooperator and the participant alone. During their conversation, the participants behavior was
filmed to measure the expression of anger emotion. Rating behavior was done by two ways,
subjective behavior rating and objective behavior rating by rater. Three scenes were judged: i)
when the result of quiz assignment was shown, ii) one minute after the experimenter leaves the
room iii) one minute before the experimenter enters the room. [Results and Discussion]
Comparisons between the groups were based on three-ways analyses of variance (ANOVA) to
confirm rousing anger or not (intimate (High/ Middle)operating condition (experiment/
neutral)rating period(the time of showing result of quiz assignment/ one minute after the
experimenter leaves the room/ one minute before the experimenter enters the room) ). The
consequence of mood rating was insignificant(). But, expressing anger mood was verified by
objective and subjective behavior rating. In the objective behavior rated by outsider High
experiment condition demonstrated stronger aggression than High neutral condition on the
rating point when the result of quiz assignment was showed (F (1,25)=7.57,p<.05) . Also, in the
subjective behavior rating, one-way ANOVA revealed operating condition effect for aggression
on all rating points (F(2,88)=7.14, p<.01). The results showed that aggression was induced by
manipulation for violating the expectation in the measure of the subjective and objective rating
to behavior. Why the result of behavior rating for mood scale was different from ? The anger
emotion may have occurred, however the participants might have hesitated to express this feely
by concerning the effect to the relationship with their friend. The scale was effective only when
the participants were aware of their own feeling. Perhaps, due to the conflict, the participants did
not even notice their own feeling of anger. Suppose that it is effect of defensive reappraisal.
Claves de Extincin y Su Efecto en la Readquisicin de una Respuesta de Tolerancia
asociativa al Etanol
Vctor Navarro1, Margarita Borquez1, Felipe Alfaro1, Vanetza Quezada1, 2, Ronald Betancourt1,
Mara Paz Contreras1, Valeria Gonzlez1, Mario Laborda1.

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1. Psicologa, Universidad de Chile, Santiago, Chile, 2. Universidad Catlica de Chile, Santiago,


Chile.
Abundante investigacin bsica coincide en que el condicionamiento Pavloviano est
involucrado en esta tolerancia. Segn esta conceptualizacin, la administracin de la droga
(Estmulo Incondicionado, EI) genera una respuesta de tolerancia farmacolgica (Respuesta
Incondicionada, RI). Cuando la administracin es sealizada por eventos ambientales (Estmulo
Condicionado, EC), estos eventos son capaces de elicitar una respuesta compensatoria de los
efectos de la droga (Respuesta Condicionada, RC). Sin la ocurrencia de la administracin de la
droga, los eventos generan sntomas de abstinencia. Esta sintomatologa es relevante pues
refuerza negativamente la conducta de consumo. La Terapia de Exposicin a Claves reduce
esta sintomatologa mediante la exposicin de los sujetos a los eventos ambientales predictivos
sin la administracin de la droga. As extingue la respuesta de tolerancia y por ende la
sintomatologa de abstinencia. Pero es posible observar la reaparicin de la respuesta
extinguida en ciertas condiciones. Uno de los fenmenos de recuperacin de respuesta es la
Rpida Readquisicin, en la cual la respuesta condicionada retorna despus de la extincin
cuando el EC se parea otra vez con el EI. Una manera de prevenir diversos fenmenos de
recuperacin es utilizando Claves de Extincin. Una Clave de Extincin (CE) es un estmulo
introducido durante el procedimiento de extincin, y su efecto es observable cuando se
presenta en las condiciones que provocan una recuperacin de respuesta, aminorando la dicha
recuperacin. Para probar hiptesis referentes al funcionamiento de las CEs, todos los
experimentos presentados realizaron, una de adquisicin en donde se desarrolla una respuesta
de tolerancia al etanol en ratas mediante pareaciones de un estmulo con el efecto de una dosis
de etanol administrada intraperitonealmente. Posteriormente, se extingue la respuesta de
tolerancia haciendo presentaciones del estmulo EC sin EI y en presencia de la CE. Finalmente,
en una fase de readquisicin, se realizaron presentaciones EC-EI en presencia de la CE. Los
resultados del experimento 1 apuntan a que la introduccin de una CE es efectiva en retardar la
readquisicin de la respuesta tolerancia al etanol, de manera sustancial en un grupo sometido a
un procedimiento de extincin convencional. Los resultados del experimento 2 mostraron que
un nuevo estmulo asociado con una clave de extincin fue incapaz de retardar la readquisicin
de la respuesta de tolerancia, lo que sugiere que el efecto de la CE es difcilmente transferible a
nuevos estmulos. Los resultados del experimento 3 muestran que la exposicin al contexto de
extincin elimina el efecto de las CEs en la readquisicin de una respuesta, sugiriendo que el
estatus asociativo del contexto de extincin o la asociacin entre CE y contexto de extincin es
el elemento relevante para observar el efecto de una CE. El conjunto de los resultados sugieren
que es conveniente tener en cuenta variables adicionales a la hora de utilizar claves de
extincin. La utilizacin de CEs provee proteccin contra recadas, pero que a la vez estas son
difcilmente generalizables y que se deben tener en cuenta situaciones de exposicin que
pueden minar el efecto de las claves.
Experimental Examinations of Self-Distancing and Decentering: Implications for
Treatment and Psychopathology
C. Beth Ready1, Carly Yasinski1, Carly Yasinski1, Adele Hayes1, C. Beth Ready1, Adele Hayes1,
Jean-Philippe Laurenceau1, Matthew Williams2, Timothy Dalgleish4, Anke Karl2, Willem
Kuyken2, Douglas Mennin3.
1. University of Delaware, Newark, DE, USA, 2. University of Exeter, Exeter, United Kingdom, 3.
Hunter College, New York City, NY, USA, 4. Cognition, Emotion and Mental Health Programme,
Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, United Kingdom.

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This symposium will focus on experimental investigations of self-distancing and the related
concept of decentering. Both self-distancing and decentering have been described as emotion
regulation strategies that involve examining ones thoughts, feelings, and/or memories from a
cognitive distance and engaging in these mental events without becoming immersed in them.
Research indicates that these regulation strategies are related to better outcomes in cognitivebehavioral therapy across multiple disorders (Bowen et al., 2009; Fresco, Segal, Buis, &
Kennedy, 2007; Hayes-Skelton et al., 2012), whereas their absence is associated with
psychopathology and dysfunctional emotion regulation (e.g. Mennin et al., 2007; Mennin,
McLaughlin, Flanagan, 2009). Recent experimental studies have also revealed that a selfdistanced perspective is associated with less negative emotional reactivity and more meaningmaking than a self-immersed perspective when recalling negative autobiographical memories
(Ayduk & Kross, 2010; Kross & Ayduk, 2008). Similarly, randomized trials of psychotherapies
that teach decentering and distancing techniques have found that more application of these
strategies in daily life is associated with less reactivity to distressing thoughts or urges (Bowen
et al., 2007; Fresco et al., 2007; Teasdale et al., 2002). This symposium will explore
experimental evidence that begins to inform how emotion regulation strategies, such as
distancing and decentering, may reduce cognitive and affective reactivity in multiple disorders.
We will also discuss factors that can interfere with the ability to distance and decenter.
Implications for cognitive behavioral therapy and psychopathology will be discussed, as well as
ways that future research can continue to delineate and effectively apply this process.
Carly Yasinski will present a daily diary study investigating the effects of decentering techniques
on reactions to daily events and functioning in a sample of high ruminators. Beth Ready will
describe an experimental study examining alexithymia (a deficit in the ability to integrate
cognitive and emotional experiences) as a potential inhibitor of self-distancing. Willem Kuyken
will discuss a series of experiments examining individual differences in mindfulness and selfcompassion and whether these differences predict mood repair following a sad mood induction.
Combating Rumination in Everyday Life: An Investigation of Daily Self-Distancing,
Distraction and Concrete Analysis in a Highly Ruminative Population
Distraction, perhaps the most frequently studied strategy for combating rumination, has
consistently been shown to lead to comparatively lower mood reactivity (Lyubomirsky et al.,
1998, Lyubomirsky & Nolen-Hoeksema, 1995; Nolen-Hoeksema & Morrow, 1993). Some
research, however, suggests that distraction may lead to thought suppression and avoidance if
used long-term (Kross & Ayduk, 2008). Additionally, recent research has suggested two
alternative strategies for effectively analyzing emotional material: self-distanced or decentered
analysis (Kross & Ayduk, 2008; Kross et al., 2005; Wisco & Nolen-Hoeksema, 2011) and
concrete or specific processing of emotional material, as opposed to abstract processing
(Moberly & Watkins, 2006; Watkins et al., 2008; Watkins & Moulds, 2006). Despite extensive
research on each respective strategy, few studies have compared these strategies to one
another directly. Still fewer studies have explored the feasibility and effectiveness of teaching
those at-risk for psychopathology to implement such strategies in their daily life.
The current study uses a daily diary methodology to compare the effectiveness of these emotion
regulation strategies in reducing ruminative processing and its negative consequences in a
sample of undergraduates (N=161) with high levels of trait rumination. Over the course of 10
days, participants were asked to use one of three styles (self-immersion (a ruminative style),
self-distancing, and concreteness/specificity) when thinking about the thoughts and emotions
surrounding a stressful event from their day, or to distract themselves. Results suggest that
distraction was associated with the lowest levels of negative mood reactivity, followed by selfdistancing, and finally by concrete analysis, which only differed from immersion on one
measure. Self-distancing was also found to be associated with less unproductive processing

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and blame of others. Implications for the efficacy of these strategies and their use in treatment
and daily life are discussed.
Limitations of a Self-Distanced Perspective: Alexithymia as a Moderator of
Self-Distancing and Emotional Processing
Many researchers view cognition and emotion as interconnected components of emotional
processing (Foa et al., 2006; Greenberg, 2002; Lang, 1968; 1994). Research indicates that
adopting a self-distanced perspective facilitates adaptive cognitive reappraisal and emotional
processing (Kross & Ayduk, 2008; Kross, Ayduk, & Mischel 2005; Teasdale, 1999). However,
little is known about the benefits of self-distancing in individuals who have difficulties integrating
their cognitive and emotional experiences. Alexithymia is a construct that characterizes a
disconnect between cognitions and emotions that involves difficulty identifying, expressing, and
analyzing feelings (Taylor, 2000) and is also associated with deficits in adaptive emotion
regulation (Gohm & Clore, 2002; Mennin, Holaway, Fresco, Moore, & Heimberg, 2007).
Together, these findings suggest that individuals with high levels of alexithymia may have
notable difficulty fully engaging and benefitting from adaptive emotion processing strategies,
such as self-distancing
The current study aimed to address this question using an experimental paradigm from the
previous work of Kross, Ayduk, and colleagues (Kross & Ayduk, 2008; Kross et al., 2005) to
examine alexithymia as a moderator of the association of self-distancing with both emotional
reactivity and cognitive-emotional processing of an interpersonal rejection experience. Using a
college-student population over-sampled for moderate to high alexithymia (N=211 study
completers), the current study examined alexithymia as a moderator of the association of selfimmersed and self-distanced perspectives with emotional processing when recalling an
interpersonal rejection experience. Self-immersed and self-distanced perspectives were
associated with higher negative affect compared to a distraction group, and alexithymia did not
moderate the association between perspective and negative affect. However, alexithymia did
moderate the relationship of self-immersed and self-distanced perspectives with one of two
measures of processing, indicating that higher levels of alexithymia may inhibit processing
during self-distancing. Implications of these findings for the benefits of self-distancing and
treatment are discussed.
The Role of Mindfulness and Self-Compassion in Mood Repair in People at Risk for
Depression
People with a history of recurrent depression tend to be more cognitively reactive and reactivity
is a risk factor for depressive relapse. Theory and research highlight an important overlap
between mindfulness and self-compassion. There is emerging evidence that mindfulness / selfcompassion may break the links between reactivity and depressive relapse (Kuyken et al.,
2010). We report two experimental studies. In a non-clinical sample we examined if individual
differences in mindfulness predict recovery from a sad mood induction. In the second study,
with a sample of formerly depressed individuals, we examined if a brief mindfulness exercise
designed to help people decenter from cognitive reactivity is effective in repairing mood
following a sad mood induction compared with a brief rumination exercise and no intervention.
We predict that those people scoring higher at baseline on mindfulness/self-compassion will
recover faster and will be better able to make use of the mindfulness exercise to repair sad
mood.
Memoria y Emociones: Estudios Bsicos e Implicancias para la Salud
Eliana Ruetti1, 2, Nadia Justel1, 2, Mariana Psyrdellis1, 2, Alba Mustaca1.

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1. Lab. de Psicologa Experimental y Aplicada (PSEA), IDIM, UBA-CONICET, Ciudad


Autonoma de Buenos Aires, Argentina, 2. Fac. de Psicologa, UBA, Ciudad Autonoma de
Buenos Aires, Argentina.
Abstract Central: La memoria y las emociones se encuentran estrechamente relacionadas.
Existe una gran cantidad de evidencia que seala que los eventos emocionalmente
significativos se recuerdan ms que los neutros. Las emociones que acompaan los eventos
funcionaran como un sistema de filtro, seleccionando qu hechos se guardan en la memoria y
con qu intensidad. El objetivo de este trabajo es presentar los principales hallazgos obtenidos
a travs de estudios bsicos sobre la modulacin de la memoria emocional, tanto en modelos
animales como en humanos. Especficamente, se van a presentar los resultados de algunos
trabajos de investigacin realizados para analizar el papel del estrs y de las emociones sobre
la memoria. Estudios en modelos animales sealan que las hormonas adrenales, liberadas
durante una situacin de estrs, acompaan este proceso de consolidacin de la memoria
emocional. Estas hormonas van a modular la memoria, facilitando o deteriorando la
consolidacin de los recuerdos sobre los eventos. En un trabajo realizado en nuestro
laboratorio, se encontr que la administracin sistmica de la hormona del estrs, facilita la
memoria de la devaluacin de un reforzador en ratas. Por otro lado, se realizaron algunos
estudios para evaluar la memoria emocional en humanos. Al igual que en la literatura, los
participantes recordaron significativamente ms imgenes con contenido emocional, que
neutro. Adems, se intent modular el recuerdo que los participantes tenan de estas
imgenes. Para ello, los sujetos tenan que realizar actividades estresantes de distinta
complejidad luego de la tarea, y se evalu si esto afectaba la consolidacin de la memoria, en
una prueba de recuerdo libre realizada una semana despus. Este estudio tambin se llev a
cabo en personas de la tercera edad, en la cuales se encontr un deterioro en la cantidad de
imgenes recordadas por los participantes, en comparacin con los adultos jvenes.
Finalmente, estos hallazgos se discuten en el marco de las principales hiptesis
neurobiolgicas que analizan los mecanismos implicados en la consolidacin de la memoria y
la persistencia de los recuerdos con relevancia emocional.
Cognitive bias modification and executive skills training unplugged: increasing cognitive
control in routine clinical practice
Frank Ryan.
1. Experimental Medicine, Imperial College, London, United Kingdom, 2. Camden & Islington
NHS Trust, London, United Kingdom.
Abstract Central: Enhancing cognitive control is a core component process of cognitive
behaviour therapy (CBT). Cognitive bias modification (CBM) and cognitive re-training
procedures aim to further this by targeting implicit processes and bolstering executive control,
respectively. However, in many treatment settings it will not be feasible to provide CBM or more
generic cognitive skills training. This could be due to resource factors such as lack of a suitably
programmed computer or appropriately trained therapist. Therapists and their clients might,
however, adopt the pragmatic strategies outlined here more readily. To set the scene,
approaches derived from experimental cognitive psychology, including the visual probe, stop
signal task and an implicit behavioural approach modification task will be outlined. For each of
these tasks a specific analogue intervention designed to be incorporated into routine therapeutic
discourse and between session practice will be described. For example, while CBM can target
attentional bias by repeated practice with a therapeutically oriented visual probe, in routine
clinical practice attentional bias can be modulated by promoting the maintenance of remedial
goals in working memory. Similarly, impulsivity can be modulated by acceptance or mindfulness

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strategies, shifting attention from short term to long term outcome expectancies, or imagery
techniques. Further, behavioural approach tendencies can be challenged by repeatedly
rehearsing drug or alcohol refusal skills or forming implementation strategies that guide
behaviour when anxiety is evoked, for instance in social situations. The real -world analogues
to core cognitive skills or brain training include encouraging the development of willpower by
practicing small acts of self-discipline or promoting cardiovascular exercise between sessions.
Overall, these procedures create a context within which cognitive control is optimised within and
between sessions. This could contribute to therapeutic gain either by complementing or
supplanting formal CBM or cognitive skills training.
A NOO DE SOFRIMENTO PSICOLGICO NAS CLNICAS COGNITIVA NARRATIVA E
ANALTICO-COMPORTAMENTAL
Thiago Sampaio2, 1, Rodrigo Sampaio2, 1, Denis Zamignani3, Roberto Banaco3, 4.
1. Instituto de Psiquiatria, Universidade de So Paulo, So Paulo, Brazil, 2. Episteme
Psicologia, So Paulo, Brazil, 3. Ncleo Paradigma, So Paulo, Brazil, 4. Pontifcia
Universidade Catlica, So Paulo, Brazil.
A associao entre as clnicas comportamental e cognitiva a partir da dcada de setenta
resultou em um conjunto de estratgias de interveno bastante eficazes na remisso de
sintomas em quadros clnicos psiquitricos, especialmente ansiedade e depresso. Entretanto,
em que pese o profcuo casamento no mbito tcnico, as duas abordagens mantm
divergncias terico-filosficas importantes, especialmente em relao concepo de homem
e, conseqentemente, em toda a forma deste se relacionar com o mundo. De l para c muito
conhecimento foi produzido em ambas as abordagens, (especialmente nas reas de controle
de estmulos e comportamento simblico na anlise do comportamento e dos processos de
significao no cognitivismo narrativo), promovendo uma verdadeira revoluo na forma de
entender o sofrimento psicolgico, seja na clnica cognitiva ou na comportamental, enfatizando
seu carter relacional e necessariamente lingstico. Tal movimento, ainda que caracterizado
pelo rompimento com pressupostos basilares desse conturbado matrimnio, indica tambm
uma possvel articulao entre as distintas correntes no campo de seus pressupostos
epistemolgicos, implicando em prticas clnicas orientadas por uma concepo contextual do
fenmeno humano e pelo enfoque crescente na subjetividade e nos processos narrativos. O
objetivo deste trabalho apresentar como, e em que medida, possvel articular as
concepes de sofrimento psicolgico nas perspectivas cognitiva narrativa e analticocomportamental, considerando a crescente nfase no papel da linguagem (e sua relao com
as emoes) na origem desse fenmeno, entendido aqui como foco principal e elemento
legitimador da psicoterapia".
Cognitivism: (Re)Emergence and Selection of a Cultural Practice in Psychology
Luiz Henrique Santana.
Ncleo de Teoria e Pesquisa do Comportamento, Universidade Federal do Par, Belm, Brazil.
Abstract Central: Cognitivism, or neocognitivism for some it is a term that most identifies a
range of theoretical and methodological systems to a unified model of knowledge production in
psychology. The origin of this movement can be taken from different historical circumstances
that may be more or less contemporary depending on what aspect of the cognitive revolution is
desired to treat and can lead us from the source cognitive psychology of the 1950s, passing
through the origin of psychology itself as a science, even the emergence of the individual's
culture in Europe from the eleventh century. The historical approach of contingency analysis

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can identify the functional aspects that led to the setting of a science focused on the explanation
of the individual from an internalist bias and / or organicist (as in cognitive psychology or
cognitive neuroscience, respectively). Particularly the emergence and spread of the cognitive
movement, which proclaimed the death of behavioral psychology, seems to be greatly attached
to a research agenda committed to the accelerated production of technological interventions
that appear even among cognitivists as a vector that has shown much more to dispersion
methods and theories that converged on a unified paradigm. It concludes with a discussion
about the required trivialization of the futurist neuroscientific discourse wich promises results
that put a great social impact prefixed the questioning as to their proper historical and
epistemological foundations, theoretical and methodological approaches, and the ethical and
pragmatic regards the value added to the production of scientific knowledge.
Effects of Vocal Verbal Interaction and Access on Ethical Self-Control under
Macrocontingencies
Luiz Henrique Santana, Emmanuel Tourinho, Felipe Leite.
Ncleo de Teoria e Pesquisa do Comportamento, Universidade Federal do Par, Belm, Brazil.
Abstract Central: Behavior Analysis has developed procedures for empirical investigations of
social phenomena in a controlled environment. Research on ethical self-control may be held
with such experimental procedures so that two levels of selection, operant and cultural, may be
accessed. The functional analysis of ethical self-control requires the consideration of concurrent
individual and cultural consequences, and their effects on different social contexts. In this study,
we sought to assess the effects of a cumulative product on the selection, maintenance and
transmission of cultural practices, in an arrangement in which the cumulative product was of a
different nature from that of the consequences contingent on individual behavior. The control by
macrocontingencies was evaluated in four conditions that varied with regard to access (or not)
of the group members to each other's behavior, and the possibility (or not) of verbal interaction
between group members. The results indicate that the emergence of control by
macrocontingencies was unstable, possibly because of early exposure to a condition in which
no vocal verbal interaction was allowed. This condition may have produced a relative
insensitivity to the verbal-social environment.
A Incrvel Mindfulness
Luiz Silva, Isabella Gelli.
FASE, Petrpolis, Brazil.
Abstract Central: Mindfulness o processo de manter todo o Organismo inteiramente focado
em uma situao - recebendo as informaes sobre essa situao pelas vias sensoriais e as
assimilando atravs do crebro, e experienciando seus efeitos cognitiva e emocionalmente.
Manter-se em estado de Mindfulness, na verdade, requer concentrao mental deliberada nas
sensaes internas e externas que esto sendo vivenciadas momento a momento.
Secundariamente, esse processo deve incluir uma atitude apropriada em relao situao,
uma postura fsica adequada, uma ateno focada no estmulo sensorial, uma percepo
global do ambiente e de tudo o que acontece ao redor do ambiente. Ser mindful significa viver
inteiramente o presente ao invs de simplesmente agir guiado por um piloto automtico, sendo
oprimido por ruminaes recorrentes sobre o passado e por apreenses sobre o que pode
acontecer no futuro - sem, no entanto, ignorar as valiosas informaes acumuladas no
passado, e mantendo-se pronto para planejar atividades futuras. O propsito desse estudo
entender e desenvolver uma explicao plausvel para a difuso da Mindfulness teraputica por

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todo o mundo. Na verdade, se um leigo fosse perguntado a esse respeito, simplesmente


responderia com a afirmao bvia: simplesmente porque funciona. Por outro lado, alguns
tericos mais cticos, podem levantar dvidas sobre a validade cientfica da Mindfulness
alegando falta de explicaes racionais que justifiquem e sustentem a crena do pblico em
geral, e questionando a receptividade profissional de tantos terapeutas pragmticos em uma
abordagem "romantica" e desprovida de credibilidade, cuja eficcia tem sid oto enfaticamente
testemunhada por aqueles que se beneficiaram de sua prtica teraputica. A eficcia dessa
prtica teraputica est agora definitivamente consolidada, tendo conquistado o status de
poderoso recurso teraputico. Existem amplas evidncias tecnicamente obtidas a partir de
pesquisas e metapesquisas apoiadas em profusos experimentos laboratoriais, bem como por
diversas observaes clnicas minunciosamente registradas e analisadas. Essa constatao
est desencadeando a rpida expanso da aplicao da Mindfulness teraputica ao redor de
todo o mundo. Considerando-se que a Mindfulness eficaz, como tem sido cientificamente
comprovado, qual seria a lgica por trs desse fenmeno, aparentemente no muito racional?
Parece que a eficcia da Mindfulness , em grande parte, fruto da caracterstica holstica desta
abordagem. Na verdade, a explicao para todo esse "mistrio" viria da constatao de que o
fluxo de informao-e-energia induzidos pela Mindfulness permeia a totalidade "corpo e alma,
denominada Organismo por Goldstein (1995). Se a eficcia da Mindfulness foi empiricamente
provada, ainda precisam ser racionalmente explicadas: as alteraes positivas geradas pela
ateno plena nas funes e na estrutura s do subsistema mente-crebro.
A Funo de Regras em Terapias Comportamentais e Cognitivas
Ronaldo Teixeira Jnior.
Universidade Federal do Mato Grosso do Sul, Campo Grande, Brazil.
Abstract Central: Desde a publicao de seu artigo em 1945 The operational analysis of
psychological terms, Skinner estabeleceu uma diferena clara nos pressupostos filosficos do
behaviorismo radical e do behaviorismo metodolgico. O reconhecimento de eventos privados
como passveis de estudo como outros comportamentos teve implicaes na evoluo da
terapia comportamental que passou a incluir a anlise de comportamento verbal e do controle
por regras em sua prtica clnica. Porm a funo que uma regra pode ter em um contexto
clnico comportamental difere substancialmente da funo que uma regra pode ter em uma
terapia de orientao cognitiva. O objetivo desse trabalho discutir sobre as diferentes funes
de regras para essas duas abordagens tericas, apresentando as semelhanas e divergncias
que o uso desse conceito pode ter no contexto clnico. Enquanto para a terapia cognitiva regras
possuem um status causal, na terapia comportamental regras fazem parte de uma cadeia em
que as conseqncias continuam sendo a maior fonte de controle. Uma discusso acerca da
relevncia e limitao de intervenes verbais na clnica ser realizada, dando destaque ao
papel das contingncias para a mudana do comportamento. Exemplos na diferena de
conduo de um caso sero apresentadas como forma de justificar a diferena terica entre as
abordagens comportamental e cognitiva.
Condicionamiento Operante Diferencial del Sentido Magnetorreceptivo de una Paloma
Nicanor Toledo De la Torre.
Universidad Nacional Federico Villareal, Lima, Peru.
Abstract Central: Se evala las respuestas de una paloma, atraves de un programa de
condicionamiento del sentido de orientacin y deteccion magnetica, en un ambiente controlado,
para lo que se diseo y uso una caja experimental rotatoria de ocho caras exclisva para este

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fin, el estmulo discriminativo es la cara que esta dirijida hacia el norte y el estimulo delta todas
las demas caras. Se procedi con un programa de reforzamiento diferencial, aumentando la
dificultad de la respuesta adecuada, exponiendo al sujeto a cuatro condiciones experimentales.
Los resultados fueron concluyentes, el sujeto logro culminar satisfactoriamente las fases de
reforzamiento planteadas, demostrando as que el sentido de magnetorrecepcin de la paloma
puede estudiarse en un ambiente controlado y de manera contingente al alimento.
SIMPOSIO: VEINTE AOS DE LA FORMULACION DEL ANALISIS CONTINGENCIAL Y SU
IMPACTO EN LA PRCTICA CLINICA
Carlos Torres1, Carlos Martinez1, Sergio Galan2, Everardo Camacho1, Everardo Camacho1.
1. Centro de Estudios e Investigacin en Comportamiento, universidad de guadalajara,
Guadalajara, Mexico, 2. Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico.
Ribes y colaboradores propusieron en el ao de 1992 una forma de intervencin aplicada en el
mbito clnico, que se destac como una derivacin conceptual sistemtica, congruente con la
perspectiva interconductual formulada originalmente por Kantor (1982). Dicha propuesta se
erigi como un lenguaje de interfase o como una propuesta de tecnologa blanda (Ribes y
Lpez, 1985) que busc mediar entre las categoras cientficas orientadas al anlisis cuidadoso
que busca generar conocimiento sobre las relaciones ordenadas en el mbito del campo
psicolgico y el campo de la complejidad de los problemas socialmente significativos en la
realidad cotidiana. Es decir, entre la dimensin bsica y la aplicada. En este contexto, se
resean tres trabajos que bajo la perspectiva del Anlisis Contingencial evalan esta
herramienta tecnolgica como recurso para la resolucin de problemas psicolgicos.
GNERO Y ANLISIS CONTINGENCIAL: PROPUESTA PARA PREVENIR CONDUCTAS DE
RIESGO PARA LA SALUD
En el presente trabajo se esbozan algunas estrategias que se han seguido para analizar las
Conductas de Riesgo para la Salud de jvenes de la Zona Metropolitana de Guadalajara,
utilizando el Anlisis Contingencial (Ribes, 1992) como eje articulador.
Teniendo en cuenta que para analizar un fenmeno desde la perspectiva de gnero es
necesario abordarlo multifactorialmente, se contempl adoptar una perspectiva interconductual
(Kantor, 1963/1990), dado que desde esta visin psicolgica se busca explicar el segmento
conductual analizando todos los factores que intervienen en dichos episodios. Ribes (1992)
propone un modelo que permite hacer ese tipo de anlisis, en donde se plantea identificar tanto
los aspectos sociales, como el ajuste individual de sujeto de anlisis. Ribes (1992) sugiere que
se realice un anlisis tanto a nivel macro, como microcontingencial. Para identificar la situacin
se abordan los factores microcontingenciales como lo son las conductas instrumentales
focales, las condiciones situacionales con funcin disposicional (conductas socialmente
esperadas, capacidades personales, propensiones y tendencias, las personas implicadas
funcionalmente en la situacin como mediador o mediado, las conductas relacionadas y por
supuesto los efectos contingenciales. En los factores macrocontingenciales encontramos a las
prcticas sociales dominantes, las prcticas lingsticas que referencian afectos reguladores, a
los individuos o grupos de referencia, a la correspondencia lingstica del individuo con otros
grupos, la correspondencia funcional entre prcticas sociales e individuales y la comparacin
entre los efectos microcontingenciales y la normatividad.
En sntesis, aplicar el Anlisis Contingencial al estudio de la conformacin de las nociones de
gnero entre la poblacin juvenil, nos ha permitido identificar con claridad las distintas
interconexiones funcionales que se establecen en estos complejos episodios del
comportamiento humano y brinda herramientas para estructurar estrategias de intervencin
educativa que nos permitan promover entre la poblacin juvenil, modelos de gnero ms

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equilibrados. En ese sentido, si asumimos que las nociones de gnero que tienen los y las
jvenes estn relacionadas al tipo de comportamiento que adoptan, en la medida que podamos
general nociones de gnero ms moderadas, estaremos reduciendo la probabilidad de que se
enfrenten a situaciones de riego extremas, y con ello estaremos previniendo las conductas de
riesgo para la salud.
QUE ES UN PROBLEMA PSICOLGICO DESDE LA PERSPECTIVA DEL ANLISIS
CONTINGENCIAL.
En el presente trabajo se parte del supuesto de que ningn comportamiento en s mismo es un
comportamiento patolgico, sino que dicha adjetivacin implica un comportamiento sustitutivo
referencial de valoracin con base en lo prohibido o permitido desde un grupo de referencia
particular. De tal forma, las inconsistencias o incongruencias valoradas por el mismo usuario
que acude a consulta constituyen el criterio bajo el cual se enfoca el ejercicio de diagnstico
clnico.
Se analizan las diferentes posibilidades lgicas de inconsistencias como una forma funcional
alternativa de clasificacin de los problemas psicolgicos, se contrastan con las formas
tradicionales de diagnstico con base en sistemas de clasificacin estandarizada de los
trastornos (DSM-IV). Se ejemplifica mediante un caso las dos alternativas, resaltando las
ventajas y desventajas de ambas opciones. Se discute en torno a las implicaciones prcticas y
ticas de las dos formas de concebir el ejercicio diagnstico.
MANEJO DE CONFLICTOS DE PAREJA DESDE UNA PERSPECTIVA
INTERCONDUCTUAL
Desde una perspectiva aplicada, la propuesta interconductual se desarrolla como una
metodologa de anlisis y cambio conductual a partir del reconocimiento de las distintas
estructuras situacionales de las que participan los individuos.
Dichas estructuras son identificadas a partir de: a) las relaciones circunstanciales que delimitan
situacionalmente la conducta de los individuos (sistema microcontingencial); y b) el sistema de
relaciones valorativas que prescriben un marco normativo que contextualiza socialmente el
comportamiento de un individuo en un grupo social especfico (marco macrocontingencial).
Desde este planteamiento se reconocen dos tipos genricos de conflicto psicolgico: 1.
conflictos por falta de competencia para cumplir los requerimientos situacionales y, 2. conflictos
por incongruencia entre lo requerido por la situacin y el sistema de valores asociados a ella.
En el presente trabajo se desarrolla una propuesta analtica para la implementacin de
estrategias de intervencin asociadas al reconocimiento de los factores situacionales y
normativos que se vinculan a la emergencia de conflictos asociados a la relacin de pareja.
Aproximacion al Estilo Interactivo de Curiosidad
Mara Valle Morfn, Mara Elena Rodrguez Perz.
Centro de Estudios e Investigaciones en Comportamiento, Universidad de Guadalajara,
Guadalajara, Mexico.
La personalidad se ha estudiado para referirse a la manera de comportarse de una persona.
Sin embargo, esta conceptualizacin trae consigo varios errores como son: la no identificacin
de la singularidad de cada sujeto; la clasificacin de las personas a partir de un criterio de
reactividad y que no concibe una estabilidad intraindividual con lo cual no es posible la
prediccin de la conducta (Ribes- Iesta, 2009). Ribes (1990) propone la nocin de estilo
interactivo, en lugar de personalidad, para destacar las caractersticas modal, particular y
consistente de las conductas que permiten la identificacin de la individualidad como diferencia.
Un estilo interactivo es la tendencia a interactuar de cierta manera como resultado de la
biografa particular de cada individuo (Ribes, 2009). Los estilos pueden clasificarse

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dependiendo de las situaciones genricas, como arreglos contingenciales, donde se pueda


observar las consistencias en los comportamientos a travs del tiempo, entre diferentes
situaciones, bajo contingencias abiertas y socialmente neutras (Ribes, 1990). Ribes (2009)
propuso una clasificacin de 8. La curiosidad es uno de esos estilos propuestos. La curiosidad,
como estilo interactivo, se ha definido a travs de dos dimensiones: responsividad a
contingencias no prescritas y eleccin de situaciones con contingencias cambiantes. La
curiosidad ha sido abordada desde distintas reas de conocimiento de la psicologa. Berlyne
(1950, en Loewenstein, 1994) clasific a la curiosidad como perceptual o epistmica. As
mismo, Berlyne en 1971, menciona que existen situaciones donde se ve favorecida la eleccin
de patrones de mayor complejidad en sujetos que estuvieron expuestos a estimulaciones
previas de menor complejidad. Estas elecciones dependern de factores tales como:
intensidad, duracin, novedad y complejidad de los objetos de estmulos del medio ambiente.
En el presente estudio, participaron 3 estudiantes universitarios en una tarea experimental del
estilo interactivo de curiosidad, la cual consisti en tres sesiones: dos de contingencia abierta y
la ltima de contingencia cerrada. La contingencia cerrada se refiere a que existe un requisito
de respuesta en la ltima sesin. Las primeras dos sesiones estuvieron integradas por 4 ciclos
de exploracin del men (o navegacin) de un tiempo aproximado de 4 minutos y un tiempo
de espera de dos minutos. La ltima sesin consisti en 2 ciclos de exploracin y 2 de espera
similares a las sesiones anteriores. Se aadieron 2 ltimos ciclos donde se seal un requisito
de respuesta: contestar trivias a un tema especfico de los presentados en el men. Se logr
observar diferentes maneras de comportarse ante arreglos contingenciales, as mismo, se
observaron consistencias en el tiempo de cada uno de los sujetos. Esta teora tiene como
aporte a la psicologa clnica el anlisis de microcontingencias para la solucin de cualquier
problema individual de la vida cotidiana. Es la interfase entre la teora de la conducta como
proceso y la aplicaciones tecnolgicas que dan cuenta de las situaciones cotidianas y
singulares que conforman la dimensin psicolgica de la vida social (Ribes, 1990).
Ruminating About Yourself After Seeing Angry Faces: Not a Good Idea!
Jens Van Lier, Bram Vervliet, Filip Raes.
Psychology, University of Leuven, Leuven, Belgium.
Many psychological problems are characterized by a gradual broadening of complaints over
stimuli, contexts, and behaviors. This expansion of complaints over stimuli, contexts, and
behaviors is known as generalization. Recently, abstract repetitive thought (A.RT) has been
proposed to be a transdiagnostic marker in several Axis-I disorders (e.g., worry in anxiety;
rumination in depression; Watkins, 2008; Ehring & Watkins, 2008). The present study examines
the impact of A.RT (compared to a more concrete repetitive thought, C.RT) as an important
mechanism underlying generalization. In this experiment, student participants learn that angry
faces are paired with their self and happy faces with others. They are instructed to adopt either
a ruminative/abstract or a non-ruminative/concrete processing mode about the faces they have
seen. In the next phase, participants are asked to indicate whether the person was paired with
their self, the other or it was a new face. Crucially, we included faces where the expression had
changed and new angry/happy faces. Results show that participants in the abstract/ruminative
thought condition generalize more angry faces to the self. Interestingly, we also notice a trend
towards more generalization for the happy faces to the other person. This shows that
abstract/ruminative thought can lead to over- generalization of bad/failure feelings toward the
self (Everyone is always angry at me) but also of good feelings towards other people
(Everyone is always nicer to other people) that is often seen in social anxiety and depression.
The findings implicate that a ruminative/abstract processing style is of transdiagnostic value
through the effect this processing style has on generalization.

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Motivacin Acadmica y Estrategias Afrontamiento en un Grupo de Estudiantes de


Psicologa
Irina Villafae Bermdez.
Psicologa, Pediacenter, Cartagena, Colombia.
Motivacin Acadmica y Estrategias Afrontamiento en un Grupo de Estudiantes de Psicologa,
es un estudio que tuvo como objetivo, la presencia de algn tipo de relacin, entre estos dos
eventos. Con enfoque de investigacin cuantitativo y un tipo descriptivo, se emple como
tcnica la encuesta, la cual recolecta informacin, solicitndola a la persona que tiene la
experiencia directa del evento y como instrumentos, Escala de Actitud hacia el Estudio (E-4),
desarrollada por Morales (s.f.), y el Inventario de Estrategias de Afrontamiento (CSI). Los
hallazgos muestran una motivacin alta en los estudiantes, de tipo interno, pues estos tienden
a mostrar seguridad en su no muestran relacin directa con las estrategias de afrontamiento,
quizs por el tamao pequeo de la muestra, sin embargo, se observa que los jvenes
estudiantes, poseen seguridad para obtener resultados exitosos en una tarea difcil, trabajan
por ello y emplean estrategias de afrontamiento que conllevan a la solucin de problemas. Se
recomienda replicar el trabajo con una muestra ms representativa y tener en cuenta altos y
bajos rendimientos acadmicos, para quizs, hallar ms relaciones y obtener resultados mucho
ms significativos.
Assessing and Changing Approach- and Avoidance Action Tendencies across
Disorders: New Perspectives
Reinout Wiers1, Nader Amir2, David Kavanagh10, Catalina Kopetz5, Janna Cousijn1, 3, Renate
Neimeijer7, Peter de Jong7, Mike Rinck6, Carolin Eberl8, Frank Ryan9, Dick Veltman4, Jennie
Kuckertz2, Najmi Sadia2, Anneke Goudriaan3.
1. Psychology, University of Amsterdam, Amsterdam, Netherlands, 2. San Diego State
University, San Diego, CA, USA, 3. Academic Medical Center, Amsterdam, Netherlands, 4.
Free University, Amsterdam, Netherlands, 5. University of Maryland, College Park, MD, USA, 6.
Radboud University, Nijmegen, Netherlands, 7. Groningen University, Groningen, Netherlands,
8. Salus Clinic, Lindow, Germany, 9. Imperial College, London, United Kingdom, 10.
Queensland University of Technology, Queensland, QLD, Australia.
Cognitive biases play an important role in many types of psychopathology. While earlier
research focussed on attentional and memory biases, recent research has highlighted the
relevance of automatically triggered action tendencies, both in appetitive disorders (addictive
behaviors, eating disorders) and in anxiety. Moreover, as with other cognitive biases, research
has demonstrated that an approach-bias can be changed with cognitive bias modification
techniques, with first effects in heavy drinkers (reduced drinking immediately after re-training,
Wiers et al., 2010) and in alcoholic patients (increased abstinence a year after repeated
approach bias re-training, Wiers et al., 2011; Eberl et al., in press), and first positive findings on
retraining in anxiety (Taylor & Amir, 2012). In this symposium, new research is presented on
automatically triggered action tendencies across different disorders (OCD, Anorexia,
Alcoholism, Cocaine and Marijuana Addiction), both regarding assessment (behavioural tasks,
neurocognitive correlates) and regarding modification. Also, new theoretical perspectives are
highlighted, such as an integration of goal-theory and maladaptive action tendencies and the
theoretically and clinically important question regarding the mechanism of action-tendency
training (mediation) and for which patients this approach works best (moderation). The
discussant will further highlight the clinical implications.

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OCD: Assessment and Modification of Automatic Action Tendencies in ObsessiveCompulsive Disorder


The tendency to approach or avoid feared stimuli is a fundamental aspect of many anxiety
disorders. Research suggests that approach-avoidance tasks (AATs) are useful measures of in
anxiety
research (Roefs et al., 2011). For example, individuals with subclinical obsessive-compulsive
(OC) contamination-related symptoms demonstrate impaired approach tendencies in response
to threat-relevant pictures, as assessed by an AAT (Najmi et al., 2010). Researchers have also
used the AAT as a training tool to successfully manipulate these automatic action tendencies for
certain forms of psychopathology (e.g., social anxiety, problematic drinking), with observable
changes in disorder-specific behaviors (Wiers et al., 2010; Taylor & Amir, 2012). In the current
study (Amir et al., 2012), we used the AAT to train automatic action tendencies in individuals
with subclinical OC contamination concerns. We hypothesized that, after manipulation of
automatic action tendencies, participants would be more likely to approach feared objects when
compared to participants in a control condition. Participants were instructed to push or pull a
joystick, resulting in contamination-related and neutral pictures moving progressively towards or
away from them. We manipulated approach by building a contingency between the arm
movement and the picture type in the active condition but not in the control condition. Consistent
with our hypothesis, participants in the active manipulation group (n = 22) showed facilitated
automatic approach tendencies and reduced avoidance tendencies for contamination-related
stimuli and completed more steps approaching their feared objects in a behavioral approach
test compared to participants in the control group (n = 22). Our results suggest that automatic
action tendencies may play an important role in the maintenance of fear-related behavioral
avoidance in individuals with OC symptoms. Our current research efforts involve extending
these findings to clinical OCD populations across different age groups.
Approach-Bias Predicts The Course Of Cannabis Use In Heavy Cannabis Users: Results
From Prospective Behavioral And Neuroimaging Studies.
One out of ten heavy cannabis users meets the DSM-criteria for cannabis dependence. To
prevent those individuals from lapsing into chronic cannabis abuse, a better understanding of
the processes underlying the course of cannabis use towards dependence is needed. The
difficulty to treat cannabis dependence further emphasizes the importance of identifying
predictors, with the ultimate goal to develop effective prevention and treatment strategies. A
potentially powerful predictor for the course of drug (ab)use is the approach-bias. In this study
we investigated the neural and behavioral mechanisms of cannabis approach and avoidance.
Moreover, we investigated the predictive power of the behavioral and neural approach-bias for
future cannabis use. In 33 heavy cannabis users and 42 matched controls the joystick
Approach-Avoidance Task (AAT) was use to measure behavioral approach and avoidance
tendencies. Using functional Magnetic Resonance Imaging (fMRI), neural approach-bias
activations were measured with a Stimulus Response Compatibility task (SRC). During the AAT,
heavy cannabis users had an approach-bias for cannabis related images compared to the
controls. Moreover, the approach-bias predicted changes in cannabis use six months later: a
stronger approach-bias was related to an increase in weekly cannabis use. During the SRC,
approach-bias activations did not differ between heavy cannabis users and controls. However,
within the group of heavy cannabis users, a positive relation was observed between total
lifetime cannabis use and approach-bias activations in various fronto-limbic areas. Moreover,
approach-bias activations in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate
cortex (ACC) independently predicted cannabis problem severity after six months over and
beyond session-induced subjective measures of craving. Higher DLPFC/ACC activity during
cannabis approach, but lower activity during cannabis avoidance were associated with

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decreases in cannabis problem severity. Approach-bias scores form the AAT and SRC did not
correlate, suggesting that both tasks tap into different processes. These findings support an
important role for the approach-bias in the maintenance of addictive behaviors. The predictive
relationship between ACC/DLPFC activity and cannabis problems suggests that cannabis users
with deficient control over cannabis action tendencies are more likely to develop problems,
supporting a specific role for the DLPFC/ACC as a biomarker in the prediction of problem
severity and as new loci for targeted prevention and treatment.
When The Goal (Automatically) Justifies The Means; Automatic Approach Tendencies
Toward Sex Exchange As A Means To Crack Cocaine Obtainment And Use
One of the most intriguing behaviors associated with drug use is sex exchange for crack
cocaine which occurs frequently among female users despite potential legal and health
consequences. The problem is not that these women do not know or understand the risk but
that they have difficulty resisting such behavior when a crack cocaine craving is induced by
contextual factors. This may happen because females who engage in sex trade to satisfy their
drug craving may form cognitive representations where the goal of alleviating such craving is
strongly associated with sex trade as a means toward their goal. The current research applies
the self-regulatory principles that govern the association between goals and means in an
attempt to understand the persistence of engagement in sex trade for crack cocaine among
female users. In line with these principles, we reasoned that experiencing a drug craving may
increase the accessibility of sex exchange as a means of drug obtainment and may result in
initiating this behavior without conscious intention and voluntary control.
To test these notions, we used a joystick task paradigm to asses cocaine users approach
tendencies toward sex trade words as a function of goal activation (i.e., cocaine primes),
gender, and history of sex exchange. In this paradigm, participants were subliminally presented
with the word cocaine (vs. neutral words) in order to manipulate the accessibility of the goal of
drug obtainment. The primes were immediately followed by sex trade words (and neutral
words). Using a joystick, participants were asked to "move" away from vs. toward the sex trade
words. When the drug goal was active (after cocaine priming), women with a history of sex
exchange (who therefore may have developed a strong association between the goal of
obtaining crack cocaine and sex exchange as a means) were faster to initiate movement toward
the sex trade targets than away from them. Additionally, we only found this effect following
cocaine primes, but not neutral primes, suggesting that approach tendencies toward sex
exchange are only relevant when the goal is active, and not otherwise. Furthermore, we did not
obtain the effect among women with no sex exchange history, or among men, presumably
because for these participants, sex exchange did not represent an instrumental means to drug
obtainment.
Goals-means associations can be altered by increasing the accessibility and importance of
alternative goals or by introducing alternative means. We will discuss these strategies and their
implications for changing drug use behavior.
Reduced Automatic Approach Tendencies Towards Food Are Predictive For The Course
Of Anorexia Nervosa
Objectives: It has been proposed that loss of automatic motivational orientation towards food is
of major importance in Anorexia Nervosa (AN) patients success in minimizing their caloric
intake. In line with this, a recent study using a computerized Approach-Avoidance Task (AAT)
showed that AN patients displayed weaker automatic approach tendencies toward high (or low)
caloric food items than healthy controls (Veenstra & de Jong, 2010). To get more insight in the
direction of this relationship, the present study used a longitudinal approach and tested whether
the level of automatic approach tendencies has predictive value for the severity of AN
symptoms at one year follow up. More specifically, we tested the prediction that the lower the

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automatic approach tendencies at baseline the more intense the symptoms of AN at follow up
(as indexed by participants BMI).
Methods: To test this hypothesis, the Affective Simon Task-manikin version (AST-manikin) was
administered to measure automatic approach tendencies towards high-caloric and low-caloric
food in young AN patients (n = 75). Patients BMI (as an objective index of underweight) was
determined both during baseline and at one year follow up.
Results: In line with the hypothesis, preliminary results suggests that relatively weak approach
tendencies at baseline were predictive of relatively poor treatment outcome: patients with
weaker or absent approach tendencies at baseline showed a lower BMI at one year follow up.
This relationship was independent of the patients BMI during baseline.
Conclusions: The findings support the view that reduced automatic approach tendencies may
contribute to the maintenance of AN-symptoms and can at least partly explain why some
patients benefit from their therapy and other patients do not improve. Moreover, the finding that
relatively weak approach tendencies at baseline were associated with relatively intense
symptom level following one year, suggests that it might be important to design interventions
that directly enhance automatic approach tendencies. Accordingly an important next step for
future research would be to focus on the possibility of retraining approach tendencies for food in
AN patients to increase their automatic motivational orientation towards food.
Approach Bias Modification in Alcohol Dependence: Do Clinical Effects Replicate And
What Are Moderators And Mediators of the Training Effect?
Alcoholism is a progressive neurocognitive developmental disorder. Recent evidence shows
that computerized training interventions (Cognitive Bias Modification, CBM) can reverse some of
these maladaptively changed neurocognitive processes. A first clinical study of alcohol
approach-bias re-training (Wiers et al., 2011, Psychol Sc.), found that trained alcoholic patients
showed less relapse at one-year follow-up than control patients. However, the expected
mediation of the clinical outcome by a change in approach bias was not found. The present
study tested the effects of a longer training (12 sessions instead of 4) in a large sample of
alcohol-dependent patients (N = 509), who were randomly assigned to receive alcohol approach
bias re-training on top of treatment as usual (primarily Cognitive Behavior Therapy) inpatient
treatment or not. Background variables, psychopathology (SCL90, BDI) and executive control
(Classical Stroop Scores) were tested as possible moderating variables of the training effect.
One year after treatment, follow-up data about relapse were collected. As expected, the group
receiving CBM developed weaker alcohol-approach tendencies and reported significantly lower
relapse rates at one-year follow-up. Change in alcohol-approach bias mediated this effect.
Moderation analyses demonstrated that older patients and patients with a strong approach-bias
at pretest profited most from CBM. The expected effect of cognitive control was not confirmed,
but this variable correlated with age, hence age may have masked this effect.
In conclusion, the present findings, as well as supplementary analyses on the initial clinical
results confirm that approach-bias retraining is an effective form of cognitive bias modification in
alcoholism, and that treatment effects are mediated by a change in the alcohol-approach
tendencies.
O Processo de Coaching e Sua Relao com a Lgica e Conceitos da Terapia CognitvoComportamental
Allan de Oliveira, Giliane Gomes, Spencer Jnior.
Universidade de Pernambuco, Recife, Brazil.
Essa pesquisa apresenta a relao entre o processo de Coaching, que tem por fim desenvolver
as pessoas para que atinjam suas metas, utilizando-se da lgica e conceitos da Terapia
Cognitivo Comportamental, ou seja, uma metodologia nova que busca detectar os pontos

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fortes e os pontos fracos do desenvolver e atender as seguintes necessidades humanas: atingir


metas, solucionar problemas e desenvolver novas habilidades, em todos os casos oferece uma
estrutura adicional para o dilogo de mapeamento de tendncias comportamentais
comportamentais. Dentro da abordagem Cognitivo Comportamental este trabalho apoia-se no
quadro terico da aprendizagem transformativa (AT) e em premissas do modelo de mudana
transterico (MMT). O objetivo desta pesquisa relacionar os mtodos utilizados no Coaching,
com a finalidade de mostrar como a mudana de processos cognitivos bsicos mudam os
comportamentos e possibilita ao indivduo alcanar seus objetivos. Para tanto necessrio
visitar os pressupostos tericos da Terapia Cognitivo Comportamental e como se desenvolve o
processo de Coaching, atravs de uma pesquisa qualitativa, integrativa, com visitas nos bancos
de dados do Scielo e da Pudmed, onde foram consideradas publicaes entre os perodos de
1991 e 2011. No universo organizacional, dilemas desorientadores, colocam em xeque
referncias conhecidas e vrios pressupostos bsicos, a dimenso motivacional e a
mobilizao emocional que a desorientao propicia, estimulando a busca por um aprendizado
que se inicia pela reviso de pressupostos e de perspectivas pessoais. Os resultados deixaram
claro que h ligao entre o Coaching, lgica e conceitos utilizados na Terapia Cognitivo
Comportamental, que possibilitam ao indivduo alcanar seus objetivos. possvel perceber
que no quadro terico da aprendizagem transformativa e em premissas do modelo de mudana
transterico a maneira como dilemas desorientadores nas carreiras catalisam processos
reflexivos e aprendizagem, visto que configuram-se como oportunidades especiais para
aprendizados, pois promovem reflexo, reviso de perspectivas, experimentao de novos
comportamentos e a adoo de novas formas de agir.
Child & Adolescent Mental Health/ Salud Psicolgica del Nio y del Adolescente/ Sade
Psicolgica de Crianas e Adolescentes
Impacto de los Conflictos Familiares y el Divorcio en Nios y Adolescentes
Gladys Aldana Primo.
Universidad Autonoma del Per, Jesus Mara Lima, Peru.
Abstract Central: JUSTIFICACIN: Segn las estadsticas, el nmero de divorcios en la
actualidad asciende a un 47% y el nmero de separaciones matrimoniales en un 50%. Ello
implica que los objetivos y roles de estas uniones ya no son los mismos, por lo que han
atravesado o atraviesan por serios conflictos. Es necesario considerar qu abordar los
conflictos familiares no resueltos que provocan el divorcio en la pareja, implica tomar en cuenta
el impacto emocional que la experiencia conlleva tanto en los cnyuges como sobre todo en los
hijos; impacto que se hace extensivo en las familias de origen de la pareja, incluso en los
grupos sociales y amicales de sta. El problema se agudiza cuando la pareja no sabe cmo
afrontarlo y pierde su capacidad de autorregulacin OBJETIVO: Esta conferencia intenta
reflexionar en la proteccin, en el desarrollo psico-emocional y social de los hijos, deben ser lo
ms armnico posible en todos sus mbitos educativos y sociales. Intenta motivar en los
presentes la accin psicoteraputica como aspecto fundamental ante los conflictos familiares y
en el abordaje frente a la decisin de divorcio. Considerando que aunque es mejor que la
pareja se separe a seguir conviviendo en constante conflicto, es propio reconocer la intensidad
con la que la separacin afectar a todos en especial a los hijos. DESARROLLO: Para ello se
abordar brevemente a la familia como primer agente psquico y formador, la presencia de los
conflictos, incidencia de los mismos y su abordaje; el divorcio visto como peligro de
desintegracin familiar y tambin como oportunidad de crecimiento; consecuencias del divorcio,
tanto en los padres como en los hijos en sus diferentes etapas. RESULTADOS: La experiencia
de una separacin acordada con asistencia psicoteraputica, permite por un lado la resolucin

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de problemas individuales de la pareja y el reencuentro de la familia, y en el peor de los casos,


si se llega al divorcio, permite a la pareja concientizar su rol de padres que jams se romper
priorizando su relacin con los hijos y de que stos se vean menos afectados ante los cambios
que pueden sufrir, como comunicar su decisin y asegurarles su amor y apoyo en todo
momento. CONCLUSIONES: Reconocer de la importancia de la intervencin psicoteraputica
en el proceso de separacin o divorcio, ya sea para una unin basada en el crecimiento, o para
el divorcio. Aunque parezca difcil decirlo o lograrlo, el divorcio debe acordarse y negociarse
hasta donde sea posible. El rol y la funcin del psicoterapeuta juegan un papel muy importante
en la salud mental de las personas inmersas en este proceso.
Cuerpos Ideales, Autoestima Corporal y Construccin de Identidad en Varones
Leonardo Amaya.
Psicologa, Universidad del Rosario, Bogot, Colombia.
Abstract Central: La cultura contempornea del cuerpo propone modelos sobre-demandantes.
El marketing del cuerpo, representado particularmente en la publicidad y en las pasarelas de
moda contribuye en la construccin de los ideales culturales a travs del uso de modelos
femeninas delgadas y modelos masculinos musculares y magros, cuyo ndice de masa corporal
es difcil de lograr y mantener en la vida real. La comparacin con esas imgenes idealizadas
pueden resultar en baja satisfaccin con sus propios cuerpos y baja autoestima. La indagacin
ha tendido a dejar de lado el fenmeno en varones, destacando los efectos sobre trastornos
alimentarios en mujeres. All los ideales de belleza y cuerpo se hacen paradigmticos y su
vinculo con el suceso personal directo. A partir de la experiencia REBT con algunos modelos
masculinos de moda en Bogot, planteamos algunos aprendizajes que pueden ser tiles para
el trabajo cognitivo conductual en adolescentes escolares enfrentados a la cultura de la imagen
perfecta. Proponemos un estudio de casos a partir de los cuales discutimos los modelos
tericos de construccin del cuerpo y autoestima corporal, considerados en atencin al modelo
de intervencin REBT.
Exposicin Frente a Terapia Cognitiva en la Intervencin en Adolescentes con Fobia
Social (IAFS)
Maravillas Amors, Ana Isabel Rosa-Alczar, Jos Olivares.
Personalidad, Evaluacin y Tratamiento Psicolgicos, Universidad de Murcia, Murcia, Spain.
Abstract Central: El objetivo de nuestro trabajo es evaluar el peso relativo de la exposicin
frente a la terapia cognitiva en los efectos generados por el tratamiento psicolgico cognitivoconductual Intervencin en Adolescentes con Fobia Social (IAFS en adelante; Olivares, 2005).
La muestra la componen 85 adolescentes de 15.50 aos de edad media (rango 14-17), que
haban recibido un diagnstico de social generalizada conforme a los criterios del DSM-IV-TR
(APA, 2000). Los sujetos fueron asignados aleatoriamente a dos condiciones experimentales:
IAFS versus IAFS sin Terapia Cognitiva y sin Entrenamiento en Focalizacin de la Atencin
(IAFS sin TC y sin FA, en adelante). Los resultados indican que la modalidad desmantelada
IAFS sin TC y sin FA, se muestra estadsticamente tan eficaz como la versin que incluye
reestructuracin cognitiva y entrenamiento en focalizacin de la atencin. Los resultados
apoyan que aunque el componente cognitivo pueda potenciar la eficacia de la intervencin, no
incrementa los beneficios del tratamiento de forma significativa.

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Peso de la Atencin Focalizada en la Intervencin Cognitivo Conductual para la


Ansiedad Social en Nios y Adolescentes
Maravillas Amors, Ana Isabel Rosa-Alczar, Jos Olivares.
Personalidad, Evaluacin y Tratamiento Psicolgicos, Universidad de Murcia, Murcia, Spain.
Abstract Central: Una de las tcnicas utilizadas con xito en el tratamiento de la ansiedad
social en adultos es el entrenamiento en focalizacin de la atencin (Amir et al., 2009). En la
infancia y adolescencia este componente forma parte junto a otros como la exposicin y la
terapia cognitiva, del tratamiento psicolgico cognitivo-conductual Intervencin en Adolescentes
con Fobia Social (IAFS; Olivares, 2005). EL objetivo de este trabajo es analizar el peso de la
focalizacin atencional en los efectos generados por el tratamiento. La muestra est formada
por 70 adolescentes diagnosticados de Fobia Social Generalizada (DSM-IV-TR; APA, 2000),
con una edad media de 14.60 (rango 13-16) y de los cuales ms del 80% eran mujeres. Los
participantes se asignaron al azar a dos condiciones experimentales: IAFS versus IAFS sin
Focalizacin Atencional (IAFS sin FA, en adelante). Los resultados no mostraron diferencias
estadsticamente significativas entre las condiciones experimentales en ninguna de las
variables medidas, encontrndose en ambas modalidades de tratamiento altos tamaos del
efecto.
Prevalncia de Transtornos Disruptivos em uma Populao de Sujeitos
Socioeconomicamente Vulnerveis
Rossana Andriola, Kelly Paim, Marcus Barbosa, Ricardo Wainer, Liza Martinato, Caroline Pinto,
Leandro Kuhl, Pedro Moser.
WP, Porto Alegre, Brazil.
Os Transtornos Disruptivos tem uma grande prevalncia na populao em geral levando a uma
relevante procura de atendimento nos servios de sade (Garland et al., 2001). Tanto o
Transtorno de Conduta, quanto o Transtorno Desafiador de Oposio representam um grande
desafio no s para os servios de sade, mas para os terapeutas devido dificuldade de
manejo com estas crianas e adolescentes. Por conseguinte, este artigo objetivou investigar a
prevalncia destes transtornos em uma populao socioeconomicamente vulnervel, atendida
por uma ONG na periferia de Porto Alegre. A metodologia utilizada foi a analise dos pronturios
de atendimentos psicolgicos realizados durante os anos de 2007 a 2011. Participaram desta
pesquisa 205 indivduos de 2 a 18 anos de idade, de ambos os sexos (101 do sexo feminino e
104 do sexo masculino). Todos os participantes assinaram o Consentimento Livre e
Esclarecido para Participao em Pesquisa. Os dados foram analisados como o auxilio da
planilha eletrnica SPSS 16.0. Os dados colhidos indicaram uma prevalncia de 4,4%, o que
est dentro do intervalo encontrado em estudos que avaliaram a populao geral (prevalncias
que vo de 1,4% a 12%; Meltzer, Gatward, Goodman, Ford, 2000; Biederman, Faraone, 2005).
A luz dos resultados obtidos no se encontra evidencias que indiquem relao entre a
vulnerabilidade scio econmica vivida por estes sujeitos e os Transtornos Disruptivos.
Transtornos de Personalidade na Infncia. possvel diagnostic-los?
Gildo Angelotti, Marilia Pereira, Luciana Rizo, Marcelo Carvalho, Maria Comis.
Ambulatrio de Ansiedade, Universidade de So Paulo, So Paulo, Brazil.
Os Transtornos de Personalidade apresentam caractersticas marcantes durante a infncia e
adolescncia, principalmente o Transtorno de Personalidade Anti-Social. Os demais
Transtornos de Personalidade apresentam caractersticas importantes, tais como os

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Transtornos de Personalidade Borderline, Evitativo e Histrinico durante todo o


desenvolvimento infantil e adolescncia e se configura como um Transtorno de Personalidade
aps os 18 anos, no Brasil. Em outros pases a idade aps os 21 anos. Discrepncias como
essa entre outras sero apresentadas como discusso de possveis sugestes para o DSM e
demais Manuais Diagnsticos.
Actitudes Sociales y Rasgos de Personalidad Situacional en Adolescentes de Lima, Per
Elizabeth Araujo1, 3, Roberto Bueno2, 4.
1. Universidad Autnoma del Per, Lima, Peru, 2. Universidad Nacional Federico Villarreal,
Lima, Peru, 3. Universidad Inca Garcilaso de la Vega, Lima, Peru, 4. Universidad de San Martn
de Porres, Lima, Peru.
Abstract Central: Examina la asociacin de los rasgos de personalidad situacional con las
actitudes prosociales, antisociales y antisociales en 260 adolescentes de Lima Metropolitana.
Se emplearon el Cuestionario de Personalidad Situacional (Fernndez et al., 2001) y de la
Escala de Estrategias Cognitivas y Sociales (Moraleda et al., 2004), ambos adaptados y
validados para la poblacin peruana por Araujo (2007). El primer instrumento evala las
tendencias o estilos de comportamiento ante diferentes situaciones de la vida cotidiana. Por
otro lado, el segundo instrumento examina tres tipos de actitud para interactuar en el medio
social: prosocial, antisocial y asocial, de acuerdo a si estas facilitan, interfieren o impiden las
relaciones interpersonales. Los resultados 1-5 se refieren a las actitudes prosociales. 1. Las
correlaciones de la conformidad con lo socialmente correcto parecen indicar que a mayor
conformidad, menor habilidad social, baja asertividad y poca autonoma, lo cual posiblemente
refleja la identificacin culturalmente determinada entre conformidad con lo socialmente
correcto y conducta sumisa. 2. La sensibilidad social correlaciona positivamente con
autoconfianza, tolerancia y deseabilidad social y negativamente con dominancia y agresividad.
3. Ayuda y colaboracin correlaciona positivamente con eficacia, sociabilidad, ajuste social y
liderazgo, Indicando que las persona dispuesta a prestar colaboracin est orientado a la
conduccin de otras personas, as como por un sentido propio de capacidad y habilidad. 4. La
seguridad y firmeza en la interaccin presenta correlaciones positivas con varias escalas de
personalidad, indicando que cuanto ms alto es el nivel de asertividad, son tambin ms
intensos el control emocional y la sensacin de competencia y efectividad. 5. Las correlaciones
del liderazgo prosocial muestran que esta actitud no refleja las cualidades propias del lder sino
que est ms relacionada con un deseo de reconocimiento social y de dominio sobre los
dems, pero que no llegan a expresarse en una verdadera capacidad de conduccin de
personas. 6. Las dos actitudes antisociales, agresividad-terquedad y dominancia, correlacionan
negativamente con casi todas las escalas de personalidad situacional, y positivamente con
estabilidad. 7. Las dos actitudes asociales, apata-retraimiento y ansiedad-timidez tambin
correlacionan negativamente con casi todas las escalas de personalidad situacional. Estos
resultados muestran que el Cuestionario de Personalidad Situacional evala rasgos que en
general son opuestos a caractersticas como agresividad o inestabilidad emocional. Por otro
lado, en el caso de las actitudes prosociales, se encuentran tambin algunas correlaciones
negativas con los rasgos de personalidad situacional. Es decir, al parecer los rasgos
prosociales evaluados por el Cuestionario de Personalidad Situacional pueden caracterizarse
como de ausencia o baja agresividad o inestabilidad emocional y muchos de estos rasgos
parecen tener poca relacin con las actitudes prosociales evaluadas, tales como la sensibilidad
social, la ayuda-cooperacin o la asertividad.

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Depressive Symptom Trajectories among Low-Income Latino Adolescents and the Role
of Gender
Jessica Arizaga, Antonio Polo.
DePaul University, Chicago, IL, USA.
A growing body of literature indicates Latino youth in the United States - and particularly Latino
female adolescents - are at greater risk for depression relative to other ethnic groups
(Merikangas et al., 2010; U.S. Census Bureau, 2012). Despite consistent findings showing
differential risk, studies have yet to examine ethnic variations in the course of depression.
Generally, depression rates are known to increase throughout adolescence (Hankin, 1998);
however, other studies have found depressive symptoms decrease over time (Twenge & NolenHoeksema, 2002). Researchers contend that such differences might be due to commonplace
group-level analyses being limited in their ability to identify subpopulations of trajectories that
diverge from normative patterns (Jung & Wickrama, 2007). Although there is emergent support
for this hypothesis (Wickrama et al., 2008), to date, there are no studies corroborating these
findings or examining person-centered trajectories among any ethnic minority groups. The
purpose of the present study is to begin to address this gap in the literature and examine the
course of depressive symptoms among Latino youth of predominately immigrant family
backgrounds using a person-centered approach, and examine whether trajectories vary for boys
and girls. The sample is comprised of 133 predominately low-income 5th (27.1%), 6th (30.8%),
and 7th (42.1%) grade Latino students from a public school in Chicago, IL, USA. The mean age
at enrollment was 11.91 years (SD = .94, range = 10-14 years). The sample includes 74 males
(55.6%) and 59 females (44.4%). Youth were of Mexican American (60.9%), Puerto Rican
(21.8%), or Central American (7.5%) backgrounds, and a few were of mixed Latino subgroups
or mixed Latino and non-Latino backgrounds (9.8%). Most youth were U.S.-born (81.9%), and
most had one or more foreign-born parent (82.6%). Data for youth depressive symptoms were
collected using the Childrens Depression Inventory (Kovacs, 1992), administered at four time
points over the span of two years. The internal consistency of the CDI in the present sample
was good at all time points (T1 = .88; T2 = .83; T3 = .88; T4 = .88). Attrition bias analyses
show no significant differences between Time 1 and Time 2 through Time 4 on age, grade, sex,
and depression levels. Preliminary results indicate a significant declining linear effect for
adolescent depressive symptoms over time [F(1, 95) = 25.24, p < .001]. Further, although no
significant time by gender interaction was found longitudinally, female adolescents had
significantly higher depressive symptom levels compared to male adolescents at Time 1 [t(130)
= -2.30, p < .05]. To allow for the possibility of multiple mean growth curves, growth mixture
modeling will be used to classify heterogeneous youth depressive symptom trajectories (Muthen
and Muthen, 2002), and a multinomial logistic regression analysis will be employed to test for
gender differences. The present study will be the first to examine depressive symptom
trajectories among Latino adolescents using a person-centered approach. The findings will
inform future research on the subtypes found within this at-risk cultural group in order to identify
and target youth with the most chronic and severe profiles.
Cognitive Assessment of the Delinquent Adolescents and Assessment of the Difference
Between Hyperactivity and Attention Deficit
Elvin Azaroglu, Gulcin Senyuva, Gonca Bastug, Naz Bozok.
Koza Psychological Consultancy, Istanbul, Turkey.
Naz BOZOK*, Gulcin SENYUVA**, Gonca BASTUG***, Elvin AZAROGLU* *Neuro-Psychologist
Msc, Koza Danismanlik ** Psychologist Msc, Ministry of Justice (Turkey) *** Psychologist, Sisli
Terakki Vakfi Lisesi INTRODUCTION: Cognitive enhancement does not have a significant

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influence only on the adolescents themselves, their friends, and families, but also on their forms
of vision of their worlds. Cognitive processes of the adolescents are different. Our complex
behaviors and cognitive functions take place by means of specific neural systems. These neural
systems are anatomically based on the activity of certain brain structures, specific brain regions,
and transmission pathways across them. Neuropsychological tests assess our complex
behaviors and cognitive functions produced by these neural systems, contributing to the
examination of these structures of the brain. Attention Deficit-Hyperactivity Disorder (ADHD) is a
neuropsychiatric condition characterized by attention deficit, hyperactivity, and impulsiveness
(Barkley, 1996). Similarly, symptoms of ADHD can be grouped under these three main
headings: 1. attention deficit, 2. hyperactivity, and 3. impulsiveness. The symptoms of attention
deficit include concentration problems, difficulties in completing a job, and difficulties in listening
to the conversations. The symptoms of hyperactivity can appear in the form of excessive
speech and fidgetry in movements. The symptoms of impulsiveness can be seen as impatience,
and difficulties in completing a task as well as in listening to, and following and performing the
instructions. The purpose of this study is to assess the cognitive enhancement of the delinquent
adolescents in terms of ADHD. It will be examined whether there is a difference between
delinquent and normal adolesents in terms of neurological structuring and ADHD diagnosis.
METHOD: The study will be conducted with a total number of 100 people, including 50
delinquent adolesents from the Ministry of Justice Maltepe Closed Prison for Children and Youth
and 50 adolescents studying at a private highschool in Istanbul. The study will use a sociodemographical information form containing the general information about the adolescents; Adult
ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale which has been tested for
validity and reliability; Stroop Test to assess the selective attention, and Wisconsin Card Sorting
Test designed to evaluate the abstract reasoning ability as well as the ability to change the
cognitive strategies against the changing stimuli.
Ideao Paranoide na Adolescncia: Caracterizao e Factores de Risco
Clia Barreto Carvalho1, 2, Vera Pereira1, Paula Castilho2, Jos Pinto-Gouveia2.
1. Science Education, University of Azores, Ponta Delgada, Portugal, 2. CINEICC, College of
Psychology and Science Education, University of Coimbra, Coimbra, Portugal.
Abstract Central: O estudo do fenmeno da ideao paranoide cada vez mais alargado
populao no clnica, verificando-se, para esta ideao, um contnuo entre o normal e
patolgico. Este contnuo e a aceitao da ideao paranide como uma experincia comum
na populao em geral consistente com a concepo de muitos, autores (e.g.: Freeman,
Pugh, Antley, Slater, Bebbington, Gittins, Dunn, Kuipers, Fowler e Garety, 2008; van Os,
Linscott, Myin-Germeys, Delespaul e Krabbendam, 2009; Barreto Carvalho, 2009), sendo o seu
impacto bastante significativo (em termos de cognio e comportamento social) e podendo
comprometer o quotidiano dos indivduos (Combs, Michael & Penn, 2006; Fenigstein, 1997;
Freeman, et al., 2002; Martin & Penn, 2001). Freeman, et al (2005) defendem que a ideao
paranide poder ser definida pela interaco entre um indivduo fragilizado psicologicamente,
nveis altos de depresso, ansiedade, stress, medo de separao e uma auto-conscincia
elevada. Sendo a parania no clnica caracterizada pela presena de sentimentos de medo de
rejeio, excluso, humilhao ou inferiorizao em relao aos outros (Gilbert, Boxall, Cheung
& Irons, 2005) e funcionando como um modo de defesa, de proteco do self contra as
ameaas percepcionadas (Chadwick e Trower, 1996). Compreender o pensamento paranide
junto da populao normal (no clnica) essencial na resoluo dos problemas de vida
associados a este (Freeman, et al., 2005), sendo esta compreenso ainda mais pertinente na
adolescncia, uma vez que se sabe que os aspectos desenvolvimentais desta faixa etria se
encontram correlacionados com o aumento da psicopatologia na vida adulta (Freeman, Garety

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e Kuipers, 2002). Neste estudo caracteriza-se a ideao paranoide numa amostra de 1762
adolescentes com idades compreendidas entre os 14 e os 17 anos. Os resultados permitemnos concluir que, na adolescncia, a frequncia da ideao paranoide (M=49.14) semelhante
encontrada em estudos realizados com adultos portugueses (M=43.42, Barreto Carvalho,
2009; M=44.14 Lopes, 2010), sendo tambm semelhantes as variveis preditivas desta
ideao. Assim, podemos afirmar que, apesar da diferena etria, o que est na gnese dos
pensamentos paranides o mesmo, designadamente a vergonha externa e os estilos
parentais. Este resultado vem reforar a importncia do papel de apoio dos progenitores,
fortalecendo a necessidade de intervir ao nvel da educao parental. Quanto mais
envergonhado for o individuo maior ser a hiptese de desenvolver pensamentos paranides,
devendo a vergonha ser tida em considerao como possvel factor de risco, na ideao
paranide. This study characterized the paranoid ideation in a sample of 1762 adolescents.The
results allow us to conclude that, in adolescence, the frequency of paranoid ideation (M = 49.14)
is similar to that found in studies with Portuguese adults (M=43.42, Barreto Carvalho, 2009;
M=44.14 Lopes, 2010). The predictive variables of this ideation is also the same in both
samples, which allows us to state that, despite the age difference, the genesis of paranoid
thoughts is the same, namely the external shame and parenting styles.
Auto-Dano e Ideao Suicida em Adolescentes: Caracterizao, Funes e Etiologia
Clia Barreto Carvalho1, 2, Carolina Nunes1, Paula Castilho2, Jos Pinto-Gouveia2.
1. Science Education, University of Azores, Ponta Delgada, Portugal, 2. University of Coimbra,
Coimbra, Portugal.
Abstract Central: A adolescncia , muitas vezes, uma fase intensa, de transformaes e de
conflitos, em que o jovem pode enveredar por comportamentos agressivos, impulsivos ou
mesmo suicidas, como soluo para os seus problemas (Borges & Werlang, 2006), sendo
relativamente comum o sofrimento psquico (Stheneur, 2006). Os comportamentos autodestrutivos so um exemplo claro destes comportamentos, o que faz com que tenham
despertado um interesse crescente na investigao, que alerta, assim, para o impacto destes
na vida do indivduo (Pelios, Morren, Tesch & Axelrod, 1999; Duque & Neves, 2004). Alguns
autores referem a adolescncia como uma fase do desenvolvimento em que estes
comportamentos auto-lesivos so um problema significativo (e.g.: Hawton, Rodham, Evans &
Weatherall, 2002; Madge, Hewitt, Hawton, Wilde, Corcoran, Fekete, Heeringen, Leo &
Ystgaard, 2008; Madge, Hawton, MacMahon, Corcoran, Leo, Wilde, Fekete, Heeringen,
Ystgaard & Arensman, 2011), considerando-os como uma perturbao grave e crnica, que
frequentemente resulta em riscos fsicos, sociais e educacionais significativos (U.S. National
Institute of Health, 1989 in Pelios, Morren, Tesch & Axelrod, 1999, p.185). Em Portugal, do
nosso conhecimento, no existem dados publicados referentes a estudos sobre os
comportamentos de auto-dano, da a urgncia de um estudo neste mbito, para que, assim, se
possam realizar futuros programas de preveno. Os resultados do nosso estudo (n = 1818)
indicam que a taxa de adolescentes que se envolvem em comportamentos de auto-dano
(47.1%.) e ideao suicida (77%) elevada, sendo o auto-dano usado para criar um estado
fisiolgico desejvel ou para escapar a demandas interpessoais, o que mostra, tal como
defendem Nock & Prinstein (2004), que a maioria dos jovens que se envolvem nestes
comportamentos tem como objetivo a regulao (reduo e/ou aumento) de experincias
emocionais ou fisiolgicas (Nock & Prinstein, 2004). O auto-dano mais frequente em jovens
entre 14 e 16 anos, com reprovao acadmica e menos satisfeitos com a escola e famlia.
Relativamente ideao suicida, esta mais frequente nas raparigas de nvel scio-econmico
mais baixo e menos satisfeitas com a escola e famlia. Ambas as variveis se encontram
correlacionadas com os sintomas de depresso e ansiedade, o auto-criticismo, a raiva e o

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estilo parental critico. Abstract: The results of our study (n = 1818) indicate that the rate of
adolescents who engage in self-harm behaviors (47.1%.) and suicidal ideation (77%) is high,
self-harm being used to create a physiological desirable state or to escape interpersonal
demands, which shows, as Nock & Prinstein advocate (2004), that most young people who
engage in these behaviors wants to regulate (reduction and / or increase) physiological or
emotional experiences (Nock &Prinstein, 2004). Self-harm is more common in young people
between 14 and 16 years, with academic failure and less satisfied with school and family.
Regarding suicidal ideation, this is more common in girls of lower socio-economic status and
less satisfied with school and family. Both variables are significantly correlated with symptoms
of depression and anxiety, self-criticism, anger and critic parenting style.
Empathy Skills Training in Children and Adolescents with Aspergers Syndrome
Patricia Barros1, 2, Eliane Falcone2.
1. Santa Casa de Misericrdia RJ, Rio de janeiro, Brazil, 2. Universidade do Estado do Rio de
Janeiro, Rio de Janeiro, Brazil.
Abstract Central: Empathy is a multidimensional concept comprised of cognitive, affective and
behavioral components.The empathy atypical operation generates significant trouble and loss in
the social field. This is what happens with those who are diagnosed with Asperger's Syndrome,
whose impasses in interactions relate, mostly, to a social atypical functioning. In other words,
the development of such skills, among these individuals, does not take place in a spontaneous
and natural way, that's why it is vital some kind of intervention in order to stimulate them. So, the
current study aims at building up and evaluating a program towards the development of
empathy among children and adolescents diagnosed with Asperger's Syndrome (SA). The main
objective was to improve this capacity by learning the strategies focusing on the development of
the cognitive component, mainly skills such as the perspective taking and mental flexibility.
Furthermore, the presuppositions of the Cognitive Behavioural Therapy were taken into
consideration and its structure counted on a set of various tools that were applied in group. The
sample was comprised of 46 children and adolescents (44 boys and 2 girls) ranging from 8 to
17 years old, diagnosed with AS according to the DSM-IV criteria. The participants were
evaluated before and after the intervention, as well as 30 days afterwards. Empathic skills were
evaluated through a list of behaviors, built up from data retrieved from Literature. Parents and
teachers considered every single item of the list based on the behavior of the participant,
observed in different social contexts. Concerning the evaluation method, the participants
watched snippets of films so as to measure their abilities in the cognitive and affective aspects
of empathy. All the seven film snippets shown to children and adolescents required the
identification of basic and complex emotions. Moreover, the participants' behaviors were
recorded during free interactions in three different moments along the intervention sessions.
Simultaneously, parents also took part in treatment, in which they could learn more about SA
and its characteristics. In addition, families were oriented towards communication strategies to
stimulate the development of empathy in their kids. The results showed significant improvement
in the empathic behaviors considering the parents', teachers' and trained judges perspective.
Besides, improvement was noticed in the cognitive and affective components of empathy
towards the identification of complex and simple emotions. Needless to say that the
improvement continued showing results throughout the segment evaluation, and the same
applies to the cognitive aspect towards identification of simple emotions. These results confirm
the training program efficacy and also agree with data collected from previous studies, which
suggest that the cognitive development of empathy is intrinsically related to the improvement of
other components (affective and behavioral), becoming widespread in various social contexts of
these individuals.

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Contribuies da Psicoeducao Para a Orientao aos Pais Sobre a Sndrome de


Asperger
Patricia Barros.
1. Santa Casa de Misericrdia RJ, Rio de janeiro, Brazil, 2. Associao de Sndrome de
Asperger do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract Central: A Psicoeducao uma das ferramentas mais utilizadas nas intervenes
em Terapia Cognitivo Comportamental (TCC). Alguns dos transtornos que ocorrem na infncia
e adolescncia dependem intensamente da ferramenta da psicoeducao como base de sua
interveno, como o caso da Sndrome de Asperger. Crianas e adolescentes com a
Sndrome de Asperger (SA) apresentam funcionamento peculiar em trs diferentes domnios
cujas consequncias esto relacionadas a uma srie de padres comportamentais repetitivos,
dificuldades relacionadas s habilidades sociais e tambm de comunicao. Tais
peculiaridades geram prejuzos significativos e persistentes em aspectos cotidianos bsicos e
em diferentes contextos sociais. Assim, as caractersticas essenciais desta sndrome so o
tema primordial do processo psicoeducacional na Terapia Cognitivo Comportamental (TCC). A
finalidade o entendimento deste funcionamento peculiar auxiliando na orientao das
condutas de manejo da famlia em relao a este jovem. A estimulao por parte dos
cuidadores tem sido usada tanto como recurso principal quanto no auxlio a uma srie de
tratamentos voltados para esta sndrome. Muitos autores tm sugerido que os pais podem
tambm funcionar como co-terapeutas facilitando e mediando a aplicao das estratgias
aprendidas na terapia. A psicoeducao apresenta-se, ento, como pea chave para que se
atinja tais objetivos. Assim, neste estudo, pretende-se abordar os principais aspectos que pais
e cuidadores devem entender sobre a SA facilitando o manejo cotidiano nos trs principais
domnios da SA. Sero apresentadas e discutidas no apenas a descrio de tais
caractersticas, como tambm algumas ferramentas relativas empatia. Em outras palavras, os
pais so convidados a se colocarem no lugar de seus filhos vivenciando um pouco do modo
como eles (os filhos) experimentam o mundo. Tal exerccio tem impacto direto em uma srie de
aspectos teraputicos como o aprimoramento das habilidades de comunicao entre pais e
filhos, a auto-regulao emocional dos pais facilitando o manejo dos sintomas no dia a dia,
dentre outros. A ideia principal a de que, medida que os pais entendam o funcionamento de
seus filhos, eles passem, ento, a desencadear menos atribuies distorcidas a respeito de
seus comportamentos (dos filhos), passando a entender tais condutas como parte de um
funcionamento peculiar, necessitando ser redirecionadas ao invs de punidas. Alguns recursos
so utilizados neste processo: trechos de filmes que contenham as temticas discutidas
durante a psicoeducao, dramatizaes, bem como material didtico com orientaes bsicas
sobre a sndrome. Este tipo de ferramenta pode ser aplicado como parte do tratamento
individual de uma criana/adolescente participando do processo geral de orientao aos pais.
Assumindo outro tipo de objetivo, a psicoeducao pode tomar forma como o nico foco do
tratamento, especialmente em crianas menores e que acabaram de receber o diagnstico.
Pode tambm fazer parte de sesses de terapia de famlia e ainda ser aplicada em grupo.
Neste ltimo, a ideia no apenas receber informaes a respeito da sndrome, mas tambm
compartilhar experincias e informaes entre os pais.
Cool Little Kids Randomized Controlled Trial: Population Level Early Prevention for
Internalizing Disorders
Jordana Bayer1, 2, Ruth Beatson2, Tamsyn Gilbertson3, 2, Lesley Bretherton3, 2, Harriet Hiscock2,
4
, Cathy Mihalopoulos5, Obi Ukoumunne6, Ron Rapee7.

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1. La Trobe University, Melbourne, VIC, Australia, 2. Murdoch Childrens Research Institute,


Melbourne, VIC, Australia, 3. University of Melbourne, Melbourne, VIC, Australia, 4. Royal
Childrens Hospital, Melbourne, VIC, Australia, 5. Deakin University, Melbourne, VIC, Australia,
6. Peninsula Medical School, Exeter, United Kingdom, 7. Macquarie University, Sydney, NSW,
Australia.
Abstract Central: Introduction: The World Health Organization predicts that by 2030
internalizing problems will be second only to HIV/AIDS in international burden of disease.
Internalizing problems affect 1 in 7 school aged children, impacting on peer relations, school
engagement, and later mental health, drug use/abuse, relationships and employment. The
development of early childhood prevention for internalizing problems is in its infancy. The
current study follows two successful efficacy trials of a parenting group intervention to reduce
anxiety disorders in temperamentally inhibited preschool children. Cool Little Kids is a
population level randomized trial to determine the impacts of systematically screening
preschoolers for inhibition and parenting group intervention, on child internalizing problems and
economic costs at school entry. Methods: This randomized trial is being conducted within the
preschool service system, attended by more than 95% of Australian children in the year before
starting school. In 2011-12, preschool services in eight government areas in Melbourne,
Australia distributed the screening tool. In total 6,346 children were screened with 11% identified
as temperamentally inhibited and 545 taking part in the trial. Intervention parents were offered
Cool Little Kids, a 6-session group program in the local community, focusing on ways to develop
their childs bravery skills by reducing overprotective parenting interactions. Results: Interim
findings to date will be presented. Outcomes one and two years post-baseline will comprise
child internalizing diagnoses and symptoms, parenting interactions, and parent wellbeing. An
economic evaluation (cost-consequences framework) will compare incremental differences in
costs of the intervention versus control children to incremental differences in outcomes, from a
societal perspective. Analyses will use the intention-to-treat principle, using logistic and linear
regression models (binary and continuous outcomes respectively) to compare outcomes
between the trial arms Conclusions: This trial addresses gaps for internalizing problems
identified in the 2004 World Health Organization Prevention of Mental Disorders report. If
effective and cost-effective, the intervention could be applied at a population level. Governments
consider mental health to be a priority, enhancing the likelihood that an effective early
prevention program would be adopted in Australia and internationally.
Indicadores Clnicos de Personalidad en la Adolescencia Clinical Indicators of
Personality in Adolescence
Martha Benitez Barraza1, Evelyn Sanchez Montero1, Marleyn Serrano1, 2.
1. universidad del norte, Barranquilla, Colombia, 2. universidad del Atlntico, Barranquilla,
Colombia.
El objetivo de este estudio, fue caracterizar la presencia de indicadores clnicos y de contenido
de personalidad en una poblacin adolescente, a travs del Inventario Multifsico de
Personalidad de Minnesota Forma A, la muestra estuvo conformada por 69 adolescentes
escolarizados, de 14 a 17 aos, tanto hombres como mujeres, de estrato socioeconmico
medio y alto de la ciudad de Barranquilla. Los datos se analizaron con el SPSS versin 19.0
para el anlisis de estadsticos descriptivos, los resultados arrojaron perfiles vlidos y fueron
consistentes con investigaciones previas segn las que se puede diferenciar poblacin normal
de poblacin con indicadores clnicos de personalidad, de importancia; en algunas escalas sin
embargo los puntajes fueron ms altos que los encontrados en otras investigaciones para
grupos similares dando cuenta de las variaciones introducidas por el contexto y la dinmica

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socio-cultural actual, particularmente para las mujeres. Las caractersticas clnicas ms


significativas fueron esquizofrenia, hipomana, masculinidad-feminidad y psicastenia; mientras
que los puntajes de las escalas de contenido ms significativos fueron en las de contenido
fueron pensamiento extravagante, obsesividad y ansiedad.
Resultados: Indicadores Clnicos de Personalidad en la Adolescencia
Las escalas de validez, L, F y K fueron analizadas mostrando perfiles vlidos, con algunas
elevaciones estadsticamente significativas, pero que analizadas en conjunto con las dems
variables no invalidaron las pruebas, siendo posible su interpretacin. Los puntajes medios
para las tres escalas fueron, en su orden, 50, 52 y 47.
El 17,4% de los sujetos obtuvieron elevaciones en la escala F superiores a 65, con un puntaje
mximo de 82 que evidencian intenciones de mostrarse peor de lo que en realidad se est,
como una forma de pedido de ayuda, mientras la escala L arroj puntuaciones sobre 65 para
un 8,7% de la poblacin, que intentan mostrarse como buenos o adecuados.
De los sujetos participantes, el 82,7% present indicadores clnicos en al menos una (01) de las
escalas, solo el 17,3% restante no obtuvo puntuaciones clnicamente significativas.
De la poblacin general, cuyas puntuaciones directas son superiores a 60, encontramos que la
para las subescalas clnicas, la de Hipomana obtuvo puntuaciones altas para el 36,2% de la
poblacin, seguida de la escala de Esquizofrenia con un 29% del total, continan la escala de
Masculinidad-Feminidad y Psicastenia que marcaron puntajes significativos en el 21,7% de los
casos.
En cuanto a las escalas de contenido, encontramos que la subescala de Pensamiento
Extravagantes, obtuvo puntuaciones altas en la mayora de la poblacin, con un 36,2% del
total, para la de Obsesividad, las puntuaciones elevadas fueron obtenidas por el 30,4% de los
sujetos, seguida de la escala de Ansiedad con un 27,5%, la de Alienacin para un 26,1% de la
poblacin y las de Cinismo, Malestar Social y Problemas familiares en un 24,6% de los sujetos.
Si bien los puntajes de 60 a 64 no carecen de importancia, son las escalas cuyas puntuaciones
T son iguales o superiores a 65 las consideradas clnicamente significativas y tenidas en cuenta
para la elaboracin de los perfiles clnicos. Un puntaje de este tipo indica el cumplimiento de la
mayora de los indicadores de patologa que se incluyen en cada escala; en el grupo de las
escalas clnicas, encontramos la escala de Hipomana, con puntajes de 66 hasta 79 para el
21,7% de la poblacin y la escala de Esquizofrenia con puntajes desde 65 hasta 78, para el
14,5%, sin embargo los puntajes ms elevados fueron registrados en las escalas de Hipomana
y Masculinidad-Feminidad.
En cuanto a las escalas de contenido, la de Pensamiento Extravagante marc puntuaciones de
70 a 77 para el 17,4% de los sujetos, a su vez las escalas de Obsesividad y Alienacin para un
15,9%, los puntajes fueron de 65 a 75 y de 65 a 87 respectivamente; Los puntajes ms altos,
fueron registrados en las subescalas de Alienacin y Malestar Social.
Discusin: Indicadores Clnicos de Personalidad en la Adolescencia
Este estudio muestra una gran mayora de la poblacin con indicadores clnicos, sin embargo al
interior de ella el comportamiento fue heterogneo en los resultados de cada escala. El 82,7%
de los sujetos que obtuvieron puntuaciones clnicamente significativas es coherente con
investigaciones previas en adolescentes que evidencian el riesgo de desarrollar trastornos o
comportamientos desadaptivos para este grupo poblacional, como lo muestran los resultados
de Vinet, Salvo y Forns (2005) donde el grupo de adolescentes no consultantes evaluados se
encontr en riesgo de desarrollar trastornos psicopatolgicos partiendo de caractersticas
maladaptativas de su funcionamiento psicolgico.
Por su parte, Alba (2010), plantea que el actual contexto socio-cultural, caracterizado por
grandes cambios y problemticas sociales y polticas, hace que los jvenes sean an ms
vulnerables a comportamientos de riesgo y a la presentacin de problemas asociados con la

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salud mental, situacin frente a la cual debern desarrollar habilidades y estrategias personales
lo suficientemente slidas y estructuradas para afrontar las circunstancias en que se
encuentren (Domnech, 2005; Moral y Sirvent, 2011).
Los resultados de los adolescentes son coherentes con lo encontrado en otras investigaciones
donde se corrobora que esta prueba permite diferenciar poblacin sana de poblacin con
indicadores clnicos de importancia, tal como lo muestran Vinet y Alarcn (2003) y Vinet y Forns
(2009), lo cual permite una caracterizacin adecuada de la poblacin en cuestin (Prez, Durn
y Lucio, 2003), adems el Inventario de Minnesota tiene como gran aporte a la investigacin y a
la prctica clnica la valoracin de la patologa mental que permiten las subescalas clnicas
(Vinet y Forns, 2009).
Conclusin y Recomendaciones: Indicadores Clnicos de Personalidad en la
Adolescencia
El objetivo de este estudio, fue caracterizar la presencia de indicadores clnicos y de contenido
de personalidad en una poblacin adolescente, a travs del Inventario Multifsico de
Personalidad de Minnesota Forma A, logrndolo a travs de la identificacin de indicadores
positivos clnicos y de contenido de la muestra en mencin, por lo que podemos afirmar que las
hiptesis acerca de la existencia de indicadores clnicos y de contenido en los adolescentes
son cierta. Es decir, si existen indicadores clnicos y de contenido de personalidad en los
adolescentes; las escalas clnicas que en su mayora obtuvieron puntajes clnicamente
significativos fueron las de hipomana, esquizofrenia, masculinidad-feminidad y psicastenia, por
su parte las escalas de Contenido mostraron este rendimiento para el pensamiento
extravagante, obsesividad y ansiedad; adems el perfil que fue ms comn a los jvenes de la
muestra fue el de Masculinidad-Feminidad/Hipomana. Es de resaltar, con respecto a este
estudio, lo limitado de la muestra que nos lleva, en trminos de recomendaciones a sugerir,
para futuros estudios una muestra significativamente ms amplia que permita resultados ms
generalizables, incluyendo estratos socioeconmicos diversos, control y diferencias entre
gnero y ampliando las edades de la muestra para verificar patrones de estabilizacin de los
indicadores; de igual forma se sugiere incluir datos sociodemogrficos relacionados con el
ncleo familiar, antecedentes personales y familiares y la realizacin de grupos focales que
permitan ampliar lo encontrado en los perfiles, ya que aun cuando la adolescencia sea una
etapa de particular vulnerabilidad psicolgica y emocional, tambin es cierto que la familia y el
entorno sociocultural actan como predisponentes y mantenedores de problemticas o por el
contrario como factores protectores para los jvenes.
Parent Counseling Based on Acceptance and Commitment Therapy: A Pilot Study
Denise Bodden1, Denise Matthijssen2, Yvonne Stikkelbroek1, Cathelijne Lont2, William Hale1.
1. University of Utrecht, Utrecht, Netherlands, 2. Altrecht, Division of Youth, Utrecht,
Netherlands.
Abstract Central: Summary Recently, Acceptance and Commitment therapy (ACT) has been
receiving more attention in the clinical practice. ACT was originally developed to treat adults, is
focused on individual problems (e.g., anxiety or depression symptoms) and is often employed
as a prevention program. In a meta-analysis on 18 RCTs in adults, ACT was found to be more
effective than control conditions (waitlist, placebo and CAU) and equally effective compared to
established interventions such as CBT and IPT (Powers et al., 2009). In this pilot study, ACT
was delivered as a parent counseling therapy in order to provide the parents new skills in
dealing with their childrens interaction problems, to teach them new parenting strategies and
enhance parental competence by increasing psychological flexibility. Previous research on the
effectiveness of ACT as a parent counseling therapy is scarce. In a study by Blackledge and
Hayes (2006), it was demonstrated that after a 2-day group ACT workshop for parents with

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children diagnosed with autism that parents improved on general psychological outcomes and
that experiential avoidance and cognitive fusion was significantly reduced. Additionally, Coyne,
McHugh and Martinez (2011) have described how ACT can be employed in families. They
concluded that additional research is necessary to investigate effectiveness of ACT parent
programs. In this study, the ACT parent counseling consisted of eight group-therapy sessions
with six to eight parents. A program protocol for the therapist and workbooks for parents were
used (Matthijssen, 2012). The goal of this study was to investigate whether this ACT parent
program led to the following hypothesized changes. The hypotheses of this quasi experimental
research are that after ACT parent counseling, psychological flexibility, parental competence,
positive parenting skills and the quality of the parent-child interaction would increase. The
design consisted of a pre-, post - and 6-month follow-up analyses. Parents self-reports were
employed. As of the moment (November 2012), 35 parents have participated in the ACT parent
counseling and the assessments. Additional parent groups will be given in the next couple of
months. Results will be presented of the effects of this parent program on psychological
flexibility, psychopathology, parenting, parental competence, parent-child interaction and the
Expressed Emotions. Preliminary results suggest that ACT parent counseling is efficacious but
only on some variables. References Blackledge, J.T., & Hayes, S.C. (2006). Using Acceptance
and Commitment Training in the Support of Parents of Children Diagnosed with Autism. Child &
Family Behavior Therapy, 28, 1-18. Coyne, L.W., McHugh, L., & Martinez, E.R. (2011).
Acceptance and Commitment Therapy (ACT): Advances and Applications with Children,
Adolescents, and Families. Adolescent Psychiatric Clinics of North America, 20, 379-399.
Mathijssen, D. (2012) ACTief opvoeden; doen wat werkt voor jou en je kind. Amsterdam,
Hogrefe uitgevers. Powers, M.B., Zum Vrde Sive Vrding, M.B. & Emmelkamp, P.M.G. (2009)
Acceptance and Commitment Therapy: A Meta-Analytic Review. Psychotherapy and
Psychosomatics, 78, 73-80.
Attachment Anxiety and Fear Acquisition in Middle Childhood
Guy Bosmans1, Adinda Dujardin1, Elske Salemink2, Andy Field3, Michael Vasey4.
1. KULeuven, Leuven, Belgium, 2. University of Amsterdam, Amsterdam, Netherlands, 3.
University of Sussex, Sussex, United Kingdom, 4. Ohio State University, Columbus, OH, USA.
Middle childhood is a period during which fears are a common and transient developmental
phenomenon. However, if fears lead to behavioral avoidance, they put children at risk to
develop long-lasting anxiety disorders. Although attachment relationships are important to
understand fear acquisition and behavioral avoidance, research on causal relational processes
is scarce. One important causal process through which parents increase fear acquisition is
through providing verbal threat information. The current study aimed to test whether this effect is
moderated by childrens attachment-related expectations. As research has found clear links
between anxious attachment and the development of anxiety disorders, we investigated the
effect of anxious attachment on fear acquisition and behavioral avoidance after having received
verbal threat information. For this purpose, 60 general population children (20 boys, 40 girls)
participated to an experiment during which two unknown animals (Cuscus and Quokka) were
introduced. Their mothers received negative information about one animal, and no information
about the other animal. Then mothers informed their child about the information they received.
Before and after children were informed by mother, they filled out a Fear Belief questionnaire
measuring fear beliefs about both animals. Behavioral Avoidance reflected whether or not
children put their hand in boxes containing these animals (0 = hand in box; 1 = behavioral
avoidance). Attachment Anxiety and Attachment Avoidance was measured with the child
version of the Experiences of Close Relationships Questionnaire. Results revealed that negative
information provided by mother influenced fear beliefs and information seeking strategies about

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the animal. But more importantly, while attachment did not correlate with changes in these
cognitive measures, more anxiously attached children were less inclined to put their hand in the
box of the threatening animal. These data suggest that fear acquisition in response to maternal
verbal threat information occurs independently of attachment. However, anxiously attached
children are more vulnerable to behavioral avoidance. These results confirm Bowlbys
hypothesis that a lack of secure base limits childrens resources to explore potentially
dangerous environments. Consequently, these children are unable to falsify fear beliefs. Future
research should investigate whether this makes them more vulnerable to develop anxiety
disorders.
Exploring Culture, Family, and Place during Psychotherapy with Young People who SelfHarm
Allan Brownrigg.
Health and Life Sciences, Northumbria univeristy, Newcastle, United Kingdom.
Abstract Central: People who self-harm do so for many reasons, including relieving a
distressed state of mind (Hawton, Harriss and Rodham, 2010. p521), escapism (McRory,
2007), and for communicating distressing material (Potter, 2003). When seeking help the
individual who self-harms can be confronted with negative experiences. Redley (2010) identified
that when practitioners theorise self-harm as impulsive and therefore avoidable, they are less
likely to assess, understand and engage patients effectively. Furthermore the professional
literature used by therapist often conforms to a pathologising of self-harmers being seen for
what they do not what they are. Practice guidelines often focus upon behaviours to stop the selfharm, with less attention focusing upon the mechanisms required to maintain effective change.
This study sought to identify which factors contributed most towards a cessation of self-harm
behaviour in a sample of young people aged 13-21 years. As an interpretive phenomenological
study, the aim was to identify how young people made sense of their cognitive and behavioural
therapy treatment, and how they learned to resolve their use of self-harm. Young people placed
high importance towards cultural identity, family ideologies and place attachments as key
contributory factors for positive reduction in self harm. Culture was experienced as bonding,
unifying, individualistic, yet powerful and containing. Family was experienced on a continuum
between relatively static and complexly chaotic, while place attachments focused upon
individual aspirations, agency and identity. Therefore, within this paper I will offer an interpretive
account of how integrating and understating beliefs connected to culture, family and place, can
contribute to successful therapeutic outcomes for people who self-harm. Hawton, K., Harriss, L.
and Rodham, K. (2010) How adolescents who cut themselves differ from those who take
overdoses. European Child Adolescent Psychiatry. 19:513-523. McRory, B. (2007) Mental
Health: self harm. British Journal of Healthcare Assistants. Vol 1, No 6. September. Potter , N.
(2003) commodity/body/sign: Borderline personality disorder and the signification of self
injurious behaviour. Philosophy, Psychiatry and Psychology, 10(1), 1. Redley, M. (2010) The
clinical assessment of patients admitted to hospital following self harm: a qualitative study.
Sociology of Health and Illness, vol. 32, no 3, pp 470-485.
The Role of Personal Agency in Parental Conflict: Mechanisms of Coping Self-Efficacy
and Children's Psychological Adjustment
Heidi Brummert Lennings, Kay Bussey.
Psychology, Macquarie University, Sydney, NSW, Australia.

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Abstract Central: Introduction: Exposure to high levels of parental conflict can lead to
psychological maladjustment and the development of externalising behaviours in children
(Cummings & Davis, 2002; Grych & Fincham, 1990). These effects are compounded by the fact
that children often do not report parental conflict, making it difficult to identify such issues early
and arrest the development of future psychological dysfunction. A childs personal agency may
mitigate the effects of parental conflict through their adaptive self-efficacy beliefs. Coping selfefficacy is defined as an individuals perceived ability to motivate themselves, access cognitive
resources and perform the actions required to take control of stressful situations (Benight &
Bandura, 2004; Ozer & Bandura, 1990; Singh & Bussey, 2010). In addition, coping self-efficacy
has been suggested to minimise the psychological maladjustment experienced in the presence
of a stressor (see Benight & Bandura, 2004). Individuals who believe in their ability to cope are
more likely to face stressful situations by controlling their negative thoughts and taking action to
lessen the negative consequences (Bandura, 1997). Therefore, it is proposed that a childs
belief in their ability to cope when they are exposed to parental conflict may be key in reducing
the psychological maladjustment experienced. Aim: This study investigates the role of personal
agency, through the Coping Self-Efficacy Beliefs Measure for Parental Conflict (Brummert
Lennings & Bussey, 2013), as a mediator of the effect of parental conflict on childrens
psychological maladjustment. Participants: The study involved 682 independent school students
from 30 schools in a range of locations within New South Wales, Australia. Participants were in
Grades 5 and 7, and were primarily from middle class backgrounds. The sample was 66%
White, 18% Asian, 3% Middle-Eastern, and 13% from other ethnic groups. Method and Design:
Children were asked to complete a questionnaire in a group session consisting of about 20
students. The questionnaire took 50 minutes to complete and children were asked not to
interact with other children. The study was repeated 6 months after the initial data collection.
Only the results from the first data collection are presented here. Results: The model was tested
using Structural Equation Modelling in AMOS as parental conflict, coping self-efficacy and
psychological maladjustment are latent variables. Coping self-efficacy mediated the effect of
parental conflict on psychological maladjustment, 2 (71)=146.479, p<.05, TLI=.955, CFI=.970
and RMSEA =.058. Once coping SE was included in the model the direct effect of parental
conflict on psychological maladjustment was no longer significant. The coefficient of the indirect
effect was 0.078, p<.05. Conclusion: This study demonstrates that childrens levels of personal
agency, as measured by the coping self-efficacy mechanism, can attenuate the effects of
parental conflict on childrens psychological maladjustment. Therefore, these findings suggest
that personal agency training for children living in parental conflict contexts may decrease their
psychological maladjustment . Other suggestions that can improve childrens outcomes will be
discussed.
Factors associated with the Oppositional Defiant Problem of Turkish Adolescents:
Parental Acceptance-Rejection and Social Support
Canan Buyukasik Colak, Tulin Gencoz, Gizem Ates, Elif Helvaci.
Middle East Technical University, Ankara, Turkey.
Abstract Central: The present study aimed to examine the factors associated with the
oppositional defiant problem of Turkish adolescents. 134 high school students(age range 14-18,
M = 15.87 & SD = 0.91) and their parents (responded mothers n = 111, responded fathers n =
102) were the participants. For this aim Parental Acceptance-Rejection Questionnaire/Control:
Child Version and Social Support Appraisals Scale for Children, were completed by the
students; whereas Conners Parent Rating Scale was administered to the parents. Regression
analyses run separately for both mothers and fathers ratings. The analysis revealed that Social
Support appraised from family was negatively associated with oppositional defiant problem

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reported by the parents. Additionally, after controlling for the effects of Social Support, maternal
undifferentiated rejection was positively associated with oppositional defiant problem reported
by both parents. The results were discussed in the light of the literature.
Enfoque Cognitivo-Conductual en el Diseo, Implantacin y Evaluacin de Programas
Preventivos del Consumo de Drogas: Implicancias para la Formulacin de Polticas
Pblicas
William Cabanillas.
COMISION NACIONAL PARA EL DESARROLLO Y VIDA SIN DROGAS - DEVIDA, Lima, Peru.
Abstract Central: La informacin epidemiolgica del consumo de drogas y sus impactos
sociales, econmicos y sanitarios en Latinoamrica, muestra a esta problemtica como
relevante para la formulacin de polticas pblicas y la puesta en marcha de actuaciones
preventivas que disminuyan la exposicin a factores de riesgo y el fortalecimiento de factores
protectores a nivel intrapersonal y de la interaccin social. Se presenta un anlisis sobre la
incorporacin del enfoque cognitivo-conductual en el diseo (adopcin de modelos tericoexplicativos del consumo de drogas, articulacin de factores de riesgo/proteccin con
estrategias preventivas, identificacin de variables de intervencin, definicin de poblaciones
objetivo, estructura e intensidad de sesiones), implantacin (transferencia de metodologas,
procesos de aplicacin) y evaluacin sobre la eficacia (reporte de ensayos controlados
aleatorizados y meta-anlisis) de programas preventivos del consumo de drogas en poblacin
adolescente. Las actuaciones preventivas que desde enfoque cognitivo-conductual se puedan
implementar involucrar el despliegue de estrategias que promuevan la adquisicin de
habilidades personales y sociales con el fin de aumentar la competencia general y reducir las
posibles motivaciones para fumar, beber o usar drogas ilcitas. Se detallaran variables clave de
intervencin preventiva: informacin sobre drogas, toma de decisiones, influencia de medios de
comunicacin, autocontrol, manejo de ansiedad, habilidades sociales, entre otros. Asimismo, se
realiza un anlisis de las perspectivas futuras de la prevencin de drogodependencias en el
marco de las polticas pblicas en materia de reduccin de la demanda de drogas.
Childhood Recycling Therapy: a childhood cognitive intervention model
Renato Caminha1, Marina Caminha1, Trcio Soares1, Eduardo Guimares1, 2.
1. Instituto da Famlia de Porto Alegre, Porto Alegre, Brazil, 2. Pontifcia Universidade Catlica
do Rio Grande do Sul, Porto Alegre, Brazil.
Childhood Recycling Therapy (CRT) is an intervention model designed by Caminha and
Caminha. Its made up of two formats: the first one is used to treat clinical problems such as
depression and anxiety and the second one has a preventive focus, designed for group work in
learning institutions, free clinics or community groups. CRT is made up in its base structure by
three instruments called childhood access tools: the Deck of Emotions (DE), the Deck of
Thoughts (DT) and the Deck of Behaviors (DB). These instruments support the basic principles
that cognitive psychotherapies hold in their axiomatic model, thus being psychotherapy and
preventive model on a cognitive-behavioral basis. The name CRT is also used as an acronym
for: Create new behaviors; Recycle your thoughts and Try to work with your Emotions. Taking
into account that most childhood treatment protocols are segmented and directed towards
specific psychopathological functioning, CRT was developed with the intent of formalizing a
non-specific intervention model that involved the therapeutic process from beginning to end.
Currently, CRT tools are used throughout several states in Brazil. The treatment model is being
used, researched and improved at the childhood cognitive therapy clinic of Instituto da Famlia

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de Porto Alegre. In this clinical round table we will present the three instruments, as well as their
usage protocols and theoretical basis. Preliminary results of research performed on CRT tools
will be presented. The CRT therapeutic process begins with the usage of the DE. The DE
consists of cards with images representing basic emotions (i.e fear) and secondary emotions
(i.e. shame), along with a scale to measure its intensity. It aims to: aid in case evaluation
through emotional monitoring; present a playful, structured method to access the child
emotions; evaluate the activation, awareness, intensity and adequacy of emotional responses;
aid in the follow-up and modification of psychopathological states (through the combined use of
other CRT tools); contribute with the usage of Dysfunctional Thoughts Records and in the
formulation of the Cognitive Conceptualization Diagram. The DT, on the other hand, focuses on
cognitive restructuring. It comprises of a manualized restructuring strategy that uses linguistic
connectors to alter the semantic attributions of thoughts and beliefs. The technique is structured
in a ludic way, with the use of cards and metaphors (i.e. thought recycling), which aims to
facilitate the understanding and increase the engagement of the child. The main goals of this
instrument are: cognitive restructuring, particularly of intermediary beliefs; psychoeducation of
both the children and their parents in regards to emotions, thoughts and the cognitive model
itself; stimulating assertive behavior and integrating principles of mindfulness and acceptance to
the intervention. Lastly, the DB seeks to increase the child repertoire of healthy behaviors and
integrate them with the previous steps of the treatment. Also the identified dysfunctional
strategies are restructured through the elaboration of adequate behavior algorithms. Playful
strategies and metaphors such as the Behavior Boomerang Effect are used.
Calidad de Vida en Nios y Nias Aymara Escolarizados en la Ciudad de Arica-Chile
Alejandra Caqueo-Urzar1, Alfonso Urza2, Jorge Escudero-Bello1.
1. Filosofa y Psicologa, Universidad de Tarapac, Arica, Chile, 2. Universidad Catlica del
Norte, Antofagasta, Chile.
Abstract Central: El concepto de Calidad de Vida (CV) ha cobrado mayor importancia desde
hace un par de dcadas, sin embargo, ha sido poco estudiado en menores, menos aun en
nios provenientes de pueblos originarios. El objetivo de este estudio es describir la CV
percibida por nios y nias de etnia aymara escolarizados en la ciudad de Arica-Chile. Se
evaluaron 135 nios aymara y no aymara de entre 9 y 13 aos de un establecimiento particularsubvencionado a travs del cuestionario KIDSCREEN-27 y se aplicaron fichas de datos sociodemogrficos a los padres y menores. Se reportan las medias de las cinco dimensiones de CV
evaluadas y se concluye que los nios aymara presentan una baja CV en relacin a su
bienestar psicolgico y al apoyo social percibido. Su CV se ve mermada cuando disminuye el
nivel de escolaridad de la madre. Se hace necesario investigar otras variables que puedan
estar asociadas al bajo nivel de CV en estas dos dimensiones.
Aplicao de Tcnicas Cognitivo-Comportamentais no Tratamento das Dificuldades de
Socializao em Paciente com TNVA
Thiago Cardoso1, 3, Silvia Feldberg3, Beatriz Sant'Anna2, 3, Ana Idalina Silva3, Adriana Rossi2, 3,
Maria Cristina Oliveira3, Lilian Del Poz3, Renata Gomes3, Mauro Muszkat1, 3, Claudia Melo1, 3,
Orlando Bueno2, 3.
1. Educao, Unifesp, Guarulhos, Brazil, 2. Unifesp, So Paulo, Brazil, 3. Centro Paulista de
Neuropsicologia, So Paulo, Brazil.
Abstract Central: O transtorno no verbal de aprendizagem (TNVA) caracterizado pela
coexistncia de baixo desempenho acadmico e dificuldades nas habilidades sociais,

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visoespaciais e motoras. Os dficits sociais incluem problemas com a percepo social e


interao social. Tcnicas cognitivo-comportamentais como o treinamento de habilidades
sociais e resoluo de problemas mostram-se especialmente eficazes no tratamento de
diversas psicopatologias que cursam com prejuzos na socializao, porm existem poucos
relatos da sua aplicao em pacientes com TNVA. O objetivo do estudo apresentar um
estudo de caso de aplicao de tcnicas cognitivos-comportamentais no contexto da
interveno neuropsicolgica com um paciente diagnosticado com TNVA. HT, sexo masculino,
14 anos de idade, cursa 9 ano do ensino fundamental, filho nico, mora na regio
metropolitana de So Paulo. HT nasceu prematuro, de parto normal. Apresentou hemorragia
intracraniana ao nascer. Evoluiu com diplegia espstica. HT apresenta dificuldades de
aprendizagem desde o inicio da escolarizao, principalmente na Matemtica. Tambm h
queixas de dificuldades de relacionamentos sociais (poucos amigos). HT foi atendido pela
equipe do Centro Paulista de Neuropsicologia entre abril e dezembro de 2012, no contexto de
um programa em reabilitao neuropsicolgica. HT apresenta inteligncia normal, porm
dficits viso-espaciais, prejuzos no senso numrico e desempenho matemtico abaixo do
esperado. Quanto aos aspectos comportamentais, foram obtidos indicadores de perfil clnico
para problemas afetivos e competncia social (CBCL). Quanto cognio social, HT
apresentou dificuldades para compreender aspectos implcitos na interao social. HT se
comunica bem do ponto de vista verbal, porm o uso de termos rebuscados na comunicao e
descontextualizados tem sido associado a problemas na cognio social. Efetivamente, HT
refere falta de amigos na escola e dificuldade no relacionamento com os pares. O atendimento
de HT em equipe interdisciplinar, permitiu o acompanhamento do paciente em vrios domnios
da sua funcionalidade, como os aspectos acadmicos, a auto-estima, conscincia das
dificuldades e estratgias de enfrentamento. Em relao aos prejuzos nas habilidades sociais
foram enfocadas tcnicas de autocontrole, expressividade emocional, empatia, assertividade e
soluo de problemas interpessoais. Foi estimulada a capacidade de associar pensamentos,
sentimentos e comportamentos em funo de objetivos pessoais e de demandas situacionais.
Utilizou-se de scripts de conversao, role play para ensaio junto ao terapeuta e definio de
metas como conversar com colegas no intervalo das aulas, convites para atividades de
diverso e visita a casa dos mesmos. Tcnicas para reduo de ansiedade tambm foram
importantes recursos e roteiros de resoluo de problemas interpessoais. HT, aumentou a sua
competncia social inicialmente com os outros adolescentes do projeto e relatou aumento do
envolvimento com colegas na escola. Nas escalas comportamentais foi observado um aumento
da sua socializao. O estudo ressalta os benefcios da interface entre a TCC e a
neuropsicologia clnica no tratamento de pacientes com TNVA.
Aggressiveness in Children: Conceptions and Attitudes of Teachers in Primary
Education from a Public School in the Municipality of Santarm - Par - Brazil
Amasa Carvalho, Lucivania Souza, Izaura A. cardoso, Maria Assis, Cileuma Mara Linhares,
Luiz Vieira.
Instituto Esperana de Ensino Superior, Santarm, Brazil.
Abstract Central: Este presente trabalho pesquisou as concepes e atitudes dos professores
no ensino fundamental de uma escola pblica do municpio de Santarm - Par. Tendo como
objetivo investigar o que o professor entende como manifestao de agressividade do aluno do
ensino fundamental de uma escola pblica no Municpio de Santarm. Os objetivos especficos
foram: conhecer quais as atitudes dos alunos que o professor considera como agressivas;
analisar as atitudes dos professores frente agressividade dos alunos; identificar as atitudes
mais saudveis dos professores frente agressividade dos alunos na concepo docente; e
verificar como o professor procura entender a agressividade do aluno na tica do aluno. Trata-

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se de uma pesquisa de campo do tipo exploratrio com enfoque qualitativo no experimental,


onde o objeto da pesquisa foram os dez professores (dois do sexo masculino e oito do sexo
feminino) de 1 ao 5 ano de uma escola pblica de turno integral do municpio de Santarm
que tiveram registradas queixas na diretoria da escola acerca da agressividade de alunos. O
levantamento dos dados foi realizado atravs da aplicao da entrevista semiestruturada,
realizada individualmente. Constatando-se que as atitudes mais saudveis dos professores
frente agressividade dos alunos na concepo docente esto: o dilogo, procurar saber o que
est acontecendo com o aluno e chamar diretora e a pedagoga. No que se refere ao
questionamento aos professores se os mesmos procuram entender a agressividade do aluno
pela tica do aluno, constatou-se que metade dos professores, s vezes, procuram entender. E
por ltimo, as atitudes pontuadas pelos professores frente agressividade dos alunos so:
conversar em particular; chamar a pedagoga; mandar os alunos escreverem textos imensos;
chamar os pais; chamar a diretora; impedir os alunos de participar das aulas de Educao
Fsica; e catar o lixo da escola na frente dos outros alunos. Uma sada encontrada para os
pontos relacionados a agressividade a promoo de oficinas de mediadores de conflitos onde
podero aprender a reconsiderar suas posies, aprender a ouvir as opinies de seus supostos
adversrios, reconhecer mutuamente o valor de cada um ou, pelo menos, estar disposto a
ceder terreno e alcanar um nvel relativo de acordo. Outra importante questo para futuras
pesquisas e intervenes fazer a interdisciplinaridade com o professor de Educao Fsica, e
com a ajuda desse outro profissional proporcionar jogos que por si s, j trazem regras e
limites para os alunos agressivos, alm da possibilidade de extravasar muito dessa energia to
prpria da criana. Assim, aps a exposio desta pesquisa, faz-se a proposta de que estudos
futuros debatam questes como: de que forma lidar de uma forma mais saudvel com seus
conflitos tanto intrapessoais como interpessoais, j que entende-se o aparecimento de atitudes
agressivas como uma juno de fatores, que envolvem desde o desenvolvimento fsico,
psicolgico, local em que se vive, a famlia a qual o individuo faz parte, at chegar no ambiente
escolar.
Inteligencia Emocional: Un Estudio Exploratorio en Nios Desde un Modelo de
Habilidades Cognitivas
Karen Castillo.
Universidad del Aconcagua, Mendoza, Argentina.
En el marco de las lneas actuales de investigacin sobre emocin-cognicin, se abord la
exploracin de la Inteligencia Emocional (IE) en la infancia. Se adopt el modelo de habilidades
cognitivas en el cual la IE es considerada como un conjunto de habilidades para el uso
funcional de las emociones divididas en cuatro dominios de aptitudes. Se la define as como la
habilidad para percibir, valorar con exactitud y expresar la emocin; la habilidad para acceder
y/o generar sentimientos cuando stos facilitan el pensamiento; la habilidad para comprender la
emocin y el conocimiento emociona y la habilidad para regular las emociones que promueven
el crecimiento emocional e intelectual (Mayer y Salovey, 1997, pg. 10). Como puede
observarse, el nfasis se encuentra puesto en el procesamiento de las emociones, el
conocimiento y utilidad de la informacin relacionada con ellas. Pese a los aos que lleva la
investigacin en relacin a este concepto, los conocimientos acerca de la IE en las poblaciones
infantiles son escasos. A esto se suma la ausencia de un instrumento validado para medir las
habilidades mencionadas en nios. An as, existe un inters creciente por ahondar en su
conocimiento en escolares debido a la relacin que se ha observado entre sta y diversas
variables del desarrollo infantil, tales como el crecimiento moral, las relaciones interpersonales,
el ajuste psicolgico, la adaptacin psicosocial y el rendimiento escolar (Extremera y
Fernndez-Berrocal, 2009; Palomera Martn, 2009). De esta forma, el objetivo del trabajo fue

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describir las caractersticas de las habilidades cognitivas de la IE en una muestra intencional no


probabilstica de 30 nios de 4, 5 y 6 grado de una escuela primaria, de gestin estatal, rural,
de la provincia de Mendoza, Argentina. Se trabaj con un diseo no experimental transeccional
de tipo exploratorio - descriptivo y se utiliz como tcnica una entrevista semi-estructurada
creada ad hoc basada en el modelo de Mayer y Salovey (1997). Dicha entrevista indag las
habilidades de reconocimiento y claves de identificacin, facilitacin, comprensin y estrategias
de regulacin emocional, en situaciones generadoras de alegra y enojo. Se observ que todos
los nios pudieron identificar las emociones propuestas (enojo interpersonal y alegra en la
propia persona) reconociendo con mayor facilidad las claves corporales y conductuales; en
Facilitacin hicieron referencia a la redireccionalizacin y priorizacin del pensamiento en los
estados positivos; en Comprensin pudieron identificar las causas de los estados emocionales
en situaciones intra e interpersonales; y en Regulacin hubo mayor uso de estrategias activas y
sociales para la autorregulacin de la alegra as como tambin para la regulacin interpersonal
del enojo. La presente investigacin intent contribuir con datos empricos al conocimiento de la
IE en nios. Como toda temtica en reciente desarrollo, queda la labor de continuar explorando
y analizando sus alcances en la infancia y en diversos contextos y, en base a ello, trabajar en la
promocin y estimulacin emocional en la infancia como una herramienta para el logro de
mejores niveles de desarrollo y bienestar en los nios.
Psicoeducao da Famlia no Tratamento do Transtorno Obsessivo-Compulsivo em
Crianas
Maria Castro.
Santa Casa de Misericrdia RJ, Rio de janeiro, Brazil.
Abstract Central: O Transtorno obsessivo-compulsivo um transtorno cujos sintomas
interferem com a dinmica familiar saudvel. Certos sintomas em particular, interferem de
maneira mais acentuada no funcionamento familiar como o colecionismo, obsesses de
contaminao e rituais de lavagem. Estudos mostram que famlias de portadores de TOC
mudam seu comportamento para acomodar-se aos sintomas ou se envolvem, de alguma
forma, na realizao dos rituais. comum a restrio ao uso de objetos (mveis, roupas,
talheres) e ao acesso a peas da casa (tanto por parte do portador como da famlia); a demora
no banheiro; a preocupao excessiva com sujeira ou contaminaes; manias de limpeza (por
exemplo, lavando excessivamente as mos, as roupas, o piso da casa), obrigando os demais
membros da famlia a fazerem o mesmo. Essas preocupaes, os cuidados excessivos e as
exigncias acabam interferindo nas rotinas da famlia e at no lazer, provocando discusses,
atritos e desarmonia. Exigncias no sentido de no interromper ou de participar dos rituais,
dificuldades para sair, atrasos etc., comprometem a vida social, podendo levar ruptura de
relaes conjugais ou demisso de empregos. A famlia, na maioria das vezes, se envolve
nos rituais do TOC, por acreditar que eles proporcionam alvio ao sofrimento do portador, no
se dando conta de que com esse procedimento esto reforando o transtorno. Por isso
crucial compreender o grau em que cada membro da famlia est envolvido com o TOC, a
capacidade da famlia de suportar a criana afetada, e mutuamente, o grau que cada
psicopatologia familiar interfere com a implementao da TCC. Este trabalho pretende mostrar
a psicoducao na famlia como efetiva na adeso dos efeitos dos tratamentos cognitivocomportamental. Estudos propem os seguintes objetivos nessa modalidade: Capacitar o
paciente e sua famlia a aceitar o fato de que o paciente sofre de uma doena
neurocomportamental que produz sintomas que podem afetam a autoestima, o humor, o sono,
e o comportamento social; Ensinar o paciente e sua famlia a identificar e caracterizar sintomas
especficos do TOC; Demonstrar para a famlia que os sintomas do transtorno tm,
inevitavelmente, um impacto sobre seu estilo de vida. Tambm interessante que os

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fundamentos e as caractersticas da terapia cognitivo-comportamental sejam esclarecidos para


a famlia. Em que pressupostos ela se baseia; o que acontece durante a terapia: o aumento
inicial da ansiedade em razo dos exerccios, o fenmeno da habituao e o desaparecimento
gradual dos sintomas. importante ainda que sejam mencionados detalhes prticos, como o
nmero e frequncia das sesses, como so as sesses, os temas de casa, o planejamento
das tarefas de exposio e de preveno de rituais, as tcnicas cognitivas e as perspectivas de
melhora. Esses esclarecimentos que podem ser dados simultaneamente ao paciente e aos
familiares, sem dvida so cruciais para a adeso do paciente ao tratamento, e para ter os
ltimos como aliados.
Performance of Children and Teenagers with and without Diagnosis of ADHD in Wechsler
Intelligence Scale III (WISC III)
Fernanda Cerutti, Regina Maria Fernandes Lopes, Camila Oliveira, Lauren Terroso, Lusa
Steiger Pires de Oliveira, Irani de Lima Argimon.
Pontifcia Universidade Catlica do Rio Grande do Sul - PUCRS, Porto Alegre, Brazil.
O Transtorno de Dficit de Ateno/ Hiperatividade (TDAH) uma condio neurobiolgica que
atinge de 3% a 7% da populao. Caracteriza-se por diminuda capacidade de ateno,
impulsividade e hiperatividade, podendo afetar crianas, adolescentes e adultos. As
manifestaes comportamentais geralmente aparecem em mltiplos contextos, incluindo a
prpria casa, a escola, o trabalho ou situaes sociais. Devido importncia de se ter o
diagnstico correto para um tratamento adequado, a busca por instrumentos que auxiliem na
avaliao necessria. O presente estudo teve como objetivo avaliar o desempenho de
crianas e adolescentes com e sem diagnstico de TDAH no ndice de Resistncia
Distrabilidade (IRD) da Escala de Inteligncia de Wechsler III (WISC III) pelos subtestes de
Aritmtica e Dgitos, assim como no quociente de inteligncia (QI) Global, Verbal e de
Execuo. Especificamente buscou constatar a sensibilidade deste teste psicomtrico na
avaliao do TDAH. Trata-se de um estudo quantitativo, transversal e observacional. Para
anlise dos dados foi utilizado o programa Statistical Package for the Social Science, verso
17.0. A amostra foi constituda por 80 participantes, 26 participantes eram do sexo feminino e
54 do sexo masculino, sendo a mdia de idade 11,2 anos (DP= 2,5), que apresentavam
desateno e suspeita de TDAH, e foram encaminhados por escolas pblicas e particulares
para avaliao e atendimento psicoterpico. Destes, 67,5% tiveram a confirmao do
diagnstico de TDAH, no apresentando diferena significativa entre os sexos (p= 0,081),
segundo o Teste Exato de Fischer. Para comparar os grupos com e sem TDAH foi realizada
anlise atravs do Teste t de Student. Em relao ao IRD foi visto que os estudantes sem
TDAH (n=26) obtiveram mdia de 117,08 (DP= 17,962) e os com TDAH (n=54) apresentaram a
mdia de 99,76 (DP=13,514). A pesquisa nos mostra tambm diferena significativa no QI, em
que as crianas com TDAH apresentaram mdia inferior no QI Global, Verbal e de Execuo,
se comparado s crianas sem TDAH. Os resultados apontam a sensibilidade da WISC-III,
especificamente o IRD, para o diagnstico de crianas com TDAH, podendo contribuir para as
avaliaes deste transtorno.
A Clnica Na Escola: Treino de Pais em Manejo de Contingncias para a Modificao do
Comportamento Infantil
Nilse Chiapetti, Carmen Amorim-Gadncio, Josemberg Andrade, Gabriela Machado, Luana
Lira.
Psicologia, Universidade Federal da Paraba, Joo Pessoa, Brazil.

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Na interveno comportamental com crianas, deve-se levar em conta todos os ambientes nos
quais elas interagem, uma vez que inmeras variveis podem contribuir para a aquisio e/ou
para a manuteno dos comportamentos. Na escola, contexto privilegiado para a preveno do
comportamento de risco e promoo de comportamentos adaptativos, encontramos a
possibilidade de intervir diretamente com aquelas crianas que apresentam problemas, bem
como com agentes sociais que gerenciam as variveis mantenedoras dos comportamentos,
especialmente os inadequados. Os pais se destacam na deteno de reforadores para o
comportamento infantil, estando, portanto, mais habilitados para coloca-los em operao na
direo das modificaes comportamentais pretendidas. Apresentam-se, aqui, os resultados de
um projeto de extenso com grupos de pais de crianas indicadas pelos professores por
apresentarem problemas de comportamento. O programa consistiu em 8 encontros, com
durao de cerca de 2 horas, e foi desenvolvido em duas escolas pblicas da cidade de Joo
pessoa. Baseou-se no treino em manejo de contingncias para a reduo de comportamentos
de risco e promoo de comportamentos pr-sociais, nas crianas. Os resultados apontam
para um aumento nas prticas educativas baseadas no reforamento e uma reduo na
aplicao de prticas aversivas (punio). Ademais, observa-se, entre os pais que
permaneceram mais tempo, uma leitura mais apropriada acerca das condutas adequadas e
inadequadas dos filhos, alm de uma percepo clara do seu papel na manuteno de
comportamentos desejveis e na reduo ou extino daqueles que no considerados
inadequados. Tais mudanas nas prticas e condutas dos pais so essenciais para que as
alteraes desejadas no comportamento infantil possam ter lugar. Destaca-se a relevncia de
programas desta natureza visando desenvolver tratamentos efetivos para crianas e
adolescentes que apresentam problemas emocionais e comportamentais, primeiramente tendo
em vista a freqncia com que os mesmos aparecem, e sobretudo porque h evidncias da
relao entre problemas na infncia e aqueles que aparecem nas fases subseqentes. A
interveno nessa fase, ento, tem valor no apenas para minimizar o sofrimento atual da
criana e da famlia, mas para prevenir ou minimizar o prejuzo que possa tomar lugar
futuramente. Resta o desafio de aumentar a adeso dos pais ao processo de interveno.
Negative Affectivity in Pediatric Behavioral Health Outpaitents: A Preliminary Study
Nathan Chow, Robert Friedberg, Micaela Thordarson, Lisa Hoyman, Benjamin Schnare, Julia
Numan-Saah, Nicholas Madian.
Center for the Study and Treatment of Anxious Youth at Palo Alto University, Palo Alto, CA,
USA.
Depression and anxiety are the most prevalent childhood conditions. Moreover, they are
commonly co-morbid. This co-morbidity raises questions regarding the shared and unique
variance between the two disorders. Together, they form the construct of negative affectivity; a
general distress factor marked by a tendency to experience negative emotions such as worry,
anxiety, fear, sadness, guilt, and anger (Chorpita, 2002; Lonigan & Vasey, 2009; Ollendick et
al., 2003). Finally, the shared variance between anxiety and depression forms the basis for the
emerging transdiagnostic unified treatment protocol (Ehrenreich et al., 2009). This study was
conducted to further clarify the presence of negative affectivity in pediatric behavioral health
outpatients. It was hypothesized that children diagnosed with internalizing disorders would score
higher on the Children's Depression Inventory (CDI) and the Screen for Child Anxiety Related
Emotional Disorders (SCARED) as well as their component subfactors than their externalizing
counterparts. Further, it was hypothesized that female children would score higher on the CDI
and SCARED total scores compared to their male peers. 54 patients (male n=37; female n=17)
treated at a pediatric behavioral health outpatient clinic in an academic medical center
participated in the study. The children were sorted into three groups based on their diagnoses

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(internalizing, externalizing, mixed internalizing/externalizing) which yielded both homotypic and


heterotypic co-morbidities. The diagnoses were determined by semi-structured clinical
interviews. All children completed the SCARED and CDI. A Multivariate Analysis of Variance
(MANOVA) was applied to the data to provide a conservative test of the hypotheses. MANOVA
analyses test variability in multiple related dependent variables simultaneously while controlling
for Type I error. A MANOVA that tested group differences in self-reported overall anxiety
(SCARED total) and depression (CDI total) indicated there were not statistically significant
differences between the three groups on the SCARED (F=2.145;p=NS) or CDI (F=.873; p=NS).
Second and third MANOVAs examining group differences in the multiple CDI and SCARED
subfactors revealed no significant differences. Indepent sample t-tests did not reveal statistically
significant gender differences for the CDI ( Male Mean=10.9; Female Mean=9) or the SCARED
(Male Mean=25.19; Female Mean=25.47). The results indicated that the children's self-report of
anxious and depressed moods did not vary as a function of their diagnostic group. Indeed, this
is entirely consistent with previous findings demonstrating that negative affectivity cuts across
most diagnostic categories. However, this preliminary study is limited by the small number of
participants which might have truncated variability. Finally, including a structured clinical
interview along with the Positive and Negative Affectivity Schedule (Lonigan et al., 1999) would
represent a meritorious extension of the present research.
Innovations in the treatment of child anxiety
Vanessa Cobham1, Vanessa Cobham1, Thomas Ollendick3, Jill Ehrenreich-May4, Silvia
Schneider5, Philip Kendall2, Muniya Khanna6, Ron Rapee7, Alexander Queen4, Emily Bilek4, Erin
Girio-Herrera4, Sarah Kennedy4, Cara Remmes4, David Barlow9, David Rosenfield8.
1. Psychology, University of Queensland, Brisbane, QLD, Australia, 2. Temple University,
Philadelphia, PA, USA, 3. Virginia Tech, Blacksburg, VA, USA, 4. University of Miami, Miami,
FL, USA, 5. Ruhr Universitat, Bochum, Germany, 6. Children's and Adult Center for OCD and
Anxiety, Philadelphia, PA, USA, 7. Macquarie University, Sydney, NSW, Australia, 8. Southern
Methodist University, Dallas, TX, USA, 9. Boston University, Boston, MA, USA.
Anxiety is the most common psychological complaint reported by children and adolescents. And
yet, more than 80% of anxiety-disordered youth do not receive treatment. In this symposium,
various innovations in the treatment of childhood anxiety are described (including approaches
designed to increase families' ability to access treatment), with empirical data presented. The
first paper examines the role of computers and the internet in treatment of this group. A
comprehensive approach to treatment is taken, with programs for anxious youth, programs for
parents of anxious youth, and programs for therapists considered. The second and third papers
each present innovative programs that should improve our capacity to reach anxiety-disordered
youth. The second paper focuses on a brief, family-directed parenting intervention ("Fear-less
Triple P") aimed at parents of anxiety-disordered youth, while the third paper examines the One
Session Treatment of Specific Phobias - in terms of both outcomes and possible mechanisms
for change. The fourth paper examines the crucial questions of differential interventions for
different anxiety disorders (specifically Separation Anxiety Disorder), as well as examining the
role of parental involvement in treatment. Finally, the fifth paper addresses the issue of the
transdiagnostic treatment of anxiety and depression in adolescents, comparing adolescents who
received the Unified Protocol for the Treatment of Emotional Disorders in Adolescence with a
waitlist control.
Computers and the internet: Interventions for anxiety disorders in youth
Following consideration of the reasons why we want to address anxiety in youth, and reasons
why we might not want to do so, a rationale for the use of computers and internet based

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programs is presented. Three approaches will be considered: programs for the anxious youth,
programs for training therapists who work with anxious youth, and programs for the parents of
anxious youth. Programs designed for each of these there target recipients will be considered,
sample screen shots from the programs will be shown, and recent research findings will be
described and discussed.
Fear-less Triple P: A brief intervention for parents of anxiety-disordered youth
More than 80% of anxiety-disordered children and adolescents do not receive treatment.
Targeting the parents of anxious children via a brief parenting intervention represents one
means of both improving families' access to treatment, and producing radiating effects within
families. The 6-session Fear-less Triple P intervention is described in this presentation, along
with the outcome results (up to 12-mth follow-up) of a recently completed pilot RCT conducted
with parents of anxiety-disordered youth aged 7-14 years. The implications of being able to
'reach' not only anxiety-disordered youth, but also potentially their siblings, via a focused
parenting program will be discussed.
Parent-augmented One Session Treatment for Specific Phobias
Specific phobias are a common disorder of childhood and adolescence. Left untreated, they
frequently lead to other internalizing and externalizing disorders. As such, they are frequently
described as a gateway disorder. In recent years, a number of cognitive-behavioral
interventions have been shown to be effective in the treatment of these disorders. One Session
Treatment (OST) is one such treatment. This presentation will focus on two major randomized
clinical control trials - the first conducted in Sweden and the United States, and the second in
the United States only. In the first trial, OST was shown to be superior to an Education/Support
condition and a Wait List Control condition (Ollendick, Ost, et al., 2009). In this study it was also
shown that maternal anxiety and maternal overprotection moderated treatment outcomes.
Based on this study, a second RCT was conducted in Virginia with 150 children between 7 and
14 years of age. The standard OST was compared to an augmented condition in which parents
were actively involved in treatment and participated in a 1-month maintenance condition.
Although follow-up data are still being collected for this study, initial finding suggest that the two
treatments produce comparable outcomes at post-treatment and at 1-month follow-up; however,
at 6-month follow-up, the Augmented Treatment is superior to the Standard Treatment. Findings
from this trial will be explored further and the role of anxious parents, and anxious parenting, will
be examined. Implications for clinical practice will be highlighted.
The role of parental inclusion and disorder-specific interventions in the treatment of
childhood anxiety disorders
Background: Meta-analyses on treatment studies for childhood anxiety disorders do not show
superiority of family-based over child alone treatment. Since these studies grouped multiple
anxiety disorders together and treated them using a single global CBT program, the present
studies will examine the relative efficacy of a disorder-specific family-based treatment program
for children suffering from Separation Anxiety Disorder (SAD) in comparison with a general
child-alone anxiety program. Methods: In a randomized comparison-controlled trial (RCT) sixtyfour children ages 8-13 with SAD and their parents were assigned to either a 16-session
disorder-specific SAD treatment program including parent-training and classical CBT
components, or to a general child-alone 16-week comparison group (Coping Cat) without any
parent-training. Diagnoses, parent psychopathology/cognitions were assessed at baseline and
at follow-ups. Global success ratings were collected posttreatment and at follow-ups. Ratings for
anxiety, impairment/distress and life quality were collected at baseline 1, again after a 4-week
waiting period, repeatedly throughout treatment, at 4-week and 1-year follow-ups. Results:
Intention-to-treat analyses indicate that 23 % of children allocated to the experimental treatment

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group fulfilled DSM-IV criteria for SAD at the 4-week follow-up, compared to 30 % in the
comparison group, with no between group difference. Ratings results indicated improvement for
both groups across time points and assessment areas, with few between-group differences, and
some small effects favoring the TAFF program. Both treatment programs yielded a reduction in
parental dysfunctional beliefs and in maternal separation anxiety and depression. Conclusions:
Results indicate efficacy of both disorder-specific and general child-based treatments for SAD.
Significant effects of the child-based treatment were evidenced in both child variables as well as
parent variables.
Transdiagnostic Treatment for Anxiety and Depression in Adolescence: Results from a
Waitlist-Controlled Trial
Anxiety and depressive disorders are the most common psychological conditions in youth, with
increasing impairment observed in adolescence. Despite high comorbidity and common risk
factors between anxiety and depressive disorders, youth with depression have often been
excluded from clinical trials of anxiety-focused interventions. In fact, depression may pose a
deleterious impact on treatment outcomes in randomized controlled trials of cognitive behavior
therapy (CBT) for anxiety disorders in youth (e.g., Ginsburg et al., 2011). Such findings indicate
that the utility of standard CBT approaches for adolescents with a wider range of emotional
disorder symptoms is less clear. The Unified Protocol for the Treatment of Emotional Disorders
in Adolescence (UP-A; Ehrenreich et al., 2009) is a transdiagnostic formulation of evidencebased treatment components targeting emotional disorders. The approach is based on five core
principles of change (e.g., Barlow, Allen & Choate, 2004; Barlow et al., 2010): increasing
emotional awareness, prevention of emotional avoidance, increasing cognitive flexibility,
promoting antecedent cognitive reappraisal and modifying behavioral action tendencies. The
UP-A is flexibly applied to be appropriate for a heterogeneous group of adolescents with varying
anxiety and depressive concerns and administered in a modular fashion over 8-21 sessions. For
the present study, 52 adolescents (ages 12-18) with primary anxiety or depressive disorders
were randomized to an immediate UP-A condition (n=27) or an 8-week delayed-treatment
waitlist condition (n=25). Adolescents were assessed using a semi-structured diagnostic
interview (ADIS-IV-C/P; Silverman & Albano, 2004), CGI scales (e.g., Guy, 1976), self- and
parent-report questionnaires at baseline, post-8-weeks of treatment/post-waitlist, post-treatment
(mean sessions received = 16), three and six months following intervention. In terms of the
clinical severity rating (CSR) for adolescents principal diagnosis, hierarchical linear modeling
results suggest that those receiving immediate UP-A were significantly improved, as compared
to those in the waitlist at both post-8-week (F=4.87, p<.05, d=1.24) and post-treatment time
points (F=2.06, p<.001, d=2.06). Similar results were observed for the CGI-Severity and
Improvement scales at the post-8-week and post-treatment time points, although parent- and
self-reports of clinical change on the RCADS (Chorpita et al., 2000) did not significantly differ
between groups at either post-assessment. Importantly, depression did not moderate effects
across most measures of treatment response. Examination of results is on going. At the time of
presentation, we will discuss outcomes relevant to the three- and six-month follow-up points,
treatment retention, alliance and satisfaction ratings for the UP-A. Overall, results to date
indicate that the UP-A is a promising approach for adolescents with a range of emotional
disorders.
Belief System with regard to the Absent Father Figure in Young Pregnant
Pilar Contreras.
Universidad Popular Autnoma del Estado de Puebla, Puebla, Mexico.
Abstract Central: Mexico could be considered a young country in a full transition to adulthood.
Currently there are 20.2 millions of people between 15 and 24 years living with their nuclear

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families. Recent researches (World Health Organization [WHO], 2010., Rodriguez, 2010.,
Anatrella, 2008) have found that it is within the family that woman can achieve optimal
biological, psychological and social development, however, not all Mexican households are
formed by both parents. When the father figure is absent, the psychic structure of the person is
characterized by the weakening of the male figure, affiliation disorders, addictive behavior, lack
of sense limits, difficulty of socializing and intercourse practices that may result in sexual
diseases or young pregnancy (Meeker, 2007., Anatrella, 2008). This research provides
information from the cognitive perspective in order to show thoughts of young pregnant women
who have lived without a father, and early maladaptive schemas that have structured and
established. The method of this study was by qualitative methodology using in-depth interviews
and focus group with three young residents of an institution that supports homeless pregnant
women. On the results and the cognitive analysis, were discovered a number of maladaptive
beliefs about family and absent biological father figure, even though young women had
identified feelings of indifference to him, caused by the identification of little interest or
carelessness of the subject to them. In which they do not discarded the feelings of
abandonment, anger and loneliness. The maladaptive beliefs identified in the analysis, talk
about unconditional beliefs about themselves in relation to his family, and their father. Young
(cited by Stein and Young, 1992) refers that these maladaptive schemas can not be questioned,
and therefore are resistant to be modified and that is why they are resistant to change, just
because of being built in a restrictive affective system from the family, which has resulted that
the young have easier ways for repeating patterns, and therefore they prefer to distort the
information that they receive from the environment (family/parent) than restructure their
cognition in a healthy way. On the other hand the young women experience feelings of
inadequacy, sadness, and anger feelings, and frustration to any member, or even to the entire
family system. That is why the term family has been included as an issues or factors that may
be involved in early pregnancy, because although it has been identified in the results of this
study, that women develop early maladaptive schemas (of abandom, inability to be loved,
rejection, incompetence and emotional disconnection) even if in most cases look for a
replacement of the absent figure of the father and receive from him the nurturing role they need
to develop, having an undesirable behavior and self -sabotaging in relation to their partner
because of the sundry domains that have been developed as their own.
Ludoterapia Na TCC: Desafios Clnicos no Diagnstico e Tratamento dos Transtornos
Infantis
Giedre Costa2, 1, Carina Todesco2.
1. Universidade Paulista, So Jos do Rio Preto, Brazil, 2. Instituto de Psicoterapia CognitivoComportamental - IPC, So Jos do Rio Preto, Brazil.
Abstract Central: O objetivo desse estudo foi verificar a dificuldade de realizar com preciso
um diagnstico de padres de comportamento e emoes que no preenchem critrios
definidos assim como implementar estratgias de tratamento eficazes frente a situao de
indefinio e comorbidades nos transtornos infantis. Foi sujeito desse relato um paciente do
sexo masculino, de oito anos, solteiro, estudante do terceiro ano do ensino fundamental. A
principal queixa apresentada foi dificuldade de aprendizagem, (dficit na alfabetizao e
comportamentos disruptivos). O paciente apresentava diagnstico de Dislexia e Transtorno do
Dficit de Ateno e Hiperatividade, entretanto outras alteraes na criana sinalizavam outras
comorbidades. Desta forma, foi realizada uma avaliao neuropsicolgica em que se constatou
que a criana possui quociente intelectual classificado como Limtrofe e apenas memria de
curto prazo preservada. Progressivamente, durante o processo de investigao, houve a
suspeita de a criana ser portadora da Sndrome de Williams-Beuren (SWB), sendo

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encaminhada para uma avaliao gentica. Entretanto, a criana no apresenta gentipo para
sndrome, somente fentipo, bem como todas as dificuldades de aprendizagem e de
relacionamento, assim como, por exemplo, a obsesso para msica, ritmo e rimas. O
diagnstico gentico no excluiu a possibilidade de a criana ter a sndrome, uma vez que 4%
dos pacientes apresentam esta condio. Desta forma, foram realizadas 58 sesses utilizando
dos recursos da Terapia Cognitivo-Comportamental. Utilizou-se a ludoterapia como a principal
tcnica referente abordagem, devido s limitaes do paciente. As metas teraputicas foram
focadas no controle dos comportamentos disruptivos e na recusa da criana a frequentar a
escola. Foram utilizados os seguintes recursos: orientaes sistemticas aos cuidadores e
escola, desenho, histria, atividades ldicas, CDI, avaliaes do HTP e, na execuo deste,
observou-se melhoras significativas. As adequaes as tcnicas da abordagem, assim como
manejo das habilidades teraputicas desenvolvidas pelo profissional, contriburam de forma
eficaz na realizao do vnculo, na colaborao e participao do paciente, o que propiciou
uma melhora significativa do mesmo, promovendo o alcance aos objetivos teraputicos, assim
como uma melhor condio de relacionamento da criana com sua famlia e ao contexto scioeducacional.
Levantamento epidemiolgico sobre o TDAH no Brasil
Ana Flvia Da Hora.
Universidade Ceuma, So Lus, Brazil.
Abstract Central: Os estudos epidemiolgicos so substanciais na identificao da etiologia,
prevalncia e critrios diagnsticos, a partir desta perspectiva, esta pesquisa objetivou mapear
as dissertaes e teses sobre o transtorno de dficit de ateno e hiperatividade(TDAH) no
cenrio nacional do Brasil, disponveis no Banco de Teses da Capes. A busca e seleo
resultou em 114 trabalhos entre os anos de 1997-2011. Os resumos foram analisados e
categorizados em: 1) Publicao de dissertaes e teses por nvel acadmico e ano; 2) rea,
palavras-chave e mtodo das dissertaes e teses; 3) Enfoque de investigao nas regies do
Brasil. Observou-se que 71,9% das pesquisas eram compostas de dissertaes de mestrado
acadmico, e reconheciam que o TDAH como um distrbio do neurodesenvolvimento que pode
persistir ao longo da vida. A maioria dos trabalhos (76,7%) utilizaram o enfoque emprico. O Sul
e o Sudeste foram as regies brasileiras mais investigadas (35,9% e 37,7%), sinalizando
assim, a incipincia de pesquisas epidemiolgicas nas regies norte(3,5%), nordeste e centrooeste(5,2%). Na categoria de instrumentos utilizados, sobressaram-se o DSM-IV, CBCL,
SNAP-IV, WISC-III e TRF. Os artigos selecionados apresentaram variaes nos critrios
diagnsticos, refletindo nas discrepantes taxas de incidncia do transtorno. Com a diversidade
dos critrios metodolgicos dos estudos, tornou-se difcil avaliar as hipteses alternativas
referentes s possveis variaes apontadas pelos estudos. Diante do panorama apresentado,
conclui-se que a taxa de prevalncia do transtorno de dficit de ateno e hiperatividade, tratase indiscutivelmente de objetivo para futuras pesquisas no territrio brasileiro a fim de atender a
demanda da escassez apresentada.
Caracterizao de Variveis Psicolgicas em Crianas Participantes de um Programa de
Promoo de Sade Na Infncia Baseado Na Abordagem Cognitive-Comportamental
Carla Daolio, Patrcia Nardi, Carmem Neufeld.
prtica privada, Ribeiro Preto, Brazil.
Nos ltimos anos tem-se notado o aparecimento de sintomas de ansiedade, depresso e
estresse em crianas. A Terapia Cognitivo-Comportamental, quando praticada em grupos,

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mostra-se eficiente na melhora dessas crianas. Este tipo de atendimento tem caractersticas
estruturadas e padronizadas, e so chamados programas de interveno e preveno. Um
exemplo desses programas o internacionalmente conhecido, Amigos. Alguns estudos feitos
com o com ele permitiram perceber como uma caracterizao inicial da amostra teria evitado
dificuldades em interpretar os dados devido presena de variveis intervenientes e tambm a
melhor entender a amostra antes da aplicao do programa, tornando-o mais efetivo. O
objetivo do presente estudo consiste em caracterizar crianas selecionadas para participar de
um programa de interveno e promoo de sade que faz parte de um projeto maior do
Laboratrio de Pesquisa e Interveno Cognitivo-Comportamental. Nesta pesquisa foi feita a
caracterizao de 20 crianas com idade de oito a dez anos de uma escola pblica, em
Ribeiro Preto. Os instrumentos utilizados foram a Escala de Stress Infantil, o Childrens
Depression Inventory e a Escala Multidimensional de Ansiedade para Crianas, para a
constatao dos nveis de estresse, depresso e ansiedade, respectivamente, na amostra. O
procedimento consistiu, aps o aceite da escola e a assinaturas dos termos de consentimento
livre e esclarecido para a participao no programa, na aplicao dos instrumentos j referidos
de forma individual, como um pr-teste para o programa. Os dados foram analisados
quantitativamente, utilizando estatstica descritiva para caracterizar a amostra quanto
presena de sinais significativos de ansiedade, estresse e depresso, bem como a comparao
entre os gneros. Os resultados indicaram que 35% das crianas apresentaram sinais de
estresse, das quais aproximadamente 43% eram meninos e 57% eram meninas; 40% da
amostra apresentaram sinais de depresso, entre os quais 37,5% eram do sexo masculino e
62,5% eram do feminino. Quanto ao teste de ansiedade, foram encontrados dois pontos de
corte na literatura, para o menor deles, os resultados indicaram que 70% da amostra
apresentaram sinais de ansiedade, das quais metade eram meninos e metade eram meninas; o
ponto de corte maior indicou que 25% das crianas apresentaram sinais de ansiedade, entre
elas 20% eram do sexo masculino e 80% do feminino. Estes dados corroboram o que se
encontra na literatura quanto a maior incidncia, em porcentagem apenas, desses sintomas em
meninas, porm, a frequncia com que apareceram est consideravelmente mais alta em
ambos os sexos. Por fim, os dados permitiram uma caracterizao mais precisa da amostra,
possibilitando que a aplicao do programa fosse dirigida as especificidades deste grupo
crianas. Palavras-chave: caracterizao, ansiedade/depresso infantil, estresse infantil.
Estilos Parentales y Problemas Emocionales y Conductuales en Adolescentes: El Papel
del Temperamento. Clemencia de la Espriella
Clemencia De la Espriella.
Psicologia, Universidad de la Sabana, Bogota, Colombia.
Palabras clave: estilos parentales, temperamento, adolescentes, problemas
internalizantes/externalizantes El debate sobre el efecto de la biologa y el ambiente en los
problemas psicolgicos ha sido largo y sin descanso en la psicologa. Sin embargo los avances
en neurociencia y gentica de los ltimos 20 aos ha puesto nuevamente en el tapete la
discusin con nuevas evidencias y nuevos retos (Goldsmith, Buss, Lemery, 1997; Saudino,
2005; Hoekstra, Bartel, Hudziak, Van Beijsterveldt, Boomsma, 2008). Basados en la literatura
reciente sobre las relaciones entre estilos parentales y problemas emocionales y conductuales
en adolescentes, en esta investigacin se ha pretendido determinar las asociaciones entre el
temperamento del adolescente (atencin, control inhibitorio y control de la activacin, timidez,
miedo, sensibilidad al placer, sensibilidad perceptual y afiliacin) y las caractersticas de los
estilos parentales (normas y exigencias que comprende ser inductivo, indulgente o rgido; as
como afecto-comunicacin que comprende confianza, disponibilidad, escucha activa, o crtica y
rechazo), en predecir, por una parte, problemas internalizante y externalizantes, y por otra el

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nivel de ajuste y adaptacin del adolescente. Se realiza un anlisis de concordancia (Kappa) de


todas las variables utilizando cuestionarios a los padres y del adolescente. Se conducen
anlisis de regresin mtiple para determinar a) si los estilos parentales son predictores del
temperamento y de los problemas internalizantes/externalizantes, asi como el ajuste del
adolescente; b) si el temperamento del adolescente y los problemas
internalizantes/externalizantes, asi como el ajuste son predictores de los estilos parentales y c)
determinar las relaciones bidireccionales entre estilos parentales y temperamento del
adolescente. Se tomaron 110 adolescentes de estrato socio-econmico bajo (1 y 2), 100
adolescentes de estrato socio-econmico medio (3-4) y 120 adolescentes de estrato alto (5-6)
en edades comprendidas entre los 12 y los 17 aos, y sus respectivos padres o madres (solo
uno de los dos respondi los cuestionarios), todos de planteles educativos de la ciudad de
Bogot, Colombia. Se les aplic el Early Adolescent Temperament Questionnaire - RevisedLong Form (Ellis y Rothbart 1999) versin para padres y versin para adolescentes, traducido y
adaptado al espaol en Colombia (De la Espriella, Trujillo, 2012) con una muestra de 100
adolescente y sus padres de los tres estratos socio-econmicos; Escala de Estilos Parentales
Educativos, (Fuentes, Motrico y Bersab, 1999) versin para padres y para adolescentes,
adaptacin para Colombia (De la Espriella, 2009); y la escala Evaluacin Muldimensional de la
Conducta adaptada para poblacin colombiana (Kamphaus, Jimnez, Pineda, Rowe,
Fleckenstein, Restrepo, Puerta, Jimnez, Mora, Snchez, Garcia, & Palacio, 2000). La
comprensin sobre estas relaciones e interacciones facilita el desarrollo de intervenciones
altamente sensibles a las diferencias individuales de los adolescentes y puede dar a los padres
herramientas y guas para manejar las caractersticas individuales y nicas de su hijo
adolescente. NOTA: Esta investigacin est apoyada por el Fondo Patrimonial de la
Universidad de la Sabana, Chia, Cundinamarca, Colombia. Cdigo:PSI 32-210
Does it Take a Village to Raise a Resilient Child? The Role of Teachers in Fostering
Positive Self-Concept in Advantaged and Disadvantaged Children in Australia
Bianca Denny, Susana Gavidia-Payne, Andrew Francis, Kate Davis, Merv Jackson.
RMIT University, Melbourne, VIC, Australia.
Abstract Central: Self-concept is an important yet understudied construct in resilience
research. A childs self-concept is associated with critical components of childhood well-being
such as self-regulation, stability, adaptive coping, and good long-term psychological and social
outcomes. As such, investigating the self-concept of children is critical to planning effective
support services for those at-risk of poor outcomes. Resilience research has long recognized
the essential role of competent adult caregivers in fostering the well-being of at-risk children.
Interactions with significant others provides a primary source of information for childrens selfconcept; positive interactions with adult caregivers are mirrored and eventually internalized by
children, resulting in positive self-concept and promotion of resilience. While it is widely
accepted that positive parent-child attachment may bolster a childs resilience levels, further
information is needed to elucidate the role of important others when parent engagement is
absent or inadequate. Teachers, who are important caregivers to young children and with whom
children spend significant time, present one such opportunity for a positive adult-child
relationship that can shape a childs self-concept. The present study investigated differences in
self-concept among advantaged and disadvantaged children in urban and rural Australia, with a
specific focus on the fostering of positive self-concept through engagement with teachers.
Results suggest that positive interaction with teachers is important in shaping the self-concept of
young children who may be disadvantaged by socio-economic status, familial mental health
problems, and lack of engagement from parents. Comparison between children from urban and
rural areas of Australia revealed important differences between the experiences of these

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populations, emphasizing the unique challenges for children in disadvantaged rural


environments. Implications for future research and intervention are discussed in regard to the
importance of significant others when parent engagement is insufficient.
As Contribuies da TCC No Tratamento da Tricotilomania
Patricia Desco, Vanessa Brabo.
Unimar-Universidade de Marlia, Marlia, Brazil.
O presente trabalho refere-se ao caso de L.A.O., 12 anos, atendida a partir dos pressupostos
tericos da TCC em psicoterapia clnica individual, no perodo de maro a dezembro de 2012.
A queixa apresentada pela famlia que L. era uma garota ansiosa, inquieta e que desde 2010
passou a arrancar os fios das sobrancelhas. Ela reside com seus pais e filha do segundo
casamento do pai. A partir dos atendimentos foram confirmadas as queixas de ansiedade,
tricotilomania e dficit no repertrio comportamental relacionado s habilidades sociais.
Identificou-se que L. possua uma vida social restrita ao convvio familiar e que o seu
relacionamento com outras pessoas da mesma faixa etria acontecia somente na escola. Os
objetivos estabelecidos aos atendimentos foram: a) estimular a percepo e discriminao de
sentimentos, situaes, reaes fisiolgicas, comportamentos e pensamentos; b) melhorar a
autoestima, autoconfiana e motivao; c) ampliar o repertrio social; d) identificar os fatores
potencializadores e mantenedores da tricotilomania e criar estratgias de reverso de hbito; e)
orientar aos pais como colaborarem com o processo teraputico. L. no fazia uso de
medicao e o tratamento baseou-se nos procedimentos e tcnicas da TCC: psicoeducao,
discriminao de sentimentos, reestruturao cognitiva, reforamento positivo, treino em
motivao, dramatizao, imaginao ativa, monitoramento da tricotilomania por meio de
fotografias, controle de estmulos com a utilizao de sinalizadores ou alertas visuais,
relaxamento, treino em repostas incompatveis ou concorrentes, treino em resoluo de
problemas e reverso de hbitos. Nas intervenes foram utilizadas diversas formas de
registros, brincadeiras e jogos adaptados faixa etria de L. Os pais contriburam motivando e
proporcionando aprendizagens em situaes de convvio social. Constatou-se a eficcia do
trabalho teraputico a partir da reduo dos sintomas de ansiedade, melhora significativa no
aspecto das sobrancelhas e ampliao das atividades sociais com amigos sem a necessidade
da presena dos pais.
Trastornos de Conducta en el mbito Escolar: Intervencin Cognitivo-Humanista
Paula Diaz Lomas.
psicologa, Instituto Cognitivo Conductual de Salud Mental de Mxico, Distrito Federal, Mexico.
La disciplina constituye un problema que sealan con frecuencia los maestros, en una
investigacin realizada por la National Education Association (1995) se revel que el 88% de
los profesores indicaban como uno de los principales problemas de la labor docente era el
manejo de los alumnos indisciplinados, incluso en los maestros con ms experiencia
profesional (Harvey y McCoy, 1995). La presencia de los trastornos de conducta en nuestros
nios y jvenes puede tener como consecuencia severas implicaciones en su aprendizaje, xito
escolar y en la adecuada convivencia y relacin social con los compaeros y profesores de sus
centros educativos (Garca, 2011). Estas implicaciones a su vez tendrn eco en las
consecuencias secundarias entre las que se encuentran baja autoestima, baja tolerancia a la
frustracin y depresin, as como el incremento en el riesgo de padecer trastorno disocial en la
adolescencia, junto al uso y abuso de sustancias adictivas (Pea & Palacios, 2011). La
bibliografa sugiere como una primera opcin psicoteraputica la intervencin cognitivo

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conductual por sus periodos de intervencin cortos y por su capacidad para aumentar la
capacidad de paciente para resolver los problemas y sus habilidades de comunicacin, control
de ira y del impulsos (Rigau, Garca y Artigas, 2006; Vzquez, Feria, Palacios & De La Pea,
2010 & Martnez, Fernndez, Lemus, Mendoza & Ramrez, 2011). La evidencia de su
efectividad est altamente documentada, sin embargo, como menciona Amescua (1997), la
prevalencia de los trastornos de conducta sigue en aumento por lo que es necesario
implementar estrategias de intervencin en conjunto con el nico objetivo de buscar el
bienestar de nuestros nios. En esta lnea, la psicoterapia humanista cuenta con tcnicas e
control emocional que parecen estar dirigidos especficamente a los nios, especialmente en lo
que se refiere al vivenciar. Los nios, ms que hablar sobre lo que les pasa, lo vivencian a
travs del juego y las tcnicas de gestalt constituyen un maravilloso juego, pues en todas ellas
est implcita la accin. (Amescua, 1997 & Oklander, 2009); siendo entonces el complemento
ideal para la intervencin cognitivo conductual en nios El presente estudio tiene como objetivo
analizar las diferencias en los problemas de conducta que presentan los alumnos de una
primaria, as como la percepcin de sus tutores y profesores antes y despus de un taller
cognitivo-humanista. Participaron 40 alumnos (20 nios y 20 nias) de la escuela Lic. Juan
Fernndez Alvarran en el municipio de Tlalnepantla Estado de Mxico, que presentaban
problemas de conducta, con edades de 6 a 12 aos, junto con sus padres o tutores y
profesores. Los instrumentos empleados para la investigacin fueron, en el caso de los nios,
el Youth Self Report con validez mexicana (Valencia y Andrade, 2005), y tanto para los padres
como profesores se aplic la Escala de evaluacin de los trastornos de conducta perturbadora:
Formulario para padres y Profesores (Barkley, 1989), traducido al castellano para poblaciones
hispanas (1991). Se presentan las diferencias estadsticamente significativas en los tres
grupos, resaltando la aportacin de ambos enfoques y la importancia de la inclusin de
maestros, padres y alumnos en la resolucin de este tipo de problemticas. Palabras claves:
nios, trastornos de conducta, mbito escolar, terapia cognitivo conductual, terapia humanista.
Parental Attachment Anxiety and Avoidance in Predicting Attachment to Parents in
Middle Childhood
Burak Dogruyol, Nebi Smer.
Middle East Technical University, Ankara, Turkey.
Abstract Central: One of the basic tenets of attachment theory is the intergenerational
transmission of attachment patterns. Parental sensitivity and responsiveness those were
assumed to result in the development of childs internal working models of attachment are
closely linked with parents own attachment orientations. Recent conceptualizations in
attachment theory claimed that attachment related anxiety and avoidance are the two
fundamental dimensions. These attachment orientations are believed to guide the expectations,
emotions, and behaviors in all sort of intimate relationships including parent child interactions.
Considering the cultural relevance of these dimensions, the present study aimed to test (a) both
main and interactive effects of attachment anxiety and avoidance of mothers and fathers on
child attachment security, (b) whether possible associations between parental attachment
orientations and child security systematically differ considering the gender of both parents and
the child, in middle childhood. For this purpose study was conducted on a large sample to
investigate all of the possible interactions and additive effects of gender, by obtaining data from
mothers, fathers, and their children (1270 mother-father-child triads). For parents reworded
version of ECR-R and for their children Kerns Attachment Security Scale were used. Mother
avoidance predicted boys attachment to mother and father anxiety predicted girls attachment
to father. Among the interaction terms, mother anxiety-avoidance, mother-father avoidance, and

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mother anxiety-father avoidance perdicted boys attachment to mothers and fathers. Results
were discussed in the light of atttachment theory and culture-specific relationship patterns.
Preveno de Ansiedade Atravs de um Programa Universal Aplicado em Grupo
Beneria Donato, Ana Nunes.
Psicologia, Faculdade Estcio, Recife, Brazil.
Abstract Central: A ansiedade um transtorno antes diagnosticados apenas na vida adulta,
hoje pode ser precocemente identificado e tratado. So vrios os fatores que podem tornar os
jovens propensos a desenvolverem transtorno de ansiedade precocemente, entre eles: ndices
altos de competitividade, frequentes presses dos pares, metas parentais altas e intensas,
aumento do bullying e evoluo rpida da tecnologia. Atualmente, cresce cada vez mais o
interesse em investir na preveno de alguns transtornos e isso tem motivado alguns
pesquisadores a buscar estratgias, intervenes, programas e evidencias de como prevenir
transtornos de ansiedade, um dos transtornos mais prevalentes na infncia. Uma
pesquisadora, a Dra. Paula Barret vem obtendo sucesso h mais de 15 anos com o Programa
Amigos. O programa baseado no modelo terico da terapia cognitivo-comportamental,
envolvendo aspectos fisiolgicos, afetivos, cognitivos, comportamentais e sociais, e o
desenvolvimento da resilincia em crianas de 4 a 10 anos e jovens de 11 a 16 anos. O
presente trabalho visa apresentar as bases tericas do Programa Amigos, algumas pesquisas
atuais sobre preveno de ansiedade e os aspectos prticos da aplicao do programa em
grupo e universal. Os programas Amigos so estruturados em trs faixas etrias e podem ser
aplicados por professores e/ou profissionais da rea de sade, em escolas e/ou comunidades.
Pesquisas realizadas com crianas que apresentavam sintomas de ansiedade mostram que
80% das crianas que participaram dos 12 encontros do Programa Amigos, no apresentavam
transtorno de ansiedade nos seis anos seguintes de folow up. O carter grupal e universal da
aplicao dos programas em escolas faz com que os participantes do programa no sejam
selecionados e, portanto, na escola todos os jovens podem participar do programa amigos. O
programa traz benefcios relacionados preveno de ansiedade, produz melhoras nas
relaes sociais e no desempenho acadmico e ajuda a potencializar os fatores de proteo da
sade mental. Os resultados positivos aps a aplicao do programa nos jovens acontecem
tambm em decorrncia da incluso ativa dos pais na sua estrutura, do uso de aspectos da
psicologia positiva e da estimulao na qualidade diria do sono, da alimentao e da atividade
fsica. O Programa Amigos existe atualmente em mais de 20 pases e tem como misso
desenvolver a resilincia na vida de crianas, jovens e suas famlias.
Internet- and Family-based CBT-interventions for children and their parents: New
directions and challenges
Pia Enebrink1, John Lochman7, Jens Hgstrm1, Pia Enebrink1, Ata Ghaderi2, Sarah Vigerland1,
5
, Ulrika Thulin1, Lars-Gran st3, Brjnn Ljtsson1, Gerhard Andersson4, 1, Eva Serlachius1, 5,
Marianne Bonnert5, Ola Oln1, 6, Eva Serlachius1, 5, Brjnn Ljtsson1, Annika Bjrnsdotter2, Pia
Enebrink1, Christina Kadesj8, Ata Ghaderi2, Ulrika Thulin1, Liv Svirsky1, Eva Serlachius1, 5,
Gerhard Andersson4, 1, Lars-Gran st3.
1. Karolinska Institutet, Stockholm, Sweden, 2. Uppsala University, Uppsala, Sweden, 3.
Stockholm University, Stockholm, Sweden, 4. Linkping University, Linkping, Sweden, 5.
Stockholm Centre for Psychiatry Research, Stockholm, Sweden, 6. Sach's Children and Youth
Hospital, Stockholm, Sweden, 7. The University of Alabama, Alabama, AL, USA, 8. Primary
Health Care in Gothenburg, Gteborg, Sweden.

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Several established CBT-treatments exist for children with conduct disorder and for anxiety
disorders. Unfortunately, not all children and their families receive these interventions. This
could be due to a lack of CBT-therapists at local child psychiatric clinics, inability for the family
to attend therapy during the day, a high parental workload, stress, or difficulties with daycare.
Although a majority of children and parents who receive these treatments report major benefits,
some children, despite treatment, still experience lower quality of life and, problems with
friendship, school attendance, and family life. Internet-based treatments have been developed
to overcome some of the barriers described above, as have treatment models where the
inclusion and targeting of the whole family (the Family Check-Up, for conduct problems) or the
addition of parents in treatment (anxiety problems) has been suggested to improve treatment
outcomes. Furthermore, another problem area where CBT has shown effectiveness but is not
widely available for children and youth are the functional gastrointestinal disorders (FGID). The
present symposium first addresses the question of whether Internet-based treatments are
effective, and discusses some of the challenges when directing treatments through the Internet
to children and/or their parents. Jens Hgstrm (Karolinska Institutet, Sweden) presents data on
an Internet-based Parent Management Training (PMT) program for parents with conduct
problem children aged 3-12 years, and discusses the possible moderating role of Callous
unemotional traits for treatment outcome. Sarah Vigerland (Karolinska Institutet, Sweden) has
been involved in conducting a study on Internet-delivered treatment targeting anxiety disorders
(generalized anxiety disorder, panic disorder, separation anxiety, social anxiety disorder,
specific phobia) in children aged 8-12 years, and will discuss preliminary findings. Marianne
Bonnert (Stockholm Centre for Psychiatry Research, Sweden) is currently investigating a
recently developed model for Internet-delivered FGID-treatment and will describe the treatment
program as well as post assessment data for youth included in the study. Regarding the
possible additive effects of including the family in treatment, Annika Bjrnsdotter (Uppsala
University, Sweden) will present data on whether the Family Check-Up could be a more
effective way of delivering treatment for conduct problem youth rather than using a model for
Internet-based regular PMT delivered through the parents, and also evaluates one of the
challenges, adherence to the treatment. Finally, Liv Svirsky/Ulrika Thulin (Karolinska Institutet,
Sweden), will discuss implications from a meta-analysis regarding parent involvement in anxiety
disorder treatments. Professor John E. Lochman (University of Alabama, USA) will serve as the
symposium discussant.
Internet-based Parent Management Training: Treatment effects and the moderating role
of Callous Unemotional traits
Parent Management Training (PMT) is generally considered the treatment-of-choice for children
with conduct problems. However, for many of these children and families, there are no available
treatments at local child psychiatric clinics or social services. Internet-based treatments could be
one way forward to solve this problem. Previous studies report several moderating parental and
child variables (e.g. maternal depression, marital status, severity of conduct problems).
Recently, Callous Unemotional (CU) traits of the child, was investigated and found to reduce
effects for children high on these traits. In addition to other moderators, CU traits could be
important to evaluate when delivering an Internet-based PMT-treatment. The current study
evaluated the efficacy of an Internet-based PMT-program for children with conduct problems, as
well as the moderating role of child CU traits on treatment outcome. Parents of 104 children
(aged 3 - 12 years) were randomly allocated to either parent training or a waitlist control
condition. Diagnostic assessment was conducted at baseline and parent ratings of child
externalizing behaviors and parenting strategies were completed before and after treatment, as
well as after 6 months. At post treatment, children whose parent(s) had received the intervention
showed a greater reduction in conduct problems compared to the waitlist children. Between
group intent-to-treat effect sizes (Cohens d) on the Eyberg Intensity and Problem scales were

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.42 and .72, respectively (study-completers .66 and 1.08). These improvements were
maintained at the 6-month follow-up. In addition, parents in the intervention group reported less
use of harsh and inconsistent discipline after the treatment, and more positive praise. Higher
levels of CU traits in children were associated with a reduced treatment response. The results
support the efficacy of Internet-based PMT, with outcomes comparable to many of the groupbased PMT programs. The cost of this Internet-based intervention was merely one third of the
cost of an ordinary group-based program. The efficacy, low cost, and high accessibility could
make this intervention a fitting part in a stepped-care model. The moderating role of CU traits
calls for more attention on empathy and emotional patterns in the assessment of children with
conduct problems.
Internet-delivered CBT for children with anxiety: a randomized controlled trial of the
DARE program
Anxiety disorders are among the most common mental problems in children and often lead to
further problems in other life domains. Although cognitive behaviour therapy (CBT) has proven
to be an effective treatment for anxiety disorders among children it is not widely available for this
group. Internet-delivered CBT (ICBT) has proven to be effective for adults with e.g. anxiety
disorders and may be a way of increasing treatment availability. However, corresponding
research in children and adolescents is scarce. The aim of this trial was to evaluate an ICBTprogram for children with anxiety disorders in a randomized controlled trial. Ninety-three children
(8-12 years) with an anxiety disorder (generalized anxiety disorder, panic disorder, separation
anxiety, social anxiety disorder or specific phobia) as principal diagnosis were recruited together
with their parents through media advertisement. Participants were randomly allocated to
treatment or a waitlist condition. Treatment consisted of ICBT with therapist support and lasted
for ten weeks. Support was delivered through written online messages and telephone calls.
Assessments were conducted at pre- and post-treatment and three month follow-up. The
primary outcome measure was the Clinician Severity Rating (CSR) assessed via the Anxiety
Disorder Interview Schedule - Child and Parent Versions (ADIS-C/P). Secondary outcome
measures were clinician rated global functioning and child- and parent-reported anxiety
symptoms and quality of life. At the time of abstract submission, post-treatment data were
available for 57 participants. Preliminary results show that participants in the treatment condition
displayed significantly greater reductions on the CSR than the waitlist condition. Results from
post-treatment and follow-up for all included participants will be presented at the conference.
Findings and the impact of therapist support will be discussed.
Internet-delivered exposure-based CBT for adolescents with functional gastrointestinal
diseases: a pilot study
Functional gastrointestinal disorders (FGID, or recurrent abdominal pain) have a high
prevalence in adolescents. The FGID, including disorders like irritable bowel syndrome,
functional dyspepsia and functional abdominal pain, have a great impact on quality of life and
may lead to anxiety, depression and gastrointestinal problems into adulthood. While medical
and dietary treatments have unsatisfying effects, cognitive behaviour therapy (CBT) has shown
promising results for this group of patients. In adults, CBT is the most well researched
psychological treatment for FGID and several studies have proven internet-delivered exposurebased CBT to be an effective treatment. Research on internet-delivered CBT for children and
adolescents with FGID is scarce. The aim of the present pilot-study was to evaluate an internetdelivered exposure-based CBT-program for adolescents. Twenty-nine adolescents (13-17
years) and their parents were recruited through paediatric gastrointestinal clinics in Stockholm.
The Internet-delivered CBT-program lasted for 8 weeks and included weekly therapist support.
The support consisted of online messages and telephone calls. The assessment points were
baseline, post-treatment and 6 months follow-up. The primary outcome measure was symptom

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severity assessed with Gastrointestinal Symptoms Rating Scale - IBS version (GSRS-IBS).
Secondary outcome measures were visceral sensitivity and functional disability. At the time of
abstract submission the post-treatment assessment was ongoing and post-treatment data was
only available for 7 of the 29 treated patients. These patients showed large improvements on
symptom severity (within-group Cohens d=1,0), visceral sensitivity, (d=1,2) and functional
disability (d=0,8). In June 2013 post-treatment and 6 months follow-up data will be available for
the entire sample and presented at the conference.
The FCU model of assessing risks and tailoring treatment to families compared to
Internet-based standardized PMT-treatment: A randomized controlled trial in Sweden
The literature describes many risk factors for the development and maintenance of disruptive
behavior in children, including coercive family processes. Early interventions for troubled
children focusing on helping parents change negative and coercive interactions with a disruptive
child in Parent Management Training (PMT) programs have been found to reduce the risk for
continued conduct disorder and other mental health problems. The Family Check-Up (FCU) has
several characteristics that distinguish it from traditional PMT-programs. It was developed to
assist a family with a child at risk through a comprehensive mapping of all risk and protective
factors, as well as a tailored feedback and discussion on the family needs. The model is
designed to proactively support families and differs from other traditional programs in the
inclusion in the model of an annual contact with the family. The FCU consists of a first meeting,
an assessment session, and a final feedback session. The feedback session is the intervention
cornerstone, tailoring feedback to the family based on their overall assessment. Thereafter,
parents can decide on the goals and choose the actions they need. Available interventions vary
depending on the resources the intervention team has access to, but as a minimum it includes
interventions relevant to specific parenting strategies. The intervention can range from shortterm individual and family work, structured parenting, to child and school-based interventions. A
unique element is that motivation to change explicitly addressed at all stages of the intervention
process. The main objective of the present study is to evaluate the possible effects of the FCU
in Gothenburg, Sweden, on conduct problems in children aged 10-13 and their families. 220
children are included in the study. The inclusion child criteria include a higher risk of developing
conduct problems, or severe conduct disorder behaviors at the assessment. Participants are
randomized to either FCU or an Internet-based PMT-program. Data is gathered through the
parents, children and the childs teacher. The presentation will include preliminary data for how
effective the FCU is for children with disruptive behavior compared with Internet-based PMT,
and discuss aspects such as treatment adherence. The study is an effectiveness study, e.g., in
that the intervention is delivered in the community through family therapists.
Does parent involvement in the treatment of anxiety disorders in children potentiate the
effect? A meta-analysis.
Anxiety disorders are the most common forms of psychiatric problems in children and
adolescents. The prevalence rate varies between different studies, ranging from 2.6% to 41.2%.
The first randomized controlled trial (RCT) on CBT for anxious children was conducted by
Kendall 1994. Since then several studies have shown that different forms of CBT are promising
treatments for childhood anxiety disorders. It has more or less been taken for granted that
parents involvement in their childrens treatment is beneficial for therapy outcome, but research
on this issue is far from clear. Despite the common sense notion of the value of including
parents in treatment, the effects of parental involvement in childrens treatment have not been
well researched. A meta-analysis was carried out in order to investigate whether parent
involvement potentiates the outcome for children with anxiety disorders when treated with
cognitive-behavior therapy. Fourteen studies, which directly compared parent involved
treatments with child only treatments, were included in the meta-analysis. Unexpectedly, the

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results showed that child only treatment was significantly better than parent involved treatment.
Despite the effect sizes being homogeneous, a number of moderator variables were analyzed
but none predicted effect size significantly. There was no indication of publication bias in the
analysis. Implications of the results are discussed.
Anxiety levels and resilience factors in children and adolescents: Evidence-based
Interventions in Brazil and Peru The Friends For Life Program
Dina Figueroa2, 5, Elsa Farfn1, 3, Circe Petersen1, 4, Lusa Fernanda Habigzang5.
1. Friends For Life Program, Lima, Peru, 2. Friends For Life Program, Rio Grande do Sul, Brazil,
3. Inst. Cond. Adictivas y Prob. Emocionales: CASAGUIA, Lima, Peru, 4. Escuela Posgrado
Universidad Ricardo Palma, Lima, Peru, 5. Federal University of Rio Grande do Sul, Brazil, Rio
Grande do Sul, Brazil.
Anxiety problems are very common in childhood and adolescent. Many fears are normal
phenomena are associated with development. They are usually transient and fulfill adaptive
functions related to growth. Sometimes, fears are more intense and interfere the child
development and affect other areas of their health. Moreover, fears, phobias and other anxiety
disorders of childhood and adolescence tend to persist into adulthood and can be related to the
emergence of other psychopathological problems. The timely detection and accurate diagnosis
of the different forms of anxiety affect prognosis of their performance in personal, school, social
and family areas. We require people with more autonomy, flexibility, initiative, self-confidence
and ability to mold to new situations. The setbacks and undergo daily demands that children
and adolescents live, exposed them to many anxious moments. It is necessary they develop
resilient and protective factors (personal strengths, cognitive and interpersonal skills) to help
them take appropriate coping responses to adverse everyday events. In this clinical round table
we show you different experiences in Latin America. The first study is the first-ever evaluation of
a selective school-based prevention program for childhood anxiety in socio-economically
disadvantaged schools Brazilian sample, using the FRIENDS for Life program, an effective
intervention for childhood anxiety that has been validated across all three levels of prevention.
The second one is about a research is to identify the levels of anxiety in children and
adolescents in Lima-Peru and know those protective factors and resiliency factors to better
prepare them to deal effectively with adversity and frustrating everyday events. We review
research in Lima.Per. We work in a selective school-based prevention program for childhood
and adolescent anxiety with low levels of resilience. Furthermore is the relevance of applying
FRIENDS For Life Program, which has been implemented for over 15 years in 19 countries, It
has been validated in the prevention and the promotion of social and emotional development
through practical strategies and comprehensive tools to help improve your relationships
proactively and deal with stress, worry, sadness or fear. The third theme is about the negative
consequences of sexual abuse to the psychosocial development of children and adolescents
victims We developed the CBT model group therapy for the treatment of children and
adolescents victims of sexual abuse in Brazil. The findings demonstrate that the group therapy
model is an effective intervention to treat the victims of sexual abuse so they learn to deal with
anxiety disorders.
Repercusiones en el Sistema de Creencias de Nios Testigos de Violencia Domstica
Mara Esther Flores, Ana Isela Valenzuela.
Psicologa, Universidad Popular Autnoma del Estado de Puebla, Puebla, Mexico.
Abstract Central: La violencia domstica es un fenmeno difcil de disminuir y culturalmente
tan reforzado, tiene consecuencias dramticas para las vctimas directas pero tambin, para los

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testigos silenciosos. Los hijos de matrimonios expuestos a la violencia entre sus padres
presentan datos clnicos tan francos como aquellos quienes son violentados directamente. Esta
investigacin realiz una documentacin sobre el fenmeno, abordando la violencia como
factor base, con acento en la violencia domstica, las repercusiones fsicas, emocionales y
sobretodo, las repercusiones en el sistema de creencias considerando la teora de la formacin
y mantenimiento de los esquemas tempranos maladaptativos de los testigos as como su edad
y nivel de desarrollo cognitivo. junto a esto, se presenta una propuesta de tratamiento integral
para padres e hijos. La discusin gira en torno a las aportaciones que la psicologa (educativa,
clnica y social-comunitaria) pudiera ofrecer en la bsqueda de mejores y diferentes formas de
afrontar el problema.
Resilience: The Role of Spirituality for Child and Parental Mental Health
Andrew Francis, Susana Gavidia-Payne, Kate Davis, Eleanor Holroyd, Merv Jackson.
Psychology, RMIT University, Bundoora, VIC, Australia.
Abstract Central: Our work is broadly framed within resilience theory, with the aim of
identifying individual characteristics and experiences which will predict continued positive
functioning and health in the face of potential life adversities. In particular, identification of
childhood protectants and risks for the development of either psychological health or pathology
is of particular importance. The positive impact of a sense of spirituality or life-meaning on
mental health is reasonably well established in adults, although very little research has been
conducted in children. The aim of our study was to determine relationships between
spirituality/meaning-making and mental health in children and their parents; and to examine
relationships between parental and child functioning in these areas. As part of a broader and
ongoing study, 230 children and one each of their parents from rural and metropolitan
communities completed self-report measures of mental health, temperament and social
connectedness. Specific measures included the FACIT-Sp measure of spirituality/meaningmaking, Beck Youth Inventories (BYI) of child mental health, Depression Anxiety Stress Scales
(DASS) for adults, the UCLA Loneliness Scale and the Loneliness and Social Dissatisfaction
Questionnaire (LSDQ). Significant correlative relationships indicate higher levels of self-reported
spirituality in children are associated with better self-concept, lower anxiety, depression, anger
and disruptiveness, and improved social connectedness. In adults, spirituality similarly predicted
levels of depression, anxiety, stress and loneliness. Parental pathology was not generally
predictive of child mental health, although there was a significant relationship between reported
parental and child spirituality. In conclusion, our results indicate that some sense of spirituality
or meaning-making is related to better mental health outcomes in both children and their
parents, and suggests a positive avenue for improving resilience across developmental groups.
Global perspectives on CBT with youth:
Robert Friedberg1, Ricardo Munoz7, Robert Friedberg1, Micaela Thordarson1, Lisa Hoyman1,
Nathan Chow1, Javier Mandil3, Eduardo Bunge3, Martin Gomar3, Michael Rosenbaum2, Tammie
Ronen-Rosenbaum2, Daniela Bakos4, Debora Fava5, Wilson Melo6.
1. Center for the Study and Treatment of Anxious Youth at PAU, Palo Alto, CA, USA, 2. Tel Aviv
University, Tel Aviv, Israel, 3. Fundacion ETCI, Buenos Aires, Argentina, 4. Cognitive
Behavioral Clinic-Brazil, Porto Alegre, Brazil, 5. Infant School Brazil, Porto Alegre, Brazil, 6.
Brazilian Institute of Business Administration, Porto Alegre, Brazil, 7. Palo Alto University, Palo
Alto, CA, USA.

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The world is becoming a smaller place and Cognitive Behavioral Therapy (CBT) is extending its
global application. Perhaps, CBT 's shared language enables its procedures to cross different
borders. Moreover, the flexibility provided by CBT's robust theoretical and philosophical
foundations allow for genuine multicultural responsiveness that transcends mere cosmetic
modifications. This symposium highlights culturallly alert CBT in four countries (United States,
Brazil, Israel, Argentina).
Friedberg, Thordarson, Hoyman and Chow review the literature on CBT with diverse youth in
the United States. Their contribution presents a brief summary and critique of the literature
which concludes with suggestions for theory building. Additionally, they offer various clinical
recommendations for practitioners. Their recommendations are augmented by several
illustrative case examples and handy clinical tips for working with diverse youth
Bakos, Fava, and Melo highlight recent advances in cognitive behavioral assessment in
treatment with youth living in Southern Brazil. They integrate these emerging directions withiin
the context of the specific cultural complexities encountered in southern Brazil. Finally, clinical
cases augment the discussion and amplify the salient points.
Ronen-Rosenbaum and Rosenbaum's presentation integrates theory, research, and clinical
practice in their contribution on CBT with Israeli youth. They address the relationship between
positive psychology and CBT. Moreover, they explicitly describe their work using sport and
music as treatment vehicles designed for teaching greater self-control. Their presentation
tackles both the theoretical mechanisms and clinical practices involved in self-control training .
Bunge, Gomar, and Mandil's presentation discusses CBT with Argentine Youth. They
specifically concentrate on particular cultural issues germane to Argentine culture. Bunge and
colleagues describe the findings of a major study and offer practical guidelines for treating
Argentine youth. Finally, they conclude with an emphasis on balancing fidelity to the theoretical
model with clinical flexibility in practice.
Finally, Munoz add his unique perspective on culturally responsive CBT with youth in his role as
discussant.
CBT with diverse youth in the United States
The United States population is becoming markedly multicultural. With increasing diversity,
there is an accompanying call for culturally alert mental health care. Cultural responsiveness is
seen both as an ethical requirement as well as a clinical virtue. While various treatment
modalities incorporate multicultural sensitivity in their protocols. CBT seems especially
responsive to this new emphasis. Indeed, there is much to recommend CBT as a particularly
ripe vehicle for culturally alert care. Accordingly, this presentation provides both a review of the
efforts to incorporate cultural responsiveness in CBT spectrum approaches as well as clinical
recommendations for practitioners.The presentation includes an overview of the current state of
knowledge pertaining to culturally responsive CBT with youth in the United States. Theoretical,
empirical and clinical models are described. Additionally, recommendations for further theory
building and empirical research are offered. The presentation emphasizes transcending mere
cosmetic modifications in order to fully genuinely embrace cultural vicissitudes. Finally, specific
clinical guidelnes are delineated for delivering culturally alert CBT to diverse youth. Numerous
case examples are presented to illustrate the salient points.
CBT with Brazilian youth
Cognitive Behavioral Therapy (CBT) is now widely applied to a range of clinical disorders in
children and adolescents. In Brazil, increased interest in and research on CBT for children and
adolescents has resulted in a growing number of qualified therapists and the development of
instruments which take into account the socio-cultural characteristics of the country. As an effect
of this maturity in the field, the 1st Brazilian and Latin American Congress of CBT with Children
and Adolescent was held in Brazil. The aim of this presentation is to summarize the recent work

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of improving the use of CBT to treat children and adolescents with mental health problems in
southern Brazil. The main goals of this paper are (a) review the key works conducted in CBT for
children and adolescent in Southern Brazil; (b) postulate sources of cultural variation that may
affect CBT practice; and (c) use a case to illustrate the CBT model in a distinct cultural setting
(Needy Institution). Issues regarding the specific techniques and strategies used are further
explored.
Using innovative cognitive behavioral methods to increase the psychological well being
of Israeli youth
From its inception four decades ago CBT is primarily associated with the "talking therapies" that
are directed at alleviating psychological disorders. However, with the advent of positive
psychological therapy CBT methods have been employed toward increasing psychological wellbeing and positive affect by harnessing the clients' strengths and virtues toward achieving these
goals, in particular self-control skills. We describe two intervention projects in which we
employed sport and music to increase the psychological well being of children and youth "at
risk". By engaging these youngsters in performing in an actual orchestra and in sport activities
we have changed their cognitions and behavior about themselves and about the world. By the
use of these basic CBT concepts without the primary use of "talking" we were able to increase
psychological well being and decrease maladaptive behavior.
From early childhood people are motivated toward increasing their personal well-being by
acquiring social and physical resources. To achieve these basic goals people learn self-control
skills These skills include: (a) use of cognitions and self-instructions, (b) problem-solving
abilities, (c) ability to delay immediate gratification, and consequently (d) the belief in selfefficacy. We conceive of these skills as a cognitive-affective personality repertoire of which
there are large individual differences in the extent to which people have them (i.e., high versus
low resourceful people). Michael Rosenbaum's presentation will expand on the hypothesized
mechanisms by which self-control skills lead to more effective human functioning (e.g., through
the mediation of positive affect, through the ability to master social support, etc.). Tammie
Ronen will focus on the use of self-control skills among children and how these skills enhance
their well-being and decrease various mental disorders.
Cultural adaptations for the implementation of cognitive behavioral therapy with youth in
Argentina
Evidence based psychotherapy has increased its dissemination around the world. Yet, its
generalization to different cultural contexts raises a number of difficulties and questions.
Although Argentina has a strong psychological culture and counts as one of the countries with
the most psychologists per capita, research on the effectiveness of psychotherapy in this
context is scarce, especially in children and adolescents mental health services (CAMHS). As
Argentine culture is characterized by the lack of adherence to organizational rules and
guidelines, the implementation of structured treatment can present a challenge for patients as
well as therapists. Accordingly, the main findings of a descriptive study of user satisfaction (US)
of CAMHS are presented. The study had a total sample of 382 subjects, consisting of; parents,
children and adolescents who were treated in three CAMHS. A quantitative analysis assessed
the degree of user satisfaction and analyzed individual differences in user satisfaction according
to the theoretical orientation of the CAMHS. In addition, a qualitative analysis of the aspects that
users value as positive and / or negative of the services was performed, following the
methodology of thematic analysis. The major clinical implications for cognitive behavioral
therapists who implement structured models for youths in cultural contexts such as Argentina
are characterized. Various ways of delivering cognitive behavioral interventions are described in
a framework of fidelity to these models and encouraging flexibility in order to promote the
acceptance of the children, adolescents and their families of such interventions.

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Sex Differences in Stress Vulnerability Among Adolescent Students


Yasuyuki Fukukawa1, Ryo Oda2, Kazumi Kawaguchi3.
1. Psychology, Waseda University, Tokyo, Japan, 2. Nagoya Institute of Technology, Nagoya,
Japan, 3. Seitoku University, Chiba, Japan.
Background: It has been suggested that the emotional impact of undesirable life stress is
different between men and women. We addressed this issue by hypothesizing that men would
demonstrate greater responses to achievement stressors, whereas women would show greater
responses to social rejection stressors. Methods: A total of 683 participants comprised the
original sample for a cross-sectional survey. Due to missing data, however, we omitted 80
participants from the analyses. All of the participants were undergraduate students (273 men
and 330 women, mean age 19.51.53 years old), who were enrolled in introductory psychology
classes. They answered to valid and reliable questionnaires on achievement stressors, social
rejection stressors, self-esteem, attachment with parents, and current mental health status.
Results: Analyses indicated that both achievement stressors and social rejection stressors were
significantly associated with lower mental health status. However, interactions of both stressors
with sex were also significant; men, compared to women, rapidly deteriorated their mental
health status when they confronted with many achievement stressors, whereas women,
compared to men, rapidly deteriorated their mental health status when they confronted with
many social rejection stressors. Further analyses also indicated that self-esteem buffered the
decrement of mental health status in men, but not in women. Parental attachment did not exert
such a stress buffering effect on both sexes. Conclusions: Men seemed to be more reactive to
achievement challenges, but women seemed to be more reactive to social rejection challenges.
Mens greater reactivity to achievement challenges may be attenuated by increasing selfesteem. The implications of our findings were discussed in detail, especially from an
evolutionary perspective.
Impacto de un Taller Cognitivo-Conductual en el Vnculo Padre-Hijo en Adolescentes de
Padres Divorciados
Adriana Galicia.
INCOSAME, Mexico, Mexico.
Abstract Central: Galicia Conde Adriana Priscila Instituto Cognitivo Conductual de Salud
Mental de Mxico La adolescencia es considerada una etapa de alta vulnerabilidad en el
aspecto social y afectivo, debido a los cambios fisiolgicos y psicolgicos constantes, as como
a la adaptacin y ajustes a su entorno social. Durante los ltimos aos el estilo de vida de los
adolescentes ha sufrido un cambio debido al divorcio de los padres, en Mxico segn public el
Instituto Nacional de Estadstica y Geografa (INEGI) para el 2010 se registraron 15.3 divorcios
por cada 100 matrimonios. Es conocido que el divorcio provoca mltiples consecuencias a nivel
personal y familiar; miedo al fracaso escolar y al abandono (Orgiles, et.al. 2008) problemas de
conducta, bajo aprovechamiento escolar, baja autoestima, poca capacidad de resolucin de
problemas, dificultades en el rea social, de comunicacin y con el vnculo padre-hijo. Valds,
Carlos y Ochoa (2010) sugieren que estas dificultades emocionales y conductuales pueden
darse por una posible disminucin de recursos parentales, apoyo emocional y participacin en
la educacin. Es as que con el divorcio, los padres de familia encuentran dificultad para
mantener un vnculo emocional con sus hijos debido a la separacin fsica, provoca en los
adolescentes emociones y pensamientos negativos y poco funcionales en su vida diaria; es
sabido que esta relacin padre-hijo se toma como un referente de relacin con otros individuos,
ya que es en esta diada que se ponen en prctica las habilidades sociales, de comunicacin,

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solucin de problemas, expresividad emocional entre otras, desde la niez. De tal suerte, que
mientras exista un vnculo ms fuerte y funcional en la relacin padre-hijo, las relaciones
futuras que establezcan con otras personas mantendran el mismo patrn de funcionalidad. Por
tanto, el propsito de esta investigacin fue analizar las diferencias en la relacin padre-hijo
antes y despus de un taller cognitivo-conductual en adolescentes de padres divorciados de
dos escuelas de educacin bsica en la ciudad de Mxico. Participaron en el estudio 30
estudiantes de educacin secundaria, con un rango de edad de 12 a 16 aos, 50% hombres y
50% mujeres, que tuvieran mnimo seis meses de haber ocurrido el divorcio. Durante el estudio
se utiliz la tcnica de redes semntica (Reyes-Lagunes, 1993) para conocer el significado que
los adolescentes dan a este vnculo con sus padres; y la Escala de relacin con pap/mam de
Patricia Andrade Palos (1998) a fin de evaluar la frecuencia con que el hijo percibe que la
relacin con su padre/madre es satisfactoria, los respeta, ama y admira como padres. La
intervencin incluyo reestructuracin de recuerdos tempranos, entrenamiento en habilidades
sociales, reestructuracin cognitiva, asertividad y solucin de problemas. Se presenta el
anlisis cualitativo y cuantitativo obtenidos, resaltando el impacto de las tcnicas cognitivoconductuales en esta rea, as como la importancia e implicaciones de trabajar en vnculo con
los adolescentes que enfrentan esta crisis. Palabras clave: Adolescencia, Vnculo Padre-Hijo,
Divorcio
Recent findings and perspectives for the assessment and treatment of children and
adolescents with anxiety disorders
LuisJoaquin Garcia-Lopez1, Eric Storch2, Nicole Caporino2, Jessica Morgan2, Alessandro De
Nadai2, Adam Lewin2, Ariz Rojas2, Lindsay Brauer2, Michael Larson3, Tanya Murphy2, Jennifer
Hudson4, Helen Dodd4, Talia Morris4, William Martinez5, Antonio Polo5.
1. UNIVERSITY OF JAEN, JAEN, Spain, 2. UNIVERSITY OF SOUTH FLORIDA, TAMPA, FL,
USA, 3. BRIGHAM YOUNG UNIVERSITY, PROVO, UT, USA, 4. MACQUAIRE UNIVERSITY,
NSW, ACT, Australia, 5. DEPAUL UNIVERSITY, CHICAGO, IL, USA.
In the first paper, Dr. Storch (USA) will present data re: the effectiveness of webcam-based CBT
(W-CBT) in a randomized controlled trial. In the second paper, Dr. Hudson (Australia) will
examine how child anxiety, behavioural inhibition, maternal overinvolvement, maternal
negativity and maternal anxiety, as assessed at age four, predict anxiety over time. Finally, Mr.
Martinez employs a within-scale meta-analytic approach to review studies that report on the The
Trauma Symptom Checklist for Children.
Cognitive Behavioral Therapy for Pediatric Obsessive Compulsive Disorder via WebCamera
Pediatric obsessive compulsive disorder (OCD) is a disabling condition that affects 1-2% of
children (Piacentini et al., 2003; Rapoport et al., 2000). Fortunately, efficacious treatment exists
in the form of cognitive-behavioral therapy (CBT) with exposure and response prevention, which
is a well-established treatment for youth with pediatric OCD (Barrett, Farrell, Pina, Peris, &
Piacentini, 2008). However, despite its efficacy, dissemination of this empirically-supported
treatment is poor; when psychotherapy is provided for OCD, it often not evidence-based CBT in
that the core elements of exposure therapy are not included (Marques et al., 2010). Thus, there
exists a substantial number of youth with OCD and a paucity of providers who can provide
optimal services in treating them. Given this limited availability of efficacious treatment, we
adapted an evidence-based treatment protocol for delivery over web-video camera (webcam) to
examine its feasibility and efficacy. Such internet-based treatment can allow for delivery of
services in places that are distant from available evidence-based practice, decrease overall
travel time and parental missed time from work, and can be used in multiple settings (e.g.,

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home, community agencies, schools, etc.).


The effectiveness of webcam-based CBT (W-CBT) was evaluated in a randomized controlled
trial. Participants included 31 youth with a principal DSM-IV-TR diagnosis with OCD as
established by the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions
(ADIS-IV-C/P; Silverman & Albano, 1996). Participants were 61% male (mean age = 11.10, SD
= 2.59), and the ethnic distribution of the sample was 75% Caucasian, 3% Hispanic, 6.5%
Asian, 3% African American, and 13% of participants self-identified as other or biracial.
Patients were randomized to either 14 webcam sessions based on the Pediatric OCD
Treatment Study (POTS; 2004) protocol or a 4-week waitlist (after which they received
treatment). Outcome measures included the Childrens Yale-Brown Obsessive Compulsive
Scale (CY-BOCS; Scahill et al., 1997) and the Clinical Global Impressions Severity and
Improvement Scales (CGI-S and CGI-I, respectively; Guy, 1976).
An ANCOVA indicated improved post-treatment symptomology on the CY-BOCS
(F(2,28)=15.58, p < .001, partial 2 = .36), and the CGI-S (F(2,28)=21.74, p < .001, partial 2 =
.44). According to criteria used by Tolin et al. (2005), 81% of those in the W-CBT group were
considered treatment responders relative to only 13% in the waitlist control group, and 56% met
remission criteria in the W-CBT group compared to 13% in the waitlist control. Participants also
reported high levels of satisfaction with the W-CBT intervention.
In the present trial, the efficacy of W-CBT was similar to that seen in clinical trials (e.g., Barrett
et al., 2004; POTS, 2004). Additionally, W-CBT was considered a well-tolerated and feasible
intervention for patients. Observed barriers will be discussed, along with ethical and pragmatic
implications.
Preschool predictors of anxiety disorders in childhood and early adolescence:
temperament and family environment.
There is increasing recognition that preschool children experience clinical anxiety and recent
research has begun to examine the efficacy of early intervention. To inform what factors should
be targeted in early intervention and for whom, the present research examines how child
anxiety, behavioural inhibition, maternal overinvolvement, maternal negativity and maternal
anxiety, as assessed at age four, predict anxiety over time. A sample of 202 children aged
between 3 years 2 months and 4 years 5 months were initially recruited and the predictors
outlined above were assessed. Follow-up assessments were conducted two years, five and 8
years later. The sample were recruited such that there were 100 behaviourally uninhibited and
102 behaviourally inhibited participants. The primary outcome measure was child anxiety as
assessed using the Anxiety Disorders Interview Schedule, parent/child version. Interviewers
were blind to participant group. Our follow-up assessments at age 9 (data at age 12 currently
being collected) demonstrate that preschool children who show early anxiety, are reported by
their parents to be inhibited, have overinvolved mothers and mothers with anxiety disorders are
at increased risk for anxiety in middle childhood. These factors can be used to identify suitable
participants for early intervention and targeted in early intervention programs.
Symptom Variation on the Trauma Symptom Checklist for Children: Cross-National,
Ethnic, Gender, and Methodological Differences
Lifetime exposure to one or more traumatic events has been estimated to be between 25% and
63% among youth (Breslau et al., 2004; Costello et al., 2002). Exposure to potentially traumatic
events (PTEs) places youth at risk of developing a range of mental health problems (Copeland
et al., 2007; Hoven et al., 2005; Widom et al., 2007). Thus, the importance of developing
adequate assessment instruments for youth exposed to PTEs cannot be understated. The
Trauma Symptom Checklist for Children (TSCC; Briere, 1996) allows for a relatively brief and
developmentally appropriate assessment of posttraumatic symptoms in youth.
Aside from the TSCC normative data, there is evidence that the symptom profile based on this

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measure varies by gender, ethnicity, and SES (e.g., Breslau, et al., 2004; Costello, et al., 2002;
La Greca et al., 1996). However, these variations have not been evaluated systematically and
inconsistent results have been reported (e.g., La Greca, et al., 1996; Wilson et al., 2007). In
addition, this measure was normed using a U.S. sample, yet is often used in international
research, without any evaluation of its use. Thus, a synthesis of available studies employing the
TSCC is necessary at this time to examine possible differences in posttraumatic symptom
expression across these and other demographic and methodological characteristics. The
present study employs a within-scale meta-analytic approach (e.g., Twenge & NolenHoeksema, 2002) to review studies that report on the TSCC.
The present study included 74 studies employing samples of youth exposed to PTEs and who
completed the TSCC. Overall, mean weighted T-scores across all subscales for U.S. samples
ranged between 49 and 52. Samples outside the U.S. had higher posttraumatic stress, anxiety,
and depressive symptoms. Percentage of females in a sample was associated with increased
symptom endorsement on all TSCC subscales except anger symptoms. Percentage of ethnic
minorities in a sample was associated with decreased depressive symptoms. Samples of youth
exposed to sexual abuse reported the highest posttraumatic stress, anxiety, depressive, and
dissociative symptoms. In addition, there were some significant interactions between age and
gender, and PTE type. Youth samples from residential treatment facilities and clinical settings
displayed the highest posttraumatic stress and anxiety symptoms. The present meta-analytic
findings help elucidate the multitude of divergent findings on the posttraumatic expression of
youth exposed to potentially traumatic events.
Advances in the field of social anxiety disorder
LuisJoaquin Garcia-Lopez1, Ceu Salvador2, Klaus Ranta3, Ewa Mrtberg5, 6, LuisJoaquin
Garcia-Lopez1, Georgia Panagiotou8, Jos Pinto Gouveia2, Eero Laakkonen4, Hanna-rita Stahl4,
Paivi Miemi4, Maria Tillfors7, Nejra Van Zalk7, Margaret Kerr7, Jose Muela-Martinez1, Lourdes
Espinosa-Fernandez1, Maria del Mar Diaz-Castela1, Deborah Beidel9, Marios Theodorou8,
Klavdia Neophytou8.
1. UNIVERSITY OF JAEN, JAEN, Spain, 2. Coimbra University, Coimbra, Portugal, 3. Helsinki
University Hospital, Helsinki, Finland, 4. University of Turku, Turku, Finland, 5. Stockholm
University, Stockholm, Sweden, 6. Karolinska Institutet, Stockholm, Sweden, 7. Orwo
University, Orwo, Sweden, 8. University of Cyrpus, Nicosia, Cyprus, 9. university of central
florida, orlando, FL, USA.
In the first paper, Dr. Salvador (Portugal) will present the intervention protocol itself and the
results of its efficacy study, including the results of the waiting list group and the results of the
treatment group, comparing pre-treatment, post-treatment, and long-term follow up. In the
second paper, Dr. Ranta (Finland) will examine interpersonal cognition related to showing social
anxiety symptoms in Finnish adolescents. The third presentation, by Dr. Mortberg (Sweden) will
talk about the Atypical Anxious-Impulsive Patterns of Social Anxiety Disorder in an Adult Clinical
Population. Then, Dr. Garcia-Lopez will present follow-up data whether adding parent training in
those with high expressed emotion could contribute to increase in treatment outcome rates.
Finally, Dr. Panayiotou examines the psychometric properties two promising measures of social
anxiety in adolescence.
The symposium will conclude with Dr. Deborah Beidels discussion of the future research lines
provided in the field of anxiety disorders.
To be myself among the others: a new intervention protocol in the treatment of
adolescents with generalized social phobia
Child and adolescent social phobia has increasingly been the focus of attention of researchers
and clinicians. Nevertheless, literature revision revealed that many of the most recent

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conceptual and therapeutic developments in adult social phobia were still absent, or under
explored, in intervention programs for children and adolescents. The new manualized protocol
To be Myself among the Others developed by the authors is based in the Clark and Wellss
model for social phobia (1995), and attempts to integrate some of the latest concepts applied to
social phobia in particular and to psychotherapy in general.
The aim of this paper is to present the intervention protocol itself and the results of its efficacy
study, including the results of the waiting list group and the results of the treatment group,
comparing pre-treatment, post-treatment, and long-term follow up. Results from the waiting list
group revealed no significant changes of the variables across time. On the other hand, results
from the treatment group revealed significant changes from pre to post-treatment, and the
maintenance of treatment gains over the follow up periods, which suggest the efficacy of the
new protocol.
These results will be discussed in terms of the existing literature, and other treatment
interventions.
Interpersonal cognition related to showing social anxiety symptoms in Finnnish
adolescents
Adolescence coincides with a heightened importance of peer relationships, increased peer
pressure and, possibly partially related to these, often with onset of significant social anxiety.
We present results from a study focused on the assessment and correlates of various aspects
of Finnish adolescents interpersonal cognition (e.g., thoughts related to anticipated classmate
and own responses) in a situation where the target person, either self or another classmate,
shows symptoms of social anxiety in a classroom context. Methods: A new instrument, the
Classroom Questionnaire of Social Anxiety and Interpersonal Cognition (CQ-SAIC), assessing
anticipated thoughts, emotions and behaviours of classmates and self towards the target person
in an imagined classroom scenario, was developed for this purpose. The psychometric
functioning of the instrument and associations between various aspects of interpersonal
cognition, gender, and social anxiety were examined in a sample of 655 adolescents aged 14
to16 years. Results: The CQ-SAIC showed evidence for acceptable psychometric properties as
a measure of interpersonal cognition. The target person being self, girls anticipated more
frequent classmate negative responses relative to boys, while there were smaller gender
differences in anticipated classmate negative responses when the target person was imagined
to be another classmate. There were also clear gender differences with regard to anticipated
classmate positive reactions: girls reported these more frequently than boys in both conditions
(themselves / another classmate being the target person). Moreover, socially anxious
adolescents, both girls and boys, displayed a cognitive bias in which they anticipated more
frequent classmate negative responses with themselves imagined as the target person, relative
to the condition in which another classmate was imagined as the target person. Conclusions:
There seems to be clear gender differences in interpersonal cognition related to showing social
anxiety symptoms between adolescent boys and girls. Socially anxious adolescents display a
negative, self-specific cognitive bias of anticipat-ing more frequent classmate criticism towards
themselves than they expect towards an-other classmate in a situation in which the anxiety
symptoms of the target person are vis-ible.
Atypical Anxious-Impulsive Patterns of Social Anxiety Disorder in an Adult Clinical
Population
People with social anxiety disorder (SAD) are typically viewed as being
behaviorally inhibited; however, an atypical subgroup with impulsive traits
has recently been reported. We examined whether an atypical subgroup could
be identified in a clinical population of 84 persons with SAD. The
subscales of novelty seeking (NS) and harm avoidance (HA) of the

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Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale
were included in a series of cluster analyses. We also compared the final
set of clusters on depressive symptoms, self-directedness, and the
moderating effect of gender. Six clusters were identified, of which two
were characterized by anxious-impulsive patterns, whereas the others showed
common patterns of SAD with different levels of social anxiety, HA and NS.
The Atypical and Inhibited cluster with generalized social anxiety, high HA
and high versus low NS, respectively, showed significantly more depressive
symptoms and lower self-directedness than other clusters. Higher levels of
HA and social anxiety in combination with higher or lower levels of NS, and
low self-directedness appeared to contribute to a more severe clinical
picture.
Do expressed emotion and parent training play any role in the treatment outcome of
adolescents with social anxiety?
The objective of this study is to examine whether adding parent training in those with high
expressed emotion could contribute to increase in treatment outcome rates. Participants were
assigned to a well-established CBT intervention for overcoming social anxiety in adolescents
named IAFS, or IAFS plus parent training if parents exhibited high expressed emotion. The
sample was composed by 60 adolescents (range: 13-17 year-old). Assessment included social
anxiety and expressed emotion measures. The findings reveal that inclusion of parent training
(only if they expressed criticism, hostility or emotional overinvolvement) contributed to an
increase of gains in reduction of social anxiety in their children. Significant differences were
revealed between the experimental conditions. These data could shed some light on the discrepancy in the literature on the need of parent training, and its role in the treatment outcome of
their children.
Measuring Social Anxiety in Adolescents: Examination of the psychometric properties
and clinical utility of two social anxiety measures in Cyprus.
Several measures with well-documented psychometric properties exists for the screening and
assessment of social anxiety symptoms among adults, while some related measures exist for
the evaluation of childhood anxiety. Few measures have been applied to the evaluation of this
clinical condition in adolescence and the clinical utility of these measures has not been fully
evaluated. The present study examines the psychometric properties, construct validity,
predictive validity and clinical utility of two promising measures that have recently been used for
the evaluation of social anxiety in adolescence. In spite of their apparent promise, these have
not received extensive research attention and have not been used widely with populations other
than the ones for which they were originally developed. One such measure is the SPAI-23
(Roberson-Nay, Strong, Nay, Beidel, & Turner, 2007), which is an abbreviated version of the
widely used Social Phobia and Anxiety Inventory for adults, developed on the basis of itemresponse theory. The second measure is the Social Phobia Screening Questionnaire for
Children (SPSQ-C; Gren-Landell, Tillfors, Furmark, Bohlin, Andersson & Svedin, 2009), which is
a modified version of the social phobia screening questionnaire for adults, and which is based
on DSM-IV diagnostic criteria. Both measures were administered to approximately 700
adolescents in high-schools in the Republic of Cyprus and then subjected to psychometric
analyses. Both measures appear to present with good internal validity and meaningful factor
structures. They both permit for a good description of the clinical picture of adolescent sufferers
of social anxiety. Their comparative clinical utility for this age group is further discussed in
relation to other clinical measures that could form part of an overall assessment of social
anxiety.

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Gato Corajoso: Adaptao do Coping Cat para Atendimento Grupal de Crianas


Brasileiras
Fabiana Gauy, Edwiges Silvares.
of Clinic Psychology, Universidade de Sao Paulo, So Paulo, Brazil.
Estima-se que 10% a 20% da populao infantojuvenil sofra de ansiedade, sendo considerado
o transtorno mais comum em crianas. A escolha e uso de intervenes grupais passaram a
ser alvos de estudos recentes, indicando vantagens em relao ao atendimento individual, no
que se refere ao tratamento da ansiedade, uma vez que possibilita a interao social, a
mediao de pares, liderana e mltiplas exposies de medo associadas a interao ou
situaes sociais. Entre os modelos vigentes cita-se o Coping Cat, proposto pelo Prof. Phillip
Kendall, da Temple University, como o que j tem evidncia bem estabelecida, segundo os
critrios da APA. Posto isso, foi objetivo deste trabalho adaptar este protocolo de atendimento
grupal para a populao infantil brasileira. Este trabalho teve 4 etapas: a) traduo do material,
b) identificao das dificuldades na aplicao do protocolo em servios-escola, c) treinamento
de terapeutas e aplicao do material adaptado nas crianas brasileiras, e d) comparao dos
dados clnicos das crianas que participaram da interveno antes e depois do atendimento, e
com os dados do grupo controle. Em uma aplicao preliminar, aps o material ter sido
traduzido, foi observado a necessidade de tornar o protocolo mais ldico do que o original.
Feito isso o protocolo foi aplicado 21 crianas em duas capitais brasileiras, distribudos em 4
grupos. A interveno foi realizada em 12 sesses com frequncia semanal e com 2 horas de
durao, e aplicada por 3 terapeutas, alunos de graduao, treinados, que se revezavam nos
papeis de terapeutas, co-terapeutas e observadores. A mdia da idade das crianas era de 10
anos e 6 meses (DP:1,39), a maioria era meninas (55%) e todos eram estudantes do ensino
fundamental e procuraram o servio ambulatorial de sade mental infanto-juvenil com queixa
de ansiedade. Foram aplicados nos pais o CBCL 6-18 e nas crianas o MASC. Os resultados
apontam que as crianas que participaram da interveno obtiveram resultados clnicos nas
escalas do CBCL indicativos de melhora, quando comparadas com elas mesmas aps a
interveno e quando comparadas com os dados do grupo controle, aps o tempo da
interveno. Na escala de ansiedade, logo aps a interveno, 30% das crianas que
receberam o atendimento apresentaram perfis no clnicos para ansiedade, e 9% no grupo
controle. Aps o follow-up de 6 meses, 65% das crianas que participaram da interveno
apresentaram escore no clinico para ansiedade. A anlise do ndice de Mudana Confivel
indicou que 35% das crianas que participaram da interveno apresentaram melhoras
confiveis na Escala de Ansiedade, e 40% na Escala de Internalizao. Nos dados do MASC
no houve diferena entre os dados do grupo de interveno e grupo controle. Conclui-se que
os dados so indicativos de que a interveno cognitivo-comportamental foi capaz de promover
melhora na ansiedade das crianas atendidas e que elas continuaram a melhorar ao longo do
tempo e que a adaptao obteve resultados clnicos semelhantes ao protocolo americano.
Me and My World: The investigation of resilience in children and families in Peru and
Australia
Susana Gavidia-Payne2, Nelly Ugarriza1, Nelly Ugarriza1, Susana Gavidia-Payne1, Bianca
Denny2, Andrew Francis2, Merv Jackson2, Merv Jackson2, Emperatriz Torres3, Emperatriz
Torres3, Maria del Carmen Espinoza REyes1, Maria del Carmen Espinoza REyes1, Nelly
Ugarriza1.
1. Universidad Ricardo Palma, Lima, Peru, 2. RMIT University, Melbourne, VIC, Australia, 3.
Corporacion Educativa BF Skinner, Lima, Peru.

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Resilience has been typically defined as a dynamic process involving a positive adaptation in
the context of significant adversity with much research being conducted over the last 50 years.
Yet, resilience continues to be a concept hotly debated, especially when one takes into
consideration the different cultural environments in which children develop. Along with other
prominent researchers in the field we argue that in order to progress childhood resilience
research, it is necessary to examine the great heterogeneity of adverse and protective
conditions to which children are exposed in their daily lives, including those moulded by their
cultural contexts. Thus, the purpose of this collection of papers is to throw further light on our
understandings of childhood resilience under the banner of the Me and My World project, a
Peruvian-Australian research partnership. How resilience processes and outcomes vary
according to the value ascribed to them by individuals with differing cultural understandings was
of key importance in all the studies undertaken. An overall conceptual perspective incorporating
the multitude of influences, and the relationships among them, on child development was used
o frame the various research questions and corresponding methodologies. The first paper is
unique in its qualitative methodology, highlighting important aspects of childrens and families
constructions of .what constitutes adverse and favourable circumstances in their lives in a
specific Peruvian neighbourhood. The second paper is grounded in the view that resilient
parents will be more likely to promote healthy outcomes in their children. What constitutes
resilient parenting and identification of the factors key to what makes some parents more
resilient than others is at the heart of this Australian study. The third paper focusses on the
analyses of child resilience in Peru, highlighting the multilayered levels of influence on child
developmental outcomes. This studys specific emphasis is on the impact of prevalent economic
circumstances in association with psychosocial factors as experienced by children and their
families. Finally, the fourth paper draws together our investigation of several aspects of
resilience by establishing both similarities and differences in the resilience trajectories of
children and their various contexts in both Peru and Australia.
How children and their mothers construct resilience in a Peruvian urban setting: A
qualitative study
The present paper discusses the theoretical aspects underlying resilience and associated risk
and protective factors. It uses and highlights the ecological model postulated by Bronfenbrenner
and Ceci (1994) as an interpretative conceptual framework for the analyses of findings.
Interviews with eleven children and their mothers who live in a context of high risk in terms of
social violence, low economic resources and overall unfavorable social environment were
conducted. Participating children attended a co-educational state primary school in the District
of La Victoria, in Lima, Peru. Results show that mothers expressed satisfaction with the outside
world but revealed some concern regarding economic factors, which may limit the educational
options for their children, having access to their own housing, as well as other amenities.
Mothers stated a positive assessment of their families as that which gives them meaning to their
lives. They also hoped and aspired for their children to achieve both higher education status and
advanced moral development. However, they expressed concern about violence in the
neighborhood in which they live, drug use, theft and frequent assaults, and the effects of
prevailing gangs. Children found satisfaction in achieving good grades in their studies, as well
as engaging in play and sports. They generally stated that their family environments were
harmonic. However, children reported some causes of stress, mainly related to academic
performance; one family reported family events like family separation and alcoholism such as
particularly stressful. The majority of children coped with these stressors by seeking support in
adults, mainly their mothers and teachers. Fewer children indicated the use of avoidance as a
way to deal with these stressors. Our findings allowed us to conclude that play, academic
achievement, and family outings are protective factors in situations of stress and adversity.
Similarly, teachers warm interaction and affection with their students are also a source of

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support when the child is stressed. Given the qualitative nature of our study, we have been able
to examine the lived experience of children and families from their own perspectives. This has
allowed us to identify the relevant aspects of resilience, which in turn, has led to the formulation
of hypotheses to be tested in a subsequent quantitative study.
Who are resilient parents? How psychological well-being and social connectedness
contribute to quality parenting
Despite the well-established link between resilient parents and child wellbeing, scant research
has investigated parenting resilience in the Australian context. In the present study, we defined
parenting resilience as parents confidence and competence in raising their children well despite
the experience of challenging conditions in their lives. While conceptual and empirical links
between parenting and some contextual variables (e.g., social support) have been established,
the combination of factors which promote quality parenting in the face of circumstances posing
a risk has received little attention. The overall aim of the current study was therefore to identify
the underlying processes that contribute to the self-reported ability of parents to deliver high
quality care to children despite risk factors and adverse circumstances. Specifically, we
investigated the role of parental psychological well-being and social connectedness as well as
other demographic type factors in parenting. Eighty-four parents of children aged between 7 and
12 years from Melbourne, Australia, participated in the study. Parents provided demographic
details and completed measures related to psychological well-being and parenting which have
shown robust psychometric characteristics in the Australian context. Associations were
identified between the variables of parental psychological adjustment and social connectedness
and parental resilience. The presence of mental illness in an immediate family member was also
found to be negatively associated with resilience. Regression analyses revealed that the three
variables of mental illness in an immediate family member, psychological adjustment, and social
connectedness explained a total of 26.1% of variance in parental resilience. Findings of the
current study suggest that parenting resilience is an important area of research with a strong
potential to inform interventions aimed at improving the resilience and wellbeing of parents.
Implications of findings will be discussed in regards to our understandings of parenting
resilience as a construct, as well as the design the design of effective interventions and
supports for parents.
Psychosocial factors associated with the resilience of school children in different socioeconomic environments in Peru
In line with previous literature, this study submits that children born in conditions of poverty are
more likely to experience physical illness, behavioural problems, family stress, insufficient social
support and parental depression. For those of involved in the study of poverty, both at
theoretical and practical levels, the concept of resilience and associated protective mechanisms
offers a wide range of possibilities; it has the potential to offer alternative explanations as it
focusses on the strengths or positive aspects of individuals despite experiencing adversity. This
approach also fits well with the positive psychology movement, as it highlights the effective
resources that children and families show to deal effectively with the unfavourable
circumstances often associated with poverty. In addition to considering the factors possibly
leading to a breakdown of physical and mental health, we postulate that children in more
advantaged socio-economic environments also experience cumulative stressful events and
circumstances, especially of a family nature, which can in turn cause psychological distress and
difficulties adjusting to their environment. We believe that in both cases (i.e., advantaged and
disadvantaged economic circumstances), it is possible that there are children and families who
demonstrate resilient outcomes. Thus, the focus of the present study deals not only with
examination of resilience in boys and girls in situations of poverty, but also those that
experience better economic, social and educational resources. Primary schools of low and high

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socio-economic levels in the city of Lima were selected. The sample consisted of 200 matched
sets of children, their mothers or guardians, and teachers, who completed adapted versions of
various valid and reliable instruments. Implications of our findings will be discussed in regards to
two specific areas: First, conceptual understandings of child development; and second,
prevention and intervention efforts designed to guide public policies and social programs at
family, school and community levels, with the aim of improving the physical and psychological
well-being for children at risk who experience disadvantaged or stressful environments.
Resilience processes and outcomes in children of two cultures: The case of Peru and
Australia
Limited attention has been devoted to the study of resilience in children and their families in
different cultural environments, especially in those that seemingly differ in contextual
characteristics such as economic, education and social conditions and practices. Thus, the
purpose of the present study was to comparatively examine childhood resilience processes and
outcomes in two specific urban centers, Lima, Peru, and Melbourne Australia. In line with
comparative studies of this nature, the research focus was more in generating evidence about
the how as opposed to the why of child resilience in these two diverse cultural milieus. Guided
by a bio-ecological conceptualisation of human development (Bronfenbrenner & Ceci, 1994)
and theoretical approaches to our understanding of childrens health and psychological wellbeing (National Scientific Council on the Developing Child, 2004), we defined child resilient
outcomes as those characterised by healthy social-emotional and behavioral performance. We
postulated this definition on the basis of increasing literature conveying the critical influence of
these outcomes on other aspects of child development (Perry, Kaufmann, Knitzer, 2007).
Another important aspect of our study was the identification of the processes and trajectories
children engage in towards the achievement of these resilience outcomes in their specific
cultural contexts. Specifically, we investigated the combined role of child (e.g., temperament);
parent (e.g., psychological well-being); family (e.g., family functioning) and school/teacher (e.g.,
student-child relationship)-factors in child resilience outcomes. We hypothesised that these
trajectories would differ for the two populations under investigation where risk and healthpromoting factors would combine in different ways to generate resilient outcomes, highlighting
important cultural understandings. Using a quantitative methodology, local researchers recruited
approximately 350 (200 in Lima, 150 in Melbourne) matched sets of parents, children and
teachers. In both sites, we used a series of measures with robust psychometric properties which
assessed the various constructs of interest. Study findings will be discussed at three levels,
namely: (1) Progressing our understanding of childhood resilience outcomes and processes; (2)
interventions and supports that strengthen children, families and communities according to their
unique cultural characteristics; and (3) methodological challenges involved in conducting studies
across cultures and recommendations for future studies in this important area of work.
Regulacin de la Agresividad entre Preescolares mediante el Entrenamiento a Madres y
Profesoras
Cristbal Guerra1, 2, Campaa Mara de Los Angeles3, Vernica Fredes3, Lisette Gutierrez3,
Hugo Plaza4.
1. Pontificia Universidad Catlica de Chile, Santiago, Chile, 2. Corporacin de Asistencia
Judicial, Valparaso, Chile, 3. Universidad del Mar, Via del Mar, Chile, 4. Corporacin de
Promocin y Apoyo a la Infancia Paicabi, Via del Mar, Chile.
Abstract Central: El objetivo de la investigacin fue evaluar la efectividad de una intervencin
dirigida a disminuir la frecuencia de conductas agresivas en preescolares mediante el
entrenamiento a madres y profesoras. Se dise e implement un programa de entrenamiento
a madres y profesoras tendiente a modificar sus creencias irracionales referidas a la crianza de

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los nios y a capacitarlas en una serie de procedimientos de manejo conductual infantil. El


diseo empleado para evaluar la efectividad del tratamiento fue el de lnea base mltiple. Se
analizan los resultados de la intervencin en base a criterios de significacin clnica y
estadstica. La intervencin fue exitosa ya que las madres y profesoras disminuyeron sus
creencias irracionales y mejoraron sus habilidades de manejo conductual para hacer frente a la
agresividad de los nios. De esta manera los nios disminuyeron la frecuencia del
comportamiento agresivo verbal, fsico y oposicionista tanto en el contexto familiar como
escolar. (The aim of this research was to evaluate the effectiveness of an intervention directed
to reduce the frequency of aggressive behavior among pre- school children, by training their
mothers and teachers. A training program for mothers and teachers was designed and
implemented, in order to modify their irrational beliefs referred to the guidance of kids and to
teach them appropriate procedures for modification in the childrens behavior. The design for
the assessment of an effective treatment implementation was the so called multiple baseline
design in terms of clinical and statistical meaning. The intervention was successful since the
mothers and teachers diminished his irrational beliefs and improved their skills of behavior
modification when tackling the aggressiveness of the toddlers. On the other hand, the children
also diminished the frequency of aggressive verbal, physical and opponent behavior both within
the family and school contexts)
Resultados de la Aplicacin del FSSC-R en la Ciudad de Bogot y sus Implicaciones
Clnicas
Claudia Gutierrez1, 2, Liliana Flores de Perez1.
1. Universidad El Bosque, Bogota, Colombia, 2. Universidad de Los Andes, Bogot, Colombia.
Abstract Central: Este estudio se realiza a partir de uno de los instrumentos ms utilizados
para medir los miedos en los nios, el Inventario de Miedos para nios, revisado por Ollendick
(1983), que se aplic en una muestra de 400 nios y adolescentes entre los 7 a 16 aos de la
ciudad de Bogot, junto con la Escala de Ansiedad Manifiesta para nios revisada CMAS-R
(Reynolds & Paget, 1981) y la Escala de Calidad de Vida (QoL) (Ollendick, 2002) con el fin de
obtener datos de confiabilidad y validez , correlaciones entre los instrumentos y contar con
datos normativos para comparar las puntuaciones de nios y adolescentes con nivel de
ansiedad normal con los de la sub muestra clnica, con puntuaciones t > 70 , medidos con el
CMAS-R. Los resultados obtenidos con la muestra bogotana en 2011 (Primera Fase), son
similares a los encontrados en estudios realizados en Norte Amrica, Inglaterra y Australia en
los cuales se obtuvo una excelente confiabilidad de 0.94 en el alfa de cronbach para el nivel
total de miedos y alfas entre 0.82 y 0.86 para las sub escalas del FSSCR: miedo al fracaso y a
la crtica, miedo al peligro y a la muerte, miedo a lo desconocido, miedo a las heridas y
animales pequeos y temores mdicos. Las nias reportan mayor temor que los nios con
medias ms altas en el nivel total de miedos y en las puntuaciones de temor de todas las sub
escalas. Se encontr tambin una tendencia en las puntuaciones del total de miedos con
relacin a la edad de los participantes: a medida que aumenta la edad disminuye el nivel de
miedo ; sin embargo en los tems que componen la sub escala de miedo al peligro y a la
muerte, las diferencias entre los rangos de edad no se presentan. Esta es una sub escala que
no tiene una distribucin normal y ocho de los diez temores ms frecuentes en los nios y
adolescentes bogotanos se encuentran en esta sub escala. Por tal razn, se analizar la
influencia que la cultura y las experiencias sociales pueden tener sobre estos resultados; as
como las implicaciones que tuvo la divulgacin de este estudio en los ms importantes medios
de comunicacin en Bogot y la forma como la psicologa puede aportar en la seguridad
ciudadana. En varios de ellos se han divulgado los resultados de este estudio, mostrando como
los 10 temores ms frecuentes de los nios bogotanos estn relacionados con las condiciones

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de inseguridad que se viven en la ciudad. Tambin, las diferencias en las medias de gnero,
que son significativas en las distintas sub-escalas. Sin embargo en la escala de temor al peligro
y a la muerte no se encuentran estas diferencias, la media tanto en nios como en nias es
alta. Por ltimo, se encontr una correlacin significante entre miedo y ansiedad de r=.493 <
.05 que muestra que a mayor puntuacin en ansiedad con el CMAS-R mayor ser la
puntuacin con el FSSC-R en el nivel total de miedos. Sin embargo, dado que el estudio en su
segunda fase (2012-2013) aplicara los instrumentos a 200 nios y jvenes ms, se espera
poder llevar al congreso los resultados en el nivel de miedos de los nios y nias con niveles de
ansiedad clnicos y no clnicos medidos con el CMAS-R.
Using media and technology web-based interventions to increase access to family
interventions
Divna Haslam1, Alina Morawska1, Matthew Sanders1, 3, Karen Turner1, Sabine Baker1, Susan
Love4, Theresa Knott4, Matthew Sanders1, Karen Turner1, Ron Prinz5, Carol Metzler2, Rachel
Calam3, Carol Metzler2, Ryann Crowley2, Julie Rusby2, Matthew Sanders1.
1. The University of Queensland, Brisbane, QLD, Australia, 2. Oregon Research Institute,
Eugene, OR, USA, 3. The University of Manchester, Manchester, United Kingdom, 4. California
State University Northridge, Northridge, CA, USA, 5. The University of South Carolina,
Columbia, SC, USA.
Evidence-based parenting interventions are highly efficacious at preventing and treating child
social-emotional and behavioural problems. Researchers have argued that population health
approaches focusing on both prevention and intervention services are needed to reduce the
prevalence of child socio-emotional and behavior problems. However the majority of empirically
validated interventions use traditional face-to-face delivery formats, and barriers such as such
as social stigma, accessibility and high delivery costs limit the reach of these programs. Novel,
cost-effective ways to increase intervention reach are needed. This symposium argues that the
media and technology can be used to engage families and for the delivery of evidence-based
interventions to increase population level reach.
Four papers are presented. Each paper represents a unique way that media and technology
can be used to increase parenting support to parents who are unlikely to attend traditional
services. The first paper presents an overview of Triple P Online, an online parenting program
based the Level 4 Triple P program. Data from a randomized controlled trial evaluating the
efficacy of the intervention will be presented and implications discussed. The second paper
builds on the first by examining the role of a specially designed social media platform, the Triple
P Online Community designed to increase engagement and retention of high-risk parents in the
Triple P Online program. A consumer informed approach was used to design social media
platform, which involves gaming technology, discussion boards and is facilitated by an
accredited practitioner. The impact of the site is being examined using a randomized control trial
with highly vulnerable families including those involved in the child protection system and ethnic
minorities. The third paper presents results from a series of two randomized controlled trials
evaluating the efficacy of brief, self-directed online parenting interventions for families with
significant mental health or physical health issues, including a sample of parents experiencing
bipolar disorder and a sample of parents of teenagers with have type one diabetes. The results
of these two studies indicate that largely self-help online delivery of parenting support with the
provision of illness specific information can significantly improve family and illness specific
outcomes. The final paper presents outcomes of a randomized controlled trial of a 10 episode
infotainment style video series aimed at increasing parenting knowledge and effectiveness. The
effects of the viewing the series, in standard or enhanced format, were examined using a multimethod, multi-informant methodology on a sample of parents of young children with elevated

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levels of disruptive problems.


Each paper in this symposium has in common the use of novel media-based approaches to
intervention delivery using parenting as a context. Together the papers highlight how technology
can be used increase recruitment and retention of high-risk populations and the potential benefit
of including media-based interventions as a component of broad population approaches to
parenting support. An integrating discussion will bring together the key themes and conclusions
from these studies.
Triple P Online: Evaluation of Triple P as a Web-based Intervention for Parents of
Children with Early Onset Conduct Problems
The internet is increasingly becoming one of the preferred methods for parents seeking
parenting advice and support. Web-based approaches have the potential to increase program
reach, and have much to offer in terms of flexibility and ease of access. However, they remain
largely untested. This paper evaluates the efficacy of Triple P Online (TPOL), an 8-module
Level 4 Triple P parenting intervention. The intervention includes a range of evidence-based
parenting strategies as well as video prompts, interactive exercises and personalised feedback.
Optional components also include downloadable worksheets, a workbook summary of all
content and exercises, email summaries of session content, SMS summaries and reminders,
and podcasts. The intervention was evaluated using a randomized controlled trial comparing
TPOL to a computer use as usual condition. The sample consisted of 116 Australian parents of
children aged 2-9 years who displayed early-onset conduct problems. Sixty parents were
randomly assigned to receive TPOL and 56 parents were allocated to the Computer Use as
Usual condition. The effectiveness of the intervention was evaluated at post intervention and 6month follow-up. At post-intervention assessment, parents receiving the internet intervention
TPOL had significantly better outcomes on measures of problem child behavior, dysfunctional
parenting styles, parents confidence in their parenting role, and parental anger. Analysis of 6month follow-up assessment revealed intervention gains were generally maintained, and in
some cases enhanced. The effect sizes obtained were similar to those in traditional face-to-face
methods of intervention delivery and consumer satisfaction ratings for the program were high.
Outcome data on usage, parent and child outcomes, client satisfaction and program
preferences was also obtained and will be discussed. The results indicated online interventions
can produce significant effects without therapist contact. The role of online and media-based
interventions as an important component of a comprehensive public health approach to
increase the reach of parenting support will be discussed.
Triple P Online Community: Exploiting the power of social media to promote child
development with vulnerable families
Reaching vulnerable parents with effective parenting programs is a formidable challenge.
Despite the demonstrated effectiveness of evidence-based parenting programs, relatively few
parents access them. Aside from logistical obstacles, the stigma surrounding a childs
behavioral or emotional disorders constitutes a meaningful barrier to participation in an inperson class due to feelings of blame and shame (Corrigan et al., 2006). Vulnerable
populations can experience the additional barrier of racism that is complicated by the
antagonistic relationship between Black communities and child welfare agencies. Other barriers
exist at the agency level: The costs of hiring, training, and maintaining professionals in EBPs
can be out of reach for isolated or poorly resourced agencies. However, the popularity and
accessibility of social media opens an opportunity to engage young parents; to maximize reach
by overcoming barriers such as limited availability of trained professionals, geography, logistics,
social stigma, and distrust; and to lower delivery cost. This study aims to evaluate whether an
evidence-based parenting program, the Triple PPositive Parenting Program, can be
effectively delivered via a social media format. This project, funded by the Robert Wood

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Johnson Foundation, is comprised of two parts. First, we used a consumer-informed approach


to design and build a social media platform to deliver Triple P Online using gaming
technology, discussion boards, and facilitation by a certified Triple P provider aimed at
engaging highly vulnerable parents in Los Angeles, CA, including those involved in the child
protection system and ethnic minorities. Secondly, the efficacy of delivering Triple P Online via a
social media platform is being evaluated in a randomized controlled trial with 120 vulnerable
families. This presentation will demonstrate the innovative program, present preliminary
findings, and facilitate discussion about the role of social media as a powerful tool in a public
health approach to promoting healthy child development.
Using the web to access high needs parents (bipolar parents and parents of children with
diabetes).
Newly developed technologies allow parenting skills interventions to be offered in non-traditional
ways, via a range of different media, to increase the reach on evidence-based interventions.
What is not yet understood however are the determinants of uptake, continuing engagement
and successful outcome for these forms of intervention. A series of studies at The University of
Manchester have aimed to engage parents with online and self-directed Triple P resources. Two
studies which have been successful in recruiting samples to online randomised controlled trials
have been carried out with recruitment via self-help organisations. In the first of these, 54
parents in families with a parent experiencing bipolar disorder and a child aged between 3 and
10 were recruited and randomised into a trial of an online intervention aimed at reducing child
behaviour problems. This included written material (Every Parents Self Help Workbook
(Sanders et al. 1999) and web handouts and video resources providing additional support.
There were significant improvements on the primary outcome variables, with significant
improvements in child behaviour (Strengths and Difficulties Questionnaire) and on parenting
strategies (Parenting Scale). In a second study, 79 families with a teenager diagnosed with type
1 diabetes were randomised in a study which tested predominantly paper-based self-directed
parenting materials, the Teen Triple P workbook (Ralph and Sanders 2009) plus a chronic
illness tip sheet, together with automated web and mobile phone resources to encourage
adherence. In this study, there was again a significant reduction in the primary outcome, the
Diabetes Family Conflict Scale (revised). Both studies have in common the presence of a strong
online illness-specific self-help network, in the context of serious physical or mental health
conditions for which expert family assistance with parenting may not be readily accessible, or
may represent a significant additional burden for families already coping with challenging and
time-consuming conditions. These studies can be contrasted to others aimed at different
populations where recruitment has been poor, or dropout has been significant. The way that
these studies contribute to our understanding of the niches where online interventions may have
most impact in increasing population reach will be considered.
Effects of the Triple P Parenting Video Series on Parents Parenting Practices and
Childrens Behavior
Media-based parenting programs show significant promise for improving parenting practices
and child behavior across a broad population of families. Media-based approaches can
decrease the stigma and cost associated with participation in parenting programs and can
dramatically increase program reach to parents who might not otherwise be reached. But the
potential of video and television for affecting parenting has received little research attention, and
little is known about the efficacy of such approaches. This presentation will present outcomes
from a randomized controlled trial of the Triple P Parenting Video Series, in which the efficacy of
two different versions of this 10-episode, brief (12-15 minutes per episode), infotainment-style
video series, based on the Triple P - Positive Parenting Program were tested against a waitlist
control. A sample of 322 families of children ages 3-6 years with elevated disruptive behavior

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problems were randomized to Standard video, Enhanced video, or Waitlist Control conditions.
The effects of the Triple P Parenting Video Series were examined on questionnaire, phone
interview, and direct observation measures of parenting practices, child behavior, and parents
cognitions, affect, and social support at post-intervention and six-month follow-up. Positive
intervention effects were found on the frequency and intensity of child behavior problems,
dysfunctional parenting practices and parenting knowledge for both mothers and fathers, and
mothers handling of misbehaviors and positive guidance. This presentation will present final
results on these outcomes at both post-intervention and six-month follow-up, as well as the
impact of moderators, dosage, and viewing patterns on these effects. The implications of these
findings for the use of media-based parenting interventions to achieve broad population effects
will be discussed.
Developmentally Sensitive CBT for School Refusal and Anxiety in Adolescence:
Treatment Efficacy and Predictors of Success
David Heyne1, Floor Sauter1, Anne-Jaan den Besten1, Brigit van Widenfelt2, P. Westenberg1.
1. Leiden University Institute of Psychology, Leiden, Netherlands, 2. Curium-LUMC, Leiden
University Medical Centre, Leiden, Netherlands.
Abstract Central: School refusal is difficult to treat and the poorest treatment response is
observed among older school refusers. This may be explained by higher absenteeism among
school-refusing adolescents; a greater likelihood of social anxiety disorder and depressive
disorder; and the impact of developmental transitions and tasks upon the young person, the
family, and the treatment process. Seeing the need to design and deliver CBT in a
developmentally sensitive way, our group modified and extended an existing protocol for school
refusal. The @school program is a modularized cognitive behavioural therapy designed to
promote developmental sensitivity when planning and delivering treatment for anxious
adolescents refusing to attend school. After outlining the treatment, we present results from a
non-randomized trial of its efficacy. Treated adolescents showed significant and maintained
improvements across primary outcome variables (school attendance; school-related fear;
anxiety) as well as secondary outcome variables (depression; overall functioning; adolescent
and parent self-efficacy). We also studied the predictors of treatment response. Candidate
predictor variables included individual, family, and school-related factors. Lower levels of overall
functioning contributed substantially to the prediction of school attendance and the
presence/absence of anxiety disorder. The clinical and research implications of the treatment
outcome study will be discussed, together with the implications of the predictor analyses.
Production and Use of a Psychoeducational Multimedia Tool for Boys Victims of Sexual
Violence
Jean Hohendorff, Leandro Soares Rodrigues, Lusa Fernanda Habigzang, Silvia Koller.
Programa de Ps-graduao em Psicologia, Universidade Federal do Rio Grande do Sul, Porto
Alegre, Brazil.
Psychoeducation is one of the main techniques used in cognitive-behavioral therapy to offer the
patients the opportunity to understand the problem they are facing and the relationship between
the involved cognitive, emotional, and behavioral factors. Different tools are used to
psychoeducate patients (e.g., readings, drawings, stories, movies) and the choice depends on
factors such as developmental stage, personal preferences, and availability of
psychoeducational material. Regarding the developmental stage, the use of psychoeducational
tools for children and adolescents must consider characteristics of these stages in order to
patients become interested. Due to the digital evolution and the interest that children and

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adolescents show to multimedia resources, these resources can be used as psychoeducational


tools. Therefore our objective was to produce a video about sexual violence (SV) against boys
for use in a cognitive-behavioral intervention protocol for this population. This protocol is
composed of 16 sessions divided into three stages - Psychoeducation (six sessions); Stress
Inoculation Training (four sessions); and Relapse Prevention (six sessions). The video, entitled
Superar - a violncia sexual contra meninos (Overcome - the sexual violence against boys),
lasts about 26 minutes and introduces the definition of SV, discusses its dynamics, and
indicates the possible consequences of this experience for boys, in addition to addressing the
importance of reporting to child protection services and the benefits of psychotherapy. We
produced the video in partnership with students and professionals from the Faculty of School of
Social Communication of our institution following these five steps: 1) review of multimedia
resources for victims of SV; 2) review of the scientific literature and screenplay writing; 3)
inviting the video participants (one male victim of SV, a psychologist, a judge, and a counselor
from the guardianship council); 4) recording the reports of the participants; 5) video editing. After
finishing the video production, the material was sent to researchers experts in SV who
evaluated it. Then the video was used in the treatment of three boys victims of SV. Qualitative
evaluation of the psychoeducation session regarding the use of the video showed the
appropriateness of this tool for these boys, as can be seen in the following excerpts: I thought it
was good, because it talks about things that happened to me too... the abuse (boy, eight years
old); It shows just as it is... as it happens (boy, 16 years old); It says a lot (about the
information presented in the video about SV - boy, 16 years old); Interesting ... Because he
suffered a lot and had no one to trust, to talk to... He was ashamed of it (boy, 14 years old); It
is cool that everything worked out... And the therapy (boy, 16 years old). The review of the
scientific literature as the guide to the contents of the video and the review of existing
multimedia resources were important aspects in the video production, which may have
contributed to its appropriateness. However, it is necessary to assess its appropriateness by
means of using it with a larger number of boys victims of SV.
Transportability of evidence-based psychosocial treatments to diverse cultures: Crosscultural implication for child and adolescent mental health
Shin-ichi Ishikawa1, Yuji Sakano2, Satoko Sasagawa3, Chiaying Wei4, Colleen Cummings4,
Mathew Carper4, Philip Kendall4, Shin-ichi Ishikawa1, Holly Waldron5, Hyman Hops5, Thomas
Ollendick6.
1. Doshisha University, Kyotanabe, Japan, 2. Health Sciences University of Hokkaido, Sapporo,
Japan, 3. Mejiro University, Shinjuku-ku, Japan, 4. Temple University, Philadelphia, PA, USA, 5.
Oregon Research Institute, Eugene, OR, USA, 6. Child Study Center and Virginia Polytechnic
Institute and State University, Blacksburg, VA, USA.
Evidence-based practice has revolutionized the field of mental health (Chambless & Ollendick,
2001). The APA Division 12 has supported several cognitive behavioral oriented
psychotherapies as evidence-based treatments for children and adolescents (e.g., Ollendick &
King, 2000). Moreover, the Second Special Issue of Journal of Clinical Child Psychology on
Evidence-Based Psychosocial Treatments for Children and Adolescents provides a 10-year
update of evidence-based psychosocial treatments for children and adolescents (Silverman &
Hinshaw, 2008). According to this review, cognitive behavior therapy (CBT) is considered as
evidence-based psychosocial treatments for child and adolescent psychological disorders
including autism, ADHD, depression, anxiety, OCD, disruptive behavior, and trauma related
problems.
In the next stage, how to more effectively deliver evidence-based practice to diverse populations
and in different settings is an urgent and critical issue when providing mental health services to

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children and adolescents (Kazdin, 2008). Although recent meta-analysis suggested medium
effect size for evidence-based psychosocial treatments among minority youth, the need and
effects of cultural adaptation have rarely been studied, with culturally validated outcome
measures mostly lacking (Huey & Polo, 2008). Additionally, to date, most clinical trials have
been conducted in Western countries with similar cultural values (Essau, Sakano, Ishikawa, &
Sasagawa, 2004, and very few studies have been done with children and adolescents from
other cultural backgrounds.
In this symposium, we will focus on the transportability of evidence-based psychotherapies to
diverse cultures. In order to improve the dissemination of evidence-based treatments, it is
critical to the effect of these treatments across races, ethnicities, and cultures. The participants
in this symposium will present and discuss research relevant to the transportability of evidencebased psychosocial treatments and its implications on cross-cultural mental health issues for
children and adolescents.
Similarities and differences in Eastern and Western childhood/adolescent anxiety:
Implications for future intervention studies
Anxiety disorders are among the most common psychiatric conditions in children and
adolescents. Recent studies have indicated that between 8 to 19% of the children and
adolescents in the general population are estimated to have met the diagnosis of an anxiety
disorder at one point in their lives (e.g. Costello et al., 2003). If left untreated, anxiety disorders
tend to persist into adulthood and may act as a risk factor for several other psychiatric disorders
(Kessler et al., 1994). Clearly, the treatment and early intervention of anxiety disorders is a
critical issue in the field of childhood and adolescent mental health.
While the increase in awareness has enhanced our understandings of childhood and adolescent
anxiety, it is not known whether findings from studies in the Western culture could be replicated
in the Eastern culture. Several studies report substantial dissimilarities in the presentation of
anxiety symptoms across different cultures. For example, Gordon & Teachman (2008) report
that African and European Americans demonstrated greater behavioral avoidance during a
physical anxiety provocation task, whereas Asian Americans reported a higher number of
anxious cognitions during a social anxiety provocation task. Increased levels of social anxiety in
people with Asian cultural background have been depicted in a number of other studies (e.g.
Essau et al., 2010). An ongoing controversy whether such variances stem from ethnic diversity
and warrant a different diagnostic criterion, or merely reflect differences in the presentation of
symptoms has not been resolved (Good & Kleinman, 1985).
The present study reports a series of cross-cultural studies comparing the symptomatology and
etiology of childhood and adolescent anxiety in Eastern and Western cultures. Specifically, a
large (n=689) non-clinical sample of Japanese and British children and one of their
parents/guardians were recruited through local junior high schools to participate in a
questionnaire study. The results showed significant differences between the two countries in the
frequency of anxiety symptoms, as well as etiological factors such as early learning experiences
and self-construal. Implications for the cross-cultural adaptation of cognitive-behavioral therapy
in non-Western countries will be discussed.
Cognitive Behavioral Treatment for Anxious Youth: Characteristics across Ethnicity
among Youth in Research Clinics
Anxiety is among the most common mental health conditions affecting youths (Kessler,
Berglund, Demler, Jin, & Walters, 2005), with 10 to 20% of children reporting clinically
significant anxiety (Costello et al., 2003). Left untreated, youth anxiety most likely extends into
adulthood (Pine et al., 1998) with long-term implications for various mental health issues
(Angold et al., 1998; Rudd et al., 2004). Cognitive behavioral therapy (CBT) has been found to
be effective for treatment in children with anxiety disorders (for review, see Silverman, Pina, &

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Viswesvaran, 2008). In particular, a manualized CBT (i.e., Coping Cat program; Kendall &
Hedtke, 2006) has been found to be efficacious in treating childhood anxiety disorders (Kendall,
Hudson, Gosh, Flannery-Schroeder, & Suveg, 2008; Walkup et al., 2008) and shown long-term
maintenance of gains in 1- and 7-year follow-up studies (Kendall, Safford, Flannery-Schroeder,
& Webb, 2004; Kendall & Southam-Gerow, 1996). Of note, the majority of participants in these
trials are European Americans. Even though an emerging literature provides evidence
supporting the efficacy of CBTs for anxious youth from diverse ethnic backgrounds (Miranda et
al., 2005), findings from a recent RCT suggest that racial/ethnicity minority status predicted
lower remission rate after acute treatment among anxious youth (Ginsburg, 2008). A review
(Huey & Polo, 2008) has emphasized the need to improve the quantity and quality of treatment
outcome research with youth across ethnicities. It is believed that cultural adaptation may be
necessary in order to enhance the outcome of evidence-based treatment for children from
different cultural backgrounds, and the consideration of cultural adaptation to standard
evidence-based treatment should focus on how it will improve the treatment outcome, and not
whether it is effecious to cultural groups (Hwang, 2011).
The current study examines potential cross-cultural differences in the characteristics of anxious
youth seeking treatment for anxiety. Participants will include youth participating in two National
Institute of Mental Health funded randomized controlled trials (RCTs) on CBT (i.e., the Coping
Cat program; Kendall, Hudson, Gosh, Flannery-Schroeder, & Suveg, 2008; Walkup et al., 2008)
for childhood anxiety, as well as youth receiving CBT for anxiety in a university clinic.
Characteristics such as demographic background, anxiety disorder diagnoses and symptoms
(e.g., social anxiety, separation anxiety, generalized anxiety and worries, and physical
symptoms, etc), comorbidity, and treatment outcome will be analyzed to compare differences
across youths ethnicities including Caucasian, African American, Latino American, and Asian
American. In addition, results will be considered to illustrate potentially necessary adaptations in
practice when working with anxious youth from specific ethnicities.
Cognitive behavioral therapy for Japanese children and adolescents with anxiety
disorders: Transportability of evidence-based psychotherapies to Asia
Anxiety disorders are common in children and adolescents (Albano, Chorpita, & Barlow, 2003;
Ollendick & March, 2004). Several randomized controlled trials have supported the efficacy of
cognitive behaviour therapy (CBT) in group and individual formats for anxiety and phobic
disorders in children and adolescents (Silverman, Pina, & Viswesvaran, 2008). Unfortunately,
few clinical trials with children and adolescents from other cultural backgrounds have been
conducted. In Japan, anxiety symptoms observed in youth are found to be comparable to
Western countries (Ishikawa, Sato, & Sasagawa, 2009). However, our preliminary study
suggested that Japanese parents and teachers have a low level of concern or insufficient
knowledge of childhood anxiety symptoms (Ishikawa et al., 2012). Moreover, there have been
no studies to date of CBT for children and adolescents with anxiety disorders in Japan, or for
that matter other non-English speaking countries in Asia except a trial in Hong Kong (Lau,
Chan, Li & Au, 2010).
Therefore, based on previous research in Western countries, we have developed a CBT
program for Japanese children and adolescents (Ishikawa, Shimotsu, & Sato, 2008). The first
trial investigated CBT for children with anxiety disorders in Japan comparing the effect between
group and individual formats. Considering specific cultural features (e.g., collectivism), one
empirical question is whether group and individual CBT are equally effective for Japanese
children. The second study evaluated family-focused CBT for Japanese children. Our crosscultural study showed that compared with parents in the U.K., Japanese parents demonstrated
different relationship between their early learning experiences and their children's anxiety
symptoms (Essau, Ishikawa, & Sasagawa, 2011). Although previous meta-analysis did not
suggest significant difference in outcome between individual and family CBT (Ishikawa,

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Okajima, Matsuoka, & Sakano, 2007), it is important to examine whether family CBT has an
additional effect when treating anxious Japanese children and adolescents. Implications on
dissemination of evidence-based psychotherapies to other countries will be discussed based on
the results of these two studies.
Sustaining evidence-based interventions in the real world: Examples from Hispanic
communities
Findings from efficacy trials evaluating outpatient treatments for adolescent SUDs, the most
common form of adolescent treatment, provide substantial empirical support for family-based
interventions. The positive effects of family therapy have been remarkably consistent across
studies/models, both with respect to adolescent substance use and behavioral outcomes and in
engagement and retention in treatment. Further, evidence is mounting to support the utilization
of family therapy in real world settings, with research showing that family treatments can be
transported to the community with high fidelity to core treatment philosophies and techniques.
Yet, the barriers to successful adoption of EBTs in community treatment programs are also well
documented. The effects of family-based EBTs as implemented in community settings may be
diminished by as much as 50% relative to the effects found in rigorously monitored efficacy
trials. The mixed success of efforts to transport efficacious interventions into practice settings is
not surprising, given the complex and multifaceted nature of the transport process.
Dissemination and technology transfer involve the interplay of characteristics of intervention
models, clients served, therapists delivering the treatments, characteristics of the community
agencies adopting and implementing the interventions, and the broader service delivery context.
All of these variables are highlighted even more when considering implementation in remote
global regions, where they have not been evaluated or are not suited to the culture, society, or
political climate. Moreover, family therapy requires intensive procedures for training and
supervising therapists to ensure that they are able to implement interventions with high fidelity to
core principles of effective clinical practice. In this presentation we will discuss our
conceptualizations and programmatic efforts to disseminate Functional Family Therapy, an
evidence-based treatment, in three Hispanic communities, within the United States and in South
America. We will focus on issues related to the fidelity of the intervention, as well as differences
in cultural and organizational features that could assist or act as detriments to successful
implementation. Additionally, we will examine culturally related barriers and facilitators to
implementation and introduce processes and mechanisms that increase program fidelity and the
potential for sustainability.
Utilising Parental Ethnotheories in the Development of Resilience in Children
Merv Jackson1, Gregory Murphy2, Susana Gavidia-Payne1.
1. RMIT University, Bundoora, VIC, Australia, 2. La Trobe University, Bundoora, VIC, Australia.
Objective: Applying parental ethnotheories and behaviours to develop resilience in at risk
children Design: Mixed method design: Qualitative and quantitative methodology
Participants/methods: A group of parents of young children who interviewed to determine
parental ethnotheories regarding the development of resilience in children. A 15 minute parentchild interaction was audiotaped and then quantified by using a coding system developed from
the qualitative interviews Results: Quantitative analyses of the qualitative elaboration of parental
ethnotheories regarding resilience in children were completed. The relationship between
parental beliefs and their translation into parent- child interactions that enhanced resilience was
explored and specific recommendations for future interventions were developed. Conclusion:
The results are discussed in terms of the role of professionals in creating and determining
parental ethnotheories that enhance the development of resilience in at risk children.

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Use of Suppression and Reappraisal In Two Clinical Samples: Comparison with


Normative Data and Associations with Psychopathology
Sarah Kennedy, Jill Ehrenreich-May.
Psychology, University of Miami, Miami, FL, USA.
In recent years, two dimensions of Grosss (1998) process-oriented approach to emotion
regulationCognitive Reappraisal and Expressive Suppressionhave received increasing
attention as examples of an antecedent-focused and a response-focused strategy for managing
emotions, respectively. Research using normative samples of children and adults has begun to
reveal important individual differences with respect to use of emotion regulation strategies and
their association with psychopathology. Use of suppression has been associated with greater
experience of negative emotion, internalizing symptoms, and reduced quality of interpersonal
relationships, while cognitive reappraisal has been linked to better mood repair, positive
emotion, and closer interpersonal relationships (e.g., Gross & John, 2003; Gullone & Taffe,
2012). However, there is little data on the use of these emotion regulation strategies in clinical
samples, particularly with youth, and their associations with various forms of psychopathology.
In this study, we compared self-reported use of reappraisal and suppression among two clinical
samples (one child, one adolescent) to normative data. We also examined convergent validity
between the two strategies and self-reported internalizing symptoms. We expected both clinical
samples to be higher in suppression and lower in reappraisal than normative samples, and we
expected suppression positively associated with symptoms of anxiety and depression.
Participants were N = 56 children ages 7-12 (M = 9.06) and N = 84 adolescents ages 13-17 ( M
= 15.34) presenting for treatment at a university-based clinic. Adolescents were 49.4 percent
female ( N = 41) and children were 51.0 percent female ( N = 27). Children and adolescents
were administered a variety of measures at baseline, including the Emotion Regulation
Questionnaire for Children and Adolescents (ERQ-CA; MacDermott, Betts, Gullone, & Allen,
2009). The ERQ-CA is a 10-item scale assessing the emotion regulation strategies of Cognitive
Reappraisal (6 items) and Expressive Suppression (4 items). Items are rated on a 5-point Likerttype scale, with higher scores indicating greater use of emotion regulation strategies. A variety
of measures were used to assess affect and internalizing symptoms in both samples. The mean
suppression score for children (M = 12.82, SD = 2.98) but not adolescents (M = 10.97, SD =
3.71) in our clinical samples was significantly higher than the mean normative suppression
score reported by Gullone and colleagues (2012), t(55) = 9.21, p<.01 and t(82) = 1.17, ns,
respectively. As predicted, mean cognitive reappraisal scores for both children (M = 19.48, SD =
4.68) and adolescents (M = 17.43, SD = 4.83) were significantly lower than mean normative
reappraisal scores reported by Gullone and colleagues, t(55) = 3.27, p<.01 and t(82) = 7.79,
p<.01, respectively. Males tend to be higher than females in suppression in normative samples,
but males and females in both our child and adolescent clinical samples did not differ with
respect to use of suppression. Associations between both strategies and internalizing symptoms
will also be discussed, highlighting differences between normative and clinical samples. In
general, suppression was associated with more diffuse symptoms of anxiety in children, but
most strongly associated with social anxiety and depression by adolescence. Of note and
contrary to expectations, we found significant positive associations between cognitive
reappraisal in adolescents and symptoms of worry-related disorders (e.g. GAD, OCD, and
panic), suggesting that this subscale may not be a valid measure of the effectiveness of
reappraisal strategies in some clinical youth populations.
Accuracy and Bias of Children's Self-Perceptions of Peer Acceptance
Janet Kistner, Rebecca Mazzulla, Christine Van Gessel, Stephanie Smith.
Florida State University, Tallahassee, FL, USA.

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Abstract Central: Childrens perceptions of their peer acceptance have been linked to a
number of maladaptive outcomes including aggression, depression, and social rejection. The
present study extends this area of research by examining correlates of two facets of childrens
perceived peer acceptance: inaccuracy (the degree to which perceptions differ from objective
indicators) and bias (systematic tendency to skew perceptions in either a positive or negative
direction). In middle childhood, children spend more time playing and interacting with same-sex
peers and thus they are expected to be more accurate about their acceptance by same- versus
opposite-sex peers. Discerning acceptance by opposite-sex peers constitutes a more
ambiguous task due to fewer opportunities for social interactions. Because biases tend to be
more pronounced in ambiguous situations, children are expected to be more biased about
acceptance by opposite- than same-sex peers. Prior research offers some support for these
predictions and suggests that differentiating between accuracy and bias as well as between
perceptions of acceptance by same-versus opposite-sex peers may enhance assessment of
childrens risk for maladaptive developmental outcomes. The present study tested two
hypotheses: 1) accuracy of perceived acceptance by same-sex peers (relative to opposite-sex
peers) is more strongly associated with depressive symptoms; and 2) biased perceptions of
acceptance by opposite-sex (relative to same-sex) peers is more strongly associated with
aggression. The sample included 912 third through fifth graders (420 girls and 492 boys) who
completed ratings for social acceptance (i.e., both for themselves and their classmates),
Childrens Depression Inventory, and peer nominations of aggression. Inaccuracy was
calculated using the absolute value of the difference between actual and perceived acceptance
ratings (higher scores reflect > inaccuracy); bias was calculated by subtracting actual
acceptance ratings from perceived acceptance ratings for each participant and then averaging
these scores (positive values = overestimation, negative scores = underestimation). Results of
multiple regression analyses offered support for both hypotheses. Inaccurate perceptions of
acceptance by same-sex (but not opposite-sex) peers were associated with higher levels of
depressive symptoms ( = .15, p < .01). Positively biased perceptions for opposite-sex (but not
same-sex) peers were associated with higher levels of aggression ( = .12, p < .05). Bias was
not associated with depressive symptoms and inaccuracy was not predictive of aggression, thus
supporting the view that bias and inaccuracy should be considered distinct measures of
childrens discrepant self-perceptions, as they differentially predict maladjustment problems.
Furthermore, these results highlight the need to examine childrens discrepant self-perceptions,
taking into account whether they are making their predictions for same- versus opposite-sex
peers. Findings such as these can inform assessment of childrens risk for maladaptive
developmental outcomes.
The Development of Self-Criticism and Dependency in Early Adolescence and Their Role
in the Development of Internalizing Symptoms
Daniel Kopala-Sibley1, David Zuroff1, Benjamin Hankin2, John Abela3.
1. McGill University, Montreal, QC, Canada, 2. Denver University, Denver, CO, USA, 3. Rutgers
University, New Brunswich, NJ, USA.
Abstract Central: According to Blatt (2004, Blatt & Luyten, 2009), the development of selfdefinition and relatedness takes place in an interactive fashion across the lifespan. Selfdefinition involves the development of a sense of self that is differentiated from others,
integrated, realistic, and essentially positive. A deficit in this process results in high levels of the
personality trait labelled Self-Criticism. Relatedness, in contrast, involves the development of
the capacity for mature, caring, and reciprocal close relationships. A deficit in this process
results in high levels of the personality trait labeled Dependency. A large body of literature has

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confirmed that Dependency and Self-Criticism confer vulnerability to psychopathology in adults.


However, there is little research examining their development in early adolescence and their
role in adolescent psychopathology, despite this being a key time for the emergence of mood
and anxiety disorders. This study examined the role of events pertaining to self-definition or
relatedness in the respective development of Self-Criticism and Dependency, and the
relationship of these personality factors to the development of depressive and anxiety
symptoms in early adolescence. Self-definitional events are those that are likely to affect ones
sense of self-concept or identity, whereas relatedness events are those that are likely to
threaten the quality or existence of important interpersonal relationships. 276 adolescents (156
boys) between the ages of 11 and 14 (M = 12.57; SD = 1.11) completed a measure of SelfCriticism and Dependency (Depressive Experiences Questionnaire for Adolescents; Fichman et
al., 1995) at baseline and again 24 months later, along with measures of depressive (Childrens
Depression Inventory) and anxiety symptoms (Multidimensional Anxiety Scale for Children).
Every three months during the study interval, participants completed a measure of life events
and hassles. Seven independent raters coded events into either domain. Ratings showed
adequate inter-rater reliability, with 80% rater agreement (kappa = .70). Latent cross-lagged
structural equation panel models showed that higher levels of self-definition-oriented events
predicted greater increases in Self-Criticism, whereas higher levels of relatedness-oriented
events predicted greater increases in Dependency. Greater change in Self-Criticism was
uniquely related to greater increases in depressive symptoms, while the effect of self-definitional
events on depressive symptoms was mediated by change in Self-Criticism. Greater change in
Dependency was uniquely related to greater increases in in anxiety symptoms, while the effect
of relatedness events on anxiety symptoms was mediated by change in Dependency. Results
support a domain-specific model of personality development in which negative events in the
domains of self-definition and relatedness respectively predict the development of selfdefinition/self-criticism and relatedness/dependency. Results suggest that anxiety in early
adolescence may stem primarily from concerns pertaining to attachment, care, and support (i.e.,
relatedness concerns), whereas depression may stem from concerns about self-concept,
achievement, and status relative to others (i.e., self-definitional concerns).
The Deck of Thoughts in Schools: Evaluating the Efficacy of a Cognitive Preventive
Intervention for Coping and Pro-Social Behaviors
Rodrigo Kreitchmann1, 2, Renato Caminha1, Trcio Soares1.
1. Instituto da Famlia de Porto Alegre, Porto Alegre, Brazil, 2. Universidade Federal do Rio
Grande do Sul, Porto Alegre, Brazil.
Introduction: Anxiety disorders not only are the most frequent psychiatric impairments in
childhood and adolescence, but also have earliest onsets and present high rates for continuity
in adulthood. Given the importance of childhood and adolescence for healthy mental
development, these stages constitute critical moments for primary prevention on anxiety and
conduct disorders. The Deck of Thoughts consists in a cognitive intervention protocol which
aims to reduce anxiety symptoms and promote pro-social behaviors in children and
adolescents. For this, the intervention applies cognitive-linguistic restructuring, based principles
of mindfulness and Acceptance and Commitment Therapy, as well as exercises on empathy.
Objectives: This study aims to present results for the efficacy evaluation of group interventions
with the Deck of Thoughts for coping, anxiety reduction and pro-social behavior increase.
Methods: This is a school-based quasi-experimental study, with nonrandomized control and
experimental groups. The participants were 52 adolescents of both genders aged 11 to 17 years
(mean = 12,4, SD = 1,2) who attended the sixth year (of the Brazilian curriculum) at a public
school in Porto Alegre city; 20 were allocated in control group and 32 in experimental group,

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divided by school classes. The protocol was implemented in 5 daily sessions of 50 minutes. The
assessment of anxiety symptoms and pro-social behaviors was made with the Brazilian
versions of the Spence Children Anxiety Scale (SCAS) and the Strengths and Difficulties
Questionnaire (SDQ), respectively, in pre-intervention, post-intervention and one month followup. During intervention, it was used a 5-point likert scale (from very weak to very strong) to
evaluate the degree of belief in automatic and alternative thoughts. The data analysis was
performed using SPSS 17.0 and results were considered significant for p<0.05. Results: Pretest assessment has shown significant basal inter-group differences for anxiety symptoms and
pro-social behaviors, as well as non-normal distributions, thus being prioritized non parametric
tests for inter-group differences. Through the Wilcoxon Signed Ranks Test it was identified
significant reduction of anxiety symptoms (SCAS total, separation anxiety and generalized
anxiety scores) and increase of pro-social behaviors in the experimental group during the three
assessment times, what was not found in the control group. Furthermore, in the experimental
group, the Students t-test has revealed significant reduction of the degree of belief in automatic
thoughts from pre-test to follow up, and moderate and significant Spearmans correlation
(rs=0.45, p<0.05) between the reduction of anxiety symptoms (SCAS total score) and conduct
problems (SDQ conduct scores), and the reduction of the degrees of belief in dysfunctional
automatic thoughts, generated by the intervention. Discussion: Although efficacy evaluations of
cognitive preventive protocols still receive little attention from researchers, the results of this
study are consistent with other literature on cognitive preventive protocols. This study provides
evidences of efficacy of the Deck of Thoughts for anxiety reduction and pro-social behaviors
increase in healthy scholar adolescents.
Espacio Interactivo de Salud Sexual en Jvenes
Mara Lara.
Direccin General de Orientacin y Servicios Educativos, Universidad Nacional Autnoma de
Mxico, Mxico, Mexico.
A partir de la expansin del VIH/SIDA los comportamientos sexuales que se consideran
riesgosos han despertado un fuerte inters ante las proporciones pandmicas. La sexualidad
es aprendida culturalmente, entonces se puede afirmar que es posible desaprender lo
aprendido y aprender otras formas que tengan como base el ejercicio responsable de la
sexualidad y la prevencin de ITS. Se diseo un espacio donde los jvenes participan en
actividades ldicas, que promueven el uso del condn y alternativas erticas de prevencin. Es
una estrategia de intervencin masiva que atrae la atencin de los jvenes por los materiales
exhibidos y la informacin que ofrece. Palabras Clave: adolescentes, prevencin, salud sexual,
sexualidad
Adaptation of a Cognitive Behavioral Intervention for Aggressive Children Across
Cultures and Settings
John Lochman1, Brendan Andrade2, Jose Cabiya-Morales3, Pietro Muratori4, Lisa Polidori4,
Maria Helander5, Pia Enebrink5.
1. The University of Alabama, Tuscaloosa, AL, USA, 2. University of Toronto, Toronto, ON,
Canada, 3. Carlos Albizu University, San Juan, USA, 4. University of Pisa, Pisa, Italy, 5.
Karolinska Institutet, Stockholm, Sweden.
A central concern in the dissemination of evidence-based preventive interventions is the degree
and manner of adaptation of interventions that is necessary to produce useful outcomes in
various settings and contexts. This Panel Discussion will address this important issue by

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examining how an evidence-based intervention, Coping Power, has been taken to different
settings, and has been necessarily adapted in the process. Coping Power is an indicated
preventive intervention delivered to children screened as being at-risk because of their
aggressive behavior, but has been adapted for use in outpatient treatment settings as well. A
question exists about whether contextual factors that vary in different countries may complicate
useful dissemination of the program. The presenters in this panel will follow a conceptuallybased, step-by-step model for adaptation of interventions such as Coping Power (Goldstein,
Kemp, Leff & Lochman, Clinical Psychology: Science and Practice, in press) and will provide
detailed illustrations of its adaptation and of how cultural factors affect adaptation, with particular
attention to whether central constructs can be meaningfully translated and to how social factors
in different cultures affect the implementation and use of the program. There will be a key
emphasis on how training is provided, as prior findings have indicated in the US that useful
dissemination of this program is clearly influenced by whether sufficiently intense training is
provided (Lochman, et al, 2009). The methods for providing workshops and followup
consultation and performance feedback across different countries will be described. The
moderator, John Lochman, will describe the development, evaluation and dissemination of the
Coping Power program, and will describe some recent findings about the degree to which this
program can continue to have sustained use, in the years after original training. The panelists,
from four countries, will describe their implementation of this program in the context of clinical
research studies. Brendan Andrade (University of Toronto) will describe the process that was
used to adapt Coping Power for use in two intensive childrens mental health services in
Canada, requiring sessions to be delivered multiple times per week and to be integrated with
other intensive mental health programs. Jose Cabiya-Morales (Carlos Albizu University) will
discuss how The Coping Power was translated into Spanish and was used with children and
their families in Puerto Rico. Pietro Muratori and Lisa Polidori (University of Pisa) will discuss
how the Coping Power program was translated into Italian, and adapted for use in a child
psychiatry outpatient institute in Pisa, Italy, and will indicate whether their implementation has
been effective in reducing childrens problem behaviors. Maria Helender and Pia Enebrink
(Karolinska Institute) will describe a new effort to integrate Coping Power with a behavioral
parent training program in Stockholm, Sweden. The panel discussion will focus on unique and
important challenges and barriers in implementing an evidence-based programs in different
cultures and settings, and will describe how adaptations can be made while maintaining the
integrity of the cognitive-behavioral intervention.
The Role of Positively Biased Self-Perceptions and Peer Group Status in Predicting
Childhood Aggression
Rebecca Lynch, Haley Stephens, Janet Kistner.
Psychology, Florida State University, Tallahassee, FL, USA.
Childhood aggression is associated with a number of far-reaching negative psychosocial
outcomes. Numerous studies have found support for the notion that children with inflated selfperceptions of their social acceptance are prone to aggression and other externalizing
behaviors; however, some important unresolved questions remain that warrant further study.
One such question regards whether or not positively biased self-perceptions of social
acceptance predicts aggression in children while accounting for childrens peer group status
(i.e., whether or not they are rejected by peers). In many of the studies linking positively biased
self-perceptions to aggression, the focus has been solely on positive bias while other aspects of
peer-relations that have also been found to predict aggression (e.g., rejected status), were not
controlled for. Consequently, these findings may be confounded by the fact that rejected status
also predicts aggression, which makes it difficult to interpret the conclusions that are drawn from

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these results. A closely related and additional unresolved question regards whether the
observed association between positive bias and aggression is moderated by childrens rejected
status. While much of the research in this area reports finding associations between positive
bias and aggression in general samples, recent work suggests that these finding may have
been driven by a subgroup of children who are rejected by their peers. The present study
addresses these two questions while improving on some of the methodological limitations of
prior research. The sample included 663 third through fifth graders (358 girls and 305 boys) who
completed self-report measures of their perceptions of their social acceptance and ratings of
their peers social acceptance. Peer nominations were used to assess rejected status and
aggression. In an effort to improve on some of the methodological limitations of the recent
findings reported in Orobio de Castro et al. (2007) and White and Kistner (2011), this study used
multiple sociometric procedures to assess the constructs of interest. Furthermore, this study
utilized peer ratings (rather than teacher ratings) to assess social acceptance and aggression.
To address a limitation of other work on bias, the current study controlled for demographic
variables that were found to be associated with aggression (i.e., sex and race). Hierarchical
regression analyses were used to answer the questions. As shown in Table 1, sex, race, and
rejected status were all significantly associated with aggression. Importantly, after controlling for
both demographic variables and rejected status, positive bias significantly added to the
prediction of aggression. Our results did not support the second hypothesis; the interaction of
bias x rejected status did not significantly add to the prediction of aggression. These results
uphold the view that positively biased self-perceptions of social acceptance is associated with
aggressive behaviors above and beyond the effects of rejected status, and this association was
not found to be limited to children with a history of social rejection. Results will be discussed in
terms of the comparability with previous findings and practical implications.
Tratamiento de Enuresis Nocturna con Alarma: Caso de Nia de 7 aos
Mara Lpez Ortega.
Universidad La Salle Morelia, Morelia, Mexico.
Abstract Central: La enuresis nocturna es un problema que se presenta en ciertos infantes y
que muchas veces es resuelto mediante mtodos equivocados. Se presenta el caso de una
nia de 7 aos de edad que ya haba recibido tratamiento farmacolgico y que no presentaba
mejora hasta que luego de una entrevista a profundidad con sus padres se descubre que no
hay causas mdicas ni emocionales que causaran el problema, por lo que se les recomienda el
uso del sistema de alarma, el cual da resultado en el primer mes de uso, teniendo algunos
problemas aislados a las 6 semanas para concuirlo con xito a los tres meses y sin reportar
recadas "accidentes", al darle seguimiento al caso un mes despus. Se resalta el trabajo en
equipo de los padres con la menor y la terapeuta en el xito de este tratamiento.
Dimensiones del Autoconcepto Fsico en Nios, Nias y Adolescentes de la IX Regin de
la Araucana, Chile
Norman Lpez Velsquez, Alex Veliz Burgos, Paula Saez.
Araucania, Universidad Mayor, Temuco, Chile.
Abstract Central: El objetivo de esta investigacin descriptiva fue conocer el autoconcepto
fsico de los estudiantes de la IX Regin de la Araucana, Chile. Considerando el autoconcepto
fsico como un agente que puede ser protector, especialmente durante la infancia y
adolescencia, de enfermedades y problemas asociados a la falta de prcticas deportivas, y
como agente generador de hbitos de vida saludables que pueden mantenerse a lo largo del

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ciclo vital, es que surgi la necesidad de conocer la realidad de nios/as y jvenes de La


Araucana respecto a esta temtica. La metodologa utilizada fue no experimental y descriptiva.
Se utiliz el Cuestionario de Autoconcepto Fsico (CAF) en una poblacin estudiantil bsica y
media de la IX Regin de la Araucana. Los resultados obtenidos mostraron que, tanto en
mujeres como hombres, los niveles de autoconcepto fsico se ubican en los rangos bajo-medio,
situacin preocupante frente al aumento nacional y mundial de obesidad y sobrepeso, as como
de enfermedades de la conducta alimenticia. Palabras claves: Autoconcepto fsico,
autoconcepto, jvenes, deporte, salud, nios/as, adolescentes, CAF, cuestionario de
autoconcepto fsico.
Efectos de la Preparacion Psicologica Previo a Cirugia Mayor Dirigido a Pacientes
Pediatricos
Mariana Mangin Valencia.
Universidad Nacional Autnoma De Mxico, Mxico, Distrito Federal, Mexico.
El vivir un proceso de enfermedad y hospitalizacin sin duda es una situacin por ende
desagradable y molesta, no solo por los propios malestares de la enfermedad, sino por el
hospital que es un lugar ajeno, que incluye procedimientos incmodos y dolorosos. Si bien los
adultos comprenden que es una situacin necesaria por salud e integridad, esta experiencia
llega a ser muy diferente para los nios, para quienes la separacin familiar, el entorno
desconocido, el malestar, los procedimientos, la intimidacin de muerte y la fantasa de los
nios sobre lo que est ocurriendo, provoca consecuencias negativas a nivel fsico y
psicolgico con interferencia importante para el manejo hospitalario tales como la poca
colaboracin y reacciones derivadas de la ansiedad. El trmino de Psicoprofilaxis quirrgica
determina procedimientos que contribuyen a minimizar las respuestas psicolgicas
desadaptativas ante la hospitalizacin; pretende que el impacto traumtico de la experiencia se
reduzca y tienda al logro de una mejor adaptacin a la situacin hospitalaria. Sin embargo en
Mxico, si bien se han realizado investigaciones concluyentes de la importancia de brindar
apoyo emocional a los pacientes peditricos durante su hospitalizacin, no es un procedimiento
realizado en las instituciones de salud. Ante tales reacciones de angustia de los pacientes
intervenidos, el poco apoyo psicolgico del personal mdico y la incapacidad de algunos
padres para apoyar a su hijos en este proceso, surgi la necesidad de estructurar una
intervencin para preparar y sensibilizar a los pacientes que serian intervenidos con una ciruga
mayor, con el propsito de bajar los niveles de ansiedad, evitar la incertidumbre, las reacciones
negativas psicolgicas y favorecer en el proceso preoperatorio. La investigacin tuvo como
objetivo evaluar un programa psicolgico que preparara e informara al paciente utilizando un
manual de informacin con la representacin visual de los espacios mdicos, los instrumentos
utilizados y los procedimientos de rutina, para brindar la informacin debida que esclarezca el
procedimiento y las dudas que pudieran surgir del evento quirrgico. Se proporcionaron
tcnicas de afrontamiento realizando con los pacientes peditricos terapia de relajacin con
tcnicas de respiracin diafragmtica y respiracin alternada, as mismo la tcnica de relajacin
por imaginacin guiada, para control emocional previo a ciruga. Participaron 60 pacientes
peditricos hospitalizados en Centro Mdico Nacional I.S.S,S,T,E, realizando un estudio
experimental pre-post test conformado por dos grupos, a ambos se les aplic la escala CMASR de Reynolds. Teniendo grupos homogneos al inicio de la intervencin, se observaron los
efectos de la preparacin psicolgica realizada en el grupo experimental sobre el nivel de
ansiedad, durante la segunda aplicacin del instrumento posterior a la intervencin,
comparando ambos grupos se obtuvo una significancia menor a p<.05 en Ansiedad Total
(t=4.007, p=.000), Ansiedad Fisiolgica (t=6.778, p=.000), Inquietud (t=2.522, p=.014) y
Ansiedad Social (t=2.110, p=.039), siendo estas diferencias atribuibles la diferencia a la

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preparacin psicolgica realizada, lo que indica que existe una reduccin importante de los
niveles de ansiedad que perjudiquen al paciente peditrico durante su estancia hospitalaria. Se
discuten los resultados en funcin del papel de la preparacin psicolgica propicia en el
paciente peditrico el aprendizaje de conductas ms adaptativas y facilitadoras del proceso
quirrgico, optimizando su estado fsico y emocional, en tiempos cortos y con tcnicas
sencillas, eficaces y viables de implementacin en el contexto hospitalario.
Influencia de la familia en el desarrollo de trastornos emocionales en el adolescente
Gina Maria, Gina Maria, Raquel Tello Cabello, Susan Colmenares.
Lima, Sentirse bien Per SAC., Lima, Peru.
El presente estudio cualitativo tiene por objetivo explorar los factores familiares que
condicionan la aparicin de trastornos emocionales en los adolescentes.
Para tal efecto, se seleccion y entrevist a un total de 50 pacientes de nuestro consultorio,
cuyas edades oscilaban entre 14 y 19 aos, y que haban sido diagnosticados con trastornos
emocionales.
Los resultados mostraron que los factores comunes en las familias de estos adolescentes eran
la presencia de una comunicacin ambigua, ausencia de expresin de emociones, as como
limitaciones en la capacidad para adaptarse a los cambios e intercambiar experiencias con
otras familias. As mismo, en el 70% de los casos se encontr que los adolescentes haban
desarrollado caractersticas similares a la de sus padres. Los trastornos o perturbaciones
emocionales se pueden definir como un estado del ser, caracterizado por aberraciones en los
sentimientos que tiene un individuo con respecto a s mismo y al medio ambiente. La existencia
de la perturbacin emocional se deduce del comportamiento. Por lo general si una persona
acta de una manera que le es perjudicial a ella y/o a los dems, puede considerarse en un
estado de perturbacin emocional. (Newcomer, 1993). Las alteraciones emocionales
comnmente eran asociadas a las personas adultas, sin embargo en base a nuestra
experiencia podemos sealar que cada vez se hace ms frecuente la presencia de trastornos
emocionales en la poblacin adolescente.
Metodologa de la Investigacin
Contexto.- La investigacin se realiz en los domicilios de los participantes, los cuales se
encuentran ubicados en los distritos de La Molina, San Borja y Santa Anita, en Lima- Per,
entre Agosto y Diciembre del ao 2011. A cada participante de este estudio se le indic en qu
consista la investigacin, a los que haban cumplido 18 aos ms se le hizo firmar una carta en
la que nos autorizaba ser objeto de estudio, y en el caso de los menores de edad la
autorizacin la firmaba el padre.
Participantes.- El nmero de adolescentes que participaron en la investigacin fueron 50, cuyas
edades fluctuaban entre 14 y 19 aos, provenientes de los distritos de la Molina, San Borja y
Santa Anita. De los participantes, 20 eran varones y 30 de sexo femenino, todos ellos de clase
socioeconmica media; los cuales haban sido diagnosticados con trastornos emocionales: 22
de ellos con trastorno depresivo mayor, 15 con trastorno de ansiedad, 11 con distimia, 2 con
trastorno bipolar. Los participantes fueron seleccionados mediante muestreo de casos-tipo, las
caractersticas que deban cumplir los participantes eran: Tener entre 14 y 19 aos.
- Haber sido diagnosticado con trastornos emocionales en la consulta psicolgica y psiquitrica.
Diseo.- La presente investigacin sigue un diseo de estudio narrativo, basado en
autobiografas de los adolescentes que atravesaban por un trastorno emocional y referencias
adicionales de los otros miembros de su familia. El mtodo que se us para la recoleccin de
datos fue la entrevista a profundidad, con preguntas abiertas pero enfocadas a explorar la
percepcin que el adolescente tena acerca de la relacin con los otros miembros de su familia

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desde edades tempranas.


Procedimiento.- El trabajo se inici cuando los participantes acudieron a nuestro consultorio
psicolgico sealando una serie de problemas emocionales que le impedan una funcionalidad
adecuada en su contexto. Al ser evaluados a travs de la entrevista, pruebas psicolgicas, as
como tambin mediante la interconsulta psiquitrica se diagnostic que la mayora de ellos
presentaban cuadros emocionales moderados y graves (trastornos emocionales). Hasta
entonces no nos habamos planteado la necesidad de elaborar una investigacin sobre el
presente tema, sin embargo era interesante observar cmo estos pacientes con trastornos
emocionales y sus respectivos padres, referan que los problemas motivo de consulta se
haban manifestado tempranamente en el seno familiar nuclear (mayormente con los padres, y
en ocasiones con los hermanos u otras personas que tenan a cargo su crianza), y luego recin
se haban evidenciado en los otros contextos: colegio, otros familiares (tos, abuelos, etc.). Fue
entonces que vimos la necesidad de explorar con mayor detalle el contexto familiar en que se
haba desarrollado el adolescente hasta ese momento, indagando los patrones de
comunicacin y expresin de emociones, los cuales son bsicos para la formacin de la
personalidad. Para tal efecto, seleccionamos a los pacientes con trastornos emocionales que
venan siendo atendidos hasta entonces en nuestro centro psicolgico para que sean
entrevistados y nos relaten de cmo haba ido evolucionando a travs de los aos la relacin
con sus padres u otras figuras a cargo de su crianza. Debemos sealar que estas entrevistas
se daban al margen de las sesiones psicoteraputicas y/o psiquitricas que los adolescentes
tenan. Estas entrevistas a profundidad otorgaban datos ms relevantes y detalles que en
ocasiones pueden ser pasados por alto en una anamnesis. Antes de iniciar con el proceso de
las entrevistas se les explic a los adolescentes y a los padres en qu iba a consistir nuestro
trabajo y el objetivo del mismo, as mismo se les indic que las entrevistas iban a ser grabadas.
Se les hizo firmar una carta de autorizacin a los mayores de edad, y en el caso de los
menores de edad, eran los padres los que firmaban tal documento.
Estas entrevistas se iniciaron el 15 de Agosto de 2011 en los respectivos domicilios de los
pacientes. Las sesiones eran cada 3 o 4 das, dependiendo de la disponibilidad del participante.
Hasta ese momento contbamos con 6 participantes: 4 diagnosticados con depresin mayor y
2 con ansiedad. A medida que en nuestro consultorio se diagnosticaba ms pacientes con
trastornos emocionales, se les haca la invitacin a participar de nuestra investigacin. Hasta el
15 de Setiembre, se haba entrevistado a 10 adolescentes; al 15 de Octubre, 15 adolescentes;
no obstante a fines de ese mes se lleg a 23 casos de adolescentes con trastornos
emocionales. A finales del mes de Noviembre ya se tenan 31 casos. Y en las dos semanas
siguientes se logr la inclusin de 19 participantes ms a la investigacin. En las entrevistas
solo participaba el entrevistador y el adolescente, y duraba alrededor de 45 minutos cada una.
No haba un nmero preestablecido de entrevistas con cada uno de los participantes; sin
embargo, el nmero total de entrevistas con cada paciente no excedi de 5, siendo el promedio
4 entrevistas por cada adolescente. Tambin se realiz una sesin entrevista a los padres y
otros familiares del adolescente con el fin de aclarar algunos aspectos que eran relatados por l
o bien para tomarlos como referencia para las prximas sesiones con el adolescente.
Resultados
RESULTADOS
a.1) Comunicacin ambigua.- En las familias de los adolescentes por lo general comunicacin
caracterizada por la ambigedad. En muchos casos, el lenguaje verbal se contradeca con la
conducta no verbal, manifestndose ello principalmente en la relacin entre padres e hijos. Una
de las declaraciones de un adolescente de 17 aos nos ejemplifica esto: Comnmente, mi
padre me deca que me quera, sin embargo cuando llegaba a casa despus de trabajar nunca
tena tiempo para m, siempre que le haca alguna pregunta sobre alguna tarea deca que
estaba muy ocupado y me mandaba a preguntarle a mi mam. Cuando vea pelculas no quera

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que hablara, siempre que le haca alguna pregunta sobre la pelcula me responda de una
manera cortante, recuerdo que me deca cllate y djame ver, en ocasiones se molestaba y
me mandaba a mi cuarto. Casi nunca poda hablar con l porque siempre deca que estaba
ocupado, yo no notaba que me quisiera, sin embargo l deca que s y siempre pona como
ejemplo las cosas caras que me compraba.
Edgar, quien actualmente tiene 14 aos, manifiesta: Recuerdo una ocasin cuando yo tena 11
aos en la que mis padres nos sentaron a m y a mi hermano mayor, que para entonces tena
13 aos, y nos dijeron que haban recibido una charla en el colegio donde les haban dicho que
a los adolescentes hay que comprenderlos porque es una etapa difcil en nuestra vida y que
ellos estaban dispuestos a apoyarnos en todo lo que fuera necesario. No obstante, das
despus mi hermano solicit permiso a mi pap para ir a un campamento que organizaba el
colegio, y mi padre lejos de entenderlo, se molest bastante y le dijo definitivamente no irs a
ninguna de esas cosas hasta que no hayas cumplido la mayora de edad. Cuando mi hermano
insisti mi padre lo castig y no lo dej salir a jugar durante una semana o creo que ms. Yo vi
que eso no era comprensin, pero mi padre siempre deca que l era comprensivo con sus
hijos. Mi madre tambin era algo as, siempre deca que nos quera y que era comprensiva,
pero cuando bamos a contarle algo, haban dos opciones: la primera era que te escuchaba y
haca gestos de que te entenda lo que le estabas diciendo, pero ni siquiera te miraba a los ojos
por estar concentrada en sus novelas, y siempre terminaba diciendo ah ya; la segunda opcin
era que cuando uno le iba a comentar algo no muy bueno, no dejaba que termines de hablar y
ya te estaba juzgando. Por eso aprend a no contarle nada de lo que me pasaba, ante lo cual
ella se incomodaba y me deca Por qu nunca me cuentas tus cosas?, yo soy tu madre,
quiero comprenderte. Eso se ha venido dando hasta el da de hoy Otro aspecto en el que se
pone de manifiesto la comunicacin ambigua es en los dobles mensajes. Lucrecia, de 16 aos
seala: Mi madre comnmente me deca que tena que hacer mi tarea y solo encargarme de
eso cuando ella no estaba; sin embargo, cuando regresaba y encontraba que yo no haba
ayudado en sus tareas a mi hermano menor de 8 aos, ella se enojaba mucho a tal punto que
deca que yo era una desconsiderada y que no la apoyaba para nada. Y no solo ocurra con
eso, en ella era frecuente enojarse porque yo no haba cumplido funciones que ella no me
haba delegado. Recuerdo que una vez me dijo que yo no me preocupara en barrer o limpiar la
sala. Sin embargo, un da lleg a casa de mal humor y me grit porque no haba limpiado el
piso, el cual a decir verdad tampoco estaba sucio. Roberto, de 19 aos refiere: Yo de
pequeo era bien caprichoso para la comida. Solo me gustaba comer lo que yo quera, no me
gustaban las menestras por ejemplo. Recuerdo que mi madre siempre renegaba de eso, y me
deca que no me iba a dar mis antojitos, sin embargo cuando llegaba la hora del almuerzo me
sorprenda que mi mam tuviese preparado un plato especial para m. Ella deca todo lo que
me haces hacer, como si yo fuera el responsable de que ella acte as, luego se quejaba ante
mi pap que yo no quera comer la comida, cuando ella misma era la que me haba preparado
otro plato. Esto era una constante en su comportamiento, se quejaba de actitudes mas pero
con sus conductas incentivaba a que yo las siga haciendo. Haca que yo siempre obtuviera
todo lo que quisiera, aunque constantemente me deca no siempre vas a tener todo lo que
quieres, me parece que desde ah empez mi baja tolerancia a la frustracin porque ella me
acostumbr darme todo lo que yo quera as ella tuviera que renegar despus.
Otro aspecto clave para comprender la comunicacin ambigua en estos adolescentes es el
hecho del ejemplo que proporcionaban los padres a sus hijos. Normalmente estos padres les
enseaban a sus hijos a ser tolerantes a la frustracin y afrontar las situaciones adversas, pero
ellos mismos no lo hacan. Ana, de 15 aos nos seala: Mi madre deca que nunca hay que
perder la cabeza por un hombre, sin embargo recuerdo varios episodios desde cuando yo era
pequea en la que se peleaba con mi padre y se pona a llorar inconsolablemente.
Discusin del tema y conclusiones

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DISCUSIN
En base a los resultados podemos sealar que existen indicios que la familia ejerce influencia
en el desarrollo de trastornos emocionales en el adolescente. Las entrevistas realizadas nos
muestran que la comunicacin ambivalente genera un estado emocional inestable en el
adolescente, ya que ste no sabe si responder a la conducta verbal o a la no verbal. As mismo
la ausencia de expresin de emociones, tanto positivas como negativas, es un factor que
podra afectar la asertividad y el afronte de conflictos en los adolescentes, hecho que
condiciona que sus emociones no sean manifestadas en el momento adecuado, con la persona
adecuada y se tienda a la evitacin como mecanismo de afronte de situaciones estresantes.
Sin embargo, cuando se dan situaciones que el adolescente ya no puede evitar, se presenta en
l un estado de indefensin ya que desde temprana edad no ha aprendido a manifestar lo que
a l le molesta y enfrentar los conflictos, frente a ello se presentan los primeros sntomas de los
trastornos emocionales, como la frustracin y baja autoestima. La pobre capacidad para
adaptarse a los cambios tambin es un factor que contribuye a la presencia de trastornos
emocionales. Esto se explicara en que los padres no ensean a los hijos cmo responder
frente a situaciones nuevas y complicadas, y es ms tienden a desbordarse emocionalmente
frente a ellas, lo cual genera que los hijos acten de la misma manera en dichas circunstancias.
Feasibility, Efficacy, and Acceptability of a School-based Intervention to Prevent
Depression in Adolescents in Chile
Vania Martnez1, Graciela Rojas1, Rosemarie Fritsch1, 2, Paul Vhringer1, Sergio Barroilhet2,
Viviana Guajardo1, Ricardo Araya3.
1. Universidad de Chile, Santiago, Chile, 2. Universidad de Los Andes, Santiago, Chile, 3.
University of Bristol, Bristol, United Kingdom.
Abstract Central: Objective: To design and evaluate the feasibility, efficacy and acceptability of
a school-based intervention to prevent depression in adolescents in Chile. Methodology: (1)
Formative research before the design of the intervention was achieved in 4 state funded
schools, using semi-structured interviews of key school staff and focus groups with students,
teachers and parents. (2) Cluster randomised controlled trial with schools as the main clusters.
There were envolved 3 state funded schools. Students in the active group attended 11 weekly
sessions of an intervention based on CBT. The control group received 1 curricular hour of
counselling each week. The measures were applied at the baseline, at the end of the
intervention and six months after the intervention. The primary outcome measure used was BDIII. Secondary outcomes were. Childrens Automatic Thought Questionnaire and Social Problem
Solving Inventory-Revised Short Form. The analyses consisted of a repeated measures
regression model, adjusting for baseline score of each scale and a multi-level logistic regression
model, adjusting for age and gender. (3) Qualitative study: 4 girls and 4 boys from each class of
the active group were randomly assigned to participate in each focus group after the
intervention. Results: (1) Formative research: Key school staff, students, teachers and parents
approved and expressed their willingness to the existence of a school-based prevention
programme to prevent depression. (2) Cluster randomised controlled trial: Participants were 163
in the active group and 114 in the control group. The mean age of the sample was 14.5 years
(SD= .6). In the baseline assessment the active group did not differ significantly from the control
group regarding age, level of depressive symptoms, level of dysfunctional thoughts and level of
problem solving strategies. There was a greater percentage of females in the intervention
group, than in the control group (51.5% vs. 27.2%). In the active group, the BDI-II score was
initially 10.7 (95% CI= 9.0 to 12.4), which increased at the end of the intervention to 11.5 (95%
CI= 9.7 to 13.4) and at the 6 months assessment was 9.2 (95% CI= 7.5 to 10.9). In the control
group, the BDI-II mean score was 9.2 (95% CI= 7.6 to 10.8), 8.0 (95% CI= 6.3 to 9.6) and 8.6
(95% CI= 6.1 to 11.1), respectively. No significant group effects were found for depressive

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symptoms, dysfunctional thoughts or solving problems strategies controlling by baseline scores.


The intervention behaved like a protective factor against new cases of depression (OR= .39; CI
95%= .19 to .79). (3) Qualitative study: Participants appraised the programme positively. They
attributed great importance to disciplinary control during sessions and to the relationship
established with the facilitators. Conclusions: Formative research was a useful tool in the
development and implementation of the intervention. No follow-up group effects were significant
on primary and secondary outcomes. The results reached at the time of the 6-month follow-up
appear to suggest that the intervention could reduce new cases of depression. It was possible
to implement a school-based intervention to prevent depression in Chile with good acceptance.
A Universal Preventive Program in Japanese Primary School: Impact of Cognitive
Behavioral Therapy on Childrens Difficulties and Strengths in Japanese Context
Yuki Matsumoto1, Chizuko Nishida2.
1. Graduate School of Medicine, Chiba University, Chiba, Japan, 2. Tanabe Tobu Primary
School, Tanabe, Japan.
A Universal Preventive Program in Japanese Primary School: Impact of Cognitive Behavioral
Therapy on childrens difficulties and strengths in Japanese context The purpose of this study
was to investigate the effectiveness of a universal preventive program with Japanese primary
school students. A universal cognitive behavior therapy emotional health program with children,
FRIENDS, is provided in Primary School by trained teachers in Japan. Japanese teachers, who
recognize the importance of psychological and preventive approach to improve childrens
mental health, confront a scarcity of information, knowledge and/or resources for the
implementation. FRIENDS is a cognitive-behavioral intervention based on a firm theoretical
model which addresses cognitive, physiological and behavioral process that are seen to interact
in the development, maintenance and experience of anxiety. The program has been designed to
be effective as both a treatment and a school-based prevention course promoting child selfdevelopment. In the present study, 49 children (age 9-11 years old) participated weekly in a
school-based 10-session program. Child difficulties such as anxiety and depression, as well as
strengths such as self-esteem and hope are assessed by a series of self-report questionnaires
at pre and post periods. Significant improvements in emotional health have been found after
completing the program, including the reduction of anxiety, depression, and total behavior
difficulties, as well as increasing self-esteem and support awareness on each of the
assessments. We also examined associations between difficulties and strengths. The results
indicated that childs hope was significantly and negatively related to child difficulties. It is
expected that the universal approach could provide the impact on the preventive education in
Japanese schools. Implications and limitations are discussed, including the need for long-term
follow-up and parent involvement on program effectiveness.
Current Advances in Treatments for Pediatric Specific Phobia
Ella Milliner1, Ella Milliner1, Ella Milliner1, Ella Milliner1, Lara Farrell1, Lara Farrell1, Lara Farrell1,
Lara Farrell1, Thomas Ollendick2, Thomas Ollendick2, Thomas Ollendick2, Thomas Ollendick2,
Caroline Donovan1, Caroline Donovan1, Melanie Zimmer-Gembeck1, Melanie ZimmerGembeck1, Harry McConnell1, Harry McConnell1, Emily Allan1, Evelin Tiralongo1, Evelin
Tiralongo1, Eric Storch6, Allison Waters1, Allison Waters1, Allison Waters1, Simon Byrne3, Nigel
Collings1, Vinay Garbharran7, Lars-Gran st8, Ronald Rapee3, Gurjhinder Malhi4, Rick
Richardson5, Jennifer Hudson3.
1. Griffith University, Gold Coast and Brisbane, QLD, Australia, 2. Virginia Polytechnic Institute
and State University, Blacksburg, VA, USA, 3. Macquarie University, Sydney, NSW, Australia,

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4. University of Sydney, Sydney, NSW, Australia, 5. University of New South Wales, Sydney,
NSW, Australia, 6. University of South Florida, St Petersburg, FL, USA, 7. Queensland Health,
Gold Coast, QLD, Australia, 8. Stockholm University, Stockholm, Sweden.
Behavioral and cognitive-behavioral procedures have received strong empirical support in the
treatment of childhood phobias (King, Muris, & Ollendick, 2005; Ollendick, Davis, & Sirbu,
2009). More recently, these cognitive and behavioural procedures have been incorporated into
an intensive one-session treatment (OST) package. To date the efficacy of OST has been
supported by two large scale randomized controlled trials (RCTs, Ollendick, st et al., 2009; st
et al., 2001) and two smaller clinical trials (Flatt & King, 2010; Muris, Merckelbach, Holdrinet &
Sijsenaar, 1998). OST has been found to be superior to a waitlist control (Flatt & King, 2010;
st et al., 2001) and an education support group (Ollendick, st, et al., 2009). Whilst outcomes
are generally favourable, unfortunately a significant proportion (20 - 50%) of children and
adolescents do not respond adequately to CBT interventions for specific phobia (Ollendick, st
et al., 2009; st et al., 2001). This symposium will present outcomes from current international
trials exploring innovative approaches for treating specific phobia which aim to improve the
overall outcomes for children and adolescents. This symposium examines trials aimed at
augmenting one session treatment through parent management training, attention modification
training and d-cycloserine. Additionally, it examines the efficacy of OST in the treatment of child
adolescent Blood, Injury and Injection Phobia.
Parent-augmented One Session Treatment for Specific Phobias
Specific phobias are a common disorder of childhood and adolescence. Left untreated, they
frequently lead to other internalizing and externalizing disorders. As such, they are frequently
described as a gateway disorder. In recent years, a number of cognitive-behavioral
interventions have been shown to be effective in the treatment of these disorders. One Session
Treatment (OST) is one such treatment. This presentation will focus on two major randomized
clinical control trials - the first conducted in Sweden and the United States, and the second in
the United States only. In the first trial, OST was shown to be superior to an Education/Support
condition and a Wait List Control condition (Ollendick, Ost, et al., 2009). In this study it was also
shown that maternal anxiety and maternal overprotection moderated treatment outcomes.
Based on this study, a second RCT was conducted in Virginia with 150 children between 7 and
14 years of age. The standard OST was compared to an augmented condition in which parents
were actively involved in treatment and participated in a 1-month maintenance condition.
Although follow-up data are still being collected for this study, initial finding suggest that the two
treatments produce comparable outcomes at post-treatment and at 1-month follow-up; however,
at 6-month follow-up, the Augmented Treatment is superior to the Standard Treatment. Findings
from this trial will be explored further and the role of anxious parents, and anxious parenting, will
be examined. Implications for clinical practice will be highlighted.
D-Cycloserine Augmented One Session Treatment of Pediatric Specific Phobia
To date, innovative one-session treatment (OST) has demonstrated efficacy for the treatment of
specific phobias in children and youth, and is currently the favoured psychosocial treatment for
these disorders. While cognitive-behavioural treatments are very effective for most children with
anxiety and phobic disorders, not all children experience a sufficient clinical response from
these treatments. Aims: The current study aimed to examine the effectiveness of augmenting
OST with anti-tuberculosis medication d-Cycloserine (DCS) for children and youth with a wide
array of specific phobias in a double blind RCT. DCS is often described as a cognitive
enhancer due its demonstrated effects of improving patient outcomes and increasing the
efficiency of behavioural therapy, when used in combination with exposure and response
prevention. Methodology: Children aged 7-17 years with a diagnosis of specific phobia were

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randomised to either DCS augmented OST (n=25), or PBO augmented OST (N=25)
(administered immediately before 3 hour OST), with two weight-related doses of DCS - 25-45kg
= 35mg DCS, or 46-90kg = 70mg DCS. Children receive a medical review and laboratory blood
screen prior to randomisation. Primary outcomes measures include diagnostic severity, clinical
global severity ratings, functional impairment and behavioural approach as measured with
standardised Behavioural Approach Tasks (BATs). Results: Data collection is currently
underway, with 30 children presently randomised (n=15 in each condition), and recruitment
continuing until February 2013. Discussion: The results of the current trial will be presented in
regards to primary outcome measures, and a discussion of the clinical implications will be
provided. We also aim to present some initial data and discussion in regards to parental
perceptions of novel treatments (i.e., DCS augmented OST), and the implications of this for
disseminating novel treatments into routine clinical practice.
One Session Treatment for Blood, Injury and Injection Phobias in Children and
Adolescents
There is a paucity of research investigating treatments for child and adolescent blood, injury and
injection (BII) phobia. In the adult literature, behavioral and cognitive-behavioral procedures
have received empirical support for the treatment of BII phobias (st, Lindahl, Sterner &
Jerremalm, 1984; st, Sterner & Fellenius, 1989; st, 1991; st, 1992; Hellstrm et al., 1996).
In - vivo exposure and applied tension have been found to be particularly effective (Ayala,
Meuret, & Ritz, 2009). Youth with BII phobia have previously been excluded from large clinical
trials, due to their distinct physiological response (Ollendick et al., 2009), or included in small
numbers (< n=14). This paper aims to evaluate the effectiveness of an intensive cognitive
behaviour treatment for blood, injury and injection phobia in children and adolescents using a
controlled, multiple baseline experimental design. Method: Twenty-four children and
adolescents (7 - 18 years), will be randomized to a one, two or three week baseline phase prior
to receiving the intensive cognitive behavioural treatment. Treatment will consist of a one 3 hour
session of graduated exposure. Results: It is expected that children and adolescents will show
significant improvements in clinician rated phobia severity, diagnostic status, number of steps
completed and ratings of anxiety and disgust during a behavioural approach task, and self
report measures of anxiety, quality of life and disgust sensitivity. Discussion: This paper will
provide a discussion of the current state of research for BII phobia in youth and will highlight the
clinical implications of present studys results.
The effect of attention training to positive stimuli on improving outcomes from a single
session of exposure therapy for children with specific phobias
Background: A single session of exposure therapy is effective in reducing anxiety in children
with specific phobias. Recent attention bias modification training has shown that training
attention away from threat stimuli may be a promising treatment approach for children with
anxiety disorders. The present study combines these innovative treatments to examine whether
outcomes following a single session of exposure therapy are improved when supplemented with
attention training towards positive stimuli compared to a control attention training condition in
children with specific phobias. Method: Children between 7 and 17 years of age with a specific
phobia completed either one session of computer-based attention training towards positive
stimuli (N = 25) or a control training condition (N=25) followed by a single, 3-hour session of
exposure therapy. Diagnostic, symptom, and attention bias measures were taken at pretreatment, post-treatment, 1-month and 6-month follow-up. Change in childrens subjective
anxiety and fear beliefs were assessed throughout treatment. Results: Data collection is
currently underway. Ten children in each condition have been treated and assessed to date and
data collection will be completed by December 2012. Discussion: Results will be discussed with
regard to the hypothesis that in comparison with the control condition, attention training towards

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positive stimuli will produce greater change in subjective anxiety and strength of fear beliefs
during treatment, enhanced attention bias towards positive stimuli and improved outcomes on
diagnostic and symptom measures.
D-Cycloserine Augmented One Session Therapy for Children with Animal Phobia
Aim: There is ongoing interest in whether medications can improve psychological interventions
for anxiety disorders. D-Cycloserine (DCS) is a cognitive enhancing medication believed to
consolidate fear extinction learning into memory during exposure therapy. We examined
whether DCS could augment extinction of an animal phobia in children when used in
conjunction with One Session Therapy (OST). Methodology: We conducted a double-blind
placebo-controlled Randomized Controlled Trial to investigate whether 50mg of DCS can
enhance extinction of a dog or spider phobia. Thus far, we have recruited N = 28 young people
(M age = 9.1 years) who ingested DCS or a placebo prior to receiving a single, massed session
of invivo exposure (OST). Avoidance was measured using standardized ten-step Behaviour
Avoidance Tests (BATs), where successive steps increased proximity and/or contact to a feared
stimulus. BATs were conducted prior to treatment, immediately after treatment and on follow-up
one week later. Follow-up BATs were conducted with a different stimulus (a different dog or
spider) to examine whether there was generalization of the original fear extinction learning.
Results: Preliminary analysis reveals 93% of children reported a significant reduction in their
phobia symptoms after the exposure therapy. This improvement is reflected in the significant
increase in BAT steps completed from pre-treatment (M = 4.4/10 steps completed, SD = 3.4) to
post-treatment (M = 9.0/10, SD = 1.8; t(27) = 8.17, p < .01), however, there was some return of
fear to a different stimulus when comparing post-treatment to follow-up (M = 6.8/10, SD = 3.0;
t(27) = 4.69, p < .01). At this stage the medication blind has not been broken but the marked
variability at post-treatment and follow-up provides ample opportunity to detect a difference
should one exist. Conclusions: Early results suggest a single session of exposure is effective in
reducing fear response for a dog or spider phobia, however; there was significant avoidance to
a different stimulus one week later and variation in the level of avoidance. We hypothesize that
children who ingested DCS will have less return of fear on follow-up when the blinding is broken
prior to the conference.
Influence of Cognitive and Behavioral Factors on Depressive Symptoms in Children with
Autistic Features
Kohji Minosaki1, Tomoya Sato1, Shunta Maeda1, Takahiro Yokoyama1, Kyoko Nagano1, Hironori
Shimada2.
1. Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan, 2. Faculty of
Human Sciences, Waseda University, Tokorozawa, Japan.
Because children with autistic features experience more failures in social activities or in
performing various tasks, they tend to develop depressive symptoms. In recent years, an
intervention based on cognitive behavioral theory has been applied to the symptoms of children
with autistic features, and has been shown to reduce these symptoms. However, because the
cognitive and behavioral variables that influence the symptoms of autistic children have not
been clarified sufficiently, the intervention cannot help becoming a comprehensive one. To
conduct a more effective and efficient intervention, it is necessary to clarify the variables that
influence the symptoms. Therefore, this study aims to clarify the cognitive and behavioral
variables that influence the depressive symptoms from autistic features. A total of 111 junior
high school students (63 males) and three classroom teachers (2 males) participated in the
investigation. The students answered the Depression Self-Rating Scale for Children (Birleson,
1981), the Automatic Thought Inventory for Children (Sato & Shimada, 2006), and the Coping
Scale for Junior High School Students (Shimada, 1998). The teachers answered the Autism

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Spectrum Screening Questionnaire (Ehlers & Gillberg, 1993). This investigation was conducted
on the basis of ethical considerations. A multiple regression analysis was conducted to clarify
the cognitive and behavioral variables (automatic thoughts and coping) that influence the
depressive symptoms from autistic features. The results of the analysis showed that negative
thoughts (self-denying) autistic tendency ( = .24, p = .008) and positive thoughts
(expectation for support) autistic tendency ( = .22, p = .014) had significant coefficients (R2 =
.649; F [9, 110] = 20.751, p < .001). Similarly, positive coping (constructive coping) autistic
tendency ( = -.18, p = .097) and negative coping (avoiding thinking) autistic tendency ( =
.29, p = .025) had significant coefficients (R2 = .244; F [7, 110] = 4.759, p < .001). The results of
a simple slope analysis indicated that in self-denying, a significant coefficient was shown only
in the high autistic tendency (high tendency: = .72, p < .001, low tendency: = .17, p =.142),
and in expectation of support, a large coefficient was shown in the low autistic tendency,
compared with the high tendency (high: = -.27, p = .002, low: = -.58, p < .001). Also, a
significant coefficient was shown only in the high autistic tendency in constructive coping (high:
= -.34, p = .058; low: = .19, p = .172), while a significant coefficient was not shown in
avoiding thinking. These results suggested that it is effective for children with a low autistic
tendency to raise their expectation of support. On the other hand, for children with a high
autistic tendency, it is necessary to raise their expectation of support, and to weaken selfdenying, and it is also necessary to expand constructive coping skills. In this study, we
investigated the continuity of the concept of autism spectrum disorder in an analog sample;
however, future research should clarify the variables that influence depressive symptoms
through a comparison with a clinical sample.
La Conducta de Los Padres como el Origen de Las Enfermedades Mentales de Los Hijos:
Un Caso de Trastorno Oposicional Desafiante F91.3
Milton Miranda, Luis Hernando Silva Castillo.
CEIC, Universidad de Guadalajara, Guadalajara, Mexico.
Se sigui un caso de un nio de 6 aos diagnosticado con un Trastorno Oposicional Desafiante
F91.3, mediante una intervencin de tipo comportamental que integraba Terapia de Aceptacin
y Compromiso (ACT), Psicoterapia Analtico-Funcional (PAF) y estrategias de modificacin de
conducta basadas en el establecimiento de contingencias. Se pudo evidenciar que los padres y
abuelos en tanto principales cuidadores, no establecan de manera clara relaciones de
contingencia que permitieran hacer evidente las consecuencias positivas y negativas asociadas
a un tipo de conducta en particular. Adicionalmente los estilos de crianza utilizados por los
padres no eran consistentes entre s: el estilo usado por la madre fue identificado como un
estilo permisivo, caracterizado por bajo control y alto afecto o apoyo, mientras que en el padre
se identifico un estilo de crianza negligente, caracterizado tanto por un bajo control como por un
bajo afecto o apoyo. La mayora de los comportamiento identificados en los padres con estos
estilos de crianza, tienen comportamientos complementarios en los hijos, muchos de los cuales
pueden ser identificados como aquellos descritos en el DSM-IV que permiten diagnosticar un
Trastorno Oposicional Desafiante F91.3. La hiptesis que se plante para el caso indicaba que
el comportamiento del nio estaba asociado a unas prcticas de crianza poco adaptativas, que
se sustentaban en las expectativas que los padres se hacan para el futuro de su hijo (valores),
lo que desencadenaba como se indic anteriormente en un estilo de crianza principalmente
permisivo. En los padres se pudo identificar un trastorno de evitacin experiencial (TEE),
puesto que los padres evitaban frustrar a su hijo para no sentirse mal, estrategia que les era til
en el corto plazo, lo que sin embargo no les permita alcanzar aquellos logros a largo plazo
asociados con un ptimo proceso de socializacin que ellos esperaban para su hijo. Los
objetivos de la intervencin consistieron en (a) hacer explcita la relacin existente entre el

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comportamiento de los padres y el comportamiento del nio, para dar cuenta del papel de la
conducta paterna sobre el motivo de consulta y mostrar su papel en la resolucin del mismo,
(b) enfrentar por medio de la desesperanza creativa el trastorno de evitacin experiencial
identificado en los padres y (c) generar un proceso de aceptacin de la sensaciones negativas
que pueden experimentar los padres en el proceso de crianza de sus hijos, lo que permitira en
ltima instancia un cambio en el comportamiento de los mismos. Mediante la ejecucin de
actividades como el entrenamiento a padres que buscaban alcanzar los objetivos propuestos
se logr que el nio encontrara alternativas de tipo verbal antes de usar la agresin fsica, la
disminucin de las conductas agresivas hacia los dems miembros de su familia, la reduccin
de conductas no deseadas mediante tcnicas de extincin, el mejoramiento de la relacin de
pareja, la disminucin de conductas oposicionales y la generacin de una mayor autonoma en
el nio.
Effectiveness of Guided Adolescent Problem Solving on Reducing or Stopping
Substance Abuse, Drug Craving, Drug Related Beliefs and Coping Strategies in
Substance using Adolescents
Parvaneh Mohammadkhani1, Leila Mohammadi2, Hedieh Azadmehr3.
1. University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran, 2.
University of Tehran, Tehran, Islamic Republic of Iran, 3. Heidelberg University, Heidelberg,
Germany.
Abstract Central: Objective: Adolescent substance use can be particularly predicted by
impulsive/careless characteristics and avoidant problem-solving styles. Compared to
developmentally matched peers, substance-abusing adolescents have been found to employ
less effective strategies for resolving interpersonal conflicts and less sophisticated approaches
to perspective-taking. This study aimed to evaluate the effectiveness of Guided Adolescent
Problem Solving (GAPS) on reducing or stopping substance abuse and drug craving in
substance using adolescents. Moreover the changes regarding drug related beliefs and coping
strategies in this group have been investigated. Method: Quasi-experimental design with
experimental and control groups and pre-test/ post-test was employed to evaluate the
effectiveness of GAPS. Thirty patients (addicted to at least one drug) aged 15-20 were
participated in this study. Patients were randomly selected from 250 adolescents who were
referred to Tehrans juvenile correction and rehabilitation center due to their substance use and
delinquent behaviors. Patients were assigned to either experimental or control group if they met
the diagnostic criteria for substance use disorder. After pre-test the experimental group met for
a total of 8 sessions of GAPS intervention (2 hours for each session). Further statistical analysis
has been carried in SPSS. Results: Substance consumption was stopped in both groups. But
there were significant changes in drug craving, positive attitude toward drug use and emotional
express as a coping strategy in experimental group relative to the control group. Conclusion:
GAPS is a useful intervention on adolescents drug use and has been shown to be effective in
decreasing drug craving, changing attitude toward drug use and also patients coping strategies.
Evaluacin de Habilidades para la Solucin de Conflictos Sociales en Nios
Preescolares
Miguel Montes de Oca, Lizbeth Vega.
Facultad de Psicologa, Universidad Nacional Autnoma de Mxico, Mxico D. F., Mexico.
Abstract Central: Resulta de gran importancia conocer las habilidades conductuales y de
procesamiento de informacin social para la solucin de conflictos sociales en nios

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preescolares, as como la relacin entre ellas, para fortalecer el conocimiento respecto de estas
habilidades de los nios en el contexto de su socializacin. Se parte del supuesto de que las
habilidades de procesamiento de informacin social son determinantes del comportamiento
social (Crick y Dodge, 1994; Mayeux y Cillessen, 2003; Mize y Cox, 1989; Stetson, Wright y
Juliano, 2006; Tur-Kaspa, 2004 y Webster-Stratton y Lindsay, 1999). El objetivo del presente
estudio es examinar si las habilidades de procesamiento de informacin social para la solucin
de conflictos sociales, que proporcionan nios preescolares ante un conflicto social hipottico,
se relacionan con sus habilidades conductuales para la solucin de conflictos sociales.
Participaron siete nios preescolares de entre cinco y seis aos de edad de un Centro de
Desarrollo Infantil (CENDI) de la Ciudad de Mxico, con previa autorizacin de los padres. Los
datos conductuales se obtuvieron mediante el Sistema de observacin conductual de las
interacciones sociales (SOC-IS) de Santoyo, Espinosa y Bach (1994) y registro anecdtico en
el aula durante el juego libre, por observadores entrenados. La evaluacin de las habilidades
de procesamiento de informacin social, se obtuvo mediante las respuestas que dieron los
nios prescolares a una entrevista de Tur-Kaspa (2004) basada en el modelo procesamiento de
informacin social de Crick y Dodge (1994). Los resultados muestran la posible relacin entre
las habilidades conductuales para la solucin de conflictos sociales y las habilidades de
procesamiento de informacin social para la solucin de conflictos sociales hipotticos.
Using Brief, Low Intensity Parenting Interventions Across Context and Culture
Alina Morawska1, Alina Morawska1, Rachel Calam2, Anilena Meja2, Michelle Adamson4, Kaitlin
Hinchliffe1, Sergio Barroilhet3, Divna Haslam1, Rachel Calam2, Matthew Sanders1, Jorge Gaete3,
Francisca Puga1, Rosemarie Fritsch3, Carolina Araya3, Camila Seoret3, Eloise Conrad1, Wes
Felsman1, Divna Haslam1, Carolina Barrueto3, Matthew Sanders1, Matthew Sanders1.
1. The University of Queensland, Brisbane, QLD, Australia, 2. The University of Manchester,
Manchester, United Kingdom, 3. Universidad de los Andes, Santiago, Chile, 4. University of
Southern Queensland, Hervey Bay, QLD, Australia.
The case for prevention and early intervention of child behavioural and emotional problems is
compelling. These problems are widespread; behavioural parenting programs are the most
empirically supported intervention for both prevention and treatment; yet treatment services
reach only a small number of parents who might benefit. A population health perspective needs
to be taken to address barriers to participation, to increase participation rates, and subsequently
reduce the prevalence rates of child behaviour problems. Such an approach requires the
provision of brief targeted support for parents with low to moderate levels of need as a means of
preventing the development of more significant problems.
While some families and children require intensive, tailored support, in this symposium, we
make the case for the value of brief parenting interventions as likely to be sufficient for many
families and likely to offer better accessibility and reach in a public health context. The Triple PPositive Parenting Program is used as an example of a multilevel system of parenting support to
illustrate the potential advantages of blending universal and indicated intervention components
within the same integrated multilevel system of evidence based parenting interventions, to
reduce the prevalence of behavioural and emotional problems in children. The guiding
assumption is that interventions need to be flexible in meeting the needs of diverse parents
across cultures, in the context of quality, evidence-based parenting support being available to all
families. The four studies in this symposium provide examples of how brief approaches can be
adapted to working with particular groups, across culture.
The first study in this symposium describes evaluations of a parenting intervention for working
parents. The presentation will highlight the value of focusing on working parents, and the key
elements of an effective, brief intervention for this group. The second study exemplifies the

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cross-cultural efficacy of a seminar series designed to be delivered to large groups of parents.


Data will be presented from an evaluation of the Triple P Seminar series in Chile, demonstrating
how interventions developed in different contexts can be applied cross-culturally. The third study
shows how brief, targeted parenting interventions can be applied with families who experience
mealtime difficulties in toddlers and preschool age children, illustrating how such an intervention
might need the very high demand for intervention in this situation. Finally, the fourth study
examines the effectiveness of the discussion group format in a cross-cultural environment. This
presentation will provide data from a randomised controlled trial of a 2-hour discussion group for
parents in Panama. While each study targets a different high-risk population, setting, or
problem, the principles and intervention elements are all based within Triple P. Each study
illustrates how evidence based parenting interventions can be adapted for a variety of risk
factors, conditions, and clinical settings within a comprehensive system of parenting
interventions. An integrating discussion will bring together key themes and conclusions from
these four studies.
Evaluating the efficacy of a brief seminar series aimed at reducing work-family conflict in
working parents with young children.
Background: Working parents face unique challenges related to balancing work and family and
their children are at risk for developing behavior problems however few working parents seek
assistance due to stigma and time pressures. Providing brief workplace parenting support has
the potential to improve the work and family lives of working parents.
Objective: This study evaluates the efficacy of a brief, light touch seminar intervention aimed at
reducing work and family conflict and improving functioning in parents of young children.
Design: Randomized controlled trial methodology was used to evaluate the efficacy of
Workplace Triple P Seminar Series over three time points: Pre-intervention, post-intervention
and at four months follow up. One hundred and twenty-six working parents with children aged 212 years participated in the trial and were randomly assigned to the intervention condition or a
waitlist control condition. Participants in the intervention received two 90 minutes seminars
covering a content including: Positive parenting, stress management techniques, strategies for
reducing work-family conflict and strategies to assist with high-risk transitions times.
Results It was hypothesized that the brief intervention would be effective at improving a range of
work and family functioning variables. Specifically, we hypothesized that compared to parents in
the waitlist control condition parents who received the intervention would report improvements in
work-to-family conflict, family-to-work conflict, personal stress, parenting efficacy, parenting
style, and child behavior problems. A series of repeated measures ANOVAs and mixed factorial
ANOVAs provided support for all hypotheses and results were maintained at 4-month follow up.
Discussion: Results indicate a brief, light touch seminar intervention can be effective at reducing
work-family conflict and stress, and improving family functioning in parents with young children.
The potential for workplace delivery of light touch will be discussed as well as the implications of
using workplace interventions as an avenue for increasing overall levels of parental access to
support.
Evaluation of a brief universal intervention on positive parenting in low income Chilean
schools
Background: There is empirical support for the efficacy of a brief universal parenting
interventions in improving child behavior and parenting variables in the developed world, but
data on low-income populations in developing countries is still lacking.
Objective: The aim of the study was to evaluate the effects of a brief seminar intervention to
foster parenting skills among primary caregivers of children attending low-income Chilean
schools.
Study Design: A quasi-experimental comparison control design was used to examine the effects

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of a three session positive parenting seminar series on a range of child and family variables.
Participants were 403 parents or primary caregivers of 365 pre-school to grade six grade school
children attending either the intervention school (n = 157) or the comparison control school (n =
246). Both schools were located in high risk, low-income areas. The intervention was
disseminated using a staggered approach starting with the intervention school. Data was
collected from all parents at three time points: pre-intervention, 6 weeks post-intervention and 6
months follow-up. A range of outcome variables was examined including child behavior (primary
outcome), child adjustment, parental efficacy, parenting style, parental & family adjustment, and
depressive symptoms. Three conditions were compared: i) full exposure (attendance at all three
seminars); ii) partial exposure involving attendance at a single introductory seminar; iii) waiting
list control group. It was hypothesized that parents who received the intervention would report
greater family functioning at post-intervention than those in the control condition and that effects
would be maintained at follow up. It was also hypothesized that a dose effect would be present
such that parents who received full exposure would report greater improvements than those
who received partial exposure.
Discussion: This is the first trial in Chile of brief universal intervention on positive parenting in a
low-income school and one of the first to examine the effects of a brief parenting intervention in
a developing country. Results of the evaluation and implications will be discussed.
Hassle Free Mealtimes Triple P: Evaluation of a brief parenting group for childhood
mealtime difficulties
Mealtime difficulties are very common in typically developing young children, affecting up to
45% of toddlers and pre-schoolers. These difficulties are not necessarily transient, and cause
considerable stress for families, and thus easily accessible, wide-reaching, early intervention is
needed to meet demand for assistance, and prevent the development of serious feeding
problems. Behavioural parenting interventions are efficacious in treating childhood mealtime
problems, however, existing programs are long, intensive, and costly, and have largely been
evaluated in the context of children presenting with disabilities or medical conditions. The
current study aimed to evaluate the efficacy of a brief parenting discussion group for young,
typically developing childrens mealtime difficulties. Eighty-six families of 2- to 5-year-old
children with mealtime difficulties participated in a randomised controlled trial of Hassle Free
Mealtimes Triple P (Morawska & Sanders, 2012), a 2-hour discussion group on positive
parenting strategies specific to the mealtime context. Results of parent-report measures showed
that after intervention, there were significant improvements with large effect sizes in childrens
mealtime behaviour, parents mealtime practices and cognitions, and both mealtime and general
parenting confidence, compared to a waitlist control group. Parents also reported high
satisfaction with the program. The current study supports the efficacy of a brief parenting
discussion group for childhood mealtime difficulties. Six-month follow up of intervention families
will be collected by January 2013 and data will be available for the conference. This costeffective format of intervention is better able to meet the high demand for assistance with young
childrens mealtime difficulties, in the context of a public health approach.
Effectiveness of parenting programs across cultures: The case of the Triple P Positive
Parenting Program in Panama
BACKGROUND: Most evidence-based parenting programs have been developed and tested in
Europe, Australia and the United States. A recent literature review of parenting programs
suggested that very few trials have been carried out in low and middle income countries (LMIC).
There is a need to disseminate existing evidence-based parenting programs into other
countries, where families are surrounded by socio-economic realities which increase their
likelihood of difficulties. However, are these existing interventions effective across cultures and
contexts? The aim of this study was to determine the effectiveness of an existing parenting

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program developed in Australia, the Triple P Positive Parenting Program, in the Latin American
context, specifically in Panama.
METHODS: One-hundred and eight parents from low-income communities in Panama took part
in a randomized controlled trial with two groups, intervention and waiting list. The intervention
was a brief, one-session Triple P Discussion Group on dealing with disobedience. The main
outcome measure was the Eyberg Child Behavior Inventory (ECBI) to assess internalizing and
externalizing problem behaviors. Other outcome measures were parent stress (Depression
Anxiety Stress Scale 21), parenting style (Parenting Scale) and parental confidence (Parenting
Task Checklist). Blind assessments took place 2 weeks, 3 months and 6 months after the
intervention.
RESULTS: Effect size from T1 to T2 was d=1.08 for the ECBI Intensity Scale and d=0.81 for the
ECBI problem scale. ANCOVA analyses suggested that the short-term effect on child outcomes
(ECBI scores) were significant from T1 to T2, F (2) = 27.02, p < 0.01 and F (2) = 14.72, p <
0.01. Parent stress (DASS-21) and ineffective parenting practices (PS) were also significantly
reduced from T1 to T2. Effect size from T1 to T2 was d= 0.46 for the DASS-21 and d=0.86 for
the PS. Three and six-month follow ups will take place between September and December
2012, and these results will be available at the conference.
CONCLUSION: Results suggest that Triple P discussion groups are effective in reducing child
behavioral difficulties, parent stress and ineffective parenting practices in families from lowincome communities in Panama. Future studies should measure the effectiveness of large-scale
preventative systems in similar settings of Latin America.
O Outro Contexto da Gravidez na Adolescncia
Samuely Moreira Zorzan Oliveira, Patrcia Ribeiro, Luciana Samezima, Vanessa Barbosa dos
Santos.
Pontifcia Universidade Catlica do Paran, Curitiba, Brazil.
A gravidez, em qualquer etapa da vida, requer ajustamentos intrapsquicos e sociais, mas
quando esta ocorre na adolescncia, essa exigncia por adaptao fica ainda maior, pois essa
fase por si s j se caracteriza por profundas transformaes psicolgicas e emocionais. Estar
grvida traz vrios significados para a adolescente, despertando pensamentos e sentimentos
com os quais podem ser difceis de lidar. O Projeto Gestante, realizado em um Hospital
Maternidade pblico do estado do Paran - Brasil, teve como objetivo identificar caractersticas
da histria de aprendizagem das adolescentes, viabilizando uma orientao em relao s
questes emocionais comuns gravidez e ao ps-parto, a partir do entendimento que cada
uma tem sobre o que ser me e como exercer essa funo. A partir da observao da
clientela atendida pelo referido projeto surgiu a ideia da pesquisa, que visou identificar os
estilos parentais presentes na interao das adolescentes com seus pais, com o objetivo de
utilizar esses dados para em seguida, elaborar e propor novas estratgias de interveno com
essas gestantes. Para contemplar os objetivos do projeto, 65 adolescentes gestantes passaram
por atendimentos individuais, nos quais responderam a um questionrio semiestruturado e
participaram da proposta de pesquisa que teve como instrumento o Inventrio de Estilos
Parentais (IEP). Os resultados apontaram uma realidade inesperada para uma gestao na
adolescncia, na qual 71% das meninas entre 12 e 18 anos estavam amasiadas e 32%
planejaram sua gravidez. Entretanto, ao analisar os dados socioculturais obtidos nas
entrevistas, percebe-se que o planejamento da gravidez est diretamente relacionado ao meio
cultural das mesmas, demonstrando a relao entre a histria de aprendizagem, cultura e a
perspectiva de vida. Alm disso, foi identificado o Estilo Parental de Risco em mais de 50% dos
pais dessas adolescentes, apontando a influncia das prticas educativas negativas no
engajamento dos filhos em situaes de risco, como a evaso escolar e a gravidez precoce.

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Utilidad del IVA/CPT Como Medida de Eficacia Teraputica del Neurofeedback Aplicado a
Nios Espaoles con TDAH
Inmaculada Moreno Garca, Gracia Delgado Pardo, Carlos Camacho Vara del Rey, Carmen
Roldn Blasco.
Personalidad, Evaluacin y Tratamiento Psicolgicos, Universidad de Sevilla.Espaa, Sevilla,
Spain.
Abstract Central: Introduccin: Los tests de ejecucin continua (Continuous Performance
Test-CPT) constituyen herramientas objetivas para evaluar atencin sostenida e inhibicin. Han
resultado eficaces como instrumentos de evaluacin y para monitorizar los efectos teraputicos
(Madaan et al., 2008). El Integrated Visual and AuditoryContinuous Performance Test
(IVA/CPT) (Sandford y Turner, 1995) permite evaluar sintomatologa hiperactiva-impulsiva e
inatencin a nivel visual y auditivo. En el tratamiento del TDAH, el IVA/CPT se ha empleado
para comparar los efectos de la terapia farmacolgica con respecto a modificaciones en las
pautas conductuales (Harding, Judah y Gant, 2003) y en relacin a Neurofeedback (Yan et al.,
2008; Moreno et al., 2011), encontrndose diferencias significativas en las escalas de atencin
y control conductual. Smith y Sams (2005) obtuvieron cambios significativos en sintomatologa
inatenta observados en adolescentes con comportamientos disruptivos tratados con
neurofeeback. Tinius y Tinius (2000) hallaron diferencias significativas, en inatencin e
inhibicin conductual al comparar adultos con TDAH y un grupo control. Objetivo: Este trabajo
pretende determinar la utilidad del IVA como medida de eficacia teraputica respecto a los
tratamientos recomendados para el TDAH (Neurofeedback, Terapia Conductual y Tratamiento
Farmacolgico) en poblacin espaola. Se analizan los resultados teraputicos atendiendo a la
sintomatologa atencional e hiperactiva caracterstica. Mtodo.:Han participado 43 sujetosde
ambos sexos, con edades comprendidas entre 7 y 14 aos remitidos para estudio con
sospecha del TDAH, segn instrumento de screening empleado (SNAP-IV). (Swanson, 1995) y
una vez confirmado el diagnstico de acuerdo a criterios DSM-IV (APA, 2000). Los nios han
sido asignados aleatoriamente a tres condiciones experimentales: Tratamiento Farmacolgico,
Terapia de Conducta y Neurofeedback. Resultados. Se ha estimando la utilidad del IVA a partir
del cambio registrado, tras los tratamientos, respecto a las medidas pre-tratamiento. Se han
realizado comparaciones intragrupo a travs de contrastes de medias de cada uno de los
tratamientos administrados y en relacin a los dos periodos de evaluacin descritos, pre y posttratamiento. Asimismo, se ha efectuado anlisis de varianza ANOVA, para la comparacin
intergrupos(Conductual, Neurofeedbacky Farmacolgico). En todos los casos, se ha estimado
el tamao de efecto. Los resultados muestran, en las comparaciones intragrupo, diferencias
significativas en la mayora de las variables estudiadas y respecto a cada uno de los
tratamientos, oscilando los tamaos de efecto entre 1,69 y 0,47. La eficacia intergrupo revela
mejores resultados del neurofeeback y terapia conductual en las variables relacionadas con el
control e inhibicin del comportamiento. Conclusin.: El IVA/CPT es una medida til para
determinar la eficacia de los tratamientos empleados en menores, espaoles, con TDAH.
Es Eficaz el Neurofeedback en Comparacin con los Tratamientos Conductual y
Farmacolgico? Un Estudio con Poblacin Espaola
Inmaculada Moreno Garca1, Gracia Delgado Pardo1, Jos Snchez Blanco2.
1. Personalidad, Evaluacin y Tratamiento Psicolgicos, Universidad de Sevilla.Espaa, Sevilla,
Spain, 2. Servicio Andaluz de Salud, Sevilla, Spain.
Abstract Central: Introduccin: De acuerdo con Leins, Goth y Hinterberger (2007) existen ms
de 20 estudios cientficos que informan de efectos positivos del neurofeedback en el TDAH. La
mejora constatada a travs de informes de padres y profesores se refieren a impulsividad,

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hiperactividad y distractibilidad (Monastra et al., 2002). Alambra, Fowler y Alambra (1995) han
hallado que el tratamiento correlaciona con reduccin en la dosis de medicacin y en algunos
casos sus efectos han permitido la supresin del frmaco administrado a los nios con TDAH
(Lora y Moreno, 2011). Investigaciones posteriores confirman el mantenimiento de los efectos
durante seis meses (Moreno, Lora, Meneres y Aires, 2011) si bien sealan la necesidad de
optimizar e individualizar los protocolos existentes e insertar esta opcin teraputica en un
tratamiento multimodal (Grevensleben, et al., 2010). Estos hallazgos confirman que el
neurofeedback puede considerarse como probablemente eficaz en estos casos (Monastra,
Lynn et al., 2005; Lofthouse et al., 2011) Mtodo. Han participado 43 sujetos de ambos sexos,
con edades comprendidas entre 7 y 14 aos remitidos para estudio con sospecha del TDAH,
segn instrumento de screening empleado (SNAP-IV). (Swanson, 1995) y una vez confirmado
el diagnstico de acuerdo a criterios DSM-IV-TR (APA, 2000). Los participantes han sido
asignados aleatoriamente a una de las condiciones experimentales, coincidentes con el tipo de
tratamiento estudiado: Neurofeedback, (N=16), Terapia Conductual (N=16) y Farmacolgico
(N=11). El tratamiento, en los tres grupos se ha prolongado durante 20 semanas, realizndose
dos sesiones de neurofeedback cada semana. Han sido administrado en la fase pretratamiento y post-tratamiento los siguientes instrumentos: (Sandford y Turner, 1995), ADHDRating Scales-IV de DuPaul et al. (1998) para padres y maestros y Attention Deficit Disorders
Evaluation Scale (ADDES) (McCarney, 2004) Resultados: La eficacia del Neurofeedback se ha
evaluado a partir de medidas intragrupo y comparando sus efectos con los resultados
obtenidos por los tratamientos conductuales y farmacolgico. En ambos casos se han
considerado tres fuentes de informacin; el nio con TDAH, sus padres y el profesor. El cambio
logrado por Neurofeedback ha sido evidenciado a travs del Integrated Visual and Auditory
Continuous Performance Test (IVA/CPT), habindose obtenido diferencias significativas en
todas las variables referidas a inatencin y mayormente en las relacionadas con control e
inhibicin del comportamiento. Esta mejora tambin ha resultado significativa a travs de los
informes del profesor respecto a la sintomatologa hiperactiva-impulsiva, alcanzndose valores
de tamao de efecto de 1,349. Los resultados proporcionados por los padres muestran
tamaos de efecto de 0.594. Conclusin: La mejora lograda por el neurofeedback se observa
fundamentalmente en el control e inhibicin de los comportamientos alterados.
The Efficacy of Cognitive Behavioral Therapy for Anxiety Disorders in Children with
Pervasive Developmental Disorders : Two Case Reports
Naoyasu Motomura.
psychiatry, Osaka medical college, takatsuki, Osaka, Japan.
BACKGROUND: Children with Autism Spectrum Disorders (ASD) are at increased risk for
mental health problems compared with the general population, especially with regard to anxiety
symptoms. Comorbid anxiety symptoms cause significant functional impairment, school
performance, peer relationships and participating in social activities. However, the study on
psychotherapy for comorbid anxiety symptoms in children with ASD has not been done yet.
METHOD: We used the manualized cognitive behavioral group therapy (CBGT) program
Icchaga-kyousitsu(Ishikawa 2006) for two ASD children with anxiety symptoms, who were
unable to access psychotherapy through mental health services. Icchaga-Kyousitsu has been
identified as the treatment of choice in addressing anxiety symptoms in children with typical
development. The CBGT program emphasized cognitive restructuring and in vivo exposure to
reduce anxiety symptoms. However, it is difficult to apply traditional CBGT program to children
with ASD, considering that their deficits in social interaction, communication problems and
restricted interests. Creating a careful casefomulation, the program is modified for their
coginitive deficit and behavioral patterns.For example, therapists intend children with ASD to

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choose alternatives about own automatic thoughts in cognitive restricting since it is difficult for
them to Identify own automatic thoughts. Children with ASD have more frequency of In-vivo
exposure than children with typical development, having reduced habituation to stimuli. The
group in CBGT consists of children with ASD and children with typical development. Participants
completed a standardized questionnaire, SCAS,CCES and DSRS-C at baseline, posttreatment
and 3-month follow-up assessments. RESULTS: Improvements of anxiety symptoms were seen
when two ASD children with anxiety disorders were treated with modified cognitive behavioral
therapy. In particular, anxiety score was decreased in SCAS. Treatment gains were maintained
at 3-month follow-up. CONCLUSIONS: This report describes a 13-year-old male and a 14-yearold male with ASD who was treated successfully in eight sessions with modified cognitive
behavioral therapy. These two cases highlight the effectiveness of cognitive behavioral therapy
for the treatment of anxiety symptoms in children with ASD and suggest the modified cognitive
behavioral therapy to reduce anxiety symptoms in children with ASD. It is difficult to apply
traditional CBT to children with ASD considering that their deficits in social interaction,
communication problems and restricted interests. They show difficulty to identify own automatic
thoughts in cognitive restricting and reduced habituation to social stimuli in in-vivo exporsure. A
careful case formulation by therapists and participants enabled the modular CBGT program to
be modified successfully for their deficit. However, further investigation of this intervention
modality with larger samples and broader outcome measures appears to be indicated.
Variveis Psicolgicas em um Programa de Promoo de Sade Mental na Infncia
Patrcia Nardi, Carmem Neufeld.
Psicologia, Universidade de So Paulo, Ribeiro Preto, Brazil.
A terceira infncia tem como sua principal caracterstica o perodo escolar e uma fase de
grande desenvolvimento cognitivo, fsico e psicossocial nas crianas. Para lidar com estes
desafios, necessrio que, cada vez mais as crianas possuam um repertrio de habilidades
sociais, habilidades de identificao e manejo de emoes de forma mais assertiva. Uma
alternativa para melhorar a sade emocional das crianas so as intervenes destinadas a
prevenir e evitar transtornos emocionais do desenvolvimento e promover a sade mental.
Assim, os programas de interveno tem gerado um duplo benefcio de reduzir problemas
atuais pelo qual a criana pode estar passando e aumentar as competncias e habilidades para
problemas futuros. Estas intervenes tm como objetivo desenvolver habilidades sociais como
a empatia, a comunicao, como lidar com emoes e estresse, soluo de problemas e
tomada de deciso. O presente trabalho objetiva testar o efeito um programa de
promoo/preveno de sade mental em crianas em Terapia Cognitivo-Comportamental.
Participaram do estudo 22 crianas com idades entre 8 e 10 anos de idade que cursavam o
terceiro ano do Ensino Fundamental de uma escola pblica de Ribeiro Preto - SP. Os
instrumentos utilizados foram: Escala Multidimensional de Ansiedade para Crianas - MASC;
Escala de Stress Infantil; Childrens Depression Inventory; Sistema Multimdia de Habilidades
Sociais em Crianas. O presente estudo envolve um delineamento quase-experimental com
aplicao dos instrumentos de avaliao no pr e ps-teste com os grupos de interveno. Os
participantes foram submetidos a 12 sesses do programa de Habilidades Sociais para
crianas do Laboratrio de Pesquisa e Interveno Cognitivo-Comportamental (LaPICC). Para
verificar a eficcia do programa foram realizadas anlises quantitativa dos dados a partir de
estatstica no-paramtrica. O nvel de significncia adotado para este estudo de = 0,05
com intervalo de confiana de 95%. Os resultados sugerem que as todas as crianas
participantes do estudo obtiveram uma melhora nos sintomas depressivos. Para o grupo (E1)
houve melhora estatisticamente significativa nos ndices de reaes fsicas e psicolgicas ao
estresse e nos itens de frequncias no-habilidosas ativas e passivas. Para o grupo (E2) os

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resultados sugerem uma piora no escore total para a varivel estresse e para o item reao
psicolgica ao estresse. Este trabalho tem como objetivo secundrio fornecer embasamento
terico para novas discusses e pesquisas a uma demanda que a cada dia se torna mais real e
expressiva na populao infantil.
Interaes Familiares e Desenvolvimento de Padres Antissociais de Comportamento
Lgia Fernanda Nascimento Roma, Yanne Azevedo.
Universidade Ceuma, So Lus, Brazil.
A famlia o contexto onde os primeiros padres comportamentais so aprendidos para
posteriormente serem generalizados nas demais interaes sociais. Dessa forma, as relaes
parentais foram enfatizadas neste trabalho, visto que essas interaes podem proporcionar a
manuteno de comportamentos adequados ou no. Dentre os comportamentos inadequados
influenciados pelo ambiente familiar, foram selecionados para anlise os padres antissociais
de comportamento, caracterizados pelas manifestaes comportamentais agressividade,
conduta delitiva, oposicionismo, dentre outras. Todavia, a perspectiva analtico-comportamental
adotada para a compreenso do comportamento antissocial no presente trabalho, considera-o
como resposta ao contexto onde o indivduo est inserido, sendo explicado pelos nveis de
variao e seleo, necessitando da investigao da histria de vida da criana para
identificao dos fatores a ela relacionados, dentre eles as interaes parentais. Essa pesquisa
trata-se de um estudo de caso envolvendo uma me cujo filho do sexo masculino com nove
anos de idade apresenta prottipos de comportamento antissocial (agressividade, birras). A
pesquisa enfatiza a investigao das Habilidades Sociais Educativas Parentais, pois esta
anlise permite a observao das prticas parentais mais frequentes no caso analisado,
buscando a identificao de um estilo parental e apontando relaes entre este estilo e padres
antissociais. Pretende-se ainda propor algumas estratgias de interveno. Como instrumento,
utilizou-se o Roteiro de Entrevista de Habilidades Sociais Educativas Parentais. Os resultados
demonstraram dficit habilidades sociais em me e filho, uso frequente de prticas coercitivas
de educao, escore clnico para problemas de comportamento infantil e classificao em estilo
parental autoritrio da interao materna. Intervenes que possibilitem o aumento de
habilidades sociais na criana e na me e a orientao parental visando diminuio das
prticas educativas negativas so consideradas eficazes para a promoo da qualidade na
relao parental e desenvolvimento satisfatrio da criana.
Impact of an Emotional Regulation Skills Training Program on the Level of Negative
Emotions in Situation of Exam: Analysis of Interactive Effects with Gender
Alvaro Ortiz, Germn Pereno, Luciana Moretti, Leonardo Medrano.
Universidad Empresarial Siglo 21, Cordoba, Argentina.
There was evaluated the effectiveness of an emotional regulation skills training program for
university students analyzing its impact on negative emotions that experience before take an
exam. Throughout six weeks, there was requested to students were present at a weekly
meeting of an hour of duration. The program involved a psycho-educational module where
explanations were transmitted on the functioning of the emotions, the second module centered
on cognitive techniques that involving reinterpretation-based emotion regulation strategies and
decrease of rumination, and finally, a module centered on relaxation strategies. To evaluate the
level of negative emotions, the subscale of negative emotions of Positive Affect-Negative Affect
Scale (PANAS) was administrated before take an exam. This scale was administrated in a
control group too. The information was analyzed in a two-way factorial ANOVA, because it was

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trying to examine in addition if the gender of participants was interacting with the effects of
training program. The obtained results suggest that the participants who received treatment
showed low levels of negative emotions during the execution of an exam in relation to control
group (F =2.22; p 0.05). Similarly, is observed a significant interactive effects with gender of
students (F =8.73; p 0.05), which demonstrated that the program presents a major effect on
men. Although new researchers would be needed to determine with major accuracy the factors
that cause an effect of interaction with gender, the obtained results maintain the effectiveness of
an emotional regulation skills training program to diminish the levels of negative emotions in
situation of exam.
Cambios Cognitivos en Escolares Diagnosticados con Trastorno por Deficit de Atencin
e Hiperactividad (TDAH) Tratados con Arte-Terapia
Ana Padron, Gabriela Gallardo Saavedra, Mara del consuelo Martnez Wbaldo.
Instituto Nacional de Rehabilitacion, Mexico City, Mexico.
Abstract Central: El Trastorno por dficit de atencin (TDAH) es una patologa comn en la
edad escolar. Su prevalencia a nivel mundial est reportada entre el 1.7 y el 17% en pases
desarrollados. En Mxico hay estimaciones que indican que hay 1,500,000 de nios, el sexo
predominante es el masculino. El tratamiento debe ser multidisciplinario. El arte-terapia es una
disciplina de reconocimiento internacional, de uso reciente en Latinoamrica aplicada a la
salud. Objetivo General: Comparar los cambios cognitivos antes y despus del tratamiento con
Arte-Terapia. Material y Mtodo: Se evaluaron 19 nios con TDAH con Dx. de Paidopsiquiatra
en edad escolar, Se utiliz para valoracin antes y despus del tratamiento: Conners 3R,
WISC-IV, Bender ,DFH, y TALE .Para la intervencin con arte-terapia los nios fueron
expuestos a 9 talleres artsticos con una hora de duracin cada una a la semana durante seis
meses. Resultados: Se estudiaron 19 nios distribuidos: 6 nias y 13 nios que al iniciar el
tratamiento contaban con una edad de 7 aos. Edad de las madres 33 aos y de los padres 35.
Se presentan datos sociodemogrficos de ellos. Se reportan las reas estimuladas en WISC-IV
y en T.A.L.E. Tambin de los cuestionarios de Conners. Se reportan cambios a nivel cualitativo
en cuanto a integracin grupal, capacidad de relacin, control de impulsos en actividades, etc.
son importantes en la descripcin del trabajo. Se necesita probar por un tiempo ms largo el
tratamiento para lograr un mayor conocimiento de los cambios cognitivos. Keywords: ADHD,
WISC-IV, TALE, schoolchildren, Art-therapy
Desafios contemporneos da clnica psicolgica na realidade brasileira: ampliao da
sua escuta na promoo de sade mental
Neuza Cristina Perez1, Carmen Amorim-Gaudncio2, Neuza Cristina Perez1, Deborah
Cavalcante1, Gilciane Silva1, Nilse Chiapetti2, Beneria Donato3, Carmen Amorim-Gaudncio2.
1. Psicologia, Universidade Federal do Piau (UFPI), Parnaba, Brazil, 2. Universidade Federal
da Paraba (UFPB), Joo Pessoa, Brazil, 3. Faculdade Estcio, Recife, Brazil.
Dra. Neuza Cristina dos Santos Perez - Departamento de Psicologia - Universidade Federal do
Piau
Segundo a Organizao Mundial da Sade (OMS) em 2020 os transtornos mentais sero
considerados a segunda maior causa de problemas sociais aps a doena cardaca. Apesar
deste aumento gradual da incidncia, os investimentos relativos preveno em sade mental
so nfimos. Quando se trata da sade mental voltada para a infncia o investimento ainda
menor. O termo sade mental muitas vezes fica restrito ao atendimento psiquitrico, deixando
margem problemas emocionais e comportamentais, que no surgem necessariamente pela

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instaurao de um transtorno. , mas que podem apresentar uma evoluo gradual e


acumulativa ao longo do desenvolvimento. No obstante, muito delicado e complexo falar em
diagnstico na infncia, tendo-se em considerao as especificidades desta etapa. Nesta fase
o limite entre uma conduta considerada normativa e uma considerada de risco ao
desenvolvimento saudvel infantil muito tnue, podendo contribuir a que dificuldades de
ordem comportamental e/ou emocional passem despercebidas sem receberem ateno e
interveno apropriadas. Desde uma perspectiva desenvolvimental, o psicopatolgico aparece
com frequncia como a evoluo de um processo que, na origem, era normal. Diante da
panormica apresentada pode-se perceber que as demandas nos servios pblicos relativos
sade mental tm aumentado consideravelmente a nvel mundial, denotando sua relevncia
clnica e social. Assim sendo, o objetivo desta mesa apresentar trabalhos que esto sendo
realizados em diferentes faixas etrias e que prope a ampliao da escuta psicolgica a
diferentes contextos sociais. Os conferencistas buscam propor estratgias de interveno que
contribuam ao desenvolvimento e potencializao dos recursos pessoais de forma
individualizada e em grupo na abordagem cognitivo-comportamental. Intervenes que visem
gerar processos protetivos no curso do ciclo evolutivo, favorecendo assim o desenvolvimento
dos sentimentos de autoestima e de auto eficcia. Trabalhos que busquem, sobretudo,
contribuir construo da singularidade e da cidadania, na medida em que se abre uma
possibilidade de mudana a partir dos recursos pessoais que cada um possui para operar na
sua realidade. Assim sendo, pode-se dizer que esta mesa de trabalho busca a ampliao da
clnica, no s em virtude do descentramento do espao fsico ou da prxis realizada, mas,
sobretudo, pelo posicionamento frente realidade social. Vale pontuar ainda que as prticas
realizadas pelos conferencistas tm propiciado aos psiclogos em formao estabelecer um
dilogo entre teoria e prtica, possibilitando o desenvolvimento das habilidades e competncias
necessrias prtica profissional. Esta prxis tem proporcionado ainda a ampliao da viso
dos estagirios em relao s inmeras possibilidades de atuao da psicologia na
contemporaneidade, uma vez que as intervenes previstas se ampliam medida que se
conhece a realidade e as demandas especficas de cada realidade. Desta forma, esta prtica
tambm tem contribudo ao desenvolvimento de um pensamento crtico-reflexivo acerca das
aes que podem ser realizadas no campo da psicologia.
Palavras-chave: sade mental, preveno, problemas de comportamento e ou emocional
Interveno cognitivo-comportamental em grupo: estratgia promotora de sade mental
na infncia
Dra. Neuza Cristina dos Santos Perez - Departamento de Psicologia - Universidade Federal do
Piau
Especialista Deborah Rodrigues Cavalcante - Universidade Federal do Piau
Estudante Gilciane dos Santos Silva - Departamento de Psicologia - Universidade Federal do
Piau
A Organizao Mundial da Sade (OMS) apontou que em 2020 os transtornos psicopatolgicos
sero considerados a segunda maior causa de problemas sociais aps a doena cardaca.
Apesar deste aumento gradual de incidncia, os investimentos relativos preveno em sade
mental zero, se comparado aos realizados em relao s doenas fsicas. O termo sade
mental muitas vezes fica restrito ao atendimento psiquitrico, deixando margem problemas
emocionais e comportamentais, que no surgem necessariamente pela instaurao de um
transtorno. Vale ressaltar que a maioria das crianas que apresentam problemas de
comportamento no cumprem os critrios para serem atendidas em um Centro de Ateno
Psicossocial Infanto-Juvenil. Assim sendo, estudos destinados descrio, avaliao e
interveno de comportamentos perturbadores na infncia ajudariam a evitar que se tornem
crnicos e evoluam a transtornos mais graves em etapas posteriores do desenvolvimento.
Assim sendo, este trabalho visa em um primeiro momento (triagem) descrever os

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comportamentos apresentados pelas crianas matriculadas nas escolas pblicas e privadas do


Ensino Fundamental I da cidade de Natal-RN, segundo os informes de pais e professores. Em
um segundo momento avaliar se os comportamentos descritos esto associados a dificuldades
nas relaes interpessoais, na realizao das atividades dirias e/ou ao baixo rendimento
escolar. Em um terceiro momento, oferecer interveno de cunho preventivo em grupo na
abordagem cognitivo-comportamental, quelas crianas em que seja avaliada a presena de
comportamentos que possam colocar em risco o seu desenvolvimento saudvel. Para tanto foi
desenvolvido um estudo de tipo transversal com amostragem simples, dividido em trs etapas
distintas: triagem, avaliao clnica e interveno cognitivo-comportamental em grupo. A
amostra (n=49) composta pelos escolares matriculados em duas das escolas colaboradoras
do projeto. Participaram da segunda etapa destinada entrevista, as crianas que na etapa de
triagem, pontuaram no nvel clnico (n=13) da escala Child Behavior Checklist 6-18. quelas
crianas (n=5) em que se avaliou presena de dificuldades nas relaes interpessoais, na
realizao das atividades dirias e/ou baixo rendimento escolar foram convidadas a participar
da terceira etapa destinada interveno psicoterpica em grupo. Foram realizados seis
encontros estruturados visando o desenvolvimento de habilidades e competncias sociais. As
dinmicas foram ldicas e psicoeducativas trabalhando os pressupostos bsicos do modelo
cognitivo-comportamental, resoluo de problemas, organizao da rotina e estudos, limites,
tolerncia frustrao, de acordo com a demanda do grupo. As crianas participaram de forma
ativa das atividades e desafios propostos nos grupos. Os resultados observados confirmam a
importncia de trabalhos preventivos em etapas precoces do desenvolvimento, de intervenes
que ajudem as crianas a desenvolverem suas potencialidades, instrumentalizando-as a
enfrentarem e superarem os desafios inerentes ao ciclo evolutivo de maneira natural, como a
maioria das crianas o faz.
Palavras-chave: sade mental, preveno, problemas de comportamento, psicoterapia
cognitivo-comportamental em grupo
Programa preventivo junto s escolas pblicas de Joo Pessoa - Brasil: orientao de
pais em prticas educativas
Dra. Nilse Chiapetti - Departamento de Psicologia - Universidade Federal da Paraba
Grande parte dos padres comportamentais de um indivduo so aprendidos e mantidos no
mbito da relao com os outros membros da famlia, o que confere a esse contexto papel
central na aquisio de um repertrio comportamental. Os pais podem aprender a manejar as
contingncias quando colocam em operao prticas educativas. A orientao de pais,
direcionada aprendizagem de comportamentos socialmente desejveis, eficaz e
potencialmente promotora de repertrios comportamentais mais adaptativos, atuando no
sentido de reduzir comportamentos disruptivos. Com base nessa perspectiva desenvolveu-se
um projeto de pesquisa-interveno com grupos de pais de crianas de 6 a 11 anos, indicadas
por apresentarem problemas de comportamento, direcionado ao enfrentamento de
comportamentos de risco e promoo de comportamentos pr-sociais nas crianas. O
programa, que consistiu em 8 encontros com durao de cerca de 2 horas, e foi desenvolvido
em duas escolas pblicas da cidade de Joo pessoa, iniciou com cerca de 30 pais e/ou mes
ou responsveis, e foi concludo com cerca de 10 pais/mes ou responsveis. Apesar do
elevado ndice de evaso, os pais/responsveis que concluram manifestaram satisfao com o
aprendizado e desejo de que pudessem ter mais oportunidades de tratar das dificuldades que
apresentam na relao com os filhos. Os resultados apontam para uma percepo mais
acurada, pelos pais/responsveis, de aspectos positivos e tambm negativos tanto dos
comportamentos dos filhos, quanto de seu papel em sua modificao ou manuteno,
evidenciando a relevncia de programas como o proposto.
Palavras-Chave: Interveno comportamental, pais, crianas, problemas de comportamento

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Programa Amigos: protocolo de preveno de ansiedade em crianas e jovens


Beneria Yace Donato (Supervisora de Estgio Clnico em TCC- Faculdade Estcio Recife - PE/
Brasil, Parceira Licenciada Internacional do Programa AMIGOS da Pathways Health and
Research Centre - Austrlia)
Na sociedade atual, crianas, jovens e famlias so confrontadas com o estresse e os desafios
do dia a dia. Hoje, crianas e jovens esto mais propensos a desenvolver um transtorno mental
do que h 20 anos. Um estudo australiano recente encontrou a prevalncia de ansiedade em
adolescentes em cerca de quinze por cento. Se deixada sem tratamento, a ansiedade na
infncia pode se desenvolver ao longo dos anos em transtorno(s) de ansiedade crnica em
adultos ou, em alguns casos, em depresso clnica. , portanto, fundamental que a preveno
da ansiedade comece cedo, e que profissionais da sade e da educao estejam equipados
com recursos para ajudar as crianas e suas famlias a desenvolver estratgias eficazes para
lidar com a preocupao, o estresse e as mudanas do dia a dia. Pesquisas apontam que
crianas e adolescentes resilientes - que tm a capacidade de lidar com adversidades - alm
de terem mais sucesso na escola e desenvolverem relacionamentos com amigos de forma
saudvel, so tambm menos propensos a desenvolverem problemas de sade mental. Sendo
assim, so importantes atitudes e orientaes ativas que ajudem crianas, jovens e famlias a
construrem resilincia emocional para melhor lidarem com as tenses da vida. Com esse
intuito, o Programa AMIGOS, de origem australiana, foi criado h 18 anos, e desde ento, vem
desenvolvendo vrias pesquisas e prticas que corroboram os seus objetivos. Considerado
inovador, o Programa AMIGOS foi concebido para ajudar crianas, jovens e suas famlias a
aprenderem habilidades e estratgias importantes que ajudam a lidar com o estresse e a
ansiedade, assim como a gerir situaes difceis e desafiadoras. O programa trabalha com as
emoes, o corpo, a mente e o comportamento, todos de forma integrada ao processo do
desenvolvimento e da experincia. No Programa AMIGOS, as crianas e os jovens vo
aprender de modo divertido e dinmico: estratgias de relaxamento, a administrar as
dificuldades e a reconhecer os sinais de ansiedade, alm de desenvolver o pensamento
positivo, com foco em solues construtivas para os problemas que podem surgir. Por fim,
aprendero como enfrentar e minimizar seus medos atuais ou futuros, assim como estratgias
de resoluo de conflitos. O PROGRAMA AMIGOS um protocolo de interveno e preveno
baseado em evidncias e concebido para promover a preveno em sade mental. O
programa eficaz e sustentvel, e os seus benefcios so levados adiante por muitos anos na
vida. Ele no requer interveno clnica cara e quando includo no contedo curricular de uma
escola se torna um modelo de custo mnimo para os pais. Diferente de qualquer outro
programa baseado em resilincia disponvel, o Programa Amigos tem eficcia comprovada na
preveno da ansiedade por at seis anos depois da exposio inicial. Ademais possui uma
histria de desenvolvimento cientfico com dados extensivamente publicados, e testados em
pesquisa clnica em andamento em todo o mundo.
Palavras Chaves: Programa Amigos, Preveno, Ansiedade.
Eficcia de um programa de interveno cognitivo-comportamental para controlar a
ansiedade frente s provas no ensino mdio
Dra Carmen Amorim Gaudncio - Departamento de Psicologia - Universidade Federal da
Paraba
A ansiedade de avaliao - test anxiety - representa um grave problema em quase todas as
culturas devido ao expressivo nmero de situaes de competio que os indivduos
necessitam enfrentar ao longo de suas vidas. Em funo da vulnerabilidade da pessoa a
apresentar reaes fortes de ansiedade e dos seus recursos de enfrentamento o problema
poder ser importante e limitar sua capacidade de adaptao s demandas do meio. Quase
sempre o incio da exigncia pelo bom desempenho tem sua origem nas situaes escolares.
Essas situaes competitivas ou de superao de desafios acabam gerando uma ativao no

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estudante que, em muitos casos, maior do que a capacidade que tem de controlar-se
voluntariamente. Este problema pode ser importante na vida do estudante e pode contribuir
para o seu fracasso escolar j que, em muitas ocasies, ocorre independente da capacidade
cognitiva, hbitos de estudo e recursos escolares dos quais se disponha. Por outro lado, a
realizao de provas uma exigncia que faz parte do sistema de avaliao utilizado na
contemporaneidade e dificilmente o estudante poder se livrar desta exigncia. Portanto, faz-se
necessria uma interveno de carter preventivo ou de segunda ordem, no sentido de
oferecer ao aluno estratgias de coping que lhe sirvam para superar o problema da situao de
prova em toda sua magnitude (antes, durante e depois de sua realizao), assim como permita
a generalizao do aprendido s situaes futuras como podem ser a realizao de concursos,
entrevistas para emprego, apresentaes de trabalhos em congressos e um sem fim de
situaes onde a pessoa poder ser avaliada e que tm um papel decisivo no futuro pessoal e
profissional. Em funo da relevncia deste problema, o objetivo do deste estudo foi avaliar a
ansiedade frente s provas em uma amostra de estudantes brasileiros e testar a eficcia de um
programa de tratamento cognitivo-comportamental de curta durao em formato grupal.
Participaram do estudo 32 estudantes de ensino mdio de uma escola particular, cuja maioria
era do sexo feminino (53,1%), de nvel socioeconmico mdio (67%) e uma mdia de idade de
15,5 anos. O programa foi realizado em trs fases: 1) Informao e Avaliao, 2) Tratamento e
3) Avaliao ps-tratamento. Os estudantes foram avaliados atravs do Test Anxiety Inventory
[TAI] (Spielberger, 1980), do Inventario de Situaes e Respostas de Ansiedade [ISRA] (Miguel
Tobal & Cano Vindel, 1994) e de uma entrevista semi-estruturada sobre comportamentos
tpicos em situaes acadmicas, desenhada especificamente para o estudo. Para a anlise
dos dados foi utilizado o software PASW, verso 18. Empregou-se o teste de KolmogorovSmirnov para comprovar a hiptese de normalidade e o teste de Levene para comprovar a
hiptese de homogeneidade das varincias. Os resultados confirmam a eficcia do programa
de interveno com diferenas significativas de mdias pr e ps-tratamento em todas as
variveis avaliadas. Os resultados reforam a utilidade de aplicao deste tipo de tratamento
em populaes estudantis com nveis elevados de ansiedade s provas e que possam ser
prejudicadas em seu rendimento escolar mesmo quando tenham adequados hbitos de estudo
e recursos acadmicos.
Palavras-chave: ansiedade s provas, preveno, interveno psicolgica, estudantes.
Promoo de Sade Mental na Infncia: Desafio na Realidade Brasileira
Neuza Cristina Perez, Gilciane Silva, Sara Ucha.
Psicologia, Universidade Federal do Piau (UFPI), Parnaba, Brazil.
Abstract Central: Sabe-se pouco sobre sade mental na infncia, apesar dos estudos
realizados nesta etapa do desenvolvimento. Este fato deve-se em parte s caractersticas
dessa fase do ciclo evolutivo, a qual marcada por muitas mudanas em vrias reas e de
forma muito rpida. Deve-se tambm ao fato de que a maioria dos comportamentos esperados
nessa etapa (hiperatividade, impulsividade, negativismo, agressividade, desobedincia entre
outros) a mesma que caracteriza os transtornos psicopatolgicos em etapas posteriores do
desenvolvimento. importante destacar que essas dificuldades so superadas de maneira
natural, no obstante, uma pequena parcela, porm significativa de crianas no as superam e
apresentam uma progresso gradual e acumulativa dessas dificuldades ao longo da vida. A
cronicidade dessas dificuldades contribui aos sentimentos de baixa autoestima e de
autoeficcia e ao fracasso escolar, podendo vir a desembocar em problemas mais graves em
etapas posteriores, como deliquncia juvenil, uso e abuso de substncias, ansiedade e
depresso. No obstante, de acordo com a literatura, os cuidados com a sade mental infantojuvenil esto longe de ser prioridade no Brasil. Busca-se, ainda timidamente, atender aos casos
mais graves de transtornos desenvolvimentais. Os casos no clnicos caracterizados por

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dificuldades de ordem comportamental e emocional no recebem ateno e interveno


apropriadas. Fala-se pouco em promoo de sade mental e preveno na infncia, apesar do
Brasil possuir um nmero considervel de jovens que necessitam receber ateno
especializada nesta rea. Este panorama deflagra a urgncia pesquisas de cunho preventivo,
justificando a realizao de um estudo que descreva os comportamentos apresentados pelos
escolares do Ensino Fundamental I da regio de Parnaba-PI, a fim de detectar de forma
precoce possveis dificuldades de ordem comportamental que possam afetar o
desenvolvimento dessas crianas. A pesquisa de tipo transversal com amostragem simples.
Os instrumentos utilizados so as escalas Child Behavior Checklist 6-18 (CBCL 6-18) e
Teachers Report Form 6-18 (TRF 6-18). Acredita-se que os resultados e as aes oriundas
desse estudo, alm de fornecer dados para o planejamento de servios, fomentaro reflexo
sobre as prticas do psiclogo e da importncia de aes de cunho preventivo frente s
mencionadas dificuldades observadas ao incio da idade escolar. Acredita-se ainda que os
resultados evidenciaro a necessidade de discusses sobre polticas de sade mental na
infncia e adolescncia, uma vez que, a grande maioria das dificuldades infanto-juvenis no
justificam a insero do paciente em um Centro de Ateno Psicossocial Infanto-Juvenil
(CAPSi), contudo, indicam a necessidade de avaliao e interveno psicoterpica e/ou
aconselhamento psicolgico, fazendo da preveno uma ferramenta de promoo de sade
mental. Palavras-chave: sade mental, preveno, dificuldades de ordem comportamental e
emocional
Grupo de Pais na Abordagem Cognitivo-Comportamental: Um Estudo Piloto de
Interveno Preventiva
Neuza Cristina Perez, Deborah Cavalcante, Gilciane Silva.
Psicologia, Universidade Federal do Piau (UFPI), Parnaba, Brazil.
Abstract Central: A famlia contempornea vem sofrendo modificaes na sua estrutura e no
modo de educar os filhos, acarretando muitas vezes dificuldades na inter-relao pais-filhos.
Os pais, enquanto formadores do ncleo familiar, so, indiscutivelmente, poderosa fonte de
influncia no desenvolvimento da criana, o que lhes atribui grande responsabilidade. O
contexto familiar, as vivncias e as prticas educacionais esto associados ao desenvolvimento
de habilidades sociais na infncia, assim como ao aparecimento e/ou a manuteno de
problemas de comportamento. Assim sendo, este estudo tem como meta realizar grupos
psicoteraputicos com os pais de crianas matriculadas no Ensino Fundamental I da cidade de
Natal-RN, daquelas que apresentam problemas de comportamento. Trata-se de um estudo de
tipo transversal com amostragem simples, dividido em trs etapas, triagem, avaliao clnica e
interveno psicoterpica em grupo na abordagem cognitivo-comportamental. Na etapa de
triagem buscou-se descrever os comportamentos apresentados pelas crianas matriculadas
em duas das escolas colaboradoras do estudo, para tanto foi usada a escala Child Behavior
Checklist 6-18 (CBCL). Na segunda etapa avaliou-se se os comportamentos daquelas que
pontuaram no nvel clnico da CBCL (n=13) estavam associados a dificuldades nas relaes
interpessoais, na realizao das atividades dirias e/ou ao baixo rendimento escolar. Aos pais
daqueles escolares em que se encontrou tal associao foi oferecido atendimento
psicoteraputico em grupo na abordagem cognitivo-comportamental (n=5). Foram realizados
quatro encontros quinzenais visando o desenvolvimento de habilidades e competncias
parentais. As dinmicas realizadas tinham como meta psicoeducar os pais no modelo
cognitivo-comportamental, nas teorias da aprendizagem, resoluo de problemas, rotina, lazer,
limites e organizao. Os pais participaram de forma ativa dos grupos e ao final do trabalho
solicitaram que fosse avaliada a possibilidade de oferec-los de forma regular junto s escolas
de Ensino Fundamental. Considera-se que o desenvolvimento de habilidades e competncias

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parentais, contribua qualidade das relaes familiares e consequentemente ao processo


desenvolvimental infantil saudvel. Desenvolvimento e sade so processos que andam de
mos dadas, assim o processo sade-doena pode ser entendido como uma expresso
singular do processo geral da vida social. Nesse processo a qualidade de vida, a qualidade das
relaes estabelecidas nas etapas iniciais do ciclo evolutivo essencial ao desenvolvimento
saudvel infantil. Palavras-chave: Terapia cognitivo-comportamental em grupo; pais; preveno
Indicadores de Salud Mental Mediante el Mental Health Inventory Online en Nios y
Adolescentes Espaoles
Jose Piqueras, Mariola Garcia-Olcina, Maria Rivera-Riquelme, Jose Espada, Mireia Orgiles,
Jose Carballo, Tiscar Rodrguez-Jimnez.
Psicologa de la Salud, Universidad Miguel Hernndez de Elche, ELCHE, Spain.
El estudio de la salud mental presenta un sesgo muy extendido consistente en equipararla con
ausencia de enfermedad mental o trastorno psicolgico. Sin embargo, un punto en comn, en
el cual coinciden los expertos, es que "salud mental" y "enfermedades mentales" no son dos
conceptos opuestos, es decir, la ausencia de un reconocido desorden mental no indica
necesariamente que se tenga salud mental y, al revs, sufrir un determinado trastorno mental
no es bice para disfrutar de una salud mental. Este mismo sesgo puede hallarse en el
desarrollo de medidas de salud mental, tanto adultos como en nios y adolescentes. As, hay
pocos instrumentos estandarizados disponibles para evaluar la salud mental de nios y
adolescentes que no se centren exclusivamente en los sntomas psicopatolgicos. El Mental
Health Inventory (MHI) es una medida de 38 tems, desarrollado para su uso con poblacin
general, que evala tanto el malestar o psicopatologa como el bienestar psicolgico o salud
mental. Tiene una versin ms corta de 5 tems (MHI-5), basada en los tems que mejor
reproducen la puntuacin total del MHI. Han sido validados para uso en poblacin adulta en
diferentes idiomas y para adolescentes de habla portuguesa. El objetivo de este estudio es
conocer los datos de salud mental en poblacin infantil y adolescente espaola a partir del MHI
y el MHI-5. La muestra estuvo formada por dos grupos. El primero grupo, formado por 1000
adolescentes (edad media = 15.73; DT = 1.20; rango = 12-18), cumpliment el MHI. El segundo
grupo cumpliment el MHI-5, estando formado por 1000 sujetos (edad media = 11.44; DT =
2.04; rango 8-18 aos). La distribucin por sexo fue equitativa. En primer lugar, se creo la
versin espaola europea del MHI y el MHI-5 siguiendo las especificaciones proporcionados
por RAND Health, Posteriormente se aplicaron a las muestras los siguientes instrumentos: un
cuestionario sociodemogrfico, el cuestionario DETECTAWEB, el RCADS (Revised Child
Anxiety and Depression Scales) y el MHI (primer curso de secundaria a segundo de
Bachillerato) o el MHI-5 (tercero de Primaria a segundo de Bachillerato). Los casos con
puntuaciones extremas en sntomas psicopatolgicos fueron: Ansiedad = 4.2%; Depresin =
2.4%, Control de Impulsos = 5.5% y Malestar Psicolgico = 4.5%. Por otra parte, los
indicadores de salud mental ofrecieron los siguientes datos: Afecto Positivo = 2.9%; Lazos
emocionales = 2.4%, Bienestar Psicolgico = 1.6%. Los casos con puntuaciones extremas en
el MHI y el MHI-5 fueron 4.2% y 3,4% respectivamente. Existieron diferencias estadsticamente
significativas en funcin del sexo, mostrando las mujeres puntuaciones ms bajas en las
dimensiones de salud mental y ms altas en las de psicopatologa. No fue as respecto a la
edad. El MHI-5 tambin mostr que los chicos presentan mayor puntuacin en salud mental
global que las chicas. En resumen, los resultados hallados indican valores superiores de
psicopatologa que de salud mental en la muestra, as como que que el MHI y el MHI-5 son
instrumentos vlidos y tiles para la evaluacin de salud mental en nios y adolescentes
espaoles.

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Innovative Technology Recommendations to Treat Hoarding in Children and


Adolescents: A Hoarding Game Mobile App
Rosa Poggesi, Sarah Tabbarah, Micaela Thordarson, Robert Friedberg.
Center for the Study and Treatment of Anxious Youth at Palo Alto University, Palo Alto, CA,
USA.
Cognitive Behavioral Therapy (CBT) is effective in treating hoarding and other anxiety-related
disorders in children and adults. Despite its efficacy, access to CBT is often limited by several
factors. Barriers to accessibility include financial difficulties, transportation limitations, and
stigma regarding receiving mental health care (Elkins, McHugh, Santucci, & Barlow, 2011).
Adaptations of traditional CBT facilitate access for individuals who may experience such barriers
to treatment. These adaptations to treat anxiety in youth include camp-based treatment, schoolbased treatment, interventions delivered through primary care settings, and treatment
administered via computer (Elkins et al., 2011). The use of technology in treatment is well suited
for children and adolescents because it provides an interactive interface that can be used at the
youths own pace and can be tailored to address the youths specific needs. Computerized CBT
(cCBT) has been used to effectively treat anxiety in children (BRAVE-ONLINE: Spence,
Holmes, March and Lipp, 2006) and adolescents (Cool Teens: Cummingham et al., 2009). In
both children and adolescents, cCBT reduced symptoms and improved self-esteem, behavior,
and cognitions (Richardson, Stallard, & Velleman, 2010). ). Boschen and Casey (2008) endorse
the use of mobile phone applications to augment traditional psychotherapy treatment. This
poster proposes the use of a mobile phone application to augment traditional treatment for
hoarding in children and adolescents The proposed application is comprised of exercises to
simulate organizing and discarding virtual possessions to facilitate hierarchical exposures, as
well as tips for in vivo discarding tasks. The exercises are structured in a game format, such that
the youth graduates to more difficult tasks following the completion of each level. In the first
level, app users will earn points for choosing to collect few objects. Fewer points will be
awarded for the greater number of objects collected. To graduate to the next level, app users
must collect fewer than half of the number of objects collected during the initial trial of the level.
In the second level, app users are awarded points for discarding undesirable objects. The
greater the number of discarded objects, the greater the number of awarded points. In the third
level of the game, app users are awarded points for organizing possessions by categories. The
greater the number of objects organized in categories, the greater the number of points
awarded. Following each level, a summary screen will recommend in vivo discarding tasks for
the youth based on their specific hoarding habits. In vivo homework assignments will
accompany the completion of each level. Finally, the app will summarize progress and provide
feedback to the clinician as well as the child.
Adaptation of a Generalized Anxiety Disorder (GAD) Cognitive Treatment for Children
aged 8-12 Years: Multiple Baseline Single Case Design
Genevive Racicot1, Frdric Langlois2, Patrick Gosselin3, Caroline Berthiaume1.
1. Riviere-des-Prairies Hospital, Montreal, QC, Canada, 2. Department of Psychology,
University of Quebec of Trois-Rivires, Trois-Rivieres, QC, Canada, 3. Department of
Psychology, University of Sherbrooke, Sherbrooke, QC, Canada.
Very little research has been carried out on the specific treatment of children with excessive
worries and GAD despite its prevalence (Cartwright-Hatton, McNicol, & Doubleday, 2006) and
the consequences - both short term and long term - associated with this phenomenon (Pine,
Cohen, Gurley, Brook & Ma, 1998). To date, the majority of treatment studies have examined
the efficacy of CBT while focusing on a holistic approach to anxiety and were conducted with

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samples of children with a variety of anxiety disorders. With respect to adults suffering from
GAD, the efficacy of therapies targeting the specific cognitive process implicated in the disorder
has been established (Dugas & Robichaud, 2007). Such results suggest that a similar treatment
could potentially be applied to children suffering from GAD with a similarly positive outcome.
The objective of the present study is to evaluate the efficacy of a GAD specific cognitive therapy
(CT) for children aged 8-12 years. Five children with a primary diagnosis of GAD that were
referred to an Anxiety Disorder Clinic in Montreal each received 20 sessions of an innovative
individual psychotherapy. Assessment data from multiple sources and a multiple baseline single
case design were used to assess outcomes. The adaptation for children targets the same
components presented in the adult original treatment: awareness training, intolerance of
uncertainty, faulty beliefs about worry, negative problem orientation, cognitive avoidance,
reassurance seeking behaviours and relapse prevention. However, the treatment was adapted
by our team to take into account the developmental stage of children. An illustrated manual
containing fictitious characters and many different visual metaphors was created to help children
understand abstract concepts and to optimize their interest and motivation into the treatment.
After the treatment, none of the 5 participants met the criteria for GAD. Daily ratings of childrens
worries, anxiety and avoidance illustrated that all of these symptoms were reduced. Moreover,
the childrens self reports on measures of worries and anxiety as well as the parents reports on
anxiety symptoms indicated statistically and clinically meaningful treatment gains. The cognitive
processes aimed by the treatment were also generally less endorsed by children, post
treatment. The results of this pilot study confirm the importance of elaborating CBT programs
designed for children with GAD. Our results further raise the hypothesis that the observed
treatment gains may be mediated by a change in the cognitive processes possibly implied in the
development and the maintenance of GAD. The authors are presently engaged in evaluating
the maintenance of the treatments gains at 3, 6 and 12 month follow-ups.
Effectiveness of Trauma-Focused Cognitive Behavioral Therapy in Youth from High-Risk
Communities
C. Beth Ready1, Charles Webb2, Adele Hayes1, Damion Grasso3.
1. University of Delaware, Newark, DE, USA, 2. Delaware Division of Prevention and Behavioral
Health Services, Wilmington, DE, USA, 3. Department of Psychiatry, University of Connecticut
Health Center, Farmington, CT, USA.
Research suggests that severe childhood stress, such as childhood trauma, can be a notable
risk factor for problematic behaviors and mental health problems, such as chronic depression,
that negatively influences youth throughout their lives (Brandon, Butler, & Beck, 2003; Caspi &
Moffit, 2006) and possibly impacts the developmental trajectory of their children (Meaney,
2010). Given the influential role childhood trauma may play in the development of concurrent,
future, and trans-generational risk, it is important for research to investigate and identify
intervention strategies to reduce the developmental risk associated with childhood trauma.
Numerous randomized control trials have shown Trauma-Focused Cognitive Behavioral
Therapy (TFCBT) to be highly efficacious in reducing many of the symptoms associated with
childhood posttraumatic stress disorder (PTSD; e.g. Deblinger, Mannarino, Cohen, & Steer,
2006). However, research is just beginning to examine the effectiveness of TFCBT when
provided to high risk youth in low socio-economic communities. The current investigation aimed
to examine the effectiveness of TFCBT in treating child traumatic stress symptoms, internalizing
symptoms, and externalizing behavior problems when implemented on a state-wide level with
high risk youth in community settings. Seventy-two youths (ages 7-16 years) with a history of
documented trauma (sexual or physical abuse, traumatic loss, domestic or community violence)
and symptoms of PTSD received an average of 10 sessions delivered in a state-contracted

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mental health agency. PTSD symptoms and internalizing and externalizing behavior problems
were assessed at pre-treatment and then at 3-, 6-, 9-, and 12-months after intake. Piecewise
hierarchical linear modeling revealed that symptoms of PTSD, as well as internalizing and
externalizing problems, decreased significantly from pretreatment to posttreatment
(pretreatment, 3 month, 6 month assessments), and these gains were maintained over the
follow-up period (6, 9, and 12 month assessments). Externalizing symptoms increased
somewhat during the follow-up period, but this change was not statistically significant. These
findings suggest that TFCBT can be implemented effectively in community settings. Treatment
outcomes were similar to those reported in efficacy trials of TFCBT delivered in specialty clinic
settings. Improvements in PTSD symptoms and internalizing and externalizing problems were
maintained over the 6-month follow-up period, although the changes in externalizing symptoms
were associated with the weakest effect size. Overall, these results suggest that TFCBT may be
useful in adressing developmental risk associated with the experience of childhood trauma in
youth from high-risk communities.
Depresso, Eventos Estressores e a Representao Mental do Apego em Crianas
Institucionalizadas
Thais Remondi.
Universidade Paulista - Unip, So Jos do Rio Preto, Brazil.
Abstract Central: RESUMO VERA, F. P.; GREGORIN, G. G.; SILVA, N. F.; AFONSO, P.;
REMONDI, T. e ROSA, L. T. B. (orientadora). Depresso, Eventos Estressores e a
Representao Mental do Apego em Crianas Institucionalizadas - Relatrio Final de Pesquisa
em Psicologia Integrada, Curso de Psicologia, Instituto de Cincias Humanas, UNIP Universidade Paulista. So Jos do Rio Preto - SP, out/2012. O presente estudo teve como
objetivo avaliar a presena da sintomatologia depressiva em crianas institucionalizadas, em
uma instituio pblica do interior do estado de So Paulo. Participaram seis crianas com
idade mdia de 9,17 anos, de ambos os sexos e com tempo de institucionalizao mdio de 20
messes. Foram utilizados os instrumentos Desenho Famlia, o Inventrio de Depresso Infantil
(CDI) e o Inventrio de Eventos Estressores (IEEA). Para tanto, foi solicitado o termo de
consentimento instituio e a ficha de identificao dos participantes. Pde-se observar a
ocorrncia de sintomatologia depressiva na maior parte da amostra (66,6%). Os eventos
estressores mais proeminentes foram encontrados nos domnios Judicial, Institucional, Social e
Familiar. No Desenho Famlia, verificou-se a representao mental dos trs tipos de apego:
ansioso-evitante, ansioso-resistente e inseguro. Assim pode-se perceber que o ambiente
institucional interfere no desenvolvimento emocional da criana. Palavras chave: criana;
instituio; sintomatologia depressiva.
Desarrollo de Habilidades y Estrategias Cognitivo Comportamentales Orientadas a la
Prevencin del Abuso Sexual en Nias y Nios
Waldo Rivero.
La Paz, Gobierno Municipal de La Paz, La Paz, Bolivia.
Abstract Central: El presente trabajo est orientado a llevar a cabo un proceso de adelanto de
las capacidades tcnicas en profesionales que trabajan en rea principalmente rural y cuya
labor est muy ligada al trabajo con nias, nios, profesoras(es), personal que trabaja en el
rea de salud, mdicos, enfermeros(as), agentes comunitarios voluntarios y autoridades
comunitarias, para as desarrollar perodos de capacitacin y entrenamiento de habilidades
orientadas a la prevencin del abuso sexual, con las cuales las nias y nios desarrollen

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destrezas para poder identificar situaciones de peligro, mantenerse alejados de este tipo de
eventos y si es necesario hacerles frente. Se trabaja principalmente el desarrollo de las
habilidades de confrontacin asertiva, comunicacin asertiva y autoconcepto, sta ltima que
es fundamental para que las dos primeras puedan ser asimiladas de manera favorable; aqu la
informacin terica y la prctica conforman una integralidad para que en conjunto logren
constituirse en factores protectores frente al riesgo de abuso sexual. Es elemental poner en
consideracin que el abordar el tema sexualidad y en particular el de abuso sexual, en algunas
de nuestras sociedades aun se plantea como complicado y complejo para la capacidad
cognitiva de nias y nios e incluso de adolescentes lo cual en el rea rural empeora, pues
hasta el presente no se da la importancia respectiva a la realizacin de programas
psicoeducativos que incluyan esta temtica; en contraparte el desarrollo del presente trabajo da
a conocer que si los temas y terminologa utilizados son aplicados con claridad, naturalidad y
con un ptimo conocimiento por parte del(as) capacitador(es), la asimilacin que se genere en
los participantes llega a ser favorable, aportando en este caso al progreso e incremento de
conocimientos, como tambin de repertorios cognitivo-comportamentales, entrenando sus
capacidades y habilidades, orientando a los nias y los nios hacia la prevencin del abuso
sexual, abriendo y creando espacios de soporte y plataformas de autoproteccin ante este tipo
de escenarios.
A Prematuridade e a Interao Me Beb
Olga Maria Rodrigues, Ana Claudia Zerbinatti.
Psicologia, UNESP, Bauru, Brazil.
A interao me-beb tem sido foco de estudo de inmeras investigaes nas ltimas dcadas,
assim como os fatores de risco que podem afetar esta interao, promovendo-a ou
prejudicando-a (Alfaya & Schermann, 2005; Camarneiro, Alves, Ferreira, & Gomes, 2009;
Andreani, Custdio, & Crepaldi, 2006). Entre os fatores de risco para o desenvolvimento infantil
est o nascimento prematuro (Pinto, 2009). O presente estudo teve como objetivo descrever e
comparar a interao de mes de bebs nascidos a termo e nascidos prematuros. Participaram
da pesquisa 40 mes e seus bebs. O Grupo 1 era composto por 20 mes de bebs a termo e,
o 2, por 20 mes de bebs prematuros. A interao da dade foi filmada, durante 10 minutos,
com brinquedos disponveis, cuja posio e utilizao no foi sugerida, ficando a critrio da
me. A anlise da interao foi feita a partir do Protocolo de Observao da Interao MeBeb 0-6 meses (POIMB 0-6, de Schermann et al., 1997). Ele contm 21 itens, avaliados de
zero a cinco pontos. Dos itens, 12 so referentes ao comportamento da me, oito ao da criana
e um ao comportamento da dade (sintonia da interao). Quanto maior o resultado, melhor a
interao. Para a anlise o tempo de filmagem foi dividido em episdios de 60 segundos,
quando foram analisados os comportamentos interativos, de acordo com as categorias
previstas pelo instrumento de anlise. Anlises estatsticas comparativas foram feitas a partir
da mdia dos pontos obtidos, dos dois grupos envolvidos. As mes do Grupo 1, tiveram mdia
maior (4,4) do que as mes do Grupo 2 (3,94), todavia sem diferena significante (p=0,288).
Anlises dos itens especficos mostrou que as mes de bebs a termo tiveram pontuaes
maiores em cinco dos 12 itens: expresso materna de afeto positivo, resposta ao
comportamento social da criana, sensitividade, ateno geral e intrusividade e, em dois deles,
sensitividade (p=0,023) e ateno geral (p=0,025) as diferenas foram estatisticamente
significantes. J as mes de bebs prematuros apresentaram melhores resultados em dois dos
itens, comunicao verbal e a contato corporal, este ltimo estatisticamente significante
(p=0,041). Os bebs do Grupo 1 tiveram mdia maior (2,53) do que os do Grupo 2 (2,16), com
diferena estatstica significante entre eles (p=0,000). Entre os oito itens de interao
avaliados, em cinco deles os comportamentos dos bebs nascidos a termo do que os dos

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bebs prematuros: resposta s comunicaes (p=0,035); intensidade de resposta positiva


(p=0,012); contato fsico ou verbal (p=0,005); quantidade de sorriso (p=0,018) e, quantidade de
vocalizao (p=0,027). No item referente dade os resultados apresentados demonstraram
uma diferena significativa de 0,09 a favor dos bebs a termo. Os resultados apresentados
sugerem que mes de bebs nascidos a termo e mes de bebs prematuros no apresentaram
diferenas nos seus comportamentos de interao com seus bebs. Entretanto, preciso
considerar que a filmagem pode interferir no comportamento das mes e no no dos bebs.
Observou-se que bebs prematuros respondem menos s tentativas de interao das suas
mes. Schermann (2001) tm mostrado que crianas nascidas pr-termo so, muitas vezes,
menos responsivas, menos ativas e menos claras em suas comunicaes do que crianas
nascidas a termo, confirmando os resultados do presente estudo. Os dados do presente estudo
avanam ao constatar a baixa reciprocidade entre o comportamento materno e do beb nas
dades onde h a condio de prematuridade o que pode significar a importncia de aes com
estas mes de forma a incentivar comportamentos de interao em seus bebs.
Estrategias de enseanzas y el manejo de nios diagnosticados con Sndrome de la
Tourette para maestros
Eduardo Rodriguez1, Jaime Veray2.
1. Dept Consejeria y Orientacion, Universidad de Puerto Rico en Bayamon, Bayamon, USA, 2.
Universidad Carlos Albizu, San Juan, USA.
El diagnostico de sndrome de la Tourette es poco estudiado en Puerto Rico. Los nios
diagnosticados con sndrome de la Tourette presentan problemas neurolgicos y congnitos
ocasionando problemas de comportamiento en su entorno social y acadmico. El departamento
de Educacin del pas no cuenta con recursos ni estrategias necesarias para identificarlos. Le
resulta difcil ubicarlos en una corriente de educacin adecuada. El programa diseado tiene un
enfoque psicoeducativo y un modelo de capacitacin con el objetivo de proveer conocimientos
y destrezas necesarias. Utilizamos un diseo pre- experimental de un grupo no equivalente con
medidas de pre - prueba y post prueba. Para esta validez de contenido seleccionamos por
disponibilidad a cinco jueces, quienes cumplieron con los criterios de inclusin. En el estudio de
necesidades participaron 50 maestros. El 100% de las personas participantes reconoci que es
necesario proveer mayor capacitacin sobre el sndrome. Entienden que los nios con
sndrome, pueden ser ridiculizados por otros compaeros de clase. El 60 % indico no estar
capacitados para manejar, trabajar e intervenir con el sndrome en la escuela. Recomendamos
desarrollar talleres dirigidos en adiestrar a maestros regulares y educacin especial, sobre
estrategias de enseanzas de nios diagnosticados con el sndrome
Estrategias de enseanzas y el manejo de nios diagnosticados con sndrome de la
Tourette para maestros
El diagnostico de sndrome de la Tourette es poco estudiado en Puerto Rico. Los nios
diagnosticados con sndrome de la Tourette presentan problemas neurolgicos y congnitos
ocasionando problemas de comportamiento en su entorno social y acadmico. El departamento
de Educacin del pas no cuenta con recursos ni estrategias necesarias para identificarlos. Le
resulta difcil ubicarlos en una corriente de educacin adecuada. El programa diseado tiene un
enfoque psicoeducativo y un modelo de capacitacin con el objetivo de proveer conocimientos
y destrezas necesarias. Utilizamos un diseo pre- experimental de un grupo no equivalente con
medidas de pre - prueba y post prueba. Para esta validez de contenido seleccionamos por
disponibilidad a cinco jueces, quienes cumplieron con los criterios de inclusin. En el estudio de
necesidades participaron 50 maestros. El 100% de las personas participantes reconoci que es
necesario proveer mayor capacitacin sobre el sndrome. Entienden que los nios con

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sndrome, pueden ser ridiculizados por otros compaeros de clase. El 60 % indico no estar
capacitados para manejar, trabajar e intervenir con el sndrome en la escuela. Recomendamos
desarrollar talleres dirigidos en adiestrar a maestros regulares y educacin especial, sobre
estrategias de enseanzas de nios diagnosticados con el sndrome
O Jogo Transformador: Protocolo Teraputico Computadorizado para Terapia com
crianas
Maria Rossi.
AMBAN USP CONSCIENTIA CPCS, Sao Paulo, Brazil.
Os terapeutas que trabalham com crianas e adolescentes podem contar com novos recursos
teraputicos atravs de jogos e programas no computador. Esses instrumentos tecnolgicos
facilitadores so utilizados nas mais variadas faixas etrias e possibilitam trabalhar
assertividade, habilidades sociais, resoluo de problemas, concentrao, autocontrole. O
paciente nesta faixa etria est em desenvolvimento, portanto essencial adaptar
procedimentos, linguagem e tcnicas para poder estar mais prximos de seu mundo e tornar a
psicoterapia interessante e eficaz. Levar as crianas a contar sua histria atravs do dilogo
direto no tarefa fcil e o processo teraputico pode tender a estagnar. Na terapia de adultos
a comunicao verbal um meio privilegiado e muitas vezes crianas lutam para se expressar
apenas com palavras; seguimos a mesma estrutura teraputica porm com criatividade para
acessar a criana clinicamente. Assim outras ferramentas foram introduzidas na terapia infantil
como livros de histrias, materiais de construo, fantoches e jogos visando o brincar como
um componente essencial no desenvolvimento emocional, psicossocial, cognitivo e
comportamental. da criana. Atualmente os pacientes convivem com mais um valioso recurso
que pode apoiar as intervenes: o computador. O envolvimento das crianas com as
atividades que usam recursos computacionais foi sempre muito elevado. Cada vez mais, e
mais cedo possuem aparelhos celulares, videogames e jogos portteis.Pensando nesta nova
realidade e tambm em variveis como tempo, custo, eficcia, pesquisa e cientificidade do
tratamento psicoterpico que estamos desenvolvendo o Projeto Transformador com o objetivo
de ser protocolo de Terapia Cognitivo-comportamental de crianas no Brasil. O Projeto
Transformador foi elaborado aps a constatao da falta de material teraputico
computadorizado completo para atendimento de crianas, em especial que possa ser adaptado
a cada paciente. Alm dos benefcios ao paciente o Projeto Transformador visa auxiliar novos
terapeutas e os que esto iniciando seu trabalho clnico com crianas. O Protocolo estruturado
das sesses propicia um planejamento, definio de objetivos teraputicos atravs das
Atividades e registro dos dados do paciente. Alm de promover o compartilhamento entre
profissionais permite a avaliao do paciente em vrios momentos da terapia. O trabalho,
estudo e pesquisa com programas informatizados vem sendo realizados em vrias partes do
mundo e na nossa prtica clnica com excelentes resultados. O Projeto Transformador objeto
de pesquisa no Instituto de Psiquiatria da Faculdade de Medicina da Universidade de So
Paulo. A tecnologia pretende contribuir significativamente para o atendimento teraputico.
Impacto de la Educacin Moral a travs de la Tcnica Cognitivo-Conductual
Martha Ruiz Garca, Arnaldo Sainz Figueroa, Clementina Garca Martnez.
Universidad Autnoma de Baja Californiia, Ensenada, Mexico.
Abstract Central: El presente trabajo ilustra los resultados de la atencin y ayuda psicolgica
brindada a un joven, remitido por la situacin de arresto domiciliario con sentencia de 18
meses, por abuso sexual. El joven bajo tratamiento del presente caso, fue remitido por el
Centro diagnstico de menores infracrtores. El pertenecer a la clase media-baja,

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econmicamente hablando, dificulta el que se pueda acceder a un tratamiento psicolgico


completo. Sin embargo, dada su situacin legal, el menor es remitido a atencin psicolgica del
programa de Terapia Cognitivo-Conductual de la Universidad Autnoma de Baja California. En
el trabajo con este joven, el motivo original de consulta qued desplazado, ya que el propio
sujeto exteriorizaba y expresaba su inconformidad acerca del estar de manera obligada por el
centro en el tratamiento psicolgico, lo que represent un reto teraputico debido a que el
sujeto no demanda ayuda; sin embargo, se evidenciaba la necesidad de la misma. A partir de
lo anterior y despus de haber revisado el test de creencias, la intervencin se orient de
manera ms directa sobre el aspecto educativo del sujeto para trabajar sobre las ideas
irracionales que mostraba, el auto-concepto, las expectativas y sobre la nica demanda que el
sujeto realiz al terapeuta, la cual fue el aprender a ser ms selectivo con sus amistades.
METODO Mtodo: El presente trabajo es un estudio de tipo correlacional, en el que se utiliz el
mtodo test-retest, as como diversos instrumentos. Sujeto: joven de sexo masculino, edad 15
aos, clase socio-econmica media baja. Instrumentos: test gestltico viso-motor de Lauretta
Bender, historia clnica, entrevista psicolgica, diversas lecturas educativas, test de creencias
irracionales y algunos registros conductuales. La elaboracin de la historia clnica, busc datos
relevantes acerca de la circunstancia actual de vida del sujeto, la historia del desarrollo y la
ficha de identificacin. Por su parte, con la entrevista psicolgica se buscaba la oportunidad de
establecer Rapport y ganar la confianza del sujeto, eliminar la idea de estar a la fuerza y el
establecimiento de acuerdos para el trabajo en sesin. El objetivo del uso de lecturas
educativas con un contenido moral y de enseanza, aporta informacin sobre la dependencia,
tcnicas de trabajo como el lenguaje interno, expectativas y auto concepto. La aplicacin del
Test de creencias irracionales, a travs del dialogo entre terapeuta y paciente, tareas
semanales como registros conductuales con el fin de que el paciente observe sus propios
cambios de pensamiento y conducta. RESULTADOS Los cambios reportados, permiten
concluir que la terapia proporcionada cumpli con sus objetivos y metas; el paciente se va listo
para enfrentar las situaciones de la vida futura conociendo tcnicas que le ayudarn a
superarlas, de igual manera el paciente aboli pensamiento automticos e ideas irracionales
que imposibilitaban su funcionamiento adecuado en sus crculos sociales como los amigos y la
familia y es posible ver el cambio en su persona. Se considera exitosa la intervencin, se logr
el cambio cognitivo y a la vez el cambio conductual esperado en beneficio del paciente.
Estado del Arte de Programas de Entrenamiento Cognitivo Dirigidos a Estimular el
Desarrollo Cognitivo en Nios
Sonia Ros Cruz.
Bogota. D.C, Universidad Catlica de Colombia, Bogot, Colombia.
Abstract Central: La primera infancia ha sido reconocida como una etapa definitiva para
construir capital humano y social, y de esa forma alcanzar el bienestar general de la poblacin.
Soto (2006), no puede haber desarrollo de una nacin a menos que se invierta en el desarrollo
temprano del nio Gaac (2006). En el desarrollo infantil, es de vital importancia los circuitos
neuronales que inciden en la salud, el aprendizaje y la conducta; en esta etapa el cerebro es
ms sensible a responder a las demandas del entorno, es por ello que se hace necesario su
estimulacin. La sociedad no ha sido ajena a esta realidad, en la literatura se encuentran
programas o intervenciones dirigidas a reconocer las mltiples posibilidades de desarrollo
cognitivo, en su mayora parten de un supuesto los nios nacen con sofisticadas capacidades
y en poco tiempo construyen mejores herramientas para pensar, procesar y transformar la
informacin que reciben de su entorno. Dentro de las intervenciones para estimular el
desarrollo cerebral estn los programas de entrenamiento cognitivo, su objetivo prioritario es
inducir cambios estructurales, que contribuyan en la elaboracin de procesos de pensamiento

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eficaces que resulten tanto duraderos como generalizables. Su estimulacin se basa en el


conocimiento de los perodos sensitivos del desarrollo madurativo, para conseguir as un mejor
aprendizaje. Gonzlez, (2003). El propsito de esta investigacin fue realiza un estado del arte
de los estudios realizados durante el periodo comprendido entre el 2007 al 2012, sobre
programas de entrenamiento cognitivo para favorecer el desarrollo infantil. Fue un estudio de
carcter documental cualitativo, las unidades de anlisis fueron las publicaciones hechas entre
el 2007 al 2012 registradas en las bases de datos: PROQUEST, EBSCO, PSYCARTICLES,
REDALIC, SCIELO y DIALNET. Para su elaboracin se siguieron cuatro fases, en la primera se
dise, elabor y valid las fichas de trabajo para recolectar la informacin, estableciendo los
criterios de anlisis; en la segunda fase se recopil la informacin a travs de la aplicacin de
las fichas, seguidamente se procedi a la sistematizacin y anlisis de la informacin tomando
como referente las categoras definidas y las emergentes, organizadas de acuerdo a las
unidades de anlisis. Se revisaron en total 60 estudios, siendo la atencin, la memoria y el
lenguaje los procesos cognitivos ms estudiados. La revisin permiti identificar caractersticas
de los programas, formas de aplicacin, estrategias utilizadas y marcos de referencias
conceptuales, se destaca el inters por las intervenciones dirigidas a poblaciones con bajos
recursos econmicos. Palabras claves: Cognicin, desarrollo infantil, entrenamiento cognitivo
Looking at the Bright Side of Life: Threat-related Cognitive Bias Modification in children
and adolescents
Elske Salemink1, Leone de Voogd1, Reinout Wiers1, Pier Prins1, Elske Salemink1, Allison
Waters4, Melanie Zimmer-Gembeck4, Michelle Craske6, Daniel Pine7, Brendan Bradley8, Karin
Mogg8, Bundy Mackintosh2, 3, Melanie Rowsell-Docherty2, Leanne Andrews2, Fran Davies2,
Jennifer Hudson5, Anke Klein9, Ronald Rapee5, Carolyn Schniering5, Viviana Wuthrich5, Maria
Kangas5, Heidi Lyneham5, Mike Rinck9, Ronald Rapee5.
1. University of Amsterdam, Amsterdam, Netherlands, 2. University of Essex, Essex, United
Kingdom, 3. MRC Cognitive and Brain Science Unit, Cambridge, United Kingdom, 4. Griffith
University, Queensland, QLD, Australia, 5. Macquire University, Sydney, NSW, Australia, 6.
University of California, Los Angeles, CA, USA, 7. National Institute of Mental Health, Bethesda,
MD, USA, 8. University of Southampton, Southampton, United Kingdom, 9. Radboud University,
Nijmegen, Netherlands.
Cognitive models of anxiety stress the importance of cognitive processes in the onset and
maintenance of anxiety. Research has shown that anxious individuals are more likely than
controls to attend to threatening information (attentional bias) en to interpret ambiguous
information in a threatening manner (interpretive bias). Note that studies in adults have shown
that such biases in information processing can be modified using Cognitive Bias Modification
(CBM) procedures and, clinically most interesting, that this training affected anxiety and stress
reactivity. CBM studies in children and adolescents are limited, but recently receiving more
attention.
In this state-of-the-art symposium, recent studies regarding threat-related CBM directed at
attentional and interpretive bias in both unselected and clinically anxious children and
adolescents will be presented. Elske Salemink (the Netherlands) will serve as the chair of the
symposium. First, Leone de Voogd (the Netherlands) will present data on attentional bias CBM
in unselected adolescents using a face-grid training. Results revealed that adolescents who
followed the CBM training were quicker in finding a positive face in a negative crowd and felt
less socially anxious after training, compared to a placebo control group. Allison Waters
(Australia) examined the effectiveness of this attentional bias face-grid CBM training in clinically
anxious children and revealed effects on both attentional bias and on clinician-rated levels of
diagnostic severity. Third, Bundy Mackintosh (UK) examined another CBM training; changing

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threat-related interpretations in children. She examined effects on cognitions and mood up to 1


week post-training. Finally, Jennifer Hudson applied this interpretive bias CBM training to
clinically anxious children and showed that children who had received training were rated as
less socially anxious by their parents than children in the placebo group. Our discussant, Ron
Rapee (Australia) will address these findings, explore issues related to CBM training in children
and adolescents, and discuss implications for future research and clinical practice.
This line of research has implications for both prevention and intervention directed at anxiety in
children and adolescents. Considering that cognitive-behavioral techniques are only successful
for about two thirds of anxious children, CBM could prove to be an important adjunct to current
treatment options or a stand-alone treatment for CBT non-responders. It could potentially be a
cost-efficient intervention with 24/7 availability that promotes life-long cognitive resilience.
Visual Search Attentional Bias Modification Reduced Social Anxiety in Adolescents
In adolescence, there is a peak prevalence of anxiety and depression, which are highly
comorbid. Given the detrimental influence of these disorders on social and academic functioning
and the associated risk of adult psychopathology, early prevention is of paramount importance.
A negative attentional bias plays an important role in the development and maintenance of both
(social) anxiety and depression and might be a predictor of other information processing biases.
Previous research has shown that attention bias modification (ABM) can be effective in
changing attentional bias and emotional vulnerability (MacLeod, 2012) and ABM might be an
interesting tool in the prevention of emotional disorders. While the dot probe task has been
regularly used as a training paradigm to change attentional bias in adults and some
adolescents, findings have been mixed.
In the current study, a face matrix was used as a training paradigm (based on Dandeneau,
Baldwin, Baccus, Sakellaropoulo, & Pruessner, 2007) in a sample of unselected adolescents
(aged 13-16). Participants (n=17) had to repeatedly identify the only smiling face in a 4x4 matrix
of negative emotional faces (angry, fearful and sad), while participants in the placebo-control
condition (n=16) received a grid of flowers. This type of ABM paradigm combines training
disengagement from negative information with training vigilance for positive information. An
assessment version of the task was developed to directly test whether attentional bias changed
due to the training.
Results revealed that the training was successful in modifying attentional bias and, more
importantly, affected social anxiety. After two sessions of training, the ABM group showed a
significant decrease in negative attentional bias and self-reported social anxiety, while the
control group did not. These findings suggest that a non-verbal, visual search paradigm might
be beneficial in changing attentional bias and associated social anxiety in adolescents and
might thus have preventative value.
References:
Dandeneau, S. D., Baldwin, M. W., Baccus, J. R., Sakellaropoulo, M., & Pruessner, J. C.
(2007). Cutting stress of the pass: Reducing vigilance and responsiveness to social threat by
manipulating attention. Journal of Personality and Social Psychology 93, 651-666.
MacLeod, C. (2012). Cognitive bias modification procedures in the management of mental
disorders. Current Opinion in Psychiatry 25, 114-120.
Attention Training towards Positive Stimuli in Clinically Anxious Children
Attention bias modification training (ABMT) is a promising treatment. Nevertheless, few studies
examine its effectiveness in anxious children. This study examined the efficacy of such an
ABMT protocol in clinically anxious children. Method: 60 anxious children are being randomly
assigned to either an ABMT condition in which children search 3 x 3 matrices for a positive
target amongst distracters or to a waitlist control condition. Children in the ABMT condition
complete 224 trials in each of four training sessions per week for three weeks at home (2688

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total trials). Clinical and attention bias measures are being assessed before and after ABMT and
the wait period. Results: Data collection is expected to be completed by May 2013. Results will
be discussed in relation to the hypotheses that children randomized to ABMT will show greater
post-training attention bias towards positive stimuli than children randomized to the waitlist
control condition. Also, ABMT is expected to produce significantly greater reductions in
diagnostic and symptom severity measures compared to the waitlist control condition.
Conclusion: Results will be discussed in terms of potential benefits of training anxious children
to focus attention on positive features of their environment.
Cognitive Bias Modification in Children: The Effectiveness of a New Paradigm on
Interpretation Bias, Anxiety and Mood
Cognitive Bias Modification is a newly emerging therapy for anxiety disorders, with a strong
base in cognitive theory. The theory driven treatment stems from research linking threat related
attention and interpretation biases with the development of anxiety, and utilises computer-based
training protocols to modify them.
The majority of research supporting this paradigm has been conducted with adults, whereas
there have only been a few published studies exploring the use of CBM in children. These
studies have shown how positive and negative interpretation biases can be induced with a nonclinical sample, resulting in a change in affect.
The current study developed a new CBM paradigm designed to modify interpretation bias in
children aged 10-11 years. An experimental design has been used to explore the effectiveness
of the paradigm in a non-clinical sample. The study has been used to explore the effects of
modifying interpretation bias on anxiety and mood at post-intervention and one week follow-up,
in children from 10-11 years of age.
Interpretation Modification Training reduces Interpretation Bias and Anxiety in Clinically
Anxious children.
The present study was designed to train benign interpretations in clinically anxious children. A
total of 66 children between 7 and 12 years of age were randomly assigned to ether a positive
cognitive bias modification training for interpretation (CMB-I) or a neutral (placebo). Training
included 15 sessions in a two week period. Interpretation bias was measured with an
ambiguous scenarios paradigm in which children were asked to finish scenarios that were
related to either social threat, general threat or separation threat. Children and their parents
were assessed with the ADIS-C/P and the Spence Childrens Anxiety Scale. Children in the
positive training showed a significant reduction in interpretation bias on the social threat
scenarios after training but not children in the neutral training. No effects on interpretation
biases were found for the general threat scenarios and the separation threat scenarios.
Moreover, all children showed lower self-reported social anxiety and generalised anxiety
independent of training condition. However, parents reported a significant reduction of social
anxiety in their children in the positive training group but not in the neutral group. This study
demonstrated that clinically anxious children can be trained away from negative interpretation
biases in much the same way as adults. This study also highlights the importance of using
specific training stimuli as it seems that interpretation biases are specific to fear-relevant stimuli.
Terapia familiar cognitiva con dificultades de comunicacin de padres e hijos que
generan inestabilidad emocional y pensamientos irracionales Perla Marina Santana
Vasquez Gobierno Autnomo Municipal de La Paz
Perla Santana Vasquez.
Psicologa, Gobierno Autnomo Municipal de La Paz Bolivia, La Paz, Bolivia.

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En el presente trabajo se explican los fundamentos de la terapia familiar cognitiva aplicada a


las dificultades comunicacionales que se presentan en la relacin de padres e hijos que
desencadenan problemas afectivo emocionales generando pensamientos irracionales a nivel
familiar asimismo se presentan datos de un estudio comparativo entre tratamientos individuales
y familiares de nios y adolescentes con problemas de comunicacin donde se demuestra la
eficacia del enfoque familiar en relacin a las mayores probabilidades de fracaso teraputico en
tratamientos individuales por otro lado se resalta la importancia de la afectividad en relacin a
los factores comunicacionales asertivos y la necesidad de trabajar sobre ello con la familia se
explica el modelo cognitivo relacional en el abordaje de la terapia familiar
Alternativa teraputica cognitivo comportamental para vctimas de maltrato Perla Marina
Santana Vsquez Albergue Transitorio del Gobierno Autnomo Municipal de La Paz
Waldo Rivero Albergue Transitorio del Gobierno Autnomo Municipal de La Paz
Perla Santana Vasquez, Waldo Rivero.
La Paz, Gobierno Municipal de La Paz, La Paz, Bolivia.
El objetivo de este trabajo fue desarrollar un plan de intervencin en base a las caractersticas
fsicas psicolgicas y sociales que presenta la poblacin remitida a Albergues Transitorios que
requieren de psicoterapia Se ha desarrollado un paquete de tcnicas teraputicas cognitivo
comportamentales que ayuden a la construccin de un programa alternativo de tratamiento
para nios y adolescentes el programa desarrollado como resultado engloba tcnicas de
desarrollo infantil temprano y motivacin personal ambas orientadas a la recuperacin
biopsicosocial de la poblacin atendida Se trabaj con un promedio de 80 nios y adolescentes
los datos demuestran que un trabajo integral entre el rea de salud y educacion dirigidos bajo
un enfoque y direccin psicoteraputica logran un avance significativo hacia su recuperacin
as mismo los datos encontrados actualmente est permitiendo que esta propuesta se ample
gradualmente a los diferentes Albergues del Departamento de La Paz Bolivia
Differences between Adolescent and Mother Reports of Maternal Rearing Behaviors
(EMBU): A Study Conducted with Turkish Adolescents and their Mothers
Dilek Saritas, Tulin Gencoz.
Psychology, Middle East Technical University, Ankara, Turkey.
Abstract Central: The aim of the present study was to explore the difference between mothers
reports of maternal rearing styles and adolescents reports of perceived maternal rearing styles
(EMBU). 595 first-grade high school students (300 females and 295 males, mean age of 15)
and 365 mothers (mean age of 42) were administered EMBU. In order to examine possible
gender and informant differences on EMBU, namely, warmth, rejection, overprotection, and
comparison, 2 (Gender) X 2 (Informant) mixed design MANOVA with repeated measures on the
last factor was performed. MANOVA results indicated significant Informant main effect
(Multivariate F [4, 316] = 28.44, p < .001, Wilks = 0.74, 2 = .27]. However, Gender main
effect, (Multivariate F [4, 316] = 1.07, p > .05, Wilks = 0.99, 2 = .01) and the interaction effect
were not significant, (Multivariate F [4, 316] = 0.44, p > .05, Wilks = 0.99, 2 = .006). To study
which of the parenting rearing behaviors were responsible for the significant difference between
adolescents report and mothers report, univariate analysis with Bonferroni correction was
performed, thus for univariate analysis only the alpha scores lower than .0125 were accepted as
significant. This analysis indicated significant informant difference for warmth (F [1, 319] =
91.80, p < .001, eta2 = .22), rejection (F [1, 319] = 33.13, p < .001, 2 = .09), and comparison (F
[1, 319] = 26.94, p < .001, 2 = .08) subscales. Results indicated that dolescents rated their
mothers as showing significantly less warmth to them (M = 4.82) as compared to their mothers

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rate of themselves (M = 5.29). On the other hand, adolescents rated their mothers as
significantly more rejecting (M = 2.22) as compared to their mothers rate of themselves (M =
1.91). Similarly, adolescents rated their mothers as significantly more comparing with other
children (M = 3.18) as compared to their mothers ratings for themselves (M = 2.79). Findings
were discussed in line with literature.
Discrepancies between Adolescent and Mother Reports of Adolescents Emotion
Regulation Difficulties: A Study Conducted with Turkish Adolescents
Dilek Saritas, Tulin Gencoz.
Psychology, Middle East Technical University, Ankara, Turkey.
Abstract Central: Information about adolescents difficulties in emotion regulation (DERS)
gathered from both adolescents and their mothers. 595 first-grade high school students (300
females and 295 males, mean age of 15) and 365 mothers (mean age of 42) were administered
Difficulties in Emotion Regulation Scale (DERS). In order to examine possible gender and
informant differences on adolescents DERS, a 2 (Gender) X 2 (Informant) mixed design
ANOVA with repeated measures on the last factor was performed. The results yielded a
significant informant main effect (F [1, 352] = 56.24, p < .001, 2 = .14) but not significant
gender main effect (F [1, 352] = 0.01, p >.05). Furthermore, a significant interaction effect was
observed indicating that adolescents difficulties in emotion regulation changed from mothers
report to adolescents own report as a function of gender (F [1, 352] = 6.60, p < .025, 2). Posthoc analysis with Bonforreni comparisons yielded that when mothers report was considered,
there is no significant difference between male adolescents (M = 72.97) and female adolescents
(M = 70.15) in terms of difficulties in emotion regulation. Similarly, there is no significant
difference between males (M = 78.72) and females own reports (M = 81.90) in terms of
difficulties in emotion regulation. However, results revealed that for both males and females,
adolescents reported more difficulties in emotion regulation as compared to their mothers report
for adolescents difficulties in emotion regulation. Moreover, this difference was particularly
salient for the female adolescents. Thus, mothers tended to underestimate the experienced
emotion regulation difficulties of their children, particularly for their daughters. Findings were
discussed in line with literature.
Suicide Attempt on Childhood and Intervention by Cognitive Behavioral Psychotherapy
Rachel Schlindwein-Zanini, Micheli Sotili, Maiara Pires Bastos.
Psychology - Hospital Universitrio, Universidade Federal de Santa Catarina - UFSC,
Florianpolis, Brazil.
The childhood and adolescence stages of life are vulnerable to psychological disturbance. In
elementary school the rates of suicidal ideation are between 12 and 25% (Brent, 1993).
OBJECTIVE:To report the experience on psychological care (Cognitive Behavioral
Psychotherapy-CBP) regarding the suicide attempt (SA) case of the child K. in the pediatric
infirmary at the general hospital. HISTORY:K., 11 years 11 months-old, female, studying on the
primary school, hospitalized, confused and disorientated by SA exogenic poisoning by
potassium permanganates ingestion, within psychotropic substances, antiparasitics, antibiotics,
analgesics, antipyretics, antilipidemic drugs and laxatives. She was found at homeunconscious.
During the first SA (2011), she mutilated herself with razor blade on arms and legs. She lives
with her brother (16 years-old) and maternal grandmother. She states to have low self-esteem
and been suffering of bullying because of her over-weight. She sleeps on the same bed as her
grandmother and maintains a relationship with a man of 52 years-old on internet. Family history

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of chemical dependence and mothers suicide (hanging). DEVELOPMENT AND


DISCUSSION:Nowadays, it can be observed the growing concern with ones self-image and
social acceptation; so, the stigma promotes difficulties, because it raises, on the individual, low
value feelings, compromising ones self-esteem (Schlindwein-Zanini et, 2008). There is also a
stigma from people regarding the suicidal behavior (Botega et al, 2009). The relation between
suicidal ideation, low self-esteem and depression must be clinically considered. Therefore, the
CBP shows good clinical indications that result on positive therapeutic answers. K. received
medical, nursing and psychological care and also nutritional orientation during her
hospitalization. It was conducted a psychodiagnosis (ICD-10:Z91.5; probable risk of death). It
was psychologically dealtthe bullying, stigma, grandmothers over-protection, fathers
aggressions toward the mother, conflictual family relations, regret for making her family suffer
because of her SA, low expectations about the future, changes the she could carry outwith the
help of her brother and grandmother (weight, changing her school, adequate use of internet and
social networks, physical activities). The family was orientated to remain vigilant. The key CBP
techniques employed were: the Planning of Daily Activities; Relapse Prevention; Social Skills
Training (SST); Feedback and Reinforcement; Resolution and Solution of Problems; Coping
Strategies. The work was centralized on the cognition levels, specially the conscious. It was
included, cognitively, the re-signification of her existence. During the hospital discharge, it was
scheduled a follow-up on out-patient basis for 6 months (aiming the suicidal ideation/not
structured plans, depression), compliance to the external psychological, nutritional and drug
treatment (fluoxetine), and monitoring; referral to psychological/psychiatric follow-ups at CAPSiCentro de Ateno Psicossocial da Infncia. Nowadays she shows therapeutic improving and
plans to study Psychology. CONCLUSION:The SA can express an application for help referred
to the inserted context (family, friends, school), existing risk and protection factors of suicide that
need mental health actions.The psychological seriousness and urgency of the SA, requires a
multidisciplinary teams care and familiar involvement on the patients treatment.
CBT Treatment for Juvenile Offenders: Implications for Integrating Anxiety and Emotion
Regulation
Brandi Schmeling, Micaela Thordarson, Lisa Hoyman, Robert Friedberg.
Palo Alto University, Palo Alto, CA, USA.
Anxiety and emotional regulation represent two essential processes for conceptualizing and
treating juvenile offenders. The presence of anxiety may mitigate against some risk behaviors
(Nicholoson, Soane, Fenton-O'Creevy, & Willman, 2005). These elements of anxiety make it
difficult for the individual to regulate the emotions being experienced. Emotion regulation
describes the processes used in order to modulate affective experience determining how and
when they are experienced (Gross, 1998). Emotional dysregulation also shapes the
development of anxious symptoms in children (Carthy, Horesh, Apter & Gross, 2010; Suveg &
Zeman, 2004). Juvenile offenders often have less adaptive strategies for regulating emotions
than their non-delinquent peers (Nas, Orobio de Castro, & Koops, 2005). When faced with
fears, possible threats, or irritations, youth who have strong negative emotional responses are
at an increased risk for conduct problems (Lahey & Waldman, 2003). Moreover, criminal
offenses often occur during negative emotional states (Day, 2009). Reducing recidivism is a key
treatment goal when working with juvenile offenders. This leads treatment to focus on the
external behaviors associated with offenders. However, unfortunately relatively less attention
has been given to internalizing processes such as anxiety and emotional regulation. This poster
aims to identify cognitive-behavioral strategies clinicians can utilize in treatment with juvenile
offenders while targeting symptoms associated with anxiety and emotion dysregulation.
Ideographic and age-appropriate interventions targeted toward identifying, experiencing, and

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monitoring emotions are explored. Interventions to identify emotions should use a simple
classification system based on major feeling categories and avoid using extensive lists
(Friedberg, Gorman, Wilt, Blockains, & Murray, 2011). This would be particularly helpful when
working with juvenile offenders who may be reluctant to engage in discussion of emotions. A
particular technique called What's your Wavelength? (Friedberg, et al, 2011), is used to scale
emotions and examine the intensity of different emotions experienced. This would allow the
juvenile offender to utilize a visual representation of emotions in a developmentally appropriate
way. Cognitive interventions such as thought records that can be tailored to examine specific,
emotion-related content and presented in creative, age-appropriate ways are explained. There
are age-appropriate alternatives to traditional thought records. Your Brainstorm utilizes a
metaphor describing negative thoughts as bad weather and is most appropriate for ages 11 to
16 years (Friedberg, McClure, & Garcia, 2009). Specific focus of this intervention should be to
examine thoughts surrounding the offender's criminal behaviors and the negative emotions
associated. Lastly, behavioral interventions such as logs and hierarchies involving behaviors
following heightened anxious and negative emotional states are discussed. Keepin' my Stats, a
tool appropriate for ages 8-15 years of age, is used for tracking behaviors utilizing an ageappropriate metaphor (Friedberg, McClure, & Garcia, 2009). This intervention would target
tracking problematic behaviors that occur following negative emotions.
Neuropsicologia e Educao: Uma Proposta de Articulao Para Polticas Pblicas de
Preveno Precoce de Dificuldades Escolares
Ana Idalina Silva.
Universidade Federal de Gois, Goinia, Brazil.
Abstract Central: Sabe-se que muitas crianas apresentam diversas dificuldades de
adaptao no processo de escolarizao. As dificuldades escolares mais frequentes esto
relacionadas a alfabetizao e a realizao de clculos numricos. O fracasso nestas
disciplinas bsicas tem graves repercusses no desenvolvimento destas crianas, pois
prejudicam seu aproveitamento educacional, podem levar a evaso escolar e restringem as
oportunidades de vida de uma maneira geral. Assim, fundamental a interveno precoce
nestas dificuldades de aprendizagem, o que infelizmente no vem ocorrendo na esfera pblica
devido a demora para diagnstico da causa destas dificuldades escolares de cada aluno.
Muitos transtornos e dificuldades de aprendizagem tm sua origem em processos neurais,
demonstrando que a neuropsicologia pode dar importantes contribuies para a rea. A
neuropsicologia pode indicar, de forma mais objetiva e clara, se a criana possui algum dficit
em processos atencionais, mnmicos ou perceptivos, por exemplo, possibilitando maior
assertividade do trabalho pedaggico. Dessa forma, e reconhecendo a importncia de um
trabalho integrado entre sade e educao, este projeto se prope a construir um modelo de
atendimento as dificuldades escolares integrando neuropsicologia e educao. Metodologia:
Prope-se a participao neste estudo piloto de 30 crianas com idades entre 7 e 10 anos
indicadas pelas escolas como apresentando dificuldades escolares. Dividimos o trabalho em
duas etapas: na primeira etapa, sero realizadas avaliaes de rastreio de dificuldades gerais,
com os seguintes testes e provas neuropsicolgicas: Procurar Smbolos (WISC-III), Inventrio
de Habilidades Sociais, HTP, Figuras Complexas de Rey e RAVLT. As crianas que
apresentarem rebaixamento importante em quaisquer provas ou testes aplicados, sero
encaminhadas a segunda etapa da pesquisa, realizada na clnica escola da universidade, onde
ser realizada uma avaliao neuropsicolgica aprofundada, utilizando diferentes
procedimentos de avaliao, de acordo com a necessidade de cada caso. Resultados
esperados: Espera-se contribuir com orientaes especficas para os professores em cada
caso, orientando sobre melhores formas de ensino-aprendizagem para as caractersticas de

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cada criana. A longo prazo, espera-se que as crianas apresentem melhor adaptao e
melhores resultados escolares. Espera-se, tambm, contribuir com a preveno de outras
repercusses sociais que poderiam ocorrer sem a interveno.
Um Estudo Acerca da Associao Entre as Prticas Educativas Parentais e o Transtorno
por Dficit de Ateno com Hiperatividade (TDAH)
Gilciane Silva, Neuza Cristina Perez, Sara Ucha.
Universidade Federal do Piau, Parnaba, Brazil.
Abstract Central: A literatura aponta que cerca de 10% a 20% das crianas apresentam
problemas de sade mental e necessitam assistncia especializada. Porm a sade mental
infantil ainda bastante negligenciada tanto pelas polticas pblicas, quanto pelos estudiosos e
profissionais da rea. Dentre as dificuldades que demandam assistncia especializada na
infncia, figuram aquelas caractersticas do Transtorno por Dficit de Ateno com
Hiperatividade (TDAH). O TDAH uma das problemticas mais prevalentes na infncia e o
estilo parental parece jogar um papel importante no surgimento e manuteno de tais
dificuldades. Este trabalho tem como meta descrever os comportamentos caractersticos do
TDAH na comunidade escolar de Parnaba-PI- Brasil, e o estilo parental adotado pelos
cuidadores, assim como avaliar se existe associao entre ambos. Para tanto foi realizado um
estudo tipo transversal, com amostragem simples, dividido em trs etapas distintas: triagem,
avaliao clnica e interveno psicoterpica em grupo na abordagem cognitivocomportamental. A amostra composta por 127 crianas matriculadas do primeiro ao quarto
ano em escolas pblicas do Ensino Fundamental I da cidade de Parnaba. Os instrumentos
utilizados na triagem so as escalas Child Behavior Checklist (CBCL 6-18) e o Inventrio de
Estilos Parentais (IEP). Os pais daquelas crianas que pontuarem no nvel limtrofe e clnico da
CBCL sero convidados a participar de uma entrevista clnica para avaliar em que
circunstncias tais comportamentos se do, e se esto associados a dificuldades nas relaes
interpessoais, realizao das atividades dirias ou ao baixo rendimento escolar. Aqueles
escolares em que for avaliada a presena de comportamentos de risco ao desenvolvimento
infantil ser oferecido interveno em grupo para as crianas e para os pais. Os dados
apresentados so relativos participao de cinco escolas. At o momento a amostra
composta por 127 escolares, dos quais 68(53,5%) so do sexo masculino e 59(46,5%) do
feminino. Dos 127 participantes, 31 (24,4%) apresentaram dificuldades caractersticas do
TDAH, sendo 12(38,7%) meninas e 19(61,3%) meninos. Observou-se que, os pais de
46(36,2%) escolares informaram adotar estilo parental negativo e que 16 (34,8%) destas
crianas apresentaram de forma concomitante dificuldades caractersticas do TDAH. O modelo
de regresso logstica mostrou que o risco de um escolar apresentar comportamentos
caractersticos do TDAH aumenta de forma significativa medida que o estilo parental torna-se
negativo. Este resultado deflagra no s o percentual de escolares que apresentam
dificuldades comportamentais ao incio da idade escolar, como tambm que o estilo parental
negativo ajuda a explicar sua presena. Tais informaes so essenciais ao planejamento de
intervenes de cunho preventivo destinado ao desenvolvimento de habilidades e
competncias da criana e de seus cuidadores, para que possam sentir-se capazes de
enfrentar os desafios do dia-a-dia de forma saudvel, flexvel e realista. Intervenes que
contribuam a que tais dificuldades no apresentem uma evoluo gradual e acumulativa ao
longo do desenvolvimento e venham a desembocar em problemas mais srios na adolescncia
e vida adulta.

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Research on Social Skills in Interlocking Behavioral Contingencies: The Case of Young


Offenders Families
Fabiane Silveira.
Universidade Federal de So Carlos, So Jos dos Campos, Brazil.
Abstract Central: The presence of multiple aversive conditions, which affect the presentation of
social skills and social educational skills, implies the consideration that the families of young
offender may represent a vulnerable population. It should be considered that these families are
facing the challenging task of promoting socially competente repertoire, which is in the opposite
direction to disregard the rights of others and search for immediate gratification. Interventions in
individual contingencies may not produce the desired effects when there is participation of such
contingencies in a system of interlocking. Therefore, analysis of individual contingencies can be
complemented by a review of interlocking in which they participate. The term interlocking
behavioral contingencies has been used to delimit the unit of analysis of social behavior in
which the behavior of each individual performs a double role the role of action and the role of
behavioral environment for the action of another individual . The study aims at the analysis of
interlocking behavioral contingencies (IBCs), that indicates deficits and reserves of social skills
and social educational skills in young offenders families.The subjects were five families
consisting of a young offender, a brother of the young offender and mother. Instruments applied:
IHSA, IHS, Indicadores de Habilidades Sociais Educativas e uma Entrevista Semi-Estruturada.
Main results: a) the general repertoire of social skills of young offender is lower than that of his
brother; b) IBCs were identified in five families, especially between mother and young offender.
The IBCs consisted of episodes of interactions - related to drug use and living with adolescents
who practice violations-that signal propagation patterns of interpersonal relationships between
mothers and sons, indicating deficits, especially in the skills of self-control, empathy and
conversation. We discuss about the promotion of the quality of social interactions within the
family, as a considerable portion of the contingencies that young people will be exposed during
life.
O Estudo da Famlia: Uma Anlise de Contingncias Comportamentais Entrelaadas
Fabiane Silveira, Natalia Orti.
Universidade Federal de So Carlos, So Jos dos Campos, Brazil.
Abstract Central: Apesar do conhecimento acerca da contribuio de prticas parentais
negativas para o desenvolvimento de problemas de comportamento externalizante e
internalizante, constata-se o despreparo de significativa parcela dos agentes educativos,
incluindo pais e professores, no planejamento de condies de aprendizagem. A famlia pode
ser considerada um grupo social especfico e particular sobre a qual recai a tarefa - atribuda
pelo grupo social mais amplo - de estabelecer comportamentos importantes para a manuteno
da sobrevivncia do prprio grupo e interao com outras agncias de controle. O estudo dos
grupos e seleo de prticas culturais na Analise do Comportamento no trata de novos
processos pelos quais os indivduos adquirem comportamentos, mas de novas propriedades e
meios de descrever os contextos onde ocorre a aquisio de comportamento operante. Nesse
sentido, torna-se relevante testar a utilidade e pertinncia de uma unidade de anlise diferente
da contingncia trplice, como no caso do conceito de contingncias comportamentais
entrelaadas (CCEs), as quais produzem consequncias individuais, que podem ser iguais ou
diferir de uma consequncia conjunta de grande magnitude, o produto agregado. Padres de
relacionamento interpessoal podem ser entendidos como produtos comportamentais
selecionados e transmitidos para outros contextos a partir das CCEs entre indivduos de uma
mesma famlia, ou seja, a propagao de repertrios funcionalmente similares entre indivduos

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sucessivamente, o que delimita um objeto de estudo das relaes familiares no nvel cultural.
Quanto ao processo de variao e seleo de CCEs, destaca-se um aspecto crtico: CCEs
podem permanecer intactas mesmo quando contingncias que descrevem o comportamento de
um indivduo so alteradas, ou quando indivduos saem e novos participantes assumem os
seus papis no entrelaamento. Discusses tericas sobre seleo de novas prticas culturais
indicam tambm que alteraes nos comportamentos dos indivduos participantes dos
entrelaamentos precisam ser suficientemente crticas para desorganizar momentaneamente
as CCEs, sendo que quanto mais as alteraes nas consequncias individuais sejam
relevantes, mais provavelmente iro gerar variaes nos produtos agregados, os quais podem
selecionar novas CCEs. Assim, supe-se que intervenes em contingncias individuais
podem no produzir ou manter os efeitos desejados, quando h participao de tais
contingncias em um sistema/unidade de entrelaamento; portanto, anlises de contingncias
individuais, que mantm dificuldades comportamentais, podem ser complementadas por uma
avaliao de possveis unidades de entrelaamento dos quais participam. Defende-se que a
investigao e descrio de possveis entrelaamentos de contingncias comportamentais dos
quais crianas e jovens com problemas de comportamento externalizantes e internalizantes
participam, indicar os mecanismos de transmisso de diferentes padres de relacionamento
interpessoal (repertrios de habilidades sociais e habilidades sociais educativas), a depender
dos entrelaamentos de contingencias dos grupos/contextos formados por membros familiares
(irmos e cuidadores) e pares.
Applying Trauma Focused-Cognitive Behavioral Therapy in an Urban Latino School
Setting
Caitlin Smith1, Larissa Borofsky1, Louise Macbeth2.
1. Psychology, University of Southern California, Los Angeles, CA, USA, 2. University of
Southern California Keck School of Medicine, Los Angeles, CA, USA.
Urban Latino youth are at risk for trauma exposure (e.g., community violence, crime
victimization), and face particularly devastating consequences when separated from their
parents in some manner (e.g., parent deportation, incarceration) (Gudio, Nadeem, Kataoka, &
Lau, 2011). In 2002, 32% of public school students in Los Angeles had clinical levels of posttraumatic stress symptoms (Jaycox et al., 2002).Unfortunately, Latino youth are also less likely
to receive mental health services than children of other ethnicities, perhaps due to their parents'
perceptions of stigma in these services, lack of health insurance, and difficulties with
transportation to mental health clinics (Kataoka et al., 2003). Trauma-Focused Cognitive
Behavioral Therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006) was offered in a
kindergarten-8th grade parochial school in Central Los Angeles. Several advantages and
disadvantages of offering TF-CBT in a school setting were identified. Advantages fit into three
categories, including 1) improving accessibility to and convenience of services, 2) supporting
classroom interventions, and 3) reducing perceived stigma of services. Disadvantages fit into
four categories, including 1) difficulty involving parents in treatment, 2) challenges to privacy and
confidentiality, 3) competing with desirable or important alternative activities (e.g., soccer
practice or afterschool homework help), and 4) practical concerns (e.g., inconsistent access to
office spaces). Case examples of five children (2 males and 3 females) between the ages of 9
and 11 will be presented to illustrate these advantages and disadvantages. In all five cases, the
child experienced a distressing separation from one of their parents. Reasons for separation
included parent deportation/detainment, parent arrest, and marital separation/divorce of parents.
Additional commonly addressed issues in the five cases included concerns about physical
safety, inconsistent parenting, and financial difficulties. Implementing TF-CBT in the school
setting appeared helpful in reducing symptoms of psychological distress in the children who

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received treatment. Furthermore, the school-based treatment allowed youth who would
otherwise have minimal access to mental health services to be treated. Specific
recommendations for improving the implementation of TF-CBT within the school setting will be
discussed.
Effectiveness and Cost Effectiveness of a Specific Cognitive Behavioral Therapy (CBT)
Program, the D(o)epression Course In Clinically Depressed Adolescents
Yvonne Stikkelbroek1, Denise Bodden2, 1.
1. Child Adolescent Studies, University Utrecht, Utrecht, Netherlands, 2. Radboud University,
Nijmegen, Netherlands.
Depressive disorders occur in 2 to 5% of the adolescents and are associated with a high burden
of disease, a high risk of recurrence and a heightened risk for development of serious problems,
like suicide attempts. Depressive disorders in 15 to 24 year olds are in the top-3 of diseases
with the highest burden of disease expressed in DALYs and a high risk of recurrence.
Therefore depressive disorders need to be treated in an early stage with an effective treatment.
Aim of this study is to test the effectiveness of a specific CBT program for adolescents
diagnosed with depression and to establish the cost-effectiveness of this program under
rigorous conditions, within routine care provided by professionals already working in mental
health institutions,. Cost-of-illness of clinical depression in adolescents is also established.
Potential moderators (gender, age, ethnicity, educational level, family income, gender, age,
ethnicity, severity of depression, comorbidity and psychopathology in parents) and mediators
(negative automatic thoughts, cognitive emotion regulation and attribution style) are assessed
too. The influence of non-specific treatment variables such as therapeutic alliance, client
expectancy, client satisfaction and treatment adherence on effectiveness of CBT is also taken
into account. A multi-site, RCT using block randomization is conducted. Recruitment is done in
14 specialized mental health care institutions in the Netherlands. The targeted sample consists
of 140 referred clinically depressed adolescents aged 12 to 21 years old. Adolescents are
randomly assigned to the experimental (N=70, CBT) or control condition (N=70, TAU without
CBT). Four assessments (pre, post, follow up at 6 and 12 months) and two mediator
assessments during treatment are conducted. Assessments consist of questionnaires and a
diagnostic interview by independent researchers with the parent and the adolescent and
reviews by the therapist. Primary outcome measure is the absence or presence of depression
diagnosis based on a semi-structured interview namely the K-SADS-PL. Secondary outcome
measures include depressive symptoms, parenting, parental psychopathology, personality,
quality of life, costs and treatment characteristics rated by the adolescent, their parent(s) and
their therapist. The individual CBT program, the D(o)epression course, is a revision of the
group protocol Coping with depression course for Adolescents (CWD-A) (Clarke et al., 1990).
The CWD-A is often investigated by means of RCTs in an American population and results
repeatedly show that the CWD-A is more effective than care as usual. It is seen as probably
efficacious. In this study the effectiveness of the individual CBT program the D(o)epression
course will be investigated by comparing it to care as usual. This trial will be the first to
compare CBT with TAU under rigorous conditions within routine care and with a complex
sample. The study addresses questions raised in research and clinical practice, which are
relevant from a scientific perspective. Furthermore, cost-effectiveness of treatment and cost-ofillness of clinical depression are established which will provide new insights on societal costs of
depression as a disorder and its treatment. The study started in December 2011 and the first
results are expected by the end of 2013.

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Specific Maternal and Paternal Age Effects on Behavioural Outcomes in Offspring


Jessica Tearne.
1. Telethon Institute for Child Health Research, Perth, WA, Australia, 2. The University of
Western Australia, Crawley, WA, Australia.
Abstract Central: BACKGROUND AND AIMS This study examined the relationship between
parental age and longitudinal mental health outcomes in offspring, using data from the Western
Australian Pregnancy Cohort (Raine) Study. We examined what links exist between maternal
and paternal age and child behaviour outcomes, and whether these relationships persist when
accounting for known perinatal risk factors. METHODS The Raine Study provided
comprehensive data from 2 900 pregnancies, resulting in 2 868 live born children. Offspring
were followed up at ages two, five, eight, 10, 14, and 17 years using the Child Behaviour
Checklist (CBCL). The CBCL provided clinical cut-offs for behavioural morbidity for overall,
internalizing (withdrawn, anxious/depressed, somatic complaints) and externalizing (delinquent,
aggressive) behaviour (T 60). We used longitudinal logistic regression models with stepwise
adjustment for known prenatal risk factors (gestational age, maternal smoking in pregnancy,
maternal education at pregnancy, parity, total family income and gender). RESULTS In the
unadjusted models, as both maternal and paternal age increased, there was a significantly
decreased risk for the later development of total, internalizing, and externalizing problems in
children throughout childhood. In the adjusted models, maternal age remained a significant
predictor of total (OR = .89, 95% CI = .81, .97), internalising (OR = .91, 95% CI = .83, .99) and
externalising (OR = .89, 95% CI = .82, .97) problems, with increased age related to decreased
behaviour problems in children. Paternal age was no longer significantly associated with risk for
total, internalising and externalising child behaviour problems. CONCLUSIONS Preliminary
findings indicate both advancing maternal and paternal age at conception contribute to the
childs later behavioural development.
Aproximacion Teorica al Suicidio Infantil
Itzel Tovar, Pablo Tonathiu Salcedo.
Universidad Nacional Autonoma de Mexico, Mexico, Mexico.
Como problema de salud pblica el suicidio ha adquirido especial relevancia en las ltimas
dcadas. la Organizacin Mundial de Salud (OMS) lo seal como la 13ava causa de muerte,
con 14.5 casos por 100.000 habitantes (Krug, Dahlberg, Mercy, Zwi y Lozano, 2002). En el ao
2000 el suicidio fue ubicado como la octava causa de muerte en escolares de entre 5 a 14 aos
de edad, cuando hace tres dcadas esto era prcticamente inexistente. Este incremento en los
casos hace necesario el diseo de programas efectivos de prevencin, requiriendo la clara
identificacin de los factores de riesgo de la conducta suicida, Un autor clsico en los estudios
sobre el suicidio infantil es Fardel, quien en 1655 public su libro Etude sur le suicide chez les
enfants, aportando datos epidemiolgicos. Sin embargo, Pfeffer en 1979 propuso una definicin
para el suicidio infantil: el comportamiento suicida en los nios son los pensamientos o
acciones que de llevarse a cabo pueden producir la muerte o graves lesiones. Por otro lado las
conductas suicidas en nios y adolescentes han sido definidas como la preocupacin, intento o
acto que intencionalmente busca causarse dao a s mismo o la muerte. Se puede entender
como un espectro que abarca: (a) las ideas y deseos suicidas (ideacin suicida), (b) las
conductas suicidas sin resultado de muerte (intentos o tentativas suicidas) y (c) los suicidios
consumados(Moran, 2004). Si bien las definiciones permiten conocer el concepto estas son
limitadas, por tanto, tambien es importante tomar en cuenta la aportacion de la psicologa. La
psicologa conductual plantea el comportamiento suicida como una condicin depresiva
aprendida, generada por carencia de reforzamiento positivo o exposicin prolongada a

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situaciones negativas que producen sensaciones de incapacidad. Los enfoques cognitivos


atribuyen el suicidio a una impotencia aprendida y de desesperanza como un esquema
patolgico persistente y automtico de organizar e interpretar las experiencias y factores
sociolgicos que plantean la influencia de distintos modelos de estructura u organizacin social
como la familia, cultura, religin, ocupacin, clase socioeconmica y otros grupos u
organizaciones en la gnesis de la familia(Quintanar, 2004). Por lo tanto el suicidio en la
infancia tambien tiene cierta relacin con la conducta en el infante, ya sea a partir de
comentarios realizados por los hermanos mayores , padres, historietas, cuentos, mitos,
leyendas o programas de televisin. Dicha relacin se explica por el hecho de que el nio
puede asociar en una etapa comprendida entre los seis y nueve aos, el tema de la muerte
como un estado similar al sueo. En la actualidad diversos estudios evidencian que los intentos
de suicidio se inician desde la etapa escolar y sealan un aumento preocupante en la poblacin
mexicana de intentos de suicidio y suicidios en nios y adolescentes, lo cual es alarmante
puesto que en cerca del 49% de los casos se desconoce la causa. Asimismo, relacionan este
fenmeno con perturbaciones emocionales tales como la depresin y la ansiedad. Es
importante destacar que la comorbilidad de ambos trastornos multiplica el riesgo(Valero, 2008).
De los suicidios ocurridos cada ao en Mxico alrededor del 3% corresponden a menores de
15 aos los que se incrementaron en 37. 6% entre 1995 y 2001 y en 104% en los aos
consecutivos. En una sociedad en transformacin, donde el modelo idealizado de familia cada
vez muestra nuevas facetas es necesario que los profesionales de la salud desarrollen ms
estudios sobre el comportamiento suicida en nios y nias en edad escolar y as aportar
conocimientos para desarrollar e implementar
Experimental Design of a Tool for Childhood Intervention with Aggression
Valquiria Tricoli.
1. CETEPEA, Atibaia, Brazil, 2. FAAT, Atibaia, Brazil.
In cognitive behavioral therapy is no need for tools that facilitate access to the child, especially
in certain tables where resistance to intervention is verified. Aggression is a behavior and
externalizing problems that entails a host system in which the child is placed. This tool was
created in order to facilitate access to aged six to 10 years in working with anger and
aggression, stimulating cognitive restructuring, self-control, problem solving and expanding
social repertoire. It is an interactive game that has a board, 20 cards, 10 cards plus tips, in
situations where there is a need for outside help, a dice and pawns for four or more players. It
started from a clinical trial presented and then there was a group of 10 children in the form of a
pilot project to suit the language of the material and the rules to the intended population, so we
organized the instruction manual and the letters to be used throughout the activity according to
the characteristics of its population. The material was used as an experimental project to work
on aggressive behavior in a private school from elementary school into two groups of 10
participants each being two girls and eight boys in the group would be eight years, indicated by
teachers as having aggressive behavior in about them and their peers. We carried out an
evaluation based on the antisocial behavior Scale Disorder and Attention Deficit Hyperactivity
Disorder (Bencziks, EBP), and a control group (CG) and the other the experimental group (EG).
Five meetings were held one hour each. For the CG worked with psychoeducation, notion of
consequence, social skills and problem solving, as with GE began and finished up the work with
the presentation of the game (which already has instructions for troubleshooting, self-control
and social skills), together with the same work done with the CG. Qualitatively we observed that
the game favored a greater adherence to the intervention and served as facilitator for interaction
and interest in the EG compared to the CG. Quantitatively, we found that 70% of children in EG
showed changes in their behavior in the relationship with the group and teachers regarding the

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suitability behavioral, attendance rules and reducing aggressive behaviors when compared to
CG where only 30% had significant change in their behavior immediately to training. One month
after completion of the intervention, there was a revaluation of antisocial behavior with the same
scale used before intervention with teachers and found that the gains were maintained in both
groups in their initial ratio 70% EG and 30 % CG. What can be verified is that with the use of
tools that facilitate access to child motivating them to reflect on their behavior can be a very
important tool for effective work in cognitive behavioral therapy, as access becomes concrete
and playful. It is worth noting that studies of this instrument are in progress, aiming to evaluate
the effectiveness of this tool in other age groups as well as obtain data with a larger number of
children at age already tested, to obtain a given with a sampling more significant.
Dificuldades Caractersticas do Transtorno Negativista Desafiante e sua Relao com o
Estilo Parental
Sara Ucha, Neuza Cristina Perez, Gilciane Silva.
UFPI, Parnaba, Brazil.
Abstract Central: A literatura aponta que cerca de cinco milhes (12,6%) de brasileiros entre 6
e 17 anos apresentam sintomas de transtornos mentais. Este dado alarmante, e denota a
demanda de trabalhos de cunho preventivo, afirmando a importncia de um olhar mais
cuidadoso voltado para a promoo de sade mental na infncia. Entre os transtornos
psicopatolgicos mais comuns na infncia est o Transtorno Negativista Desafiante (TND), sua
prevalncia varia entre 2% e 16% na populao em geral. Apesar do aumento dos estudos
acerca dos transtornos psicopatolgicos da infncia, a etiologia do TND ainda no conhecida.
Os estudos sugerem que sua origem seja multifatorial, ocorrendo uma interao entre fatores
biolgicos e ambientais. Entre estes fatores as prticas educativas parentais parecem jogar um
papel importante no desenvolvimento infantil saudvel, assim como no aparecimento de
problemas de comportamento. Diante deste contexto, a meta inicial deste estudo descrever
os comportamentos das crianas matriculadas no Ensino Fundamental I da cidade de
Parnaba-PI. Em um segundo momento avaliar se os escolares apresentam comportamentos
caractersticos do TND e se estes esto associadas a dificuldade nas inter-relaes pessoais,
na realizao das tarefas dirias e/ou baixo rendimento acadmico. quelas crianas que
apresentem tal associao, ser analisado se o estilo parental adotado ajuda a explicar sua
presena. Em um terceiro momento ser disponibilizado atendimento psicoterpico em grupo
na abordagem cognitivo-comportamental quelas crianas em que se avalie a presena de um
conjunto de comportamentos que seja considerado de risco ao desenvolvimento infantil
saudvel. Para tanto foi realizado um estudo de tipo transversal com amostragem simples,
tendo como informantes pais e professores. Na etapa de triagem utilizou-se a escala Child
Behaviour Checklist 6-18 (CBCL) e o Inventrio de Estilos Parentais (IEP). Para avaliar o efeito
do estilo parental sobre a presena de dificuldades caractersticas do TND foi empregada a
prova estatstica de regresso logstica Os resultados preliminares da etapa de triagem (n=127)
apontam que o estilo parental negativo aumenta em 2.9 vezes o risco de um escolar apresentar
dificuldades caractersticas do TND (OR=2.9; IC 95%: 1.2 a 7). Este risco tambm se v
incrementado em 5.3 vezes quando se trata do sexo masculino (OR=5.3; IC 95%: 2 a 14).
Espera-se que a magnitude destes resultados deflagre a demanda de programas de
interveno precoce que ajudem s crianas e aos seus respectivos pais a aprenderem a usar
seus recursos internos, no sentido de promover prticas parentais positivas e um ambiente
familiar acolhedor. Acredita-se que a deteco e preveno precoce de comportamentos
perturbadores contribuam a que estes no evoluam a transtornos mais graves na adolescncia
e vida adulta, tornando a preveno uma estratgia promotora da sade mental.

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Bullying, diagnstico e intervencin teraputica


Pamela Ullauri2, 1, Mara Angeles Landzuri2, 1.
1. Psicologa Clnica, Superar Centro Integral de Psicologia, Quito, Ecuador, 2. Proyectos de
Salud Mental, Superar Centro Integral de Psicologia, Quito, Ecuador.
Las vctimas de bullying han atravesado por traumas que muchas veces son trivializados y
reducidos a una dinmica comn de interaccin entre jvenes, siendo los padres y maestros
los causantes de una victimizacin secundaria al atribuirles la culpa de dichos maltratos o
quitando importancia a estos eventos. Los daos psicolgicos por los que estos jvenes
atraviesan son varios y se explicarn con mayor detalle en este trabajo, entre ellos se presenta
al estrs postraumtico como consecuencia de dichas vivencias. As tambin es posible que los
agresores hayan vivido violencia en alguno de sus entornos y descarguen su ira con el ms
dbil, produciendo de esta manera un crculo de agresin interminable. Es muy importante
concienciar a nuestra sociedad y al mundo entero de esta evidente situacin que est siendo
cada vez ms evidente con el paso de los aos. Los casos de bullying en la regin estn
creciendo de manera alarmante. En un estudio realizado por la Organizacin de las Naciones
Unidas para la Educacin, la Ciencia y la Cultura (UNESCO) entre 2005 y 2011, en
Latinoamrica (Argentina, Brasil, Colombia, Costa Rica, Cuba, Chile, Ecuador, El Salvador,
Guatemala, Mxico, Nicaragua, Panam, Paraguay, Per, Repblica Dominicana y Uruguay)
en 2.969 escuelas, 3.903 aulas y 91.223 estudiantes de sexto grado, se obtuvo como resultado
que el 51% de los estudiantes fueron vctimas de abuso durante el mes anterior a la
evaluacin, el 39% haban sido vctimas de robo, el 27% haban recibido violencia verbal, el
17% violencia fsica y el 18% otro tipo de maltrato. Siendo Ecuador el segundo pas con
mayores casos de violencia fsica. El objetivo de la presentacin es comprender el estrs
postraumtico que presentan los pacientes afectados con miras a una intervencin eficaz y a la
psicoeducacin a la comunidad sobre el tema. El trabajo presentar y analizar un caso de
Bullying atendido y cmo se pudo detectar y comprobar su problemtica. A travs del anlisis
del caso, se observarn los resultados de una evaluacin inicial completa al paciente previa al
tratamiento y los avances dentro del proceso teraputico. La presentacin se enfocar en el
anlisis de el Bullying, su definicin, causas y consecuencias, fases del acoso escolar, daos
psicolgicos y maneras de detectarlo y prevenirlo. As tambin se abordar el estrs
postraumtico partiendo de su definicin y criterios diagnsticos. Se espera que este trabajo
contribuya a crear espacios de reflexin, debate y aportes referentes al entendimiento del
fenmeno de Bullying, su diagnstico e intervencin considerando el estrs postraumtico que
presentan en terapia los pacientes debido a los traumas en su historia.
Conductas Parentales y su Influencia en el Desarrollo de la Ansiedad Social en Nios del
4to al 6to de primaria de un Distrito de Lima Metropolitana
Lizeth Vilcherrez Pizarro, Cesar Merino.
Lima, Universidad de San Martn de Porres, Lima, Peru.
Resumen
El presente trabajo se centra en investigar la influencia de la conducta parental sobre la
ansiedad social en nios, controlando por los efectos de la deseabilidad social. Estas
experiencias fueron registradas mediante tres instrumentos de auto-reporte (Inventario de
Percepcin Parental (IPP), de la Escala de Ansiedad Social Revisada para Nios, SACS-R; y la
Escala de Deseabilidad Social Infantil, EDESI), en una muestra de 202 nios de Lima, entre 8 y
12 aos de edad. El anlisis se orient a validar los instrumentos y a probar las relaciones de
influencia entre las variables. En la primera parte de los resultados indican buenas propiedades
psicomtricas respecto a la estructura interna y confiabilidad de los instrumentos. En la

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segunda parte, se verific la influencia de las conductas parentales negativas sobre la ansiedad
social en nios; luego de remover estadsticamente los efectos de la deseabilidad social, las
conductas parentales positivas no mostraron efectos estadsticamente significativos. Estos
efectos fueron similares en nios y nias. Se discute las consecuencias de estos resultados
para la programacin de intervenciones de modificacin de conducta.
Conductas Parentales y su Influencia en el Desarrollo de la Ansiedad Social en Nios del
4to al 6to de primaria de un Distrito de Lima Metropolitana
El presente trabajo se centra en investigar la influencia de la conducta parental sobre la
ansiedad social en nios, controlando por los efectos de la deseabilidad social. Estas
experiencias fueron registradas mediante tres instrumentos de auto-reporte (Inventario de
Percepcin Parental (IPP), de la Escala de Ansiedad Social Revisada para Nios, SACS-R; y la
Escala de Deseabilidad Social Infantil, EDESI), en una muestra de 202 nios de Lima, entre 8 y
12 aos de edad. El anlisis se orient a validar los instrumentos y a probar las relaciones de
influencia entre las variables. En la primera parte de los resultados indican buenas propiedades
psicomtricas respecto a la estructura interna y confiabilidad de los instrumentos. En la
segunda parte, se verific la influencia de las conductas parentales negativas sobre la ansiedad
social en nios; luego de remover estadsticamente los efectos de la deseabilidad social, las
conductas parentales positivas no mostraron efectos estadsticamente significativos. Estos
efectos fueron similares en nios y nias. Se discute las consecuencias de estos resultados
para la programacin de intervenciones de modificacin de conducta.
Conductas Parentales y su Influencia en el Desarrollo de la Ansiedad Social en Nios del
4to al 6to de primaria de un Distrito de Lima Metropolitana
Resumen
El presente trabajo se centra en investigar la influencia de la conducta parental sobre la
ansiedad social en nios, controlando por los efectos de la deseabilidad social. Estas
experiencias fueron registradas mediante tres instrumentos de auto-reporte (Inventario de
Percepcin Parental (IPP), de la Escala de Ansiedad Social Revisada para Nios, SACS-R; y la
Escala de Deseabilidad Social Infantil, EDESI), en una muestra de 202 nios de Lima, entre 8 y
12 aos de edad. El anlisis se orient a validar los instrumentos y a probar las relaciones de
influencia entre las variables. En la primera parte de los resultados indican buenas propiedades
psicomtricas respecto a la estructura interna y confiabilidad de los instrumentos. En la
segunda parte, se verific la influencia de las conductas parentales negativas sobre la ansiedad
social en nios; luego de remover estadsticamente los efectos de la deseabilidad social, las
conductas parentales positivas no mostraron efectos estadsticamente significativos. Estos
efectos fueron similares en nios y nias. Se discute las consecuencias de estos resultados
para la programacin de intervenciones de modificacin de conducta.
Conductas Parentales y su Influencia en el Desarrollo de la Ansiedad Social en Nios del
4to al 6to de primaria de un Distrito de Lima Metropolitana
Resumen
El presente trabajo se centra en investigar la influencia de la conducta parental sobre la
ansiedad social en nios, controlando por los efectos de la deseabilidad social. Estas
experiencias fueron registradas mediante tres instrumentos de auto-reporte (Inventario de
Percepcin Parental (IPP), de la Escala de Ansiedad Social Revisada para Nios, SACS-R; y la
Escala de Deseabilidad Social Infantil, EDESI), en una muestra de 202 nios de Lima, entre 8 y
12 aos de edad. El anlisis se orient a validar los instrumentos y a probar las relaciones de
influencia entre las variables. En la primera parte de los resultados indican buenas propiedades
psicomtricas respecto a la estructura interna y confiabilidad de los instrumentos. En la
segunda parte, se verific la influencia de las conductas parentales negativas sobre la ansiedad

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social en nios; luego de remover estadsticamente los efectos de la deseabilidad social, las
conductas parentales positivas no mostraron efectos estadsticamente significativos. Estos
efectos fueron similares en nios y nias. Se discute las consecuencias de estos resultados
para la programacin de intervenciones de modificacin de conducta.
Para un mundo ms justo donde lo diferente no sea un obstculo
Diana Zilberman.
practica privada, San Martn, Argentina.
Abstract Central: Autora: Profesora Diana Raquel Zilberman Educadora en Sexualidad y
gnero. (UBA) Investigadora en Salud Activa sobre "Abuso Infantil" Docente de Varios Niveles
Author: Professor Diana Raquel Zilberman Sexuality and sex educator. (UBA) Active Health
Research on "Child Abuse" Professor of several levels. Teniendo en cuenta los cambios
socioculturales de los ltimos tiempos, es imposible no preocuparse por aquellas personas que
quedan excluidas de nuestro sistema educativo. Ultimamente la demanda de vacantes para
inscribir en las escuelas a nios/as con dificultades ha crecido, ya que ante el pedido de los
padres a escuelas convencionales, en la mayora, la respuesta es simplemente NO. Los
establecimientos educativos , carecen de infraestructura adecuada, lo que no facilita el trabajo
con personas diferentes, como es el caso de las problemticas motoras. Las/los docentes en la
mayora, no tienen la formacin para resolver los conflictos que derivan de esta compleja
relacin docente-escuela-padres-estado. La falta de proyectos comunes entre las escuelas
especiales y las convencionales es un tema muy importante a resolver. Es una temtica con
muchas aristas a resolver, con poco camino recorrido, y en el medio nios/as, padres, madres y
familias a la espera de una respuesta satisfactoria, que ante tantas complicaciones necesitan
de toda una sociedad que cambie su mirada, y de ms respuestas a sus necesidades. Por todo
lo expuesto queda ms que evidente la necesidad de visibilizar esta problemtica, si queremos
que se cumplan los derechos para todo/as en forma igualitaria y lograr as una verdadera
escuela inclusiva. Given the cultural changes of recent times, it is impossible not to worry about
those who are excluded from our educational system. Lately the demand for vacancies in
schools to enroll children / as has grown with difficulty because when asked by parents to
conventional schools, at most, the answer is simply "NO". Educational institutions, lack of
adequate infrastructure, so that makes the work with different people, as in the case of motor
problems. The / teachers in the majority, are not trained to resolve conflicts arising from this
complex relationship teacher-school-parent-state. The lack of common projects between
conventional and special schools is a very important issue to resolve. It is a subject with many
sides to solve, with little progress made, and in the middle children / as, parents and families
waiting for a satisfactory answer to so many complications that require an entire society to
change its look, and more answers to your needs. For these reasons it is more than evident the
need to visualize this problem, if we are to fulfill the rights to all / as equally and thus achieve a
truly inclusive school.
Habilidades Socio Emocionales de las Jvenes Tuteladas en Catalua-Espaa
Nair Zrate Alva.
Psicologa, UAB-LOAPSI, Barcelona, Spain.
Abstract Central: Un estudio realizado por Sala, Villalba, Jariot y Rodrguez (2009) respecto a
la insercin sociolaboral de los jvenes tutelados encontr que un 46% de los mencionados
presentaban mucha inestabilidad laboral y un 21% de los jvenes presentaban serias
dificultades para encontrar trabajo. Siendo una de las causas principales la inestabilidad
emocional (59.6%) donde las chicas eran las que tenan ms inestabilidad emocional (49.1%

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vs. 28.3%) y maternidad adolescente (30.4% vs. 9.4%) que los chicos. Es por la complejidad de
problemticas psicosociales de los jvenes tutelados que nos hemos planteado como objetivos:
Analizar si las jvenes tuteladas presentan diferencias en las habilidades socioemocionales
respecto a las jvenes no tuteladas y si fuese as, analizar si estas diferencias son atribuidas a
la condicin de ser tutelada o al ambiente desfavorecido, y por tanto, tendran habilidades
similares a las jvenes no tuteladas de ambientes desfavorecidos. As como, tambin analizar
si las jvenes tuteladas no madres presentan diferencias en las habilidades socioemocionales
respecto a las jvenes tuteladas madres. La muestra de nuestro estudio estuvo conformado por
cuatro grupos: 18 madres tuteladas, 18 jvenes tuteladas no madres y dos grupos control de 18
jvenes no tuteladas de poblacin normalizada y 18 jvenes de ambientes desfavorecidos que
se encuentran entre los 15 y 19 aos de edad. El Instrumento utilizado fue el Test de
Habilidades Socioemocionales (EQi de Bar-On), el cual es un inventario compuesto por 5
factores generales: Componente Intrapersonal, Interpersonal, Adaptabilidad, Gestin del Estrs
y Estado Afectivo. Entre los principales resultados se encontraron que las jvenes tuteladas
informan de peores habilidades socioemocionales que las adolescentes no tuteladas de
ambientes normales, pero no difieren de las no tuteladas de ambientes desfavorecidos, lo que
implica que el entorno desfavorecido sera el que explicara las carencias en las habilidades
socioemocionales y no la tutela en s. Respecto a las jvenes tuteladas estas informan de
peores habilidades socioemocionales que las tuteladas madres. Adems, las jvenes tuteladas
madres informan de semejantes habilidades socioemocionales que las jvenes no tuteladas de
ambientes normalizados, lo que impresiona que la maternidad proporciona atribuciones
emocionales positivas a las madres adolescentes.
Cognitive & Neuroscience/ Neurociencia y Cognicin/ Neurocincia e Cognio
Linguagem da Alma no Processo de Envelhecimento em Santarm - Par - Brasil
Izaura A. cardoso, Lucivnia de Souza.
Instituto Esperana de Ensino Superior (IESPES), Santarm, Brazil.
Abstract Central: A arte tem um falar. Nenhuma arte ou qualquer desenho, por mais simples
que seja no deixa de revelar uma linguagem da alma. Proporciona, s pessoas que esto na
idade avanada, expressar sentimentos, emoes, medos e angstias acerca do seu processo
de envelhecimento, possibilitando, alm do resgate de situaes de vida que no foram
devidamente elaboradas, um canal de escuta, de ateno por parte dos outros, bem como,
lazer. O presente trabalho tem como objetivo possibilitar a expresso de sentimentos e
rememorao das experincias de vida dos idosos atravs de tcnica. E objetivos especficos
resgatar as lembranas, pensamentos e histrias de superao dos idosos atravs da roda da
conversa, estimulando, dessa maneira, suas habilidades cognitivas; Oportunizar aos idosos a
expresso da auto-imagem; Proporcionar aos idosos um momento para expressarem suas
necessidades, sentimentos, emoes, medos e angstias, no processo de envelhecimento,
atravs da arte terapia. Pblico alvo: Idosos que participam do grupo de idosos do bairro
Ipanema, em Santarm - Par- Brasil, com a idade a partir de 60 anos, no perodo de maro a
dezembro de 2011, totalizando 30 participantes regulares. Com a tcnica da roda da conversa,
junto com a arte terapia foi observado a necessidade que os idosos tem de se expressar,
falando de suas preferncias, satisfaes ou frustraes, expondo suas lembranas,
pensamentos e histrias de superao estimulando, dessa maneira, suas habilidades
cognitivas, onde foi observado que a problemtica mais citada foi a solido e o medo da morte.

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The Interface Between Cognitive Neuropsychology, Neurobiology, and Psychopathology:


Insight into the Neuroscience of OCD and Related Disorders
Amitai Abramovitch1, 2, Sabine Wilhelm1, 2, Carina DAlcante4, Juliana Diniz4, Victor Fossaluza4, 5,
Marcelo Batistuzzo4, Antonio Lopes4, Thilo Deckersbach1, 2, Roseli Shavitt4, Leandro MalloyDiniz6, Euripedes Miguel4, Marcelo Hoexter4, 7, Amitai Abramovitch1, 2, Jonathan Abramowitz3,
Andrew Mittelman1, Sabine Wilhelm1, 2, Maja Nedeljkovic8, Michael Kyrios8, Richard Moulding8,
Matthew Hughes8, Claire Gillan9, 10, Annemieke Apergis-Schoute9, 11, Sharon Morein-Zamir9, 10,
Valerie Voon9, 11, Emilio Fernandez-Egea9, 11, Gonzalo Urcelay9, 10, Naomi Fineberg9, 12, Barbara
Sahakian9, 11, Trevor Robbins9, 10.
1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA, 2. Department
of Psychiatry, Harvard Medical School, Boston, MA, USA, 3. Department of Psychology,
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 4. Department of Psychiatry,
University of So Paulo Medical School, So Paulo, Brazil, 5. Institute of Mathematics and
Statistics, University of So Paulo, So Paulo, Brazil, 6. Institute of Biological Sciences, Federal
University of Minas Gerais, Belo Horizonte, Brazil, 7. Department of Psychiatry, Federal
University of So Paulo, So Paulo, Brazil, 8. Faculty of Life and Social Sciences, Swinburne
University of Technology, Hawthorn, NSW, Australia, 9. Behavioural and Clinical Neuroscience
Institute, University of Cambridge, Cambridge, United Kingdom, 10. Department of Psychology,
University of Cambridge, Cambridge, United Kingdom, 11. Department of Psychiatry,
Addenbrooke's Hospital, Cambridge, United Kingdom, 12. Department of Psychiatry, Queen
Elizabeth II Hospital, Hertfordshire, United Kingdom.
As supported by robust evidence of frontostriatal pathophysiology, there appears to be a
consensus regarding the validity of the prevailing neurobiological model of obsessivecompulsive disorder (OCD). However, research into the neuropsychology of OCD has yielded
notoriously inconsistent results. Additionally, very little is known about the interface between
neuronal substrates, neurocognitive functions, and the clinical aspects in OCD and obsessivecompulsive spectrum disorders in particular. Thus, despite a surge of imaging and
neuropsychological investigations published within the last decade, several essential questions
remain unanswered. Notably, what is the nature and dynamic of the interface between
neurocognitive functioning and obsessive-compulsive symptom severity? Can we identify neural
substrates and cognitive domains associated with treatment response in OCD, or in difficult-totreat conditions such as hoarding disorder? Finally, can we harness neuroscientific research to
improve our understanding of the similarities and differences within a disorder category, such as
the proposed obsessive-compulsive and related disorders category for DSM-V?
In this symposium, four researchers will present findings from innovative projects that promote
our understanding of the neurocognitive and neurobiological aspects of OCD and hoarding
disorder. Moreover, these presentations will provide important insight into the interface between
the neurobiological, neuropsychological, and clinical aspects of these disorders.
Carina DAlcante et al. will present the results of a study examining neuropsychological
predictors of response to cognitive-behavioral therapy or fluoxetine in treatment-nave patients
with OCD. Amitai Abramovitch and colleagues will present results from the first meta-analysis of
neuropsychological functioning in adult OCD, an undertaking that spanned nearly 25 years of
global research and included more than 3500 patients. Maja Nedeljkovic and colleagues will
present the results of a study examining the neural substrates of response inhibition and the
performance on the emotional Go/No-Go task within in a group of hoarding disorder patients
prior to receiving CBT. Finally, Claire Gillan and colleagues will present the results of a series of
novel studies exploring the neurobiological substrates of habit formation in OCD.
Sabine Wilhelm from Massachusetts General Hospital and Harvard Medical School will serve as
the discussant for this symposium. Dr. Wilhelm will integrate findings across presentations,

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highlighting the translational value and prominent contribution of neurocognitive advancements


to our understanding of OCD and related disorders.
Neuropsychological predictors of response to randomized treatment in obsessivecompulsive disorder.
OBJECTIVE: To identify neuropsychological predictors of treatment response to cognitivebehavioral therapy (CBT) and fluoxetine in treatment-nave adults with obsessive-compulsive
disorder (OCD).
METHOD: Thirty-eight adult outpatients with OCD underwent neuropsychological assessment,
including tasks of intellectual function, executive functioning and visual and verbal memory,
before randomization to a 12-week clinical trial of either CBT or fluoxetine. Neuropsychological
measures were used to identify predictors of treatment response in OCD.
RESULTS: Neuropsychological measures that predicted a better treatment response to either
CBT or fluoxetine were higher verbal IQ (Wechsler Abbreviated Scale of Intelligence) (p=0.008);
Higher verbal memory scoring on the California Verbal Learning Test (p=0.013); shorter time to
complete part D (Dots) (p<0.001), longer time to complete part W (Words) (p=0.025) and less
errors on part C (Colors) (p<0.001) in the Victoria Stroop Test (VST). Fewer perseverations on
the California Verbal Learning Test, a measure of mental flexibility, predicted better response to
CBT, but worse response to fluoxetine (p=0.002).
CONCLUSION: In general, OCD patients with better cognitive and executive abilities at baseline
were more prone to respond to either CBT or fluoxetine. Our finding that neuropsychological
measures of mental flexibility predicted response to treatment in opposite directions for CBT
and fluoxetine suggests that OCD patients with different neuropsychological profiles may
respond preferentially to one type of treatment versus the other. Further studies with larger
samples of OCD patients are necessary to investigate the heuristic value of such findings in a
clinical context.
Neuropsychological Performance in Adult Obsessive-Compulsive Disorder: A MetaAnalysis
Background: The past two decades have witnessed a progressively increasing interest in
neurobiological mechanisms and associated neuropsychological functioning in OCD. In contrast
to imaging studies, OCD trials have suggested notoriously inconsistent neuropsychological
findings that have led to much debate. In an attempt to investigate the divergent nature of
results in this field, we have conducted the first meta-analysis of neuropsychological functioning
in adult OCD.
Methods: Literature search in Medline, ISI, and PsychInfo enabled us to identify 209 studies, of
which 115 studies met inclusion criteria. Each of the studies reported at least one of 32
standardized neuropsychological tests comparing adult OCD patients with healthy controls. We
have categorized the results into 10 functional domains: planning, response inhibition, set
shifting/cognitive flexibility, verbal memory, non-verbal memory, processing speed, verbal
working memory, spatial working memory, visuospatial functions, and sustained attention. For
each domain, weighted pooled Cohens d effect size (ES) was calculated. In an attempt to
account for the pattern of inconsistent results, mediator analyses were also performed.
Results: Across all domains, we have found significant and heterogeneous effect sizes. Medium
effect sizes were found in planning, response inhibition, set shifting/cognitive flexibility,
processing speed, sustained attention, and spatial working memory (d ranging from -0.49 to 0.57). Small ES were found in verbal working memory, visuospatial functions, and verbal
memory (d ranging from -0.34 to -0.39). A large effect size was found for non-verbal memory,
primarily corresponding to performance on the Rey-Osterrieth Complex Figure test (d = -0.73).
Mediator analyses yielded complex results in which OCD severity, age of onset, percent
participants with comorbidity, percent medicated participants, and percent male were found to

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mediate ES in some of the domains.


Conclusion: Our results suggest that adults with OCD exhibit neuropsychological functioning
disparities relative to healthy controls. Specifically, individuals with OCD performed within an
average of 0.5 standard deviations below controls across domains. Moderator analyses yielded
a complex picture in which OCD severity, depressive severity, medication, comorbidity, and
gender may have differential mediating effects in OCD. These results will be discussed in view
of current neurobiological and neuropsychological models of OCD.
Brain function in Hoarding Disorder: an fMRI investigation.
Previous research has reported that hoarding patients tend to exhibit, attenuated ability to
sustain attention, difficulty with distinguishing relevant items from irrelevant items, and problems
with impulsivity, compared to clinical and healthy controls (Grisham et al., 2007; Tolin et al.,
2011). Hoarding patients have also been reported to demonstrate excessive emotional
attachment to their possessions (Steketee & Frost, 2003). Therefore, brain networks that
underpin these cognitive impairments related to inattention and excessive emotional expression
may have clinical utility as biomarkers to predict treatment response outcome. The paper will
present preliminary results from an ongoing clinical study examining brain networks associated
with attention and emotional decision-making processes, and the predictive utility of these
neurological functions in treatment response. The participants, all of whom met the criteria for
Hoarding Disorder and underwent CBT based group treatment program were required to
complete the Continuous Performance and the Affective Go/No-go Task while undergoing an
fMRI prior to starting treatment. Baseline neuropsychological performance and brain function
were examined in relation to symptom change over treatment. Results are discussed in the
context of current approaches to treatment.
The Neural Basis of Habits in OCD: Implications for the Obsessive-Compulsive Cycle
In a departure from more traditional models of Obsessive-Compulsive Disorder (OCD), it has
been suggested that a more tenable account of the OCD is one in which compulsions, not
obsessions, are central to the disorder. One promising model of the compulsive problem in OCD
is based on the excessive formation of habits. In two separate studies in our group, we have
demonstrated that OCD patients have a disruption in the balance between goal-directed and
habitual behavioural control in appetitive and avoidance instrumental learning. Furthermore,
behaviour was not associated with any differences in conditioned or explicit fear that might
otherwise explain the habit phenomenon in OCD. These habits were associated with a
premonitory urge to perform them, adding support to the notion that excessive habits are an apt
model of compulsions in OCD. To delineate the neural substrates of this bias towards habit
formation in OCD, in this experiment we carried out an avoidance habit task with 20 patients
and 20 matched healthy controls in an fMRI scanner using electric shock as the aversive event.
We aim to test the competing hypotheses that (1) failures in top-down behavioural inhibition in
the prefrontal cortex render OCD patients unable to exert goal-directed control over habits in the
striatum, and (2) that enhanced bottom-up activation in the striatum is responsible for
increasing the strength of stimulus-response habits in OCD, irrespective of prefrontal inhibition.
We predict that both mechanisms are involved in the habit bias in OCD patients and that this
might explain the heterogeneity of the disorder, particularly in terms of pharmacological
treatment response.
The Role of Cognitive Processes in Generalisation of Conditioned Fear
Ola Ahmed, Peter Lovibond.
Psychology, The University of NSW, Sydney, NSW, Australia.

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Abstract Central: Generalisation of conditioned fear has been implicated in the maintenance
and proliferation of fear in anxiety disorders. It is still unclear to what extent generalisation of
fear learning is an automatic as opposed to a cognitively controlled process. The present study
aimed to explore the role of cognitively controlled processes in fear generalisation by
manipulating the instructions given to participants. Specifically, the study aimed to test whether
explicitly instructed information would affect the pattern of generalisation observed following fear
conditioning. In the experiment, participants were presented with repeated presentations of
simple geometric figures, each consisting of a particular shape and colour. One of these figures
(the conditioned stimulus, CS) was always followed by an electric shock (the unconditioned
stimulus, US). Before the test phase, participants were instructed that one of the stimulus
features (either colour or shape) was useful for predicting the occurrence of the shock. In the
test phase, participants were presented with new stimuli that contained either the same colour
or shape as the CS. On all trials, self-reported shock expectancy and skin conductance were
recorded. Based on self-reported expectancy of shock, participants showed significantly greater
generalisation to the test stimuli that included the instructed stimulus feature. Participants
instructed that colour/shape was predictive of shock were seen to generalise more strongly to
stimuli that were the same colour/shape as the CS. Skin conductance data also reflected this
overall pattern (not statistically significant). As such, generalisation of conditioning was
observed to be stronger in a direction consistent with the instruction manipulation, suggesting
that explicitly instructed information was used to guide responding. While such a result does not
rule out the existence of an automatic process in the generalisation of conditioning, it does
suggest that higher-order cognitive processes play an important role that requires continued
investigation.
NEUROCIENCIAS Y COGNICIN-NEUROSCIENCES AND COGNITION
Vctor Arce Carren.
Escuela de Posgrado, UNMSM - UCSUR, Lima, Peru.
DETERMINACIN DEL SISTEMA DE CONSCIENCIA PERSONAL: APORTES DE LA TEORA
INFORMACIONAL Y LAS NEUROCIENCIAS
VCTOR ARCE CARREN
La conciencia ha sido -en Psicologa, especialmente-, como el ter lo fue para la fsica en su
poca; el flogisto para los alquimistas, etc. Pero, qu es?, es una sustancia ontolgicamente
distinta de la materia? Si es as, cules son sus propiedades?, o acaso es una nueva
propiedad de la misma sustancia que rebasa los conocimientos hasta ahora existentes? Es
una propiedad emergente del cerebro humano?
Somos una realidad que articula lo gentico y lo social. No obstante, en qu forma ocurre la
misma?
Planteamos explicar tales relaciones desde las Neurociencias y la Teora Informacional, que
nos explica los procesos mediante los cuales el sistema social nos transforma de individuos
biolgicos en individuos sociales gracias a la actividad consciente.
Ergo, en Psicologa, orientar -o intervenir- a una persona implica -adems de la pertinente
tecnologa- precisar respuestas a: qu es realmente la persona orientada?, qu es cuando
est siendo afectada por x situacin o condicin?, qu procesos o razones han determinado
su problema actual?, qu est siendo afectado: un(a) rgano, organismo, cerebro, psiquis,
mente, conciencia, espcimen del reino animalia, o en su defecto, una persona, una
personalidad?
UN ESTUDIO NEUROCIENTFICO DE LA EMERGENCIA DEL SISTEMA DE LA ACTIVIDAD
PERSONAL

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A NEUROSCIENTIFIC STUDY OF THE EMERGENCY OF THE PERSONAL ACTIVITY


SYSTEM
Vctor Arce Carren
La naturaleza de la actividad personal est se engarza con dos procesos esenciales: las
relaciones existentes entre la consciencia y el cerebro, y el moldeamiento del cerebro humano.
Darle salida a esta cuestin involucra tanto cuestiones ontolgicas -nuestra naturaleza
esencial- cuanto gnoselgicas -definicin y la explicacin de la sociedad, la conciencia y la
personalidad. esto nos lleva a generar aun modelo sociobiolgicodel cerebro con un enfoque
monista materialista, con la finalidad de explicar qu es y cmo emerge la actividad personal.
Por ello, igualmente es fundamental precisar la importancia de los determinantes sociocinticos
de nuestra actividad personal. Esto implica estar en condiciones de explicar la relacin ente la
sociedad y la conciencia, entre la conciencia y el cerebro, entre el cerebro y el cuerpo; para lo
cual la hiptesis de que los procesos esenciales de la vida, que abarcan desde las bacterias
hasta la sociedad humana, son de carcter informacional, creemos que ser de gran utilidad.
PSICOPATA, NEUROCIENCIAS Y TRASTORNOS DE PERSONALIDAD
PSYCHOPATHY, NEUROSCIENCES AND PERSONALITY DISORDERS
Vctor Arce Carren
La primera indagacin que surge es precisar lo que son en realidad los llamados trastornos de
personalidadUn Un primer acercamiento importantes es asumir que los defectos de
personalidad son defectos neuropsquicos del sistema de consciencia y se vinculan en su
origen con trastornos patogenticos (neuropsicolgicos) y patocinticos (psicopatolgicos).
Pero qu es la personalidad. Es el sistema referido al individuo social organizado a partir de la
informacin gentica de sus clulas y a base de la informacin social transcrita en informacin
psquica consciente, de cuya actividad depende la reestructuracin social de sus componentes:
temperamento, intelecto y carcter. esto nos lleva a explicar cules son los soportes neurales
de los subsistemas afectivo-emotivo, cognitivo-productivo y conativo-volitivo, respectivamente.
Y al i9nterior del carcter -motivo bsico de la exposicin- debemos expplicar en qu consisten
realmente la motivaciones, actitudes y conducta, que son precisamente las que alteran en el
trastorno psicoptico
La psicopata es un trastorno sumamente complejo y generador de un enorme inters en
cientficos sociales, neurocientficos, psiclogos y filsofos especialmente, tanto por la cuanta y
la gravedad del dao que genera al sistema de la personalidad, en lo econmico-social, cuanto
por las significativas implicancias que significa para los sistemas de justicia criminal y salud
psquica.
Aun cuando todava hoy en da se sigue debatiendo e investigando respecto a la etiologa, la
dinmica y los lmites conceptuales de este trastorno, hay una larga tradicin clnica y emprica
en lo que se refiere a los principales atributos afectivos, cognitivos y motivacionales que lo
tipifican. Entre los rasgos ms devastadores de este trastorno se encuentran la cruel
indiferencia hacia los derechos de los dems y la propensin al comportamiento depredador y
violento.
Representacin Cognitiva a Partir del Estilo de Procesamiento de Informacin
Carlos Astroza.
Centro de Investigacin en TI y Aprendizaje, Anfofagasta, Chile.
Abstract Central: Uno de las complicaciones, que se presenta al momento de estimar
conductas asociadas a procedimientos y maniobras referidas a un determinado perfil de
desempeo, es la determinacin o representacin de la estructura cognitiva que dispone el
individuo o grupo, sobre el cual se desea estimar dicho desempeo. De forma de determinar,
con algn grado de certeza el perfil de desempeo a disponer por el individuo o el grupo, sobre

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el cual se desea hacer dicha estimacin. El poder realizar este tipo de estimacin, en mbitos
laborales donde se trabaja con procedimientos y desempeos acotados a especificaciones de
instructivos de manejo de equipos y desarrollo de maniobras, sin duda entrega orientaciones
significativas, al momento de hacer las asignaciones de personal. El presente trabajo, presenta
un procedimiento para determinar la estructura o potencial cognitivo de un individuo o grupo, a
partir del estilo de procesamiento de la informacin indicado por Kolb D. Dicho procedimiento,
es puede utilizar como una referencia para situaciones en las cuales se desea distribuir el
personal para una determinada actividad o procedimiento, en el contexto de maniobras
referidas a un determinado perfil de desempeo.
Participacin de la Familia en la Distribucin y Empleo del Tiempo, como Estrategia de
Tratamiento en Nios de 5 aos a 12 aos de Edad con Problemas de Aprendizaje en Es
Salud -2009
Marilu Barreto Espinoza.
Tumbes, Universidad Nacional Tumbes, Tumbes, Peru.
Abstract Central: La investigacin realizada busca establecer los efectos de la participacin de
los padres en la aplicacin de la estrategia: distribucin y empleo del tiempo en nios de 5 -12
aos de edad con problemas de aprendizaje que acuden a ES Salud 2009., utilizando cuna
hoja de registros elaborada para el estudio asi como tambin un formato de horario para cada
caso, El diseo de la investigacin es no experimental, descriptivo. Los datos se tomaron de las
historias clnicas de 26 nios diagnosticados con problemas de aprendizaje entre mayo y
Octubre del ao 2008, concluyndose que la participacin de los padres (madre) luego de
aplicar la estrategia de uso y distribucin del tiempo demuestra que si es una tcnica eficaz en
el tratamiento de los problemas de aprendizaje de los nios de es salud con problemas de
aprendizaje. The research "Family participation in the distribution and use of time, as a
treatment strategy in children 5 years to 12 years with learning problems in ESSALUD -2009 Is
it possible to establish the effects of parent involvement in the implementation of the strategy:
distribution and time use in children 5-12years old with learning disabilities who attend IS wHO
2009., using a recording sheet prepared for study as well as a time format for each case , The
research design is not experimental, descriptive. The data were taken from the medical records
of 26 children diagnosed with learning disabilities between May and October of 2008,
concluding that the involvement of parents (mother) after applying the strategy of use and time
allocation shows that if a effective technique in the treatment of learning problems of children's
health with learning disabilities.
Attentional control and attentional bias in anxiety: Multiple perspectives on their
relationship
Julian Basanovic1, Michael Eysenck7, Colin MacLeod1, Nigel Chen2, Patrick Clarke1, Tamara
Watson3, Colin MacLeod1, Adam Guastella2, Oana Mocan4, Oana Stanciu5, Laura Visu-Petra4,
Julian Basanovic1, Julie Hadwin6, Helen Richards6.
1. University of Western Australia, Perth, WA, Australia, 2. Brain and Mind Research Institute,
University of Sydney, Sydney, NSW, Australia, 3. University of Western Sydney, Sydney, NSW,
Australia, 4. Babes-Bolyai University, Cluj-Napoca, Romania, 5. University of Edinburgh,
Edinburgh, United Kingdom, 6. University of Southampton, Southampton, United Kingdom, 7.
Royal Holloway, University of London, Egham, United Kingdom.
It has been well established that when multiple stimuli compete for attentional resources high
trait anxious individuals selectively focus attentional resources towards emotionally negative

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information if present, with non-anxious controls instead tending to shift attention away from
negative information. (Bar-Haim, Lamy, Pergamin, Bakermans-Kranenburg, & van IJzendoorn,
2007). It is of importance to identify mechanisms that underpin attentional bias as these
mechanisms are likely to influence the manifestation and maintenance of heightened anxiety
vulnerability, as has been observed in research which attempts to modify these biases (e.g.
Attentional Bias Modification; ABM). Research has also identified anomalies in the ability for
anxious persons to control their attentional resources independent of the effects of valenced
stimuli. Current theories on the relationship between anxiety and attentional control have
suggested that anxiety impedes the ability to control attentional resources through changes in
the central executive component of working memory, as well as specifically the inhibition and
shifting functions required for successful attentional control (Eysenck, Derakshan, Santos, &
Calvo, 2007). As both of these anxiety-linked phenomena implicate changes in the distribution
of attention across stimuli, the understanding of the relationships they hold with each other is
important in order to develop a greater understanding of each phenomena itself, as well as the
role attention plays in anxiety overall.
The current symposium draws together leading research groups from Australia, Romania and
the United Kingdom resulting in a range of research from varying points of focus which all hold
the common trait of investigating attentional control and attentional bias in anxiety.
Presentations will showcase research offering a varied selection of methodologies including
eye-tracking, dot-probe, working memory (WM) and CBT, and attentional shifting paradigms, as
well as sampling from adult, adolescent, and child populations. Specifically, presented research
will shed light on the ability to measure attentional control and attentional bias in a single
paradigm and their relation to trait anxiety, the role of stimulus driven and attentional control
processes in ABM, the effects of trait anxiety on attentional shifting in mid-childhood, and
whether WM and CBT interventions are effective in improving WM and reducing anxiety as well
as their effect on attentional control and academic achievement.
Assessing the relationship between attentional control and attentional bias in trait
anxiety.
Current cognitive theories of anxiety posit that heightened anxiety vulnerability is characterised
by anomalies in attentional processing. Studies into attentional biases in anxious populations
have shown that high anxious persons have a propensity to focus attentional resources on
negative information more so than non-anxious persons (Bar-Haim, Lamy, Pergamin,
Bakermans-Kranenburg, & van IJzendoorn, 2007). Further, more recent research has shown
that high anxious persons exhibit deficient control of attentional resources, resulting in new
contemporary theories such as Attentional Control Theory (Eysenck, Derakshan, Santos, &
Calvo, 2007). However while both these anxiety-linked anomalies are associated with
attentional processing of stimuli, the exact relationship between these two anomalies remains
unknown, the understanding of which has both theoretical implications for the aetiology of
anxiety vulnerability and practical applications in areas such as cognitive bias modification
research.
Through novel methodologies which aimed to provide measures of both attentional control and
attentional bias in the same task, utilising the same stimuli and temporal parameters, the current
project was able to explore the nature of relationship between attentional control and attentional
bias without the confound of employing differing task parameters in measuring each construct.
This new methodology involved the presentation of emotional-neutral image pairs, with the
requirement for participants to discriminate the orientation of a target probe appearing behind
one of the images. Trials either gave instruction beforehand as to the location of the target
probe, with the aim to measure the ability of participants to move attention between stimuli
(attentional control), or gave no instruction, with the aim to measure the tendency for
participants to move attention between stimuli (attentional bias). Using this methodology the

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current project was able to obtain measures of attentional control and attentional bias and the
current presentation will discuss the nature of the observed effects with the aim of better
understanding the relationship between attentional control and attentional bias in anxiety.
Elucidating the Mechanisms of Change Underlying Attentional Bias Modification:
Evidence from Eye Tracking.
A strong base of research suggests that social anxiety disorder is maintained and exacerbated
by biased attentional processing towards threatening information. Evidence further suggests
that the experimental induction of a bias away from threat may attenuate anxious reactivity in
response to a subsequent stressor, and repeated administration may reduce social anxiety
symptoms in clinically socially anxious individuals. While such attentional bias modification
(ABM) may show promise as a potential treatment adjunct for social anxiety, the mechanisms of
change remain unclear. Selective attention is governed by biasing signals from both a bottomup stimulus driven system and a top-down attentional control system, and consequently, the
modification of attentional selectivity may reflect a change in either system. Hence, the present
study sought to determine the relative contribution of stimulus driven and attentional control
processes in ABM, using an eye movement based assessment. Participants were randomly
assigned to received either ABM or placebo. In addition, participants were administered an
antisaccade task immediately prior to and following ABM. In this task, participants were required
to either prosaccade towards, or antisaccade away from an emotional stimulus, providing an
index of stimulus driven and attentional control processes respectively. Relative to placebo,
participants who received ABM exhibited a pre-post reduction in the mean latency to correctly
execute an antisaccade. The findings support the notion that ABM may modify selective
attention by increasing inhibitory attentional control. Implications for the understanding and
treatment of social anxiety are discussed.
Emotional set-shifting in mid-childhood: Effects of individual differences in trait anxiety
and attentional control.
A robust body of evidence points to the fact that individuals with high levels of anxiety
experience various executive functioning deficits. The attentional control theory (ACT; Eysenck,
Derakshan, Santos, & Calvo, 2007; Derakshan & Eysenck, 2009) provided a unifying theoretical
framework for clarifying the relationship between anxiety and cognitive performance. According
to ACT anxiety impairs attentional control, leading to performance decrements in executive
functions such as inhibition or shifting. The current study is investigating shifting, a function
deployed when switching back and forth between multiple tasks, operations or mental sets
(Monsell, 1996).
Even though anxiety symptoms and disorders manifest themselves early in development
(Cartwright-Hatton, McNicol, & Doubleday, 2006; Miu & Visu-Petra, 2009), the evidence
concerning the effects of trait anxiety upon the shifting function, particularly during midchildhood is so far scarce. The current study aimed to investigate attentional shifting in a sample
of early school age children (8-10 years), using a task-switching paradigm which required
participants to alternate between emotional and non-emotional judgments. Trait anxiety and
attentional control capacity were assessed via self-report using the Revised Child Anxiety and
Depression Scale (RCADS; Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000) and the Child
Version of the Attentional Control Scale (ACS-C; Derryberry & Reed, 2002) , while shifting was
assessed using an adapted version of the Attentional Control Capacity for Emotion task (ACCE;
adapted after Johnson 2009). The main results indicated that higher levels of trait anxiety had a
detrimental effect on performance efficiency (measured by response times), but only in the
condition in which trial-by-trial feedback was provided. Furthermore, this anxiety related deficit
was present only in the case of children with poor attentional control capacity. The effect of
anxiety was not exacerbated in switching trials which made more demands on executive

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resources as compared to repetition trials. Regardless of anxiety levels and of stimulus valence,
the costs of disengaging an emotional mental set were smaller than those for engaging an
emotional mental set. Our results partly support the Attentional Control Theory (Eysenck et al.,
2007) and initiate an interesting line of investigation into the relationship between feedback and
anxiety in executive tasks.
Do changes in attention mediate anxiety reductions in interventions aimed to improve
working memory capacity or lower anxiety in young people?
Conceptual frameworks suggest that working memory capacity is lowered in individuals with
elevated anxiety due to interference from worry-related thoughts and impairments in attentional
control. In young people, there is evidence to suggest that poor working memory is a
mechanism that underlies the relationship between elevated anxiety and lowered academic
achievement. The current paper presents findings from a randomised controlled trial in which
young people reporting elevated anxiety and lowered attentional control were allocated to a
computerised working memory training program or a group-based CBT program. We assessed
whether the working memory and CBT interventions were effective in improving working
memory and reducing anxiety. We also considered the possibility that the interventions would
have broader positive effects on attentional control (as indexed by cognitive tasks related to
inhibitory control and attention to threat) and academic achievement (spelling and maths). We
consider two hypotheses: 1) Reduced anxiety leads to improvements in attentional control and
reductions in attention to threat; 2) Improvements in attentional control and reductions in
attention to threat mediate changes in anxiety. Therefore, the results have implications for
understanding the pathways to elevated anxiety and underachievement in school via poor
attentional control and increased attention to threat. The findings also have implications for
developing a viable intervention protocol that could be used within the school environment to
ensure that young people with elevated anxiety can achieve a positive learning outcome and
experience reduced anxiety.
Attentional Control and Attentional Bias in Trait Anxiety: Assessing Their Relationship in
a Single Task
Julian Basanovic, Colin MacLeod.
Psychology, University of Western Australia, Crawley, WA, Australia.
Current theories propose that heightened anxiety vulnerability is characterised by cognitive
anomalies in attentional processing. Studies into attentional biases in anxiety have shown that
persons high anxious have a propensity to focus attentional resources on negative information
more so than non-anxious persons (Bar-Haim, Lamy, Pergamin, Bakermans-Kranenburg, & van
IJzendoorn, 2007). Furthermore, research has shown that high anxious persons experience
decrements in their ability to engage in control of attentional resources (Eysenck, Derakshan,
Santos, & Calvo, 2007). While both these anxiety-linked anomalies are associated with
attentional processing of stimuli, the exact relationship between these two anomalies remains
unknown, the understanding of which has theoretical implications for the aetiology of anxiety
vulnerability as well as practical applications in areas such as cognitive bias modification
research. Through novel a novel methodology aiming to provide measures of both attentional
control and attentional bias in the same task, utilising the same stimuli and temporal
parameters, the current project was able to explore the nature of relationship between facets of
attentional control and attentional bias without the confound of employing differing task
parameters when measuring each construct. This methodology involved the presentation of
emotional-neutral image pairs, with the requirement for participants to discriminate the
orientation of a target probe appearing behind one of the images as quickly as possible. Trials
either gave instruction beforehand as to the future location of the target probe, in order to

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measure the ability of participants to move attention between stimuli (attentional control), or
gave no instruction, with the aim to measure the tendency for participants to move attention
between stimuli (attentional bias). Using this methodology the current project was able to obtain
measures of attentional control and attentional bias as well as evaluate their relationship. The
nature of the observed effects will be discussed with the aim of better understanding the
relationship between attentional control and attentional bias in trait anxiety.
Participao da PAK I na Consolidao, Persistncia e Evocao da Memria Aversiva
em Ratos
Juliana Buonocore1, 2, Andr Koth1, 2, Gustavo Parfitt1, 2, Sara Fernandes1, 2, Daniela Barros1, 2.
1. Universidade Federal do Rio Grande, Rio Grande, Brazil, 2. Instituto de Cincias Biolgicas,
Rio Grande, Brazil.
Juliana Q. Buonocore2*, Andr P. Koth1,2** , Gustavo M. Parfitt1,2**, Sara F. Fernandes2*,
Daniela M. Barros1, 2 1Programa de Ps-graduao em Cincias Fisiolgicas, Fisiologia
Animal Comparada 2Laboratrio de Neurocincias- Instituto de Cincias Biolgicas Universidade Federal do Rio Grande (FURG), Rio Grande - RS- Brasil. Introduo: A formao
da memria envolve alteraes moleculares e estruturais na regio CA1 do hipocampo, que
favorecem o incremento do citoesqueleto e aumentam a eficcia sinptica. Esse processo
decorre da ativao de uma cascata de molculas, dentre elas a serina/treonina cinase
ativadas por p21, PAK, essencial para a plasticidade sinptica no sistema nervoso central.
Objetivo: O objetivo deste trabalho foi identificar o envolvimento da PAK do grupo I no
processamento da fase final da consolidao, persistncia e evocao da memria aversiva de
longa durao (MLD). Mtodos: Foram utilizados ratos Wistar machos (n = 239, 2-3 meses,
250-280 g), obtidos do Biotrio da Universidade Federal do Rio Grande - FURG (Rio Grande,
RS, Brasil). Este trabalho foi aprovado pelo Comit de tica em experimentao animal da
FURG 067/2011. Os animais foram submetidos cirurgia estereotxica para o implante de
cnulas na regio CA1 do hipocampo direito e esquerdo, atravs das quais foi infundido o
inibidor da PAK I, IPA-3, nas concentraes de 0,5; 1,0 e 2,0 mM, salina ou DMSO 3%
(controles). O comportamento foi avaliado atravs do teste de medo condicionado contextual
(MCC), sendo que o efeito dos tratamentos sobre a memria foi investigado em trs momentos
distintos: na consolidao (infuso 6h ps-treino), na persistncia (infuso 12 h aps a sesso
de treino) e na evocao (infuso 15 min antes da sesso de teste). Os testes para MLD foram
executados 24h aps o treino e os testes para avaliar a persistncia da memria foram
realizados 7 dias aps o treino. A partir da verificao da normalidade e homogeneidade de
varincia, a anlise estatstica foi feita atravs de ANOVA seguida pelo teste de Dunnett (p
<0,05 foi considerado para indicar significncia estatstica). Resultados: A infuso 6h ou 12h
ps-treino ou 15min pr-teste no causou alterao na MLD medida 24h aps o treino. A
injeo de IPA-3 12h ps-treino causou prejuzo na persistncia da MLD avaliada 7 dias pstreino, no entanto, no houve alterao significativa na atividade locomotora dos animais
submetidos ao tratamento, verificada atravs da tarefa de campo aberto. Concluso: De acordo
com esses resultados, a PAK I no parece ter participao significativa na fase final da
consolidao da MLD, quando bloqueada s 6h ps-treino, nem na fase da evocao s 24h
ps-treino. Porm, o bloqueio dessa cinase 12h ps-treino prejudicou a persistncia da MLD.
Apoio financeiro: CNPq, CAPES.
La Creacin de Sentido en el Humano y su Representacin Mediante dos Modelos
Biosociales de Comunicacin Intrapersonal
Gil Burgos C.

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Universidad de Puerto Rico, Rio Piedras, USA.


Abstract Central: El objetivo principal de esta investigacin es el estudio de la comunicacin
intrapersonal como instancia fundamental en el proceso de creacin de sentido. Demostrar
que el ser humano carece de instintos y es, precisamente por esta condicin, que este proceso
se desarrolla de manera particular en nuestra especie. Mediante la exposicin de dos modelos
bsicos, uno que corresponde a la instancia prelingstica y el otro a la lingstica de la
comunicacin intrapersonal, buscar identificar la relacin entre los componentes bio-genticos
y los socio-culturales, estableciendo como frontera entre ambas instancias la adquisicin del
lenguaje. El estudio de la comunicacin intrapersonal puede constituirse en la piedra angular
para unir las ms variadas teoras ya que nos obliga a adentrarnos en el comn denominador
de toda actividad comunicativa humana, el cerebro.
Programa Para Instaurar Habilidades Comunicativas a Traves de un Sistema de
Comunicacion a un Nio con Agenesia del Cuerpo Calloso
M. Cabrejos.
privada, Lima, Peru.
Abstract Central: instaurar un sistema de comunicacin a un nio sin habla y problemas de
conducta
Impacto de Un Programa de Estimulacin Cognitiva En Nios Escolares de Entre 7 y 9
Aos
Mara Gabriela Caligiore Gei.
Universidad del Aconcagua, Lujn de Cuyo - Mendoza, Argentina.
RESUMEN La presente investigacin aborda desde una perspectiva neuropsicolgica y
cognitiva, la eficacia de la implementacin de un programa de estimulacin cognitiva aplicado a
nios escolares mendocinos (Provincia de Mendoza - Argentina) de ambos sexos cuyas
edades oscilaron entre 7 y 9 aos. Los procesos psicolgicos tales como la percepcin, la
atencin, el aprendizaje, la memoria facilitan la interaccin y adaptacin continua del nio con
el medio ambiente. Estos procesos psicolgicos tienen base orgnica, por lo que los cambios
en las conductas cognitivas son posibles gracias a la plasticidad del cerebro. La estimulacin
cognitiva durante la infancia permite entrenar, mejorar y optimizar el funcionamiento cerebral; y
a su vez estas modificaciones consolidan los aprendizajes adquiridos. Para llevar a cabo la
investigacin se conformaron dos grupos de 30 nios cada uno: a) un grupo experimental, al
cual se le aplic un programa de estimulacin cognitiva y b) un grupo control, que no recibi
estimulacin. Los procesos atencionales y mnsicos se evaluaron a travs de las siguientes
tcnicas neuropsicolgicas: Test de Percepcin de Diferencias Caras, Test VADS y Bloques de
Corsi. Para evaluar la efectividad del programa de estimulacin cognitiva, se realizaron
comparaciones intergrupo, en las medidas pre y post-intervencin, a fin de analizar si ste
posibilit una mejora en la eficacia cognitiva en aquellos nios participantes de dicho programa,
en comparacin con los escolares no participantes. En lneas generales, los resultados
demuestran importantes modificaciones en cuanto al rendimiento cognitivo, principalmente en
el grupo experimental. Palabras clave: Neuropsicologa - Estimulacin cognitiva - Atencin Memoria
Neuropsicologa de la Esquizofrenia

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Sandra Camelo, Katherine Gross, Milena Gil, Camila Vivi.


Facultad de Psicologa, Universidad Catlica de Colombia, Bogot, Colombia.
Abstract Central: Sandra Camelo Camila Vivi Katherine Gross Jessica Milena Gil
MODALIDAD: PRESENTACION LIBRE TEMA: NEUROPSICOLOGIA DE LA
ESQUIZOFRENIA RESUMEN La presente revisin tiene como objetivo la discusin, anlisis y
reflexin de las diferentes teoras neurocognitivas que explican la esquizofrenia, las teoras
sobre la etiologa de la enfermedad (Harrison & Owen (2003) y las hiptesis neurobioqumicas
encontradas como la dopaminrgica, retomando estudios de Connell, (1958) hasta Prez y
Vergara (2012);la hiptesis de los segundos mensajeros en donde estn implicados
neurotransmisores como la serotonina, noradrenalina, y el Glutamato, encontrados por Kapur &
Remington, (1996). Por otro lado, se sealan los dficits a nivel cognitivo presentes en esta
enfermedad los cuales afectan procesos como la atencin (Cornblatt, 1989), citado por
Martnez en el 2011; Blanchard, (1994), citado por Galverna & cols 2011; Hass(2001), citado
por Lozano en el 2009; el dficit en la memoria estudiada por autores como Galaverna, Marino,
& Abraham, (2008); Chan, Chen, &Law, 2005; Kalkstein, Wylie, citados por barrera en el 2006;
dficit en las funciones ejecutivas como la capacidad para iniciar, planificar, controlar y
monitorizar la propia conducta con autores como Baddeley (1974), citado por Barrera en el
2006 y Lozano 2009; por ltimo se han encontrado alteraciones en la cognicin social como en
la capacidad de percibir, interpretar y responder en funcion de las emociones de otros, en
estudios de Rund (2007), citado por lozano 2009. De esta manera, el semillero pretende llevar
a cabo un estudio piloto en la ciudad de Bogot con pacientes que padecen de esta
enfermedad para evaluar el dficit cognitivo. Referencias American PsychologicalAssociation
(APA), 2012. Schizophrenia. Recuperado de:
http://search.apa.org/search?query=schizophrenia. Cornblatt BA, Keilp JG.( 1994).Impaired
attention, genetics, and the pathophysiology of schizophrenia.Schizophr Bull; 20:31-46. Barrera,
A (2006). Los trastornos cognitivos de la esquizofrenia. Revista Chilena Neuro-Psiquiat 2006,
44(3). Pp. 215-221. Galaverna, F.; Bueno, A; Mora, C. (2011). Perfil neurocognitivo en la
esquizofrenia. Universidad de Crdoba, Argentina Harrison PJ, Owen MJ.(2003). Genes for
schizophrenia Recent findings and their pathophysiological implications. Lancet; 361: 417-419.
Haas, G.L; Keshavan, M.S; Dickey, J.A; Sweeny, J.A; Dew, M.A. (2001). Patterns of premorbid
psychosocial dysmaturation predict neurocognitive deficits in working memory and psychomotor
speed: Schizophrenic. Res. 49: 108. Lozano, M; Acosta, R. (2009). Alteraciones cognitivas en
la Esquizofrenia. Revista Med.Vol. 17 (01):87-94. Bogot Colombia. Martnez, A. (2011).
Calidad de vida en pacientes esquizofrnicos. Aquichan, Vol 11 (1). Pp. 66.76. Universidad de
la Sabana. Bogot, Colombia. Oreallana, V; Slachevsky, A. (2006). Trastornos neurocognitivos
en la Esquizofrenia. RevistaChilenaNeuropsicologica. Vol 1 (1) pp 41-49; Temucho Chile.
Perez, A; Vergara, L. (2012). Introduccion a una neurobioquimica de la esquizofrenia.Panama.
Instituto nacional de salud mental. Recuperado de
http://www.psiquiatria.com/bibliopsiquis/bitstream/10401/5284/1/7conf1%2052943.pdf
Neuropsicologa de la Depresin
Sandra Camelo.
Facultad de Psicologa, Universidad Catlica de Colombia, Bogot, Colombia.
Abstract Central: Sandra Camelo ( Docente y directora semillero de neurociencias de la
facultad de psicologa de la Universidad Catlica de Colombia) Angie Alejandra Diaz Baquero
(estudiante de quinto semestre facultad de psicologa Universidad Catlica de Colombia) Diana
Carolina Almeida Guerrero (estudiante de sptimo semestre facultad de psicologa Universidad
Catlica de Colombia) Diego Sebastin Moreno Ramrez (estudiante de sptimo semestre

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facultad de psicologa Universidad Catlica de Colombia). MODALIDAD: PRESENTACION


LIBRE TEMA: NEUROPSICOLOGIA DE LA DEPRESION RESUMEN La presente revisin
tiene como objetivo la discusin, anlisis y reflexin de las diferentes teoras neurocognitivas
que explican la depresin, as como la presentacin de los hallazgos relacionados con la
neurobiologa del trastorno y los dficit neuropsicolgicos encontrados. A lo largo de la historia
las diferentes definiciones y causas atribuidas a la depresin se han ido transformando. En
general este es un trastorno relacionado con alteraciones principalmente del humor que tiene
unas caractersticas propias expresadas en alteraciones psicolgicas como: a) la afectividad
(tristeza), b) la cognicin (desesperanza), c) la psicomotricidad (inhibicin) y d) la conducta
(hipoactividad) (Zandino, Ferreira y Cuesta, 2002). En las ltimas dcadas, los avances en
neurociencia, nos han brindado otra perspectiva de la depresin, reevaluando las definiciones
conceptuales, especialmente con respecto a la neurobiologa del trastorno, por lo que podemos
encontrar en la literatura nacional e internacional distintas hiptesis como la catelcolaminergica
propuesta por Schildkraut en 1965; la serotoninergica en 1969 por Coppen; hiptesis genticas
y otras que relacionan el funcionamiento macro estructural con el nivel celular y molecular del
cerebro ( Zandino, M 2002.) y la monoaminergica que surge a mediados del siglo XX junto a las
del los ejes (HPA) Hipotalamo-Pituitaria-Adrenal e Hipotalamo-Hipofisis-Tiroideo (HHT) para
explicar la neurobiologa del trastorno. Adems de los nuevos desarrollos elaborados con
relacin a aspectos cruciales del modelo cognitivo de la depresin como seala Vsquez y cols
(2010), que desde la comprensin de los esquemas negativos, la autoestima, el estilo
atribucional, procesos de memoria y estilos rumiativos, buscan dar explicacin a la depresin.
Por otro lado la evidencia emprica encontrada a nivel de dficit neuropsicolgico en la
atencin, memoria (Goodale, 2007) y funcin ejecutiva (Goodale, 2007 y Uekermann y cols,
2006) nos permitir proponer los objetivos de analizar y entender la dinmica neurobiolgica y
cognitiva de la depresin entorno al dficit neuropsicolgico para aportar en la comprensin de
este y as, al posible desarrollo de alternativas teraputicas para su tratamiento y prevencin.
Adicionalmente el semillero, posterior a la comprensin de la depresin desde la perspectiva
neurocognitiva, pretende realizar estudios desde la neuropsicologa con pacientes depresivos
para poner a prueba las distintas hiptesis y aportar evidencia emprica a favor de la
comprensin del fenmeno.
Neurobiological approach to anxiety disorders from animal models
Fernando Cardenas2, Jevrahym Castellanos2, Johanna Duran1, Rodrigo Sierra1, Ana Paula
Crestani1, Laura Leon3, 4.
1. Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 2. Universidad de los
Andes, Bogota, Colombia, 3. Universidade de So Paulo, So Paulo, Brazil, 4. Pontifcia
Universidade Catlica do Rio de Janeiro, Rio de Janeiro, Brazil.
Animal models have allowed a better understanding of the neurobiological mechanisms
associated with different psychopathological disorders. Hence, research on anxiety disorders is
one of the most important areas in psychology because it has helped to understand the
mechanisms and potentially treatments. In this symposium we will present some of the work
carried out in laboratories of Brazil and Colombia and we are going to share different
approaches associated. In particular, we will focus on the mechanisms of the reduction of
aversive memories, as in the post-traumatic stress disorder (PSTD) and in generalized anxiety
disorder (GAD).
The symposium is divided in 5 expositions:
In first place, we will show the results of the function of the orbitofrontal cortex (OFCX) on the
extinction of cued aversive conditioning and its relationship with the efficiency of D-Cicloserine
(NMDArs partial agonist), that had shown positive results on preclinic and clinic trials.

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The second presentation will show results of the local effects of CP 55,940 (a CB1 agonist) in
dorsal hippocampus and infralimbic cortex on extinction of contextual fear conditioning (CFC).
The endocanabinoid modulation on emotional memories will be discussed.
The third intervention focuses on preliminary results of the evaluation of some pharmacological
and behavioral strategies that are used to sensitize the aversive memories in a PSTD model.
In the fourth intervention we are going to illustrate the effects of the attention deviation on the
reactivation of an aversive memory. The discussion will focus on viability of the model to
partially explain the neurobiological mechanisms of eye movement desensitization and
reprocessing technique (EMDR), because it actually has a great clinic acceptance but low
knowledge about the way it acts.
Finally, will present the results of joint research between Brazil and Colombia, using a strain of
rats which had been phenotipically selected in a CAC model for express high and low levels of
anxiety. We will show the different vulnerabilities to stress of strains, their basal differences and
changes in the conditions product of pharmacologic treatment for the 5-HT2a, Ketanserine.
In this way, we expect to explain the recent advances in neurobiology of anxiety disorders and
the magnitude of animal models in basic research on psychopathology.
EFFECTS OF ACUTE INTRAGASTRIC ADMINISTRATION OF
D-CYCLOSERINE IN RATS WITH LESION OF ORBITO-MEDIAL PREFRONTAL CORTEX
ON EXTINCTION OF FEAR CONDITIONING
Ventromedial orbital prefrontal cortex (OPFC) lesions result in generalized fear and impaired
extinction in a discriminative fear conditioning task. Systemic administration of the NMDAreceptors partial agonist, D-Cycloserine (DCS), shortens the time needed to extinguish a fear
response to a conditioned stimulus. Intercalated cells (ITC) in the amygdala are a likely site of
action of DCS and a possible site of potentiation of prefrontal or basolateral inputs.
The aim of this study was to assess the function of orbito medial prefrontal cortex (OM) in the
extinction of fear conditioning and the possible changes in the effects of DCS associated to OM
lesion.
Thirty-eight male Wistar rats (30020 g) received electrolytic or sham lesion of OPFC. On day 0
animals were habituated to the conditioning box (10-min). On days 1 and 2 three parings of
tone-shock (CS=800Hz; 65dB, US=0.2mA; 0.5s, per day) were done. On day 3 the freezing
response were analyzed. At the end of the session 1ml of saline solution (0.9%) or DCS
(15mg/kg) was intragastrically administrated. The extinction was performed between days 4 and
11. 20 seconds prior to first presentation of CS, 20 during and 20 after the termination of CS
were analyzed. The two-way ANOVA showed significant differences in the freezing time for the
interaction between the factors (drug x lesion) for extinction days 5 (F[1,34]=5.547; p<0.05) and
6 (F[1,34]=23.627; p<0.05) . The post hoc comparison showed that Sham+DCS animals had
less freezing than both Sham+saline and Lesion+DCS animals (Student Newman-Keuls;
P<0.05)
Our results suggest that the lesion of OM did not have any effect in the acquisition and
extinction of fear conditioning. Additionally, DCS facilitates extinction of learned fear to CS as
reported in other experiments. However, the integrity of cortical areas involved in extinction like
OM are crucial for the facilitatory effects of DCS. These findings suggest that the substantial
clinical value of DCS in the treatment of anxiety disorders may depend of proper functioning of
prefrontal cortex structures.
Consolidation of extinction of an aversive memory may be disrupted by a CB1 agonist
infused into the infralimbic cortex but not into the hippocampus

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The endocannabinoid system plays a retrograde modulatory role on excitatory and inhibitory
neural activity in central and peripheral nervous system. The CB1 cannabinoid receptors have a
high concentration in important areas related with memory modulation, such as the
hippocampus-responsible for the contextual component-, and infralimbic cortexinvolved in the
maintenance of extinction-. The objective of this work was to study the effects of microinfusion
the CB1 receptor agonist CP55,940 into the dorsal hippocampus or infralimbic cortex upon the
extinction process of an aversive memory.
Were used 57 adult male Wistar rats. Animals were bilaterally cannulated in the dorsal
hippocampus or infralmbic cortex and trained in the context fear conditioning task (2shocks
mA/2s 0.7). After 48h, the extinction session(30min) was performed. 15min before or after the
re-exposure, animals were bilaterally infused into the hippocampus or the infralimbic cortex with
vehicle or CP55,940(5ug/ul). Tests were performed 24h (test I) and 7 days (test II) later,
freezing behavior being recorded during 4min.
In the dorsal hippocampus, no significant difference was found either in the test I or II between
the post-reactivation infused animals and controls, the same taking place with the prereactivation groups. In the infralimbic cortex, the infusion of CP55,940 resulted in a significant
inhibition of extinction in test I, but no difference was observed in test II: both pre-and postreactivation groups exhibited this short lasting effect. The exogenous activation of CB1
receptors by CP55,940 in the infralimbic cortex but not in dorsal hippocampus was able to
inhibit the consolidation of extinction memory, but this effect was temporary, disappearing
before the seventh day.
This disrupting effect confirms the known involvement of this cortical area in the modulation of
extinction, but suggests a temporally restricted role of the CB1 modulatory subsystem for this
menmonic process in this brain area.
Attenuating strong fear memories through reconsolidation in an Animal Model of PostTraumatic Stress Disorder
Retrieval can induce some memories to undergo a stabilization period, called reconsolidation.
The result of this plastic state is that memory can be changed after the destabilization induced
by reactivation, requiring a reconsolidation process in order to persist. The mechanism of
reconsolidation has been extensively studied. However, the destabilization induced by
reactivation of a previously consolidated memory is less known. In the present study, we
addressed the question: how are the mechanisms that cause a memory to be transformed from
a fixed consolidated state, to a labile one?
We found that exposure time, novelty, D-cicloserine and NR2B hippocampal activation are
required in some boundary condition in order to undergo memory destabilization/reconsolidation
in contextual fear conditioning task. A better comprehension of how memory becomes labile is
critical because targeting reconsolidation of traumatic memories has been proposed for many
psychopathology treatments.
We took advantage of these results to create a protocol where subjects were able to impair
strong aversive memories and its related commorbities in a post-traumatic stress disorder
model in rats
Descrease of aversive content of memory through distractor stimulus during memory
reactivation
All memories undergo a period of consolidation. Is known that exist a temporal window of
consolidation memory where it is unstable and can be influenced by external and internal
agents (e.g. drugs, stress). After closed this unstable period the memory is consolidated, remain
in a stable state. A previous consolidated memory can becomes unstable newly when recalled
(retrieval), been susceptible to modifications. The memory is then restabilized (reconsolidated)
in its altered form.

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Different drugs applied in unstable state can weakened an aversive memory by blocking the
restabilization process. A disadvantage of these pharmacological agents is that most of them
are tested only in animal models and are administrated intracranially, making difficult a clinical
use.
Clinically, some therapies are used with finality of modify a traumatic or phobic memory. A
therapy that has been widely applied is Eye Movement Desensitization and Reprocessing
(EMDR). This therapeutic approach emphasizes the modification of traumatic or phobic
experiences into an adaptive memory through external stimulus (eye movement) during retrieval
of maladaptive memories. Not only eye movement, but others treatments like attentional
breathing, auditory shadowing, drawing a complex figure, doing arithmetic, or playing the
computer game tetris, can decrease the aversive content of original memory. Based in this
variety of studies, we believe that stimuli cause a distraction during evocation of aversive
memory. Our hypothesis is that application of a distractor stimulus during evocation of memory
could reduce the aversive content because this act like interference in original memory, and it
would reconsolidate in a less aversive state.
Based in this hypothesis we (a) create an animal model of distraction during retrieval of a
previous consolidated aversive memory, (b) decrease the negative emotional content of this
aversive memory through stimulus distractor during retrieval of aversive memory and (c)
demonstrated that these alterations are mediated by neurobiological process of
desestabilization/reconsolidation.
In our model used contextual fear conditioning task that create an aversive memory in the
animal. Is knowing that, depend of time of rechallenge in the training context, memory can be
destabilized. If memory is destabilized and any stimulus or drug is administered, this session
strengthens original memory. However, if an external stimulus is administered during
reactivation session, when memory is labile, is possible interfere in original memory. We used a
distractor stimulus during reactivation session and it was able to decrease the aversive content
of original memory in a posterior task. The fear memory is quantified by freezing response and
distractor stimulus was able to decrease this response. In other experiment, with drugs, we
demonstrate that reduce of aversive content of memory occur because the memory was
destabilized and if this process is blocked the distractor stimulus have not effect.
Our results are the first that demonstrated reduce of an aversive memory in an animal model
using only a behavioral stimulus. We believe that distractor stimulus administered when the
memory is destabilized can be a good alternative to reduce traumatic and phobic memories in
humans, however many previous studies might be development.
Anxiety traits in rats
Nowadays anxiety and depression are two very common pathological conditions. Most scientific
research in neuroscience, psychology, psychiatry and general medicine is aimed to find different
ways for treating, healing and prevention. However, most of the research does not take into
account individual differences or personal history. Almost all pharmacological research is done
in heterogeneous populations of animals thus leading to average data. A more specific
approach is the work using knock out animals by extracting particular genes. Nevertheless the
genetic interference could have several secondary effects that not always could be easily
assessed. Recently, in the laboratory of behavioral neuroscience at the Pontificia Universidad
Catlica de Rio de Janeiro two new strains of Wistar rats were bred by phenotypic selection of
the emotional response in the conditioned fear test. One of the strains, named Carioca High
Freezing, shows an enhanced freezing response in the test, while the other (Carioca Low
Freezing) shows little freezing response.
Here we present data from several experiments aimed to assess differences in basal conditions
and stress vulnerability between the two strains. A pharmacological challenge using the 5-HT2a
antagonist Kethanserin was conducted and animals were tested for anxiety. The levels of

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corticosterone were compared between the two strains in both basal and after the emotional
challenge. A c-fos immunohistochemistry assay was conducted in order to determine
differences in neural activity between the two strains.
All of our results showed strong differences between the two strains. These results clearly
indicate that different basal conditions have a strong impact upon the behavioral reaction
displayed by each animal. This is an important and very relevant aspect to be taken into
account in behavioral experiments. This could help to attain most homogeneous results, to
improve the power and precision of behavioral testing and to reduce the variability of results.
A Estrutura Familiar como Factor de Risco para Depresso e Suicdo Entre Adolescentes
Universitrios
Debora Chiararia.
Universidade de Marlia, Marlia, Brazil.
A adolescncia considerada fase da evoluo da personalidade, sendo o seu incio precedido
e denunciado pelas importantes modificaes biolgicas e psicolgicas da puberdade. Inicia-se
toda uma srie de esforos de ajustamento do sentimento e do comportamento, no raro com
francas caractersticas psicopatolgicas. Porm, tais caractersticas podem evoluir para
patologias mais graves, culminando no fim da adolescncia, incio da idade adulta, quando eles
ingressam no mundo universitrio. Portanto, o presente trabalho tem como objetivo estudar,
atravs de uma pesquisa bibliogrfica, a influncia que o contexto familiar tem para o
desenvolvimento de tais patologias, no caso, a depresso e o suicdio, focos da pesquisa. No
raro, os jovens trazem problemas familiares como queixa principal que o levou procurar
ajuda psicolgica. Tanto a Depresso quanto o Suicdio, esto ligados aos contextos sciofamiliares, psicolgicos, biolgicos e culturais nos quais os jovens esto inseridos. Segundo a
literatura especfica sobre o assunto, a depresso do adolescente associa-se, frequentemente,
dos pais, em famlias submetidas a agresses exteriores ou interiores ligadas
desestruturao e discrdia. Tais desavenas tm repercusso na vida dos filhos, podendo
levar formulao de crenas negativas. Muitos suicidas tiveram uma infncia marcada por
cuidados parentais deficitrios, clima emocional negativo em que as necessidades mais
profundas de proximidade, contacto, compreenso e amor foram negligenciados. Traumas
vividos na infncia so frequentemente mantidos quando as famlias so disfuncionais e, por
conseguinte, so geradores de padres de vinculao inseguros. Experincias traumticas
precoces, decorrentes de privaes durante a infncia, podem alterar o funcionamento do
sistema nervoso central e contribuir para o aumento do risco suicida. Atravs das pesquisas
realizadas at o momento, percebe-se que geralmente a depresso vem associada a outros
transtornos como: transtorno de humor e transtorno de ansiedade. Lidar com o suicdio no
uma tarefa fcil. um momento de tenso tanto para o paciente quanto para o terapeuta. So
casos que exigem decises rpidas e certas. Todos os textos j pesquisados indicam que,
sejam quais forem os resultados finais, devemos ficar atentos, pois, uma pessoa com risco de
comportamento suicida tem fortes crenas de que no h mais soluo para seus problemas e
que ela no capaz de resolv-los.
Biological Approaches to Attention Bias Modification Research
Patrick Clarke1, Andrei Miu7, Colin MacLeod1, Michael Browning2, Geoff Hammond1, Colin
MacLeod1, Kristoffer Mnsson9, Per Carlbring10, Andreas Frick11, Carl-Johan Olsson12, Owe
Bodlund12, Tomas Furmark11, Gerhard Andersson9, 13, Jennifer Britton3, 5, Michelle Clementi3,
Lindsey Sankin3, Jenna Suway6, Gang Chen3, Kara Lindstrom3, Tomer Shechner3, 4, Yair BarHaim8, Nathan Fox8, Daniel Pine3, Tomer Shechner3, Yair Bar-Haim8, Jennifer Britton3, Johanna

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Jarcho5, Jamie Mash3, Kate Degnan6, Olga Walker6, Nathan Fox6, Daniel Pine3, Stefan
Hofmann14, Liviu Crisan7, Nigel Chen15.
1. Psychology, University of Western Australia, CRAWLEY, WA, Australia, 2. University of
Oxford, Oxford, United Kingdom, 3. National Institute of Mental Health, Bethesda, MD, USA, 4.
University of Haifa, Haifia, Israel, 5. University of Miami, Coral Gables, FL, USA, 6. University of
Maryland, College Park, MD, USA, 7. Babes-Bolyai University, Cluj-Napoca, Romania, 8. Tel
Aviv University, Tel Aviv, Israel, 9. Linkping University, Linkping, Sweden, 10. Stockholm
University, Stockholm, Sweden, 11. Uppsala University, Uppsala, Sweden, 12. Ume
University, Ume, Sweden, 13. Karolinska Institutet, Stockholm, Sweden, 14. Boston University,
Boston, MA, USA, 15. University of Sydney, Sydney, NSW, Australia.
Biased attention for negative information is causally implicated in the development and
maintenance of a range of emotional disorders. Techniques aimed at modifying biased attention
for negative information were initially developed to address theoretical questions concerning the
causal status of such selective attention in emotional vulnerability. Original work by MacLeod et
al. (2002) confirmed that modifying biased attention causally influences emotional vulnerability.
This early research has since spawned a large volume of enquiry aimed at establishing the
potential clinical utility of such attention bias modification (ABM) techniques, with current results
suggesting that ABM interventions hold considerable promise in targeting emotion pathology.
This expansion in research interest has also driven more detailed theoretical and applied
questions about the precise biological processes that are influenced by, contribute to, and
facilitate ABM.
The content in this symposium will cover both theoretical questions concerning the biological
basis of ABM and applied clinical issues regarding its delivery in disordered populations. This
symposium brings together researchers from a range of international institutions with
complimentary areas of expertise in the biological underpinnings of ABM. Kristoffer Mnssona
of Linkping University, Sweden will present results of a study contrasting the neurological
changes associated with symptom improvement following Cognitive Behavioural Therapy (CBT)
as compared to ABM for individuals with Social Anxiety Disorder using functional Magentic
Resonance Imaging. Andrei Mui of Babes-Bolyai University, Romania examines the impact of
ABM on a range of anxiety-related biomarkers to examine whether changes in selective
attention also produce changes in biomarkers known to be sensitive to long-term stress load.
Tomer Shechner of the National Institute of Mental Health, USA, will present results from an
imaging study examining the neurocognitive mechanisms that promote biased attention for
threat in children, and also reports data from a trial contrasting combined and stand-alone CBT
and ABM. Jennifer Britton, also of the National Institute of Mental Health, USA, examines
changes in neurological patterns associated with selective attention to threat over time in
children, and reports imaging data examining neurological changes driven by both acute and
extended delivery of ABM. And finally, Patrick Clarke of the University of Western Australia
reports results of a study examining whether localised neurostimulation of cortical regions
implicated in attentional control can enhance ABM-induced changes in attentional bias, and
their consequent impact on emotional vulnerability.
These presentations address complimentary areas of research interest in biological approaches
to ABM and showcase a range of measures to address the critical clinical and applied questions
under consideration including neuroimaging, neuro-stimulation, and physiological biomarkers of
anxiety. It will therefore provide a detailed overview of novel research onthe biological
approaches to attention bias modification.
Autonomic, Neuroendocrine and Immune Changes associated with Attentional Bias
Modification in Social Anxiety

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Several clinical trials support the efficacy of attentional bias modification (ABM) in social anxiety.
However, the effects of ABM on anxiety-related biomarkers has not been studied to date. In this
study, an analog sample of non-clinical participants selected for social anxiety symptoms
underwent an ABM intervention similar to the ones that showed clinical efficacy in social anxiety
disorder (SAD). The impact of ABM was assessed using a standardized laboratory social stress
task during which self-reported state anxiety, salivary cortisol, and cardiac vagal suppression
were recorded. In addition, we also monitored changes in cortisol awakening response and
proinflammatory cytokines IL-6 and TNF- in order to describe the influences of ABM on these
biomarkers that are sensitive to long-term stress load. By revealing whether these anxietyrelated biomarkers are altered by ABM, the results contribute to an integrative understanding of
the cognitive, behavioral and physiological effects of ABM, and further inform the clinical
potential of this intervention in SAD
Attention Bias to Threat: From an Early Bio Marker of Anxiety to Therapeutics
Threat-related attention biases are causally implicated in the etiology and maintenance of
anxiety disorders (Bar-Haim et al., 2007). The current talk will describe two studies aimed at
delineating the clinical implications of this well-established relationship.
The first study focuses on children at-risk for anxiety based on early temperament, and
describes the neurocognitive mechanisms that promote attention biases toward threat.
Behavioral inhibition (BI) is a temperament identified in early childhood that is characterized by
consistent vigilance towards novel and social situations. These behavioral patterns predict a 2
to 4 fold increase in risk for anxiety disorders (Chronis-Tuscano et al., 2009). At 10-years of
age, 15 BI and 14 non-BI participants completed an fMRI study targeting attention bias towards
threat using a dot-probe task. Preliminary behavioral results indicate that BI participants exhibit
an attention bias towards angry faces while non-BI participants show an attention bias away
from angry faces (p<.001). Imaging results indicate a significant interaction between BI status
and attention bias to threat in ventrolateral prefrontal cortex (vlPFC) [-33, -41, -11], ke=20,
p=.005. This between-group difference reflects greater vlPFC deactivation among BI than nonBI individuals. These data resemble findings from behavioral and imaging studies in anxiety
patients, raising questions about the degree to which selective attention moderates risk for
anxiety in BI children.
Next, we will discuss the first randomized controlled trial to examine the degree to which threatfocused attention bias modification therapy (ABMT) augments response to cognitive behavioral
therapy (CBT) among clinically anxious children. Based on its success in diminishing threatrelated attention biases and associated heightened anxiety in adults, ABMT shows promise as a
method of CBT augmentation (Bar-Haim, 2010). Sixty three subjects were randomly assigned to
one of three groups: CBT+ABMT; CBT+ ABMT Placebo; CBT alone. Results indicate that,
compared with the CBT alone group, both the active and placebo training groups had greater
reduction in the number of their clinical anxiety symptoms (p = .025) and symptom severity
(p=.035). However, no differences in treatment-related biases were noted across the three
groups. These results indicate that ABMT in a clinical context may provide additional treatment
benefits, although the mechanism by which this benefit is conferred remains unclear.
Neural Approaches for understanding Attention Bias Modification
Attention Bias Modification (ABM) is emerging as a possible treatment for anxiety disorders.
ABM procedures reduce anxiety symptoms and stress reactivity by training individuals attention
away from threat (Hakamata et al., 2010; Eldar et al., 2012). Understanding the neural indices
that change with ABM will help refine the therapeutic strategy.
In study 1, 12 youth (8-17 years old) completed an attentional probe assessment task in the
MRI scanner twice, separated by approximately 4 months. In this task, an emotional face (angry
or fearful) and a neutral were presented simultaneously. Participants were asked to identify the

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location of probe that followed one of the faces via button press, yielding reaction time
differentials between incongruent and congruent trials to assess attention bias. Although
behavioral measures of attention bias were inconsistent over time, stability of attention bias to
threat in healthy youth (n=12) was detected in the ventrolateral prefrontal cortex in response to
angry bias [(-32, 29, 3), ICC=0.73] (Britton et al., in press).
In study 2, 53 highly socially anxious adults (18-30 years old, Liebowitz anxiety scale 50) were
randomized to receive either active (n=26) or placebo ABM training (n=27). The active training
task was designed to train participants to attend away from threat. The placebo training involved
the standard dot-probe task. In this dot-probe task, a angry-neutral face pairs were presented
and individuals were asked to identify the probe (E vs. F). Attention biases were measured in
the MRI scanner before and after acute training and after extended training. A subset of these
individuals (n=15 per group) completed both acute (i.e., single session training) and extended
training (i.e., twice weekly over a 4-week period). Interaction effects were detected following
extended training in several brain regions, including the left rostral anterior cingulate [(-9, 44, 1), F(2,56)=7.0, k=15 voxels] and amygdala [right: (19, 4, -24), F(2,56)=6.9, k=128 voxels; left (19, 1, -11), F(2,56)=11.1, k=106 voxels]. Following extended training, changes in neural
activation were primarily detected in the placebo group. Although unexpected, this result could
reflect increased neural stability in attention control in the active group; whereas, exposure to
threatening stimulus without active training may result in heightened threat sensitivity.
ABM is thought to modifying underlying, stable patterns of attention; however, these results may
suggest that ABM is increasing the stability of attention control mechanisms.
Amygdala Changes after Cognitive Behavior Therapy and Attention Bias Modification via
the Internet - an fMRI-study
Randomized clinical trials have yielded promising results both for Cognitive Behavior Therapy
(iCBT) and Attention Bias Modification (ABM) delivered via the Internet. The aim of this study
was to explore brain mechanisms using functional magnetic resonance imaging (fMRI) pre and
post to intervention, in patients with social anxiety disorder (SAD).
A total of 26 individuals diagnosed with SAD were randomized to either iCBT or ABM. The ABM
was conducted 8 times over a 4 week period. The dot probe task used in ABM involved 160
trials of disgust or neutral facial expressions during 500 msec. ABM repeatedly redirect
participants attention away from threat cues. iCBT was delivered over a period of 9 weeks, and
consisted of standard CBT interventions, delivered as guided self-help with weekly support from
a therapist. Liebowitz Social Anxiety Scale - Self-report version (LSAS-SR) was used as primary
outcome measure.
An emotional face assessment task, matching different facial expressions of anger, fear,
surprised and neutral faces, was used during image acquisition. This paradigm has previously
yielded robust activation of the brains fear network, including the amygdala, which was one
region of interest evaluated. A priori hypotheses of decreased amygdala reactivity in responders
to both treatments were defined. Brain imaging data were collected pre and post treatment,
using a GE 3.0T scanner (T2* weighted), with a 32-channel head coil.
A differential treatment response in the amygdala (bilaterally: x = 27, y = -1, z = -11 and x = -27,
y = -1, z = -11, Montreal Neurological Institute, MNI coordinates) was observed in responders:
decreased reactivity with iCBT but increased reactivity with ABM: Z = 3.05 - 3.15. For these
analyses, a statistical threshold of p < .05 was used. Results were further family wise error
(FWE) small volume corrected at p < .05. In addition, differential activations of the prefrontal
cortex were noted in medial orbitofrontal cortex (mOFC), ventromedial prefrontal cortex
(vmPFC), dorsolateral prefrontal cortex (dlPFC) and rostral anterior cingulate cortex (rACC).
To our knowledge this is the first study exploring change in brain mechanisms by two promising

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internet-delivered treatments for SAD. These results emphasize that iCBT and ABM changes
the brain's fear network differentially.
Enhancing the modification of attentional bias through trans-cranial direct current
stimulation of the lateral prefrontal cortex
Biased attention to threatening information is consistently implicated in the development and
maintenance of anxiety pathology. Neurocognitive models of anxiety suggest that biased
attention is influenced by both a stimulus-driven threat-detection system, associated with the
amygdala, and an attentional control inhibitory pathway, associated with the lateral prefrontal
cortex (lPFC; Bishop, 2007). Biased attention to threat is believed to occur as a result of an
imbalance between these two systems resulting in enhanced threat detection and deficient
inhibition of attention to threat. This biased attention to threat and its associated emotional
vulnerability can be successfully altered using attention bias modification (ABM) tasks.
Consistent with neurocognitive models of anxiety-related selective attention, research has
directly implicated the lPFC in this modification of biased attention for threat. In a functional
magnetic resonance imaging study, Browning et al. (2010) found that participants trained to
attend either towards or away from threatening stimuli demonstrated increased activation of the
lPFC when subsequently presented with the type of stimuli they were trained to attend away
from.
While this study directly implicates the activation of the lPFC in the modification of attentional
bias, no studies to date have sought to directly assess whether enhancing cortical excitability in
the lPFC will also enhance the acquisition of attentional bias. The principal aim of the present
study was to assess the degree to which increasing excitation of the lateral prefrontal cortex
would serve to enhance the acquisition of an attentional bias either towards or away from threat
in response to an ABM task encouraging the acquisition of either bias, and further, to examine
whether this would also enhance the associated effects on emotional vulnerability in response
to a subsequent stressor. Participants were delivered either attend threat or avoid threat ABM
training while receiving active or sham trans-cranial direct current stimulation to the left
dorsolateral prefrontal cortex. This was followed by a brief anagram stress task. Results from
this study directly inform theories regarding the role of the lPFC in biased attention to threat.
Furthermore, the potential for tDCS to enhance modification of selective attention holds
significant implications for ABM-based clinical interventions.
Frequency of Therapy Interfering Behaviors of Client Population at Harbor-UCLA Medical
Center
Michelle Dexter3, Lizbeth Gaona1, Lily Brown2, Lynn McFarr1, Suhadee Henriquez1, Aurora
Farias1.
1. Harbor-UCLA Medical Center, Torrance, CA, USA, 2. University of California, Los Angeles,
Los Angeles, CA, USA, 3. California School of Professional Psychology, Los Angeles, CA, USA.
Dialectical Behavior Therapy, (DBT) has shown to be an effective treatment modality for
persons diagnosed with Borderline Personality Disorder (Linehan, 1993; Linehan et al., 2006).
One component of this treatment is targeting therapy interfering behaviors (TIBs). These
behaviors are described as any behavior that interferes with therapy. If these behaviors occur,
they are targeted to help the patients stay in treatment. In this treatment modality, these
behaviors are prioritized and targeted before quality of life interfering behaviors can be
addressed (Linehan, 1993). The literature is remarkably limited in exploring the frequency of
patients TIBs. Specifically, the frequency of TIBs in specific Outpatient DBT Programs is yet to
be explored. The purpose of this study is to examine the frequency of therapy interfering
behaviors of patients participating in a standard DBT program at Harbor-UCLA Medical Centers
Adult Outpatient DBT program. Data was collected using the Therapy Interfering Behavior-

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Patient (TIB-P) measure, created by Lynn McFarr, PhD at Harbor UCLA Adult Outpatient
Cognitive Behavioral Therapy Clinic, 2005. This is an online survey completed on a weekly
basis by all clinicians who have clients participating in the DBT program. The TIB-P measure
asks clinicians to endorse whether the patient participated in TIBs within a given week. If a TIB
has occurred, clinicians then provide specific information in a multiple-choice format. Examples
of options include if clients have missed individual therapy sessions, threatened to drop out of
therapy, refused to complete assignments, or argued incessantly with therapist. It is
hypothesized that TIBs will decrease over time in treatment. This data will be analyzed using a
multi-level modeling using time as a predictor. This analysis will provide a growth curve of TIBs
over time. Additionally, this data may be used to further enhance clinical treatment at HarborUCLA as well as expand on the limited research on TIBs in standard DBT.
Participao da Cinase Ativada por p21 na Aquisio e Consolidao da Memria
Aversiva em Ratos
Sara Fernandes, Andr Koth, Gustavo Parfitt, Juliana Buonocore, Daniela Barros.
Universidade Federal do Rio Grande, Rio Grande, Brazil.
Sara S. Fernandes2*, Andr P. Koth1,2** , Gustavo M. Parfitt1,2**, Juliana Q. Buonocore2*,
Daniela M. Barros1, 2 1Programa de Ps-graduao em Cincias Fisiolgicas, Fisiologia
Animal Comparada - 2Laboratrio de Neurocincias- Instituto de Cincias Biolgicas Universidade Federal do Rio Grande (FURG), Rio Grande - RS- Brasil. Introduo: O processo
de aprendizagem envolve alteraes neuronais denominadas plasticidade sinptica o que
contribui para formao da memria. Essas alteraes dependem da ativao de uma cascata
de enzimas, dentre elas uma serina/treonina cinase ativada por p21, PAK. Este processo no
imediato e ocorre em distintas fases, tais como aquisio e consolidao. Objetivo: O objetivo
deste estudo foi identificar o envolvimento das cinases ativadas por p21 (PAK) do grupo I, na
regio CA1 do hipocampo, nos processos de aquisio e consolidao da memria aversiva de
curta (MCD) e longa durao (MLD) de ratos. Mtodos: Foram utilizados ratos Wistar machos
(n = 186, 2-3 meses, 250-280 g), obtidos do Biotrio da Universidade Federal do Rio Grande FURG (Rio Grande, RS, Brasil). Este trabalho foi aprovado pelo Comit de tica em
experimentao animal da FURG 067/2011. Os animais foram submetidos a cirurgia
extereotxica para implante bilateral de cnulas na regio CA1 do hipocampo. A fim de avaliar
a memria aversiva foi utilizado o teste comportamental de medo condicionado contextual
(MCC). Os animais foram tratados com salina ou DMSO 3% (controles) ou com IPA-3 (inibidor
das PAK do grupo - 0.5mM; 1.0mM; 20mM). Os animais foram infundidos na regio CA1 do
hipocampo, 15 min pr-treino e testados 90 minutos e 24h ps treino (MCD e MLD,
respectivamente) ou 15 minutos ps-treino e testados 90 minutos e 24h ps-treino (MCD e
MLD, respectivamente) ou 3h ps-treino e testados 24h ps-treino (MLD). Aps a verificao
da normalidade e homogeneidade de varincia a anlise estatstica foi realizada atravs do
teste de ANOVA seguida pelo teste de Dunnett (p <0,05 foi considerado para indicar
significncia estatstica). Resultados: A injeo de IPA-3 15 min antes do treino no causou
alterao na aquisio das MCD e MLD. Os animais que receberam a infuso de IPA-3 15min
ou 3h aps o treino apresentaram prejuzo na MLD, no entanto, no houve diferena
significativa na MCD dentre os grupos injetados 15min ps-treino. Concluso: Os dados
sugerem que a inibio da PAK I no interfere na aquisio da MCD e MLD. Entretanto, o
bloqueio dessa cinase 15min e 3h ps-treino provocou efeito amnstico prejudicando a
consolidao da MLD. O tratamento no causou alterao na atividade locomotora dos
animais, verificada atravs da tarefa de campo aberto. Apoio financeiro: CNPq, CAPES.

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Estrategia de Orientacin Cognitivo Conductual a Pacientes con Tratamiento Dialtico del


Centro Nefrolgico de Charallave, Para el Reforzamiento de Conductas Resilientes.
Venezuela- 2012
Albin Fumero1, 2, Johel Torres1, 3.
1. Deparatmento de post grado, Centro de Investigaciones Psuiatricas, psicologicas y
sexolgicas de Venezuela, Caracas, Venezuela, 2. Universidad Bolivariana de Venezuela,
Caracas, Venezuela, 3. Universidad Simon Bolivar, Caracas, Venezuela.
Abstract Central: La presente investigacin se orienta a proponer una estrategia de
orientacin cognitivo conductual a pacientes con Tratamiento Dialtico del Centro Nefrolgico
de Charallave, que permita el reforzamiento de conductas resilientes. Las bases tericas que
sustentan el trabajo corresponden al Modelo Teraputico Cognitivo Conductual y la Resiliencia
en el mbito de las Ciencias Humanas. Por otro lado, se tienen como bases conceptuales la
Insuficiencia Renal y Tratamiento Dialtico, Aspectos Biopsicosociales del paciente con
Insuficiencia Renal, y la relacin familia / paciente. La investigacin se ubica en la modalidad de
proyecto factible, la cual se apoya en un estudio de campo con enfoque descriptivo. El diseo
es no experimental de tipo transeccional. El trabajo de investigacin se realizar con una
poblacin conformada por ochenta y seis (86) sujetos, distribuidos en catorce (14)
profesionales y setenta dos (72) pacientes con Tratamiento Dialtico. La recopilacin de la
informacin se desarrollar a travs de la tcnica de la encuesta a travs de dos (2)
cuestionarios, uno aplicado a los profesionales y otro a los pacientes, los cuales estn
estructurados en una Escala Tipo Likert. Su finalidad ser comparar la realidad investigada con
los planteamientos tericos previamente establecidos. La validez de los instrumentos se
realizar mediante el juicio de expertos. La confiabilidad se establecer con el Clculo del
Coeficiente de Alpha de Cronbach. Posteriormente, los datos que se recolecten en los
cuestionarios sern codificados y tabulados, presentados en grficos de barras y analizados
desde el referente terico desarrollado en la investigacin, todos estos servirn como base
fundamental para la creacin de la propuesta en torno al tema planteado.
Impact of the Affective Schemas on Verbal Production
Barbara Gawda.
Psychology, University of Maria Curie-Sklodowska, Lublin, Poland.
Abstract Central: BARBARA GAWDA EWA SZEPIETOWSKA UNIVERSITY OF MARIA
CURIE - SKLODOWSKA LUBLIN POLAND Impact of the affective schemas on verbal
production We intend to explain how better understand the affective dysfunctional schemas
through linguistic analysis. The aim of the study is the analysis of the impact of positive and
negative emotions on verbal fluency. We tend to describe the cognitive mechanisms of the
semantic networks of words; the determinants of mental representations of words. The
description of the determinants of verbal fluency tasks can be useful in the description of the
cognitive-affective schemas. A sample group of 300 adult people (aged: 18-70) without brain
pathology was examined. All participants performed the semantic and affective verbal fluency
tasks. We assessed verbal fluency in following terms: the number of words correctly
enumerated according to a criterion, the number of errors (repetitions, incorrect words, etc.),
and the number of semantic and phonemic clusters (connections between at least 2 words).
The methods we used were: Structured Clinical Interview, PANAS Inventory, WAIS-R. The
following set of explaining variables was taken into consideration: age, sex, verbal intelligence,
positive emotions (state), negative emotions (state), positive emotions (trait), and negative
emotions (trait). The multiple regression analysis has been done to show how the variables
(positive mood, negative mood, positive emotions, negative emotions) explain semantic, and

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affective verbal fluency. The results show that negative and positive emotions modify verbal
production (both semantic and affective fluency tasks). The semantic networks of words are
linked to emotions. More significant links have been found for the affective verbal fluency. The
authors discuss the implications of these findings in relations to the cognitive theory of the
dysfunctional schemas.
Una Visin Cognitiva Sobre Nios Mendocinos
Berenice Hernndez Navarro1, 2, Adriana Espsito3, 4.
1. Escuela n 1-672 "Renato Della Santa", Godoy Cruz, Argentina, 2. Municipalidad de Godoy
Cruz, Godoy Cruz, Argentina, 3. Consejo Nacional de Investigaciones Cientficas y Tcnicas,
Mendoza, Argentina, 4. Universidad del Aconcagua, Mendoza, Argentina.
Abstract Central: La investigacin aborda, desde una mirada neuropsicolgica, el impacto de
la implementacin de un programa de intervencin cognitiva en nio mendocinos de entre 7 y
10 aos, de una escuela urbano-marginal. Los procesos cognitivos bsicos son unidad de
funcionamiento mental, que se puede unir o complementar con otras, para formar una unidad
de orden superior (Amador Campos, Forns Santacana y Kirchner Nebot, 2006), los mismos son
capaces de ser modificados significativamente por medio de la estimulacin. En la actualidad la
neuroplasticidad es considerada el fundamento biolgico en el que se sustenta la estimulacin
de funciones cognitivas. Los programas de trabajo y estimulacin secuencial, gracias a la
capacidad plstica del cerebro humano, instauran cambios estables en la organizacin cerebral
que permiten la adquisicin de funciones no desarrolladas o la maduracin de las mismas.
(Hernndez-Muela, Mulas, Mattos, 2004). As mismo, es importante considerar el contexto
socioeconmico y cultural en el que se encuentra una persona, ya que las capacidades que va
adquiriendo el nio durante su desarrollo no son producto solamente de la maduracin a nivel
neurolgico, sino que en gran medida son el resultado de la interaccin del nio con el medio,
de su estimulacin y educacin (Yurelis Ginarte Arias, 2007). Por esto es que en este trabajo
se tuvo en cuenta el contexto de vulnerabilidad social en el que se encontraban los sujetos de
la muestra estudiada. El objetivo de este estudio fue evaluar la eficacia de la aplicacin del
programa de intervencin dirigido a estimular la capacidad atencional, mnsica y perceptiva, en
escolares mendocinos entre 7 y 10 aos de edad, de una zona urbano marginal de Godoy
Cruz, Mendoza. A los fines de esta investigacin, se evaluaron los procesos atencionales,
mnsicos y perceptivos para identificar el rendimiento de tales habilidades cognitivas,
posteriormente se aplic un programa de entrenamiento cognitivo, que permitiera estimular
dichas funciones, para as lograr mejoras en su funcionamiento. La eficacia del mismo se
percibi a partir de la evaluacin final, realizada con las mismas tcnicas aplicadas en la preevaluacin. Se trabaj con 60 nios que asistan a la Escuela N 1-672 Renato Della Santa,
pertenecientes a una zona urbano- marginal del departamento de Godoy Cruz de la provincia
de Mendoza. Del total de nios que conformaban la muestra 30 de ellos conformaron el grupo
experimental (recibieron el programa de estimulacin cognitiva) y los 30 restantes conformaron
el grupo control (no recibieron el programa de estimulacin). Los resultados finales mostraron
una mejora en el rendimiento de las habilidades cognitivas evaluadas, fundamentalmente en el
grupo experimental.
Emotional Facial Processing in SSRI Resistant Social Anxiety Disorder
Yoshiyuki Hirano1, 2, Takayuki Obata2, 1, Chihiro Sutoh1, 2, Daisuke Matsuzawa1, 2, Zhongming
Liu3, Hiroshi Ito2, Hiroshi Tsuji2, Eiji Shimizu1, 2.
1. Chiba University, Chiba, Japan, 2. National Institute of Radiological Sciences, Chiba, Japan,
3. National Institute of Health, Bethesda, MD, USA.

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Introduction: Recently the application of cognitive behavioral therapy (CBT) is considered to be


one of the most effective therapies for patients with social anxiety disorder (SAD). Many
functional magnetic resonance imaging (fMRI) studies for SAD focused on amygdala activities
for facial expression images (Freitas-Ferrari et al., 2010). Indeed, the activity of higher-order
visual cortex to these images can be a biomarker to predict the success of CBT (Doehrmann et
al., 2013). However, investigations of how CBT modifies the neural circuits involved in the
regulation of negative emotions were limited (Porto et al., 2009). Recently, we developed social
anxiety provocation tasks for fMRI and evaluated activities in not only amygdala but also
prefrontal cortices in healthy subjects. Now, we applied these tasks to the patients with selective
serotonin reuptake inhibitor (SSRI) resistant SAD to investigate the modification of neural circuit
with CBT. In this study, we estimated the effects of our task on the fear related neuronal circuit.
Methods: Ten patients with SSRI resistant social anxiety disorder (36.1 +/- 9.2 years old) and
eight healthy subjects (27.7 +/- 9.8 years old) were recruited for this study. Social anxiety levels
were measured with the Japanese version of the Liebowitz Social Anxiety Scale (LSAS-J) and
the Social Phobia and Anxiety Inventory (SPAI-J) prior to 16-week CBT sessions. We
developed anxiety tasks; pictures consist of four facial expressions (neutral, angry, fear and
smile faces), a video in which subjects were gazed by 20 people (video task) and an imaginary
speech. fMRI experiments were performed in a 3T MRI (Siemens MAGNETOM Verio) equipped
with a 32-channel array coil. Conjunction analysis was performed using SPM8 to assess
activated brain regions during the social anxiety tasks. Thereafter, region-of-interest (ROI)
analysis was performed in amygdala regions. Results: Bilateral dorsolateral prefrontal cortex,
inferior occipital gyrus, fusiform gyrus and amygdala for the face task were robustly detected in
both healthy controls and patients with SAD (p<0.001, FWE corrected). In addition, medial
orbitofrontal cortex (mOFC) and bilateral ventromedial prefrontal cortices (vmPFC) were
activated in patients with SAD. For the individual facial expression, bilateral vmPFCs were
activated for all three facial expressions except for neutral faces in healthy controls, on the other
hand, bilateral vmPFCs in addition to mOFC were activated for all facial expressions even for
neutral faces (p<0.001, uncorrected). In the ROI analysis using common ROI, the beta values in
patients with SAD were 2.3 and 3.0 times greater than healthy controls in left and right
amygdala, respectively. Conclusions: mOFC and vmPFC which play important roles in fear
related neural circuits were activated only in patients with SAD for the face task, and amygdala
activation was much greater than healthy controls. Results suggested that face images, even
neutral face, strongly activated fear related neuronal circuits in patients with SAD, resulting in
perception of normal social situation as threatening.
Visuospatial Processing of Facial Emotion in Patients with Anxiety Disorders Pre and
Post Group Psychotherapy: A Longitudinal Eye-Tracking Study
Pawel Holas1, Izabela Krejtz2, Marzena Rusanowska3.
1. II Dept. Psychiatry, Warsaw Medical University, Warsaw, Poland, 2. University of Social
Sciences and Humanities, Warsaw, Poland, 3. University of Social Sciences and Humanities,
Warsaw, Poland.
Abstract Central: Background: Cognitive theories indicate enhanced detection to threat
contributes to the development and maintenance of anxiety disorders. People are typically
faster and more accurate to detect angry compared to happy faces. Clinical studies showed that
anxiety patients exhibit a differential pattern of enhanced bias towards emotional faces. In the
present study a face-in-the-crowd task with eye-tracking measurements was applied to examine
the spatial detection of facial emotion in the course of a psychotherapeutic outpatient group
treatment. Methods: Patients with anxiety disorders (ADPs, n=26) were tested twice, about 12

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weeks apart, pre and post group psychotherapy; whereas healthy controls (HCs, n=53) were
tested once, on a face-in-the-crowd task using pictures of faces depicting angry, happy and
neutral expressions. Results: For both group a search asymmetry favoring happy faces was
found, but ADPs were faster in detecting emotional faces among neutral crowd compering to
HCs. In clinical group there was increased pupil dilation in favor of angry comparing to happy
faces. From test 1 to test 2, anxiety, social anxiety and depressivity of patients improved
significantly. Interestingly, we found that in the 2nd session, the detection time (latency of the
first saccade) for emotional faces got longer and there was a significant reduction of pupil
dilation for angry faces, when compared to the 1st measurement. Conclusions: Our data
indicate a spatial processing bias for positive facial expression in both clinical and nonclinical
group, however it was enhanced in the anxiety group. Further, this data suggest that clinical
improvement can be accompanied by decrease in emotional reactivity indexed by changes in
the eye-movement indices. We believe, eye-tracking measurement could be useful tool for
psychotherapy research.
REHABILITACIN DEL DETERIORO COGNITIVO EN LA ENFERMEDAD
CEREBROVASCULAR ISQUMICA Cognitive impairment rehabilitation in ischemic
cerebrovascular disease
Ana Isaza.
Antioquia, Universidad, Medelln, Colombia.
Rehabilitacin Cognitiva.
Introduccin: El deterioro cognitivo leve, se caracteriza por un compromiso fundamentalmente
en la memoria, hacindose la salvedad que esta disfuncin no obedece a otro trastorno
funcional. Lo anterior en muchas ocasiones ha guardado relacin con sntomas de algunas
demencias.
Objetivos: Determinar la presencia del deterioro cognitivo en un grupo de pacientes con
diagnstico de enfermedad cerebrovascular isqumica adscriptos a la institucin prestadora de
servicios de salud.
Establecer agrupamientos vlidos en relacin con los sntomas de la enfermedad
cerebrovascular isqumica en presencia de un patrn de oro diagnstico Deterioro cognitivo
leve. (DCL).
Efectuar una valoracin neuropsicolgica del deterioro cognitivo, producto de una lesin
isqumica
Pacientes y Mtodos: La muestra no aleatorizada estuvo conformada por 30 participantes
adultos, con enfermedad cerebrovascular isqumica, evaluados en dos momentos al alta
clnica y a los tres meses y 30 participantes sin enfermedad cerebrovascular con edades
comprendidas entre los 45 y 83 aos con una media 65,13 El promedio de aos de educacin
fue de 7,43, se les aplicaron: Mini-Examen de Estado Mental (MMSE), Test del Reloj (CDT),
Test Vocabulario de Boston (TBV), Test de Aprendizaje Auditivo Verbal de Rey /RAVLT), Test
de Trazados (Rastreo) (TMT), y el Test de Asociacin Controlada de Palabras (COW). Para el
anlisis estadstico se estratific la muestra por edades, de acuerdo al tipo de prueba
psicomtrica de modo que se tuviera el respectivo anlisis de grado de severidad
Resultados: La arquitectura factorial de las diferentes pruebas de atencin, conciencia,
habilidad visuoespacial, memoria y funcin ejecutiva evaluada al momento de la alta clnica y a
los tres meses del episodio cerebrovascular lo cual explica la varianza, tanto en los casos como
en los controles
En ambos grupos se encontraron factores como los resultados en pruebas como el Test del
Reloj (CDT), el Test de Aprendizaje Auditivo Verbal de Rey, el Test de Vocabulario de Boston y
el Test de Trazados (Rastreo).

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Conclusiones: Tanto en el grupo evaluado al momento del alta como a los tres meses con
enfermedad cerebrovascular isqumica como en el grupo control, se observa una estructura
factorial diferente, por lo cual la hiptesis nula se acepta al presentar los pacientes con
enfermedad cerebrovascular isqumica luego de un tiempo determinado del accidente cerebrovascular (ACV), diferencias sutiles pero significativas en el deterioro cognitivo leve.
Bibliografa
Aplicacin de las Estrategias de Enseanza Lgico Verbales y Visuo-Espaciales , Su
Influencia en el Aprendizaje en Alumnos Universitarios
Maria Elena Isaa, Liliana Maulini, Cristina Collino, Carlos Mias.
Facultad de Psicologa, Universidad Nacional de Crdoba, Crdoba, Argentina.
La evolucin del cerebro y de las conductas se relacionan con factores genticos y
epigenticos. El programa gentico requiere siempre del ambiente para desarrollarse. La
plasticidad celular es la funcin sobresaliente de las neuronas cerebrales, reaccionan ante
estmulos o dejan de responder a los mismos y modifican su funcin de una manera ms o
menos permanente, por lo que memorizan y reconocen estmulos. La interaccin del hombre
con el ambiente bio-socio-cultural, le posibilita la construccin del conocimiento, por la relacin
recproca de sus potencialidades biolgicas innatas y un ambiente rico en substancias nutricias
y estimulaciones sociales y culturales oportunas y adecuadas. Dada la complejidad funcional
del sistema nervioso humano los hemisferios cerebrales desarrollaron especialidades
diferentes, con formas particulares de pensamiento, aunque complementarios y
equipotenciales. El sujeto se favorece con su especializacin porque requiere de los dos
hemisferios para desarrollar conductas adaptadas. Estudios experimentales demostraron que
cada hemisferio cerebral posee formas peculiares y especficas de pensamiento que se
manifiestan por medio de estrategias de aprendizaje y conductas singulares relacionadas con
un tipo especfico de pensamiento hemisfrico. El hemisferio izquierdo posee un pensamiento
convergente, deductivo, racional, abstracto, secuencial, analtico, objetivo, sucesivo, causal,
verbal, no realiza sntesis. El hemisferio derecho desarrolla un pensamiento divergente,
simultneo y sinttico, sensual, metafrico, imaginativo, mltiple, holstico, tcito y subjetivo,
intuitivo, analgico, metafrico, no causal, visual, musical, reconoce rostros e imgenes tctiles.
Cada persona tiene un modo de pensamiento relacionado con la preeminencia en el
procesamiento de la informacin de uno u otro hemisferio para la resolucin de problemas,
aunque el funcionamiento de ambos es complementario. Objetivos: 1. Planificar y desarrollar la
clase de Gentica empleando Estrategias de Enseanza Lgico-Verbales y Visuo-Espaciales.
2. Evaluar el rendimiento en relacin a las estrategias empleadas. 3. Analizar y comparar la
relacin entre el rendimiento acadmico y las estrategias de enseanzas. 4 .Analizar el efecto
de variables gnero, edad, ocupacin laboral, horas de estudio, entre otras. Materiales y
Mtodos: Investigacin transversal de tipo exploratoria descriptiva. Muestra accidental de
alumnos que cursen la asignatura de primer ao de la Licenciatura en Psicologa, Biologa
Evolutiva Humana y que concurran los das prefijados del dictado de la clase Gentica y su
evaluacin, aos 2012 y 2013. Se formarn 2 grupos, a cada uno se les dictar la clase con
una estrategia de enseanza diferente (Visuo-Espaciales y Lgico-verbal). Se evaluarn los
conocimientos adquiridos por los alumnos al finalizar el dictado de cada clase y en el primer
parcial de la asignatura. A todos los grupos se les aplicar la misma evaluacin. Los datos
obtenidos sern ordenados, analizados e interpretados a travs de tablas de distribucin de
frecuencia y porcentajes con la finalidad de establecer con qu estrategias de enseanza la
poblacin objetivo realiza mejores aprendizajes.

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Procesamiento de la Informacin y Estrategias de Enseanza-Aprendizaje en Alumnos


Universitarios
Maria Elena Isaa, Liliana Maulini, Cristina Collino, Carlos Mias.
facultad de Psicologa, Crdoba, Argentina.
El comportamiento del ser humano se desarrolla en forma paulatina a partir de la vida
intrauterina. La plasticidad celular es la funcin sobresaliente de las neuronas cerebrales de los
seres superiores. El conocimiento logrado por el ser humano resulta nico, individual,
progresivo e intransferible. Dada la complejidad funcional del sistema nervioso humano los
hemisferios cerebrales desarrollaron especialidades diferentes, con formas particulares de
pensamiento, complementarias y equipotenciales. El pensamiento del hemisferio izquierdo es
convergente, deductivo, racional, abstracto, secuencial, analtico, objetivo, sucesivo,
secuencial, causal, verbal. El pensamiento del hemisferio derecho es divergente, simultneo y
sinttico, sensual, metafrico, imaginativo, concreto, impulsivo, mltiple, holstico, tcito y
subjetivo, intuitivo, analgico, metafrico, no lineal, no causal. Aprecia formas, reconoce rostros
e imgenes tctiles, estructuras rtmicas, musicales, artstico e imaginativo. Cada persona tiene
un modo de pensamiento relacionado con la preeminencia en el procesamiento de la
informacin de uno u otro hemisferio para la resolucin de problemas, aunque el
funcionamiento de ambos es complementario, difieren en como manejan la informacin y no en
como establecen su colaboracin. Dadas las evidencias de la funcionalidad del hemisferio
derecho y su importancia en los procesos de aprendizaje, hemos realizado desde el ao 2000
investigaciones neuropsicolgicas en los estudiantes universitarios de las Universidades
Nacionales de Crdoba y de Ro Cuarto. Los objetivos fueron :1- planificar y desarrollar el
dictado de clases empleando estrategias de enseanza diferenciales-lgico-Verbales y VisuoEspaciales, 2- evaluar el rendimiento en relacin a las estrategias empleadas,3- analizar y
comparar la relacin entre la variable rendimiento acadmico y las variables estrategias de
enseanzas. Conclusiones:1- Las estrategias de enseanza Visuo-Espaciales promueven un
mejor rendimiento acadmico, que las estrategias de enseanza Lgico-Verbales. 2- Las
Estrategias Integradas, (estrategias Lgico verbal ms Visuo- espacial) generan mejores
aprendizajes que cuando se aplicaron slo Estrategias de Enseanza Lgico-Verbales. 3-No se
observaron diferencias de aprendizaje referidas al gnero, edad y ocupacin laboral de los
alumnos. Aunque investigaciones realizadas en nuestro medio reportan que las estrategias de
aprendizajes visuo espaciales son preferidas por el sexo femenino, mientras que el uso de
estrategias de aprendizaje lgico verbales predominaron en los varones. La capacidad del
cerebro humano por su plasticidad, posibilita que la Universidad fomente el uso de ambos
hemisferios entre sus alumnos y ofrezca variadas estrategias de enseanza . Enfatizando que
ms all de las diferencias operativas, la alternancia funcional de los hemisferios es sistemtica
y continua de tal modo que sus procesos acontecen de modo simultneo.
The Relationship between Cognitive Fatigue, Cognitive Functioning, Depression and
Accuracy of Appraisals Regarding Cognition in People with Multiple Sclerosis
Sadhbh Joyce1, Cynthia Honan1, Kerry Sherman2, Rhonda Brown3.
1. Psychiatry, UNSW, Sydney, NSW, Australia, 2. Macquarie University, Sydney, NSW,
Australia, 3. Australian National University, Sydney, NSW, Australia.
Abstract Central: Multiple Sclerosis (MS) is a neurodegenerative disorder affecting the central
nervous system for which there is no cure. People with MS (PwMS) often experience additional
difficulties including fatigue, cognition problems and depression. The association between these
factors is a point of contention in the current research. Cognitive complaints are frequently
reported by PwMS and are often attributed to fatigue. However, these difficulties are typically

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not reflected in performance on neuropsychological tasks designed to objectively examine


cognition. Therefore, how accurately PwMS appraise their cognitive ability remains uncertain,
which is further complicated by the high prevalence of depression in MS. The present crosssectional study examined the nature of the relationships among a group of people diagnosed
with MS (N=118) between the factors of: cognitive fatigue, depression, actual cognitive ability,
perceived cognitive difficulties and accuracy of appraisal of cognitive functioning. To our
knowledge, this is the first study to concurrently examine the relationships between these
factors. Regression analyses revealed that cognitive fatigue was significantly associated with
perceived cognitive difficulties and reduced appraisal accuracy, i.e., a tendency to
underestimate cognitive functioning and overestimate cognitive difficulties. Depression was
associated with cognitive fatigue, perceived cognitive difficulties, and appraisal accuracy.
Depression was found to partially mediate the relationship between cognitive fatigue and
appraisal accuracy. Overall our findings suggest that cognitive fatigue and depression are
associated with decreased appraisal accuracy among people with MS. Therefore, self-reported
cognitive decline is not a good estimate of actual cognitive functioning among individuals with
MS. These results have important clinical implications for the detection and management of
cognitive fatigue in MS. More specifically, these findings suggest that inaccurate appraisals
regarding cognitive ability may influence the choices and decisions people with MS make in
their daily lives and when engaging in tasks that are generally perceived as requiring a certain
level of cognitive functioning (e.g. work, continued education). Once cognitive fatigue increases,
people with MS may inaccurately appraise their actual cognitive abilities. In turn, it is probable
that people with MS may begin to opt out of certain tasks/daily activities before there are actual
concrete needs to do so. For example, they may decide to reduce work hours or withdraw from
work altogether (early retirement) due to concerns over their cognitive capacity. From an
occupational health perspective, these findings provide support for the use of
neuropsychological screening tools in the management of those individuals with MS reporting
cognitive difficulties. Providing clear feedback regarding their current cognitive skills may well
serve as a protective factor against unnecessary withdrawal from work. This is likely to have
long-term psychological benefits considering the strong link between continued engagement in
daily activities such as work and quality of life in MS.
sLORETA Findings in Patients with Panic Disorder treated by CBT and Pharmacotherapy
- Changes after Therapy
Dana Kamardov, Jn Prako, Ale Grambal.
University Hospital Olomouc, Olomouc, Czech Republic.
Abstract Central: Background: Standardized low-resolution electromagnetic tomography
(sLORETA) is a new quantitative EEG method for determining distribution of neuronal electrical
activity in the form of three-dimensional images of current density of the cerebral cortex. The
study aimed at finding electrotomographic differences between patients with panic disorder who
respond well to cognitive behavioral therapy (CBT) and those with an inadequate response and
to determine factors predicting a response to treatment. Methods: The study comprised 24
patients diagnosed with panic disorder with or without agoraphobia (ICD-10 F41.0).. The
severity of symptoms was measured with the Beck Anxiety Inventory (BAI), Beck Depression
Inventory (BDI), Sheehan Anxiety Scale, subjective and objective Clinical Global Impression
(CGI) and Dissociative Experiences Scale (DES). Additionally, quality of life was evaluated
using the Q-LES-Q questionnaire. Based on final BAI score decreases by 25%, the patients
were classified into two groups - responders and non-responders. 21-channel EEGs were
recorded at baseline and after completion of therapy. Power spectra and intracortical
tomography were computed by sLORETA in seven frequency bands and compared between

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(responders vs. non-responders) and within (pre- vs. post-treatment) groups. Results: There
were no differences between responders and non-responders with respect to age, gender and
baseline disorder symptomatology. Statistical analysis of sLORETA values demonstrated no
significant inter-group differences in the pretreatment current density distribution. After
treatment, only responders showed a significant decrease of alpha-2 sources (p<0.05) in the
occipital lobes and cuneus and a statistical trend for increased beta-3 sources (p<0.10) in the
posterior cingulate. In non-responders, there were no statistically significant changes in
sLORETA findings following therapy. Conclusion: The study failed to use pretreatment
sLORETA in the prediction of therapeutic response in patients with panic disorder. However, we
clearly demonstrated that only treatment response was associated with significant changes of
electric neuronal activity.
Neural Correlates of Visuospatial Perspective Taking Associated with Autistic Traits
Yusuke Kanayama1, 2, Yoshiya Moriguchi2, Kentaro Oba2, Yuri Terasawa2, Hiroki Murakami2,
Kazuo Mishima2, Hiroaki Kumano1.
1. Waseda Univ., Tokorozawa, Japan, 2. National Center of Neurology and Psychiatry, Kodaira,
Japan.
Perspective taking is one of the dimensions of empathy and plays a key role in our ability to
promote communication. Previous research already has shown that individuals with Autism
Spectrum Disorders (ASD) have deficits in perspective taking. Evidence from recent
neuroimaging studies suggest that taking a third-person perspective (3PP) as opposed to firstperson perspective (1PP) has been associated with the inferior parietal cortex, the prefrontal
cortex and the precuneus (Andrea & Michael,2006; Dosch et al.,2010). Our question here is
whether deficits in lower level of perspective taking such as 'visiospatial' perspective taking
relate to deficits in ASD. To address this question, we used functional magnetic resonance
imaging (fMRI) to investigate whether the brain activity in visuospatial perspective taking (VPT)
task correlates with autistic traits. Participants were 20 right-handed college students and
completed Autism Spectrum Quotient (AQ) . The task was an adapted version of the VPT
introduced by Piaget & Inhelder (1948). Participants observed a stereoscopic image of three
mountains on the screen and were required to change their viewpoint as indicated by the
marker around three mountains. The viewpoint angular difference, i.e., difference in degrees
between participants viewpoint (1PP) and indicated new viewpoint (3PP), was angle 0, 45,
90, 135 or 180. The response time was measured by pressing the button when participants
visualized the layout of the objects from the required viewpoint (3PP). After a short delay,
participants viewed the picture from one of 8 viewpoints and were required to answer whether it
matches their maintained image from the required viewpoint. In order to analyze the behavioral
data of the VPT, two-way ANOVA was conducted with group (high AQ vs low AQ) as a
between-subjects factor and viewpoint angular difference (0,45, 90, 135,180) as a withinsubjects factor. The dependent variable was response time. As a result, the response time in
VPT differed between viewpoint angles, F(4, 52) = 12.67, p<.001, and the post hoc analysis
indicates that participants took more response time at 45 and 135 than at 180 (p<.05). The
response time were also different between high(n=8) and low(n=7) AQ groups F(1,13) = 10.04,
p<.01, such that high AQ group took more response time than low AQ group. The result
suggests that the task required more cognitive load in autistic people. We thought that
perspective taking process from 3PP were induced more strongly in angle 45 and 135 than in
other angle conditions. To identify the activated brain regions during VPT, we compared
hemodynamic responses to taking perspectives from angle 45/135 vs. 0/ 90/180. As
expected, we found significant activations in the precuneus, p<.001(unc.) , cluster size>10
voxels. Finally, the contrast estimates of the brain activation in the precneus positively

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correlated with the AQ score, r(18) = 0.52, p<.05. These findings suggest that individuals with
high autistic trait show difficulty in visuospatial perspective taking, and this difficulty in lower
level of perspective taking may link to difficulty in perspective taking of others mental states.
Terapia Comportamental Cognitiva Integrada aplicada a Patologas Neurolgicas y
Psiquitricas Integrated cognitive behavioral therapy applied to Neurological and
Psychiatric Disorders
Raquel Krawchik1, Carlos Daniel Mias2, 1, Moira Tribulo1.
1. Fundacin SEMAS, Crdoba, Argentina, 2. Facultad de Psicologa, Universidad Nacional de
Crdoba, Crdoba, Argentina.
Abstract del Simposio: La integracin en las terapias comportamentales y cognitivas pueden
entenderse desde diferentes ngulos. En nuestro equipo la integracin est directamente
vinculada a la evaluacin y tratamiento de patologas neurolgicas y/o psiquitricas desde una
perspectiva que incluye la evaluacin de las funciones neurocognitivas, la indagacin del modo
en que las diferentes patologas interfieren en estas funciones, el modo en que es percibido por
la persona que las padece (y por su entorno) y de qu manera interfieren en su calidad de vida.
Inclusive en nuestros das no es la psicologa la que interviene en las patologas neurolgicas
ni examina el modo en las funciones neurocognitivas se ven afectas en las patologas
psiquitricas.
Cuando el psiclogo interviene intenta contener al paciente de modo que pueda aceptar su
nueva situacin, pero no interviene para modificarla, accin delegada a la medicina. De esta
manera no solamente no hay una mirada integrativa, sino ms bien todo lo contrario. Es una
intervencin dual en la que ninguna de los dos profesiones intercambian ideas y opiniones,
solamente se precisa una determinada informacin que se considera en alguna manera util.
Sin embargo en nuestra experiencia se demuestra que se deben reconocer laas formas en que
la perona se ve afectada y trabajar a partir de un anlisis de su nuevo comportmaiento sobre la
construccin de una nueva mirada. Nuevos guiones, nuevas competencias, nuevas estrategias.
En el simposio se expondran tres patologas diferentes, la intervencin y sus resultados.
Tecnicas de terapia cognitivo conductual en abordaje neuropsicolgico ecolgico de
traumatismos craneoenceflicos. Anlisis de casos
Cognitive behavioral therapy techniques in the ecological neuropsychological approach
of head injuries. Case Analysis
Las personas con un dao cerebral traumtico cambian bruscamente su vida. Se afectan en su
personalidad, rendimiento general y destrezas especficas. Su vida y la de los familiares
adquieren particularidades para las cuales no se est preparado. Se desdibujan sus programas
habituales de comportamiento, tanto como sus condiciones reforzantes. Su tratamiento implica
considerar las funciones neurocognitivas afectadas y conservadas, facilitado con el empleo de
tcnicas cognitivo conductuales para un tratamiento ecolgico. Se presentan dos casos clnicos
de traumatismo craneoenceflico. Los casos: 1. Masculino, 52 aos. Alteraciones
neuropsicolgicas: Trastorno afsico, con anomias y parafasias. Logorrea, con frecuente
prdida del ncleo semntico. Alteracin de la memoria episdica y semntica, con
recuperacin desorganizada y reiterativa. Fatigabilidad y latencias de respuesta. Alteraciones
conductuales: Desorganizacin de hbitos de la vida diaria. Cambios de humor y conductas
agresivas en familia. 2. Masculino, 37 aos. Alteraciones neuropsicolgicas: Trastorno afsico
mixto, con perseveraciones y sntomas excitatorios. Con amnesia antergrada y afectacin de
la memoria de trabajo y episdica en menor grado. Alteraciones conductuales: Desorganizacin
de hbitos de la vida diaria. Desinhibiciones, conductas fuera de lugar, perseveraciones y
agresividad.. Los objetivos: 1. reorganizar hbitos de la vida diaria, 2. estimular y reorganizar

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las funciones cognitivas, 3. sensibilizar el reconocimiento de sntomas, 4. mejorar su


desempeo social y familiar, 5. lograr ambiente familiar reforzante de objetivos teraputicos.
Mtodo: diseo de caso nico tipo ABA, con plan asistencial integrado de naturaleza ecolgica,
coordinando las actividades a los objetivos propuestos, y trabajando con la familia tanto para la
resignificacin cognitiva y emocional, como de participacin en tareas teraputicas en el
manejo de reforzadores pertinentes. Procedimiento: Se trabaj en dos etapas, una centrada en
la reorganizacin de la vida diaria y la estimulacin de las funciones cognitivas y, otra etapa
centrada en la recuperacin tanto del lenguaje como la orientacin ocupacional. Se hizo con
sentido ecolgico, simulando situaciones sociales y de destrezas especficas. Se obtuvieron
cambios significativos y notables con relacin a los objetivos. Tecnicas empleadas: 1Programas de rehabilitacin de afasias, 2- Reestructuracin cognitiva y modificacin semntica,
3- Relajacin condicionada y ensayos imaginarios de conducta, 4- Tcnicas de autocontrol y
autorregulacin, 5- Reforzamiento diferencial en la recuperacin del discurso centrado y
organizado, 6- Ensayo de roles y conducta (en consultorio y mbitos naturales), 7Autorregulacin de conducta (reconocimiento y detencin de sntomas). Resultados: Se
obtuvieron cambios significativos y notables en relacin a los objetivos. Se logr recuperar gran
parte del lenguaje comprensivo y expresivo de uso cotidiano, y habilidades comunicacionales.
Se desarrollaron nuevos hbitos adaptativos de la vida diaria, un ordenamiento de actividades,
un manejo significativo de sntomas secuelares leves (fatiga, anomias, desinhibiciones,
logorrea) con conductas alternativas (descanso, rodeo semntico, conducta asertiva, regulacin
emocional) y un mejoramiento del desempeo familiar y social, para el cual la colaboracin de
vnculos premorbidos fue muy importante. Conclusin: La integracin de un abordaje
neuropsicolgico con tcnicas cognitivo conductuales resulta de gran utilidad en tratamiento de
patologas cerebrales.
Terapia Cognitiva y Comportamental en Pacientes con Enfermedad de Parkinson
Avanzado
Cognitive Behavioral Therapy in Patients with Advanced Parkinson's Disease
La enfermedad de Parkinson tiene una fuerte frecuencia de consulta entres las personas
mayores de 50 aos y una frecuencia importante entre los menores de 50 aos, conocida como
Enfermedad de Parkinson Juvenil que inicia aproximadamente entre los 34 y 37 aos de edad.
Es una enfermedad progresiva y con consecuencias invalidantes, por lo tanto es objeto de
mltiples investigaciones con el fin de conocer su origen y determinar formas teraputicas que
logren lentificar la progresin y mejoren la calidad de vida de los pacientes.
En general son ms frecuentes los modos acotados de intervencin a diferentes profesionales
que se van sumando a medida que la enfermedad avanza. Los sntomas ms conocidos se
observan en la rigides en los movimientos que afectan sobre todo la marcha, rigidez en la
expresin, temblor y trastornos en el lenguaje (siempre por la afeccin motora). De modo que
es asistido por el neurlogo, fisioterapeuta y fonoaudilogo a medida que la enfermedad
avanza.
Se lograron grandes avances con la farmacologa y en algunos casos con la ciruga
estereotxica.
Sin embargo la enfermedad avanza. Aumentan los sntomas invalidantes que afectan la vida de
la persona en todos sus aspectos. Pierde autonoma, no puede asistirse por sus propios
medios, tiene dificultades en el habla y en la comunicacin y se crean serios problemas
familiares.
Por lo general el rol del psiclogo es el de contener, intentar que el paciente acepte su situacin
y no se aisle.
Sin embargo, hemos demostrado que se puede realizar una lectura neuropsicolgica con
respecto a los aspectos de la dinmica motriz y neurocognitivos con relacin a la posibilidad de
generar modos alternativos de mejorar sustancialmente los sntomas. Un enfoque integrado

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con una lectura comportamental a partir del anlisis del comportamiento del paciente y una
evaluacin del afrontamiento y niveles de creencias respecto a la enfermedad, permite construir
nuevos esquemas mentales respecto a la misma, el rendimiento mejora, los sntomas
neurolgicos se alivian y lo que es mas importante, le permite al mdico administrar mejor el
programa farmacolgico.
Cuando una persona siente que ya no es la misma, que no puede caminar sin caerse o correr
ese riesgo, que habla y no se le entiende y que empiza a perder autonoma, desarrolla
conductas evitativas porque el incremento de emociones negativas con respecto a su
rendimiento aumentan su ansiedad y aumentan sus dificultades, de modo que tiende a aislarse.
Includive se han observado ataques de pnico y mecanismos fbicos cuando el paciente
detecta que el efecto del frmaco disminuye.
De modo que hay que incorporar un programa focalizado a los trastornos de ansiedad junto con
un programa neurocognitivo a partir de la utilizacin del lenguaje contextual en la
reorganizacin del programa motor.
Se mostrar en video un par de minutos la aplicacin del programa neuroconductual.
Intervencin Comportamental Cognitiva: un Modelo Integrado en el Tratamiento de un
caso de TOC infantil grave
Cognitive Behavioral Intervention: An Integrated Model for the Treatment of a Severe
Case of Child OCD
Lic. Moira Trbulo - Fundacin Semas
Ms. Moira Trbulo - Semas Foundation
Nio de 10 aos
Motivo de consulta: onicofagia en manos y pies desde hace cinco aos.
El sntoma fue incrementndose en gravedad y compulsin, hasta generar una serie de
infecciones locales de gravedad moderada en manos y severa en las uas de los pies.
Se realizaron consultas peditricas, que no derivaron en ningn tratamiento especfico.
Realizan la consulta por la gravedad de las infecciones y la imposibilidad de controlar la
compulsin.
El nio presenta rasgos de ansiedad, est sobrecargado de actividades diversas: Deportivas,
musicales, informticas, idiomas y escouting. Concurre a un colegio estructurado y exigente
donde es uno de los mejores alumnos.
Presenta sntomas obsesivos cambiantes. Uno de los ms estables es la compulsin
onicofgica y la limpieza.
Las conductas objeto de intervencin son aquellas sobre las cules se opera en funcin de las
metas teraputicas. En este caso son: la onicofagia, la sobreexigencia (tanto por parte de los
padres como por parte del propio nio), el pensamiento distorsivo respecto a la patologa (tanto
en los padres como en el nio) y el comportamiento social del nio referido a sus pares.
El tratamiento se organiz en tres etapas para el primer perodo teraputico:
1. Reconocimiento de aspectos disfuncionales de la conducta y de la percepcin de los padres
relativa a las caractersticas personales de su hijo.
2. Reestructuracin cognitiva.
3. Tratamiento especfico de la onicofagia y de los niveles de exigencia y autoexigencia.
Se presentarn los resultados de las etapas teraputicas mencionadas.
Neurociencia, Cognicin Y Psicoterapia Neuroscience, Cognition and Psychotherapy
Raquel Krawchik1, Carlos Daniel Mias2, 1, Maria Elena Isaa3.
1. Fundacin SEMAS, Crdoba, Argentina, 2. Facultad de Psicologa, Universidad Nacional de
Crdoba, Crdoba, Argentina, 3. Facultad de Psicologa, Universidad Nacional de Crdoba,
Crdoba, Argentina.

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Las neurociencias han tenido un desarrollo altamente significativo en los ltimos 30 aos. Los
trabajos cientficos en ese campo han proliferado y se fueron acercando cada vez mas a las
ciencias del comportamiento de un modo integrado. Desde las neurociencias se buscan
explicaciones para todo tipo de actividades humanas, desde el aprendizaje hasta los
movimientos y polticas sociales.
Obviamente tambin hay importantes hallazgos explicativos de diferentes modelos patolgicos
en neurologa (sobre todo) y en psicopatologa.
Sin embargo, tenemos una deuda con su integracin al campo teraputico, tanto desde las
neurociencias cuanto desde las psicoterapias. Aun en nuestros dias se trabaja de modo
separado o como mximo en comunicacin uno con otro. Pero no se construyen modelos
explicativos que integren y optimicen la incidencia de los programas comportamentales
cognitivos a las diferentes patologas del campo neurolgico.
En este Simposium se presentarn trabajos clnicos que sealen la importancia del modelo
integrativo y la eficacia de la TCC para el tratamiento de estos problemas que tanto sufrimiento
producen.
Procesamiento de la informacin (o lateralidad) y estrategias de enseanza-aprendizaje
en alumnos universitarios.
Information processing and teaching-learning strategies in university students
Lic. Mara Elena Isaa
El comportamiento del ser humano se desarrolla en forma paulatina a partir de la vida
intrauterina.
La plasticidad celular es la funcin sobresaliente de las neuronas cerebrales de los seres
superiores.
El conocimiento logrado por el ser humano resulta nico, individual, progresivo e intransferible.
Dada la complejidad funcional del sistema nervioso humano los hemisferios cerebrales
desarrollaron especialidades diferentes, con formas particulares de pensamiento,
complementarias y equipotenciales.
El pensamiento del hemisferio izquierdo es convergente, deductivo, racional, abstracto,
secuencial, analtico, objetivo, sucesivo, secuencial, causal, verbal.
El pensamiento del hemisferio derecho es divergente, simultneo y sinttico, sensual,
metafrico, imaginativo, concreto, impulsivo, mltiple, holstico, tcito y subjetivo, intuitivo,
analgico, metafrico, no lineal, no causal. Aprecia formas, reconoce rostros e imgenes
tctiles, estructuras rtmicas, musicales, artstico e imaginativo.
Cada persona tiene un modo de pensamiento relacionado con la preeminencia en el
procesamiento de la informacin de uno u otro hemisferio para la resolucin de problemas,
aunque el funcionamiento de ambos es complementario, difieren en como manejan la
informacin y no en como establecen su colaboracin.
Dadas las evidencias de la funcionalidad del hemisferio derecho y su importancia en los
procesos de aprendizaje, hemos realizado desde el ao 2000 investigaciones
neuropsicolgicas en los estudiantes universitarios de las Universidades Nacionales de
Crdoba y de Ro Cuarto.
Los objetivos fueron :1- planificar y desarrollar el dictado de clases empleando estrategias de
enseanza diferenciales-lgico-Verbales y Visuo-Espaciales, 2- evaluar el rendimiento en
relacin a las estrategias empleadas,3- analizar y comparar la relacin entre la variable
rendimiento acadmico y las variables estrategias de enseanzas.
Conclusiones:1- Las estrategias de enseanza Visuo-Espaciales promueven un mejor
rendimiento acadmico, que las estrategias de enseanza Lgico-Verbales. 2- Las Estrategias
Integradas, (estrategias Lgico verbal ms Visuo- espacial) generan mejores aprendizajes que
cuando se aplicaron slo Estrategias de Enseanza Lgico-Verbales. 3-No se observaron
diferencias de aprendizaje referidas al gnero, edad y ocupacin laboral de los alumnos.

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Aunque investigaciones realizadas en nuestro medio reportan que las estrategias de


aprendizajes visuo espaciales son preferidas por el sexo femenino, mientras que el uso de
estrategias de aprendizaje lgico verbales predominaron en los varones.
La capacidad del cerebro humano por su plasticidad, posibilita que la Universidad fomente el
uso de ambos hemisferios entre sus alumnos y ofrezca variadas estrategias de enseanza .
Enfatizando que ms all de las diferencias operativas, la alternancia funcional de los
hemisferios es sistemtica y continua de tal modo que sus procesos acontecen de modo
simultneo.
Palabras claves
Plasticidad neuronal/ Procesamiento de la informacin/Estrategia de Enseanza-Lgico -Verbal
/Estrategia de Enseanza Visuo-Espacial/ Aprendizaje
Terapia Comportamental-cognitiva en Pacientes Vctimas de Accidentes Viales
Cognitive-Behavioral Therapy in Patients Victims of Road Accidents
Lic. Raquel Krawchik
Uno de los flagelos que ms vctimas produce en los ltimos tiempos, sin duda provienen de
los accidentes viales. Los programas preventivos no cumplen su objetivo y los controles
policiales tampoco. La conducta vial no se modifica y los accidentes aumentan poniendo en
riesgo la vida de las personas, produciendo consecuencias discapacitantes y un alto costo
social y econmico.
Un vez que la persona padeci un accidente de este tipo si no perdi su vida, suele resultar
con un alto costo de discapacidad permanente. Un accidente por definicin, es un suceso
imprevisto. Pero en el caso vial, no se puede decir que est sujeto a imprevisiones. En la
mayora de los casos se debe justamente a la falta de previsin, a la conviccin de la
capacidad de control y fundamentalmente a conductas que el medio refuerza constantemente,
desde la propia publicidad vehicular.
La vida de la persona sufre una dramtica transformacin y la de su familia tambin. Se debe
diferenciar el accidente de automviles y el producido en la conduccin de motocicletas. En
principio porque los afectados suelen ser muy jvenes. Las estadsticas muestran un rango
etario entre los 18 y 30 aos. Porque ademas en nuestras regiones (amrica latina) es un
vehculo elegido porque es facil de adquirir, porque el sistema de transportes es ineficaz y caro
y es la posibilidad de autonoma en la movilidad.
Tiene por lo tanto un sesgo socio-econmico importante.
Los jvenes por otra parte, asumen la conducta de riesgo como un desafo y por lo tanto son
ms vulnerables.
Producido el accidente generalamente se tratan sus consecuencias con intervenciones
mltiples y aisladas una de otra. La consecuencia ms frecuente es el traumatismo crneoenceflico (TCE), por lo tanto requiere de un equipo complejo: Fisioterapia, psicomotricidad,
neurologa, muchas veces fonoaudiologa y psicologa. Cada uno con un diagnstico y cada
uno con una propuesta teraputica aunque los profesionales formen parte de un mismo equipo
o institucin tratante.
En la disertacin se har hincapi en las fortalezas del tratamiento comportamental-cognitivo
sobre la exposicin de un caso. Cuando la persona sufre un (TCE) deja de ser la misma. No
camina como antes, pierde eficacia motriz, muchas veces afecta su elocucin y no puede
seguir con su actividad habitual. Su guiones previos pierden eficacia, no tiene otros, todo le
resulta aversivo y desarrolla diferentes trastornos en su comportamiento y en sus vnculos.
Genera trastornos de ansiedad con componentes fbicos y se aisla por evitacin.
De modo que la intervencin teraputica debe centrarse en el conocimiento de los efectos del
trauma y de los antecedentes personales previos al trauma, para comprender sus
consecuencias y partir de un anlisis de la conducta para desarrollar un programa focalizado y
especfico con la familia como coterapeuta y construir nuevos guiones y nuevos procedimientos

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operativos.
No alcanza con terapias de apoyo o contencin. Lo que la persona espera es recuperar una
calidad de vida posible y poder superar las consecuencias devastadoras de su sufrimiento
psiclogico y emocional.
Modelos y tendencias de evaluacin en neuropsicologa. Hacia una integracin con el
abordaje cognitivo conductual
Evaluation models and trends in neuropsychology. Towards an integration in the
cognitive behavioral approach
Dr. Carlos D. Mias
Dr. Prof. Carlos Daniel Mias
El auge neurocientfico de los ltimos aos, ha resultado en el estudio de numerosas variables
biolgicas del comportamiento. La neuropsicologa clnica se ha beneficiado de modelos de
funcionamiento cerebral emergentes, aunque sus desarrollos teraputicas resultan an
limitados. Los retrasos o cambios de conducta derivados de anomalas cerebrales, implican
sistemas de refuerzo errneos, con ambientes poco estimulantes. Asi, no siempre se considera
la conducta que opera siempre en un medio y est bajo los efectos de eventos reforzantes
(internos o externos). Esto puede implicar la consolidacin de diversas patologas o sntomas
no deseados. En la actualidad, diversos modelos de evaluacin e intervencin en
neuropsicologa tienden a la integracin con los abordajes cognitivo conductuales. Se revisan
dichos modelos, hasta fundamentar una necesaria integracin. Modelos y tendencias de
evaluacin en neuropsicologa: 1. El paradigma localizacionista. Implica el uso de test con el fin
de localizar en el cerebro las funciones afectadas. Los aspectos emocionales se observan
desde una perspectiva anatmica. 2. Los modelos neurocognitivos. Implican procesos y
subprocesos (constructos) que deben ser evaluados. Proponen planes de estimulacin
neurocognitiva de las funciones afectadas. Con frecuencia los logros reportados derivan de la
superacin del post-test, ms que de un reporte conductual del mejoramiento de la vida diaria.
Los aspectos cognitivo-afectivos, con las interacciones con los sistemas de refuerzo son
escasamente considerados. 3. El paradigma de validez ecolgica. Los test neuropsicolgicos
son complementados con valoraciones conductuales en contextos especficos, como
actividades de la vida diaria, relaciones afectivas y toma de decisiones. Los test demandan ser
validados en relacin a procesos involucrados en la vida diaria. Las propuestas teraputicas
implican un abordaje sobre problemas de la vida diaria, generalmente limitados a las funciones
afectadas. 4. El paradigma centrado en el tratamiento. Implica una valoracin neuropsicolgica
y de diversas actividades de la vida diaria. La propuesta teraputica considera la interaccin de
aspectos neurocognitivos, conductuales y afectivos, en el entorno mismo del paciente. Se trata
de comprender los sistemas de refuerzo e interaccin medio ambiental, como las
representaciones y esquemas mentales de significados claves en los procesos de recuperacin
o desarrollo. Supone conocer estrategias de resolucin, modalidades de procesamiento y
programas de accin que aporten a un esquema teraputico de carcter ecolgico-integrado.
Implica un compromiso del medio ambiente y familiar muy importante, en donde la familia
requiere ser entrenada en relacin a los objetivos teraputicos. En sntesis, las tendencias
actuales de evaluacin y tratamiento en neuropsicologa implican aspectos psicolgicos,
medioambientales y familiares. La evaluacin de constructos neurocognitivos especficos y
sistmicos, el empleo de pruebas con validez ecolgica, el estilo procesal y de toma de
decisiones del paciente; las consideraciones conductuales, contextuales y de los sistemas de
refuerzo, como las representaciones y esquemas mentales movilizados, aportan herramientas
fundamentales en los abordajes teraputicos actuales. Se vislumbra asi, una tendencia hacia la
integracin de disciplinas neurocientficas y conductuales en el campo clnico.
Funes Executivas: Flexibilidade Cognitiva de Idosos com Depresso

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Regina Maria Lopes, Roberta Fernandes Lopes Nascimento, Camila Oliveira, Cristiane
Esteves, Fernanda Maria Stein, Irani Argimon.
PSICOLOGIA, PUCRS, Porto Alegre, Brazil.
Diversos transtornos afetam os idosos, dentre eles, a depresso merece ateno, uma vez que
apresenta prevalncia elevada e conseqncias negativas para a qualidade de vida das
pessoas. A depresso est associada a dficits cognitivos e funcionais. O Teste Wisconsin de
Classificao de Cartas (WCST) um instrumento freqentemente utilizado para avaliao de
pessoas com disfuno frontal, pela sua especificidade para leses nesta regio do crebro,
relacionadas com a flexibilidade mental, cognitiva ou do pensamento e funes executivas.
Desta forma, a capacidade de modificar estratgias, o curso do pensamento ou dos atos, de
acordo com as exigncias externas, envolve a flexibilidade cognitiva. O objetivo deste estudo
foi de avaliar o desempenho quanto a flexibilidade cognitiva de idosos com e sem depresso.
Participaram do estudo 38 idosos com idade igual ou superior a 60 anos, com diagnstico de
Transtorno Depressivo Maior e 123 idosos da populao geral. O delineamento foi de um
estudo quantitativo e transversal. Os instrumentos utilizados foram: Ficha de dados
sociodemogrficos, Teste Wisconsin de Classificao de Cartas (WCST), Mini-Exame do
Estado Mental (MEEM), Inventrio de Depresso de Beck (BDI), Inventrio de Ansiedade de
Beck (BAI), Escala de Depresso Geritrica (GDS) e os subtestes Vocabulrio, Cdigos,
Dgitos e Cubos da Escala Wechsler de Inteligncia para Adultos III (WAIS-III). O projeto foi
aprovado pelo comit de tica da PUCRS e os participantes que aceitaram participar do estudo
assinaram o termo de Consentimento Livre e esclarecido. Os resultados mostraram que entre
os indicadores do WCST no grupo de idosos sem depresso e no grupo de idosos com
Transtorno Depressivo Maior, no foram encontradas associaes estatisticamente
significativas. Alm disso, o prprio delineamento do estudo, do tipo transversal, impede a
visualizao prospectiva dos dficits cognitivos aqui encontrados e se eles persistem ou no no
decorrer do tratamento. A anlise do desempenho no teste WCST, em idosos depressivos,
identificou que, apesar de ambos os grupos apresentarem resultados estatisticamente no
significativo, os idosos com depresso mais grave mostraram maior nmero total de erros
cometidos ao realizar a tarefa e maior percentual de respostas de nvel conceitual, indicando
que cometem mais erros. Alem disso, demonstram evidncias de acertos casuais e no
intencionais e quanto mais grave a depresso, maiores os prejuzos cognitivos no desempenho
das tarefas no WCST. O conjunto desses resultados, tambm possibilitou compreender que os
idosos com depresso podem apresentar tambm sintomas de ansiedade em alguma
intensidade e que h declnio na coordenao visomotora, percepo, capacidade de anlise,
sntese, raciocnio lgico e memria de trabalho.
Efeito de Treino das Funes Executivas em Idosos
Regina Maria Lopes, Camila Oliveira, Cristiane Esteves, Lusa Steiger, Marina Zanotto, Irani
Argimon.
PSICOLOGIA, PUCRS, Porto Alegre, Brazil.
As Funes Executivas (FE) so altamente sensveis aos efeitos do envelhecimento humano.
Devido ao crescimento da populao de pessoas com mais de 60 anos, estudos destas
transformaes so de relevncia peculiar. O objetivo do presente estudo realizar uma
reviso sistemtica da literatura, pesquisando nas principais bases de dados, estudos que
envolvam treino das funes executivas em idosos. Esta pretende auxiliar os profissionais a
escolher mtodos de treinos mais adequados e corroborar para pesquisas futuras. Os artigos
indexados em bases de dados internacionais foram pesquisados e analisados. Os descritores
foram: training executive function and elderly. As buscas se concentraram nos resumos de

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peridicos indexados nas bases de dados Lilacs, PsyicINFO, PubMed, que permite acesso a
um banco de dados gratuito com as citaes, resumos e artigos completos fornecidos pelo
MEDLINE; Scopus e Web of Science. O perodo de busca foi do ano de 2008 at 2012. Foram
selecionados os abstracts que preenchiam os critrios de estudo, envolvendo pelo menos um
grupo controle, com uso de qualquer tipo de treinamento cognitivo/ estimulao entre os
idosos. Foram localizados 142 estudos, destes 19,01% foram excludos por estarem repetidos.
J dos 142 resumos, 9 (6%) foram excludos por serem de reviso de literatura. E por fim,
66,19% destes estudos tambm foram extintos, por envolverem atividades e treinos fsicos,
alm de outras faixas etrias e temticas que fugiam do assunto de interesse, portanto no
atingiram objetivo deste estudo. Restaram 10 (7%) artigos que atenderam os objetivos da
pesquisa e, portanto foram mantidos, que especificamente apresentavam treino das funes
executivas em idosos. Nos resultados destes estudos consta a melhora ocorrida aps treino de
habilidades. salientada a importncia do treino de tarefas da vida diria, atividades
instrumentais da vida diria e melhor qualidade de vida. Desta forma, um treino das FE poderia
ser til no tratamento de longo prazo para prevenir declnio e melhorar a qualidade de vida. A
implementao de um programa de treino das FE pode trazer benefcios na vida diria e na
qualidade de vida dos idosos, alterando assim o impacto funcional na vida dos seus
participantes.
Correlacin Entre Nivel de Atencin y Rendimiento Acadmico en Nios/ As de Sexto
Ao Bsico, Pertenecientes a Dos Establecimientos Educacionales
Norman Lpez Velsquez, Alex Veliz Burgos, Loreto Espina Florez.
Araucania, Universidad Mayor, Temuco, Chile.
Abstract Central: En esta investigacin se pretende determinar si existe relacin entre los
problemas de rendimiento acadmico y dificultades atencionales en los nios de sexto ao
bsico de la escuela Repblica de Italia (Municipal) de Capitn Pastene y colegio Inmaculada
Concepcin (particular subvencionado) de la ciudad de Valdivia. Pues diversos estudios
afirman que el rendimiento acadmico de los nios esta en directa relacin con su nivel
atencional, ya que sin duda este ltimo afecta directamente diversos mbitos de la vida de una
persona, principalmente social y acadmico. Para esta investigacin se escogieron dos
establecimientos con caractersticas diferentes, para comparar las variables propuestas, por un
lado la escuela Repblica de Italia, siendo un establecimiento municipal, por otro lado el colegio
Inmaculada Concepcin, siendo particular subvencionado. Pues se ha comprobado a travs de
la revisin de investigaciones base de este trabajo y de la aplicacin del test de Stroop, que
existe evidentemente una directa relacin entre rendimiento escolar y dificultad atencional en la
muestra evaluada. Se observa, que los nios que tienen mejores notas, presentan mejores
capacidades atencionales. Por ltimo cabe destacar que el desempeo en la prueba de Stroop,
fue superior en Capitn Pastene por sobre Valdivia.
Caracterizacin Neurocognitiva y Funcional de Adultos Mayores de la Comuna de
Temuco, Chile
Norman Lpez Velsquez, Alex Veliz Burgos.
Araucania, Universidad Mayor, Temuco, Chile.
Abstract Central: El objetivo del estudio fue describir el nivel de funcionalidad
neuropsicolgica de 186 adultos mayores (AM) de la comuna de Temuco, edad promedio de
71.21 aos y dt 7.18 aos, durante el ao 2011. Se administr la Evaluacin Funcional del
Adulto Mayor (EFAM) y una batera de instrumentos neuropsicolgicos (Test de la Figura

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Compleja de Rey, Test de Aprendizaje Auditivo Verbal de Rey, Test de Rastreo o TMT y
MiniMental). Se observ que la clasificacin que arroja el EFAM es un predictor de desempeo
en las pruebas neuropsicolgicas administradas a los AM. Se observan dos grupos de adultos
mayores: AM autovalentes que presentan buena integridad sensorial enceflica, conservada la
memoria auditiva y visuoespacial, sin problemas de orientacin temporoespacial, atencional, ni
deterioro cognitivo. Un segundo grupo de AM dependientes, con dificultades a nivel
musculoesqueletal, motor y funcional, disfunciones a nivel de atencin a fenmenos acsticosmnsicos, visuoconstruccionales, auditivos; defectos confusionales y desorientacin
temporoespacial, problemas conductuales y deterioro cognitivo. Palabras claves: Adulto Mayor,
evaluacin neuropsicolgica, rendimiento neurocognitivo
Psychophysiological Correlates of Social Cognition in Adults with High-Functioning
Autism Spectrum Disorder
Danielle Mathersul, Skye McDonald, Jacqueline Rushby.
University of New South Wales, Sydney, NSW, Australia.
Abstract Central: Individuals with autism spectrum disorders (ASDs) are characterised by
severe impairments in social-emotional reciprocity. It has been proposed that these deficits may
be due to impairments in theory of mind (ToM) or empathy, potentially due to underlying
disruptions in neural networks including the amygdala, orbitofrontal cortex and/or insula. We
have previously found that advanced ToM ability in high-functioning adults with ASDs is
associated with cognitive but not affective empathy. This is consistent with the proposal that
affective empathy is related to emotional responsivity. Psychophysiological measures such as
facial mimicry (electromyography; EMG) and autonomic responses (skin conductance; SCL,
SCR) provide an objective index of emotional responsivity. Furthermore, these measures may
provide further information regarding the proposed neural deficits in ASDs. The aim of the
present study was to investigate psychophysiological responses (EMG, SCL, SCR) to social
stimuli in high-functioning adults with ASDs, and relationships with cognitive and affective
empathy. Thirty adults (24 males; mean age 38.4 years) with ASDs were matched to 32 controls
(25 males; mean age 41.5 years) on age, gender, IQ and years of education. As expected, the
ASD group had significantly lower levels of both cognitive and affective empathy. The ASD
group also demonstrated atypical EMG, SCL and SCR. Interestingly, the ASD group could be
divided into two subgroups centred on resting baseline SCL. The ASD subgroup with typical
resting baseline SCL (i.e., no difference from the control group) showed negative correlations
between SCL and affective empathy, similar to the control group. In contrast, the ASD subgroup
that had significantly lower resting baseline SCL had no significant associations between SCL
and empathy. Empathy was also associated with facial mimicry in the ASD group. These
findings suggest a disruption in the allocation of attention and (emotional) significance to social
stimuli, and may provide a potential mechanism for deficits in social-emotional reciprocity.
Implications for treatment interventions will also be discussed.
Using Behavior Functional Analysis into Supervision Practice
Qian Mingyi.
Department of Psychology, Peking University, Beijing, China.
Abstract: Kanfer & Saslow (1974) raised a SRC model for behavior functional analysis. S means
stimuli/situation; R means reactions; C means consequences. The model is useful for helping
professionals to formulate any case in their CBT practice, especially for the newly ones. During
my supervision practice, both in individual and group case supervision, help supervisee to learn

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and apply the SRC model, can make them handle their cases more easily and fast. It serves as
a frame, to help professionals understanding the cases behavior, cognition, emotional and
physical reactions; it also help professionals get to learn why the dysfunctional behavior could
be maintained; furthermore, how to deal with the dysfunctional behavior based on the SRC
analysis. Examples will be supplied to discuss these issues. Keywords: Behavior functional
analysis, supervision, SRC model
A Caixa de Areia Como Uma Ferramenta Prtica Para a Reestruturao Cognitiva
Brbara Monteiro.
prtica privada, Rio de Janeiro, Brazil.
Abstract Central: A reestruturao cognitiva um dos principais aspectos do processo
teraputico na Terapia Cognitivo-Comportamental e as dificuldades encontradas por muitos
indivduos nesse processo de modificao do pensamento disfuncional em um pensamento
mais funcional so de conhecimento dos terapeutas. Este trabalho visa apresentar a caixa de
areia como uma ferramenta prtica para o processo de reestruturao cognitiva, esta tcnica
consiste em apresentar para o indivduo uma caixa quadrada ou retangular, preenchida com
areia branca. Juntamente com a caixa o terapeuta deixa disposio do sujeito uma gama de
miniaturas que envolvem vrios temas como objetos, pessoas, animais, etc. Na caixa o
indivduo montar a situao que lhe gerou os pensamentos disfuncionais, ele utiliza as
miniaturas para relatar toda a situao, o passo a passo como ela aconteceu, como um filme,
por exemplo, se a situao foi uma briga conjugal que ocorreu na sala de estar da casa do
casal, o indivduo remonta sua sala de estar e insere dois bonecos que representem a si e sua
esposa, a partir da ele comea a manipular os dois bonecos, verbalizando o que foi dito na
discusso por cada um. Alm de verbalizar o que falou na situao ele tambm traz a tona os
pensamentos que teve no momento, ao mesmo tempo em que aponta como se sentiu ao ter
esses pensamentos, deste modo ele consegue visualizar como os seus pensamentos e
sentimentos influenciaram o que foi dito por ele (seu comportamento) e como isto alimentou a
situao. Desta forma ele consegue visualizar na cena montada, de uma forma mais concreta,
como os pensamentos e sentimentos influenciam o comportamento. Aps ele mostrar a
situao, ele pode elaborar junto com o terapeuta de uma forma colaborativa, questionamentos
que poderiam ter sido utilizados na situao e reestruturar seus pensamentos disfuncionais em
pensamentos mais funcionais. Aps esta tarefa, ele pode remontar a situao na caixa de
areia, porm desta vez verbalizando os pensamentos reestruturados, mostrando atravs de
cenas, como a situao seria diferente se ele tivesse se questionado, conseguindo visualizar
que pensando de uma maneira mais funcional, ele ter sentimentos mais positivos e
conseqentemente comportamentos mais produtivos. As miniaturas tambm podem ser
manipuladas por ele ou pelo terapeuta para demonstrar com uma situao possui vrios pontos
de vista e que o pensamento disfuncional no deve ser aceito como uma verdade nica. Em
todos os momentos a caixa de areia permite que o indivduo visualize a situao, como ela se
d e como os seus pensamentos influenciam diretamente suas aes, a partir de ento ele
pode se questionar e manipular a situao, conseguindo visualizar de uma forma mais concreta
como os questionamentos e a reestruturao podem ser produtivos para sua vida. Aps a
realizao desta tcnica, terapeuta e paciente tero em mos um material rico para discusso
em sesso, onde poder ser mostrado para o indivduo como ele pode generalizar os seus
questionamentos para outras situaes. O trabalho tambm tem como objetivo apresentar
ilustraes de casos onde foi possvel observar como esta tcnica foi fundamental para o
sucesso do processo de reestruturao cognitiva.

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Implicaes da Ansiedade Social nas Falsas Memrias


Priscila Palma, Carmem Neufeld, Carolina Rossetto.
USP - Ribeiro Preto - SP -Brasil, Ribeiro Preto, Brazil.
Os processos mnemnicos so responsveis por manter a qualidade e estabilidade de, porm
pesquisas vm mostrando ao longo do tempo, que tais processos podem apresentar erros e
distores que podem mudar o curso de nossa vida. As falsas memrias so recordaes de
situaes, eventos que na realidade no ocorreram exatamente como recordamos,
ultrapassando a experincia real. O processo de recuperao de uma situao envolve voltar
mentalmente e reviver a experincia, e durante essa recuperao podem ocorrer erros,
fazendo com que a memria no seja recordada exatamente como aconteceu. Desde a dcada
de 90 pesquisadores vm estudando processos mnemnicos e estudos tm indicado que o
tempo pode transformar nossas memrias, estudos com populaes clinicas, entre outros.
Alm disso, sabe-se que o nvel de desajustamento e instabilidade emocional, interferem para
um maior nmero de falsas memrias, caracterstica muito marcante na populao de
portadores de ansiedade social. O presente estudou o qual visou comprar participantes adultos
portadores de TAS e participantes adultos sem esse sintoma (n = 137), a partir de duas
narrativas, sendo que uma delas gera emoo e a outra no gera impacto emocional, nas quais
apresenta uma sequncia de onze slides, a fim de investigar o impacto da emoo na
performance de memria nessa populao clnica. Participaram deste estudo universitrios
adultos, entre 18 e 30 anos, sendo 61 portadores de Transtorno de ansiedade social e 76
participantes sem sintomas clnicos, foram realizadas anlises paramtricas utilizando o test t
de student e anlises de Varincia (ANOVA). Todos os tratamentos estatsticos utilizaram um
< 0,05 para o teste de hipteses e testes post hoc com correo para Bonferroni para identificar
as possveis diferenas encontradas. Os resultados sugerem que os participantes portadores
de TAS, os quais assistiram a narrativa sem impacto emocional, permaneceram mais vigilantes
sobre as informaes do vdeo, obtendo ndices superiores de memrias verdadeiras. Porm
ansiosos apresentam vieses de memria para fatos ameaadores, obtendo ndices superiores
de falsas memrias, sugerindo que a ansiedade social tem uma ao significativa sobre a
performance de memria, sugerindo que os portadores de fobia social apresentam recordaes
mais fidedigna porm tambm apresentam maior nmero de distores. Com relao a
emoo, foi percebido que a emoo apresentou duplo efeito, sendo que a emoo no agiu
como protetora da memria verdadeira dos portadores de TAS, porm agiu tambm como
protetora das falsas memrias dos mesmos sujeitos. Diante dos achados da atualidade e a
falta de pesquisas em populao clnica, v-se a necessidade de abordar tal tema o qual pode
ter repercusses dentro do mbito clinico, assim como dentro do mbito jurdico, acarretando
conseqncias decisivas na vida das pessoas. Apoio financeiro: FAPESP e CAPES
Efectos de un Programa de Imaginera Motora Sobre la Cadencia, la Longitud Del Paso,
Longitud de Zancada, y Velocidad de la Marcha, en un Grupo de Pacientes entre 50 y 80
aos con Hemiparesia Espstica Secundaria a Enfermedad Cerebro Vascular
Adriana Perugache1, Cesar Pabon Rozo2, Francia Restrepo de Meja3.
1. Psicologa, Universidad de Nario, San Juan de Pasto, Colombia, 2. Universidad de
Pamplona, Pamplona, Colombia, 3. Universidad Autnoma de Manizales, Manizales, Colombia.
Abstract Central: La imaginera motora es un proceso durante el cual se representa una
accin especfica, sin ninguna ejecucin de movimiento(1 ). Actualmente su uso como
estrategia teraputica se ampli a las enfermedades neurolgicas(2 ), que segn la
Organizacin Mundial de Salud (OMS) se presentan con tasas de prevalencia de entre 5 y 10
afectados por cada mil habitantes(3 ), en Colombia se estima una tasa de prevalencia de 5,7

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por cada mil habitantes. En la enfermedad cerebro vascular se generan lesiones del
parnquima cerebral que frecuentemente generan alteraciones en la marcha. En este trabajo
se plantea la rehabilitacin funcional de la marcha a partir del uso de estrategias cognitivas
complementarias a las tcnicas fisioteraputicas utilizadas tradicionalmente. La propuesta
teraputica utiliza la imaginera motora durante 12 sesiones en las cuales el paciente recibe
instrucciones audiovisuales sobre la manera de desarrollar en la imaginacin las fases de la
marcha con ambas piernas y en diferentes planos (frontal, posterior, lateral derecho y lateral
izquierdo). Objetivo: Determinar los efectos de un programa de imaginera motora sobre la
cadencia, la longitud del paso, longitud de zancada, y velocidad de la marcha, en un grupo de
pacientes entre 50 y 80 aos con hemiparesia espstica secundaria a enfermedad cerebro
vascular. Metodologa: Esta investigacin es un estudio explicativo, cuantitativo, en el que se
realizaron PRETEST y POSTTEST en los grupos experimental y control de lista de espera.
Para determinar el efecto del programa se realiz el anlisis de la marcha, a travs de
videografa, con el programa SIMMI REALITY MOTION. Para determinar la existencia de
diferencias estadsticamente significativas entre las medias de las variables obtenidas durante
las prepruebas y postpruebas de los grupos experimental y control de lista de espera, se aplic
la prueba t para muestras relacionadas cuando las variables analizadas se distribuyeron de
forma normal y cumplieron con el criterio de homocedasticidad. Cuando no cumplieron los
criterios mencionados se aplic la prueba U de Mann Whittney. Los datos obtenidos se
analizaron con el programa SPSS versin 19 Resultados: Los efectos de la aplicacin del
programa de imaginera motora facilitaron en los pacientes el logro de mejoras
estadsticamente significativas en cuanto a: longitud de zancada y velocidad de marcha, las
cuales se mantuvieron an despus del entrenamiento. Las variables cadencia y longitud del
paso mostraron mejoras sin embargo no fueron estadsticamente significativas.
Craving como Utilidade: O Contexto Econmico por Trs da Recada em Usurias de
Cocana
Giovanna Piccoli1, Bruna da Rocha1, Breno Sanvicente Vieira1, Bruno Kluwe Schiavon1, Thiago
Wendt Viola1, Julio Carlos Pezzi2, Rodrigo Grassi de Oliveira1.
1. PPG - Faculdade de Psicologia, Pontfica Universidade Catlica do Rio Grande do Sul, Porto
Alegre, Brazil, 2. Universidade Federal de Cincias da Sade de Porto Alegre, Porto Alegre,
Brazil.
INTRODUO: Atualmente o modelo de tomada de deciso mais reconhecido e com poder
explicativo o de Daniel Kahneman. Seus achados indicaram que h uma tendncia de lose
avoidance maior do que uma the pursuit for profits. A teoria Prospectiva um avano as teorias
baseadas apenas na utilidade considerada anteriormente, pois leva em conta
comportamentos mais complexos como o envolvimento moral. Em termos de aplicabilidade os
resultados so uteis para finalidades do comportamento econmico e da psicologia positiva.
Entretanto, embora seja reconhecida para compreender a tomada de deciso, poucos estudos
investigam seu comportamento na dependncia qumica, cuja essncia exatamente uma
continua opo por risk-taking. OBJETIVO: Testar duas hipteses fundamentais - (1) DQs
apresentaro o comportamento de loss avoidance mais frequentemente que o de profits
pursuit; (2) o craving para chocolate se comportar como a utilidade, sendo portanto maior no
grupo que evitou o risco. MTODO: 57 usurias de cocana internadas h pelo menos 7 dias
foram submetidas aos seguintes procedimentos: 1) entrevista; 2) aplicao de uma escala
anlogo visual, que pode ser pontuada de zero (0) a dez (10), para craving de chocolate; 3) gono-go e Trail Making A e B, para determinar variveis de flexibilidade e Funo executiva; 4)
Verso experimental do Ultimatum Game. O experimento consiste em um single trial, no qual
elas acreditam estar jogando com uma desconhecida, e a comunicao feita atravs do

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pesquisador. O jogo consiste na deciso da participante aceitar ou recusar a diviso de um


total de dez unidades de chocolate. A proposta apresentada sempre injusta - de acordo com
a literatura ofertas abaixo de 40% so recusadas - ficando a participante com 2 chocolates e a
outra jogadora com 8. O aceite consiste em ganhar os dois chocolates e deixar a outra parte
com 8; a recusa implica em perda de todos os chocolates para as duas partes. RESULTADOS:
As participantes que aceitaram essa proposta foram dispostas em um grupo (n=39), e as
participantes que recusaram em outro (n=18) - confirmando nossa primeira hiptese. Resultado
de ANCOVA, covariando os resultados para idade, escolaridade e escores de flexibilidade
cognitiva, demonstrou que a mdia de craving do grupo que aceitou a proposta foi
significativamente mais alta (F= 12,88 p = 0,001). CONCLUSES: Os resultados indicam que a
hiptese de que o craving funciona como a utilidade para as usurias de cocana no caso dos
chocolates, levando-as a ignorar premissas consideradas morais e optando pelas unidades de
chocolate. Os achados ainda suportam inferir que a intensidade do craving influencia-as a optar
por ofertas injustas, de forma que as circunstncias do craving sejam preponderantes na
deciso, mesmo controlando-se variveis como escolaridade e funes executivas. Os
resultados de pesquisas bsicas como esta devem ser considerados como estratgias
anlogas para desenvolvimento de estratgias de manejo de fissura, bem como o de
teraputicas baseadas no arousal relacionado com o desejo de dependentes de cocana.
Terapia Cognitivo Conductual de la Fibromialgia
Francisco Pizarro1, 3, Jos Luis Rossi1, 2.
1. Facultad de Psicologa, Universidad Adolfo Ibez, Santiago, Chile, 2. Departamento de
Psicologa, Universidad de Chile, Santiago, Chile, 3. CEDETi UC, Pontificia Universidad
Catlica de Chile, Santiago, Chile.
La Fibromialgia es un Sndrome caracterizado por dolor musculo esqueltico generalizado y
difuso, de al menos 3 meses de duracin. En la delimitacin del Sndrome se considera la
presencia de hiperalgesia diseminada y presencia de dolor a la palpacin de localizaciones
anatmicas definidas. Es una alteracin crnica, que se acompaa de diversos sntomas como
fatiga, alteraciones del sueo, rigidez matutina, cefaleas, dismenorrea, sntomas ansiosos y
depresivos, entre otros (Pascual , Garca- Campayo, Lou e Ibaez, 2004; Vidal-Coll y Alegre,
2007). De acuerdo a los datos epidemiolgicos, la prevalencia estimada en la poblacin mayor
de 20 aos, oscila en torno al 2 y 3%, y predominando una relacin 21/1 en el sexo femenino.
Segn estudios longitudinales, el proceso tiende a la cronicidad y provoca un grado importante
de discapacidad y alteracin en la calidad de vida. En la actualidad, pese a que no hay
consenso en cuanto a las variables involucradas en su etiopatogenia, existe una delimitacin
nosolgica del sndrome y se plantea que los abordajes diagnsticos y teraputicos deben ser
interdisciplinares (Reumatlogo, Psiquiatra, Psiclogo, entre otros). De acuerdo al Consenso
Interdisciplinar para el tratamiento de la Fibromialgia (Alegre de Miquel, et al, 2010) existira
evidencia cientfica que sustenta la indicacin de Terapia Cognitivo Conductual en pacientes
con Fibromialgia, constituyndose como una alternativa teraputica, que si bien no logra
eliminar completamente el dolor, permite controlar y mejorar los sntomas, otorgando al
paciente diversas estrategias de afrontamiento que le permiten tener mayor control sobre su
condicin, mejorando la calidad de vida y la percepcinn de autoeficacia . En el presente
trabajo se pretende realizar una conceptualizacin cognitiva conductual del dolor crnico y la
fibromialgia, poniendo nfasis en las variables que contribuyen en la modulacin de la
experiencia de dolor en el paciente, delimitando un perfil cognitivo (distorsiones y esquemas
caractersticos), emocional (activacin autonmica y emociones relacionadas) y conductual
(comportamientos del paciente y de los miembros de la familia) que contribuyen al
mantenimiento del problema. De la misma manera, se realiza una revisin de las principales

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tcnicas psicoteraputicas conductuales y cognitivas que han mostrado efectividad y eficacia


en la reduccin de la sintomatologa, para finalmente proponer un diseo de tratamiento que
puede ser aplicado en formato individual o grupal. Se sugiere adems la inclusin de la
hipnosis como una tcnica que incrementa los resultados del tratamiento, mediante la
reduccin de los niveles percibidos del dolor (analgesia hipntica). Para estos efectos se
realizar una revisin terica de los fundamentos de la Terapia Cognitiva del Dolor Crnico
(Winterwood y Beck, 2002) y la adaptacin del modelo al tratamiento de los pacientes con
fibromialgia (Bennet y Nelson, 2006; Moix y Casado, 2011). Finalmente se expone la evidencia
cientfica disponible en relacin a la efectividad del modelo y los efectos neurobiolgicos de las
intervenciones cognitivo conductuales de la fibromialgia.
Recursos Inovadores em Terapia Cognitivo-Comportamental
Maria Rossi1, Paula De Vitto2, rica Duran2.
1. AMBAN USP CONSCIENTIA CPCS, Sao Paulo, Brazil, 2. AMBAN USP PSIQ, Sao Paulo,
Brazil.
A Terapia Cognitivo-comportamental tem sido utilizada na prtica clnica nos diversos
momentos do ciclo vital e quadros psicopatolgicos. Recursos inovadores e tecnolgicos, entre
outros, esto sendo utilizados para tornar o processo psicoterpico mais efetivo e dinmico. O
propsito dessa mesa apresentar alguns desses novos recursos: computador, realidade
virtual e biofeedback no processo psicoterpico. Na psicoterapia com crianas os programas
informatizados podem se constituir em um importante recurso teraputico e em fator motivador
e reforador terapia, proporcionando a aprendizagem de novos repertrios cognitivos e
comportamentais. O Projeto Transformador, protocolo computadorizado para terapia com
crianas, foi elaborado para suprir com eficcia essa demanda. O Tratamento proposto para
medo de avio foi desenvolvido utilizando a tcnica da exposio associado `a realidade
virtual propiciando efeito ilusrio de estar na realidade, facilitando aderncia e auxiliando no
tratamento destes indivduos. O biofeedback vem sendo aplicado com resultados excelentes no
processo psicoterpico em diferentes fases da vida proporcionando maior adeso,
aprendizagem e controle dos mais variados transtornos. Esses so os temas que estamos
estudando e pesquisando a sua eficcia.
Empathy for Pain Patients Depends on Ingroup/Outgroup Decisions: A fMRI Study
Judith Ruckmann1, Maren Bodden1, 3, Andreas Jansen2, Tilo Kircher2, Richard Dodel3, Winfried
Rief1.
1. Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipp's
University of Marburg, Marburg, Germany, 2. Division of Brain Imaging, Department of
Psychiatry and Psychotherapy, Faculty of Medicine, Philipp's University of Marburg, Marburg,
Germany, 3. Division of Neurological Therapy Research, Department of Neurology, Faculty of
Medicine, Philipps University of Marburg, Marburg, Germany.
Showing empathy and understanding how others feel, think and behave, is crucial for social
functioning, and especially in psychotherapeutic interactions. A close relationship between
empathy, social cognition and psychological disorders is assumed. Pain empathy is an example
for empathy in general. It is modulated by different factors. These are situational variables, as
well as target features and observer characteristics. Several studies have shown that empathy
is also related to group membership and the social relation between the person showing
empathy and the person receiving empathy (e.g. ethnicity). The current study investigates the
influence of experimentally induced group membership on empathy for pain. Thirty right-

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handed, healthy volunteers participated in an fMRI-experiment. Group membership was


experimentally manipulated by a minimal group paradigm. To assess neural processes
associated with pain empathy, we measured fMRI reactions during the presentation of pictures
showing hands and feet in painful and neutral everyday situations. These pictures were
experimentally assigned to either ingroup or outgroup members. Participants were instructed to
empathize with persons shown on the pictures. They also had to rate the intensity of the pain
the person on the photograph may have, using a visual analog scale. ANOVA results for fMRI
data revealed a main effect for pain in areas belonging to the so-called pain matrix, i.e. Insula,
IFG, SMA and ACC. Although there was no ingroup bias in pain intensity ratings, subjects
showed higher neural activation in regions of right fusiform gyrus, hippocampus area bilateral
(with peaks in right Thalamus and left Pallidum) and also cerebellum. Post-hoc analyzes show
that these differences in brain activation patterns are mainly due to a higher activation of these
areas when subjects watching ingroup members experiencing pain. Activation in these areas
suggest that participants pay more attention to ingroup members than to outgroup members
during the pain-condition. Thalamic and Pallidum area activation might also reflect inhibition of
pain experience. Furthermore, self-reported empathic concern and neural activation are
significantly related. Our findings underline the relevance of pain empathy for interactional
processes with patients suffering from pain and somatization.
Biased Attentional Engagement With, and Biased Attentional Disengagement From,
Negative Information in Anxiety Vulnerability
Daniel Rudaizky, Colin MacLeod.
University of Western Australia, Perth, WA, Australia.
Abstract Central: Compelling evidence has been found to support cognitive models of anxiety
disorders that propose selective attention to negative information plays a pivotal role in the
development of the elevated levels of anxiety vulnerability that precipitate anxiety pathology.
Researchers have sought to distinguish whether these attentional biases represent a biased
tendency to engage attention with threatening stimuli or with a difficulty in disengaging attention
from threatening stimuli. Although evidence has been found for both engagement and
disengagement biases, methodological limitations in their assessment has meant that their
respective contribution to elevated levels of anxiety vulnerability remains to be determined. We
present a novel methodology to assess these biases and provide evidence that biases in both
selective engagement with, and selective disengagement from, negative information
independently contribute to elevated levels of anxiety vulnerability. These results invite
speculation about the possible differential concomitants of the anxiety response that could be
associated with these independent attentional biases and how these alternative facets of the
anxiety-linked attentional bias for negative information may differentially contribute to alternative
manifestations of anxiety dysfunction. We present some preliminary investigations addressing
these subsequent issues in both clinical and non-clinical samples.
Contribuies da Terapia Cognitiva Comportamental Reabilitao Neuropsicolgica de
Adolescentes com Leso Cerebral: Uma Proposta de Interveno
Beatriz Sant'Anna1, 2, Ana Idalina Silva2, Adriana Rossi1, 2, Lilian Del Poz2, Maria Cristina
Oliveira2, Renata Gomes2, Silvia Feldberg2, Thiago Cardoso1, 2, Mauro Muszkat1, 2, Claudia
Mello1, 2, Orlando Bueno1.
1. Psicobiologia, UNIFESP, So Paulo, Brazil, 2. Centro Paulista de Neuropsicologia, So
Paulo, Brazil.

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Abstract Central: Introduo. Reabilitao neuropsicolgica (RN) um processo em que


paciente e equipe profissional buscam construir conjuntamente estratgias para superar,
reduzir, contornar, enfrentar ou conviver melhor com dficits cognitivos advindos de um
problema neurolgico. As tcnicas utilizadas na RN so bastante variadas e no existe um
protocolo nico pr-definido. A Terapia Cognitivo-Comportamental (TCC), como uma
abordagem que enfoca a interao entre fatores cognitivos, emocionais e comportamentais, e
sua relao com o ambiente, possui um arcabouo de tcnicas que podem ser aplicadas em
diversos contextos e com excelentes resultados. O objetivo deste estudo foi investigar a
aplicabilidade do uso de tcnicas frequentemente utilizadas em TCC em um programa de RN
de adolescentes com leso cerebral. Mtodo: Participaram do estudo trs adolescentes com
leso cerebral, integrantes de um programa de RN, cujas idades variaram entre 13 e 15 anos.
Foram realizados 18 encontros com durao de noventa minutos. Durante as sesses,
estruturadas segundo a TCC, foram utilizadas as tcnicas: registro de sesso, identificao e
expresso das emoes primrias e secundrias, identificao de pensamentos relacionados
s emoes, a tcnica de economia de fichas, o questionamento socrtico e a modelagem de
comportamentos. Resultados: Verificou-se aumento do repertrio de habilidades sociais aps o
treinamento sobre as emoes, observado dentro do grupo e tambm fora dele de acordo com
relato de familiares. Este treinamento especfico revelou-se um importante passo para que se
atingisse a etapa posteriormente delimitada no tratamento, que foi conversar com os
adolescentes sobre a leso cerebral e suas consequncias. Tambm foi observado maior
nmero de comportamentos adaptativos aps a tcnica de economia de fichas e da
modelagem de comportamentos. O questionamento socrtico auxiliou o grupo a refletir sobre
as contingncias impostas pela leso e a buscar solues possveis para os problemas
enfrentados. Uma importante contribuio da TCC para o contexto da RN foi a possibilidade de
desenvolver nos participantes o conhecimento dos prprios sentimentos, o que aumenta a
capacidade de lidar com diversas situaes difceis de vida, como uma leso cerebral e seus
desdobramentos. Observamos que, por meio deste trabalho, os participantes puderam refletir
sobre suas prprias dificuldades e planejar de forma mais eficaz estratgias de enfrentamento,
que o objetivo de um programa de RN. Este trabalho tambm possibilitou aos adolescentes
construir uma noo de identidade ampliada, integrando suas percepes acerca da leso
cerebral. Concluso: As tcnicas de TCC podem ser usadas no contexto da RN e se mostram
importantes ferramentas para o alcance das metas teraputicas de reabilitao, auxiliando no
planejamento e execuo de programas de reabilitao neuropsicolgica.
Adaptao e Aplicabilidade de Protocolo de Treinamento em Grupo para Pais de
Adolescentes com Leso Cerebral: Um Projeto Piloto
Beatriz Sant'Anna1, 2, Ana Idalina Silva2, Adriana Rossi1, 2, Lilian Del Poz2, Maria Cristina
Oliveira2, Renata Gomes2, Silvia Feldberg2, Thiago Cardoso1, 2, Mauro Muszkat1, 2, Claudia
Mello1, 2, Orlando Bueno1.
1. Psicobiologia, UNIFESP, So Paulo, Brazil, 2. Centro Paulista de Neuropsicologia, So
Paulo, Brazil.
Abstract Central: Introduo. O envolvimento ativo da famlia na reabilitao neuropsicolgica
de adolescentes com leso cerebral fundamental. A realizao de grupos de trabalho com
estes familiares visa promover a troca entre os pares, possibilitando acolhimento e fornecendo
informaes relevantes que possam favorecer a reabilitao do paciente. No entanto, na
literatura cientfica so escassos os programas sistemticos desta natureza. Assim, buscou-se
adaptar o Protocolo de Treinamento para Pais de Crianas com TDAH (Anastopoulos, Rhoads
e Farley, 2008), baseado na Terapia Cognitivo-Comportamental (TCC), para pais de
adolescentes com leso cerebral, avaliando sua aplicabildade para estes pacientes. Mtodo.

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Participaram do estudo 3 mes de adolescentes com leso cerebral, integrantes de um projeto


de reabilitao neuropsicolgica holstica. O programa baseou-se nas etapas propostas pelo
Protocolo para TDAH, fazendo adaptaes necessrias populao estudada. Realizou-se 18
sesses em grupo, com durao de 90 minutos cada, estruturadas em 9 etapas: I)
Psicoeducao sobre o crebro e funes cognitivas, e sensibilizao para a proposta de
reabilitao neuropsicolgica; II) Promoo do dilogo entre pais e filhos sobre leso cerebral e
suas consequncias; III) Modulao de expectativas parentais; IV) Discusso sobre os
princpios do comportamento; V) Estilos de Reforo e Promoo de ateno positiva; VI)
Sistema de Fichas em casa; VII) Sistema de Fichas para atividades escolares; VIII) Apoio
escola; IX) Direitos legais e o futuro de adolescentes com leso cerebral. Para avaliar a
aplicabilidade do projeto, foram realizadas observaes pela equipe, relato livre de familiares e
adolescentes. Resultados. Pde-se constatar o alcance das seguintes metas: aquisio de
informaes bsicas sobre o funcionamento do crebro e das funes cognitivas, troca entre
pares e discusso sobre as dificuldades e preocupaes, desenvolvimento de percepo mais
acurada a respeito das necessidades dos seus filhos, prticas educativas parentais mais
apropriadas, e formas mais adequadas de comunicao e de resoluo de problemas. Com
relao proposta do protocolo original, alm das adaptaes s etapas sugeridas, foram
includas discusses sobre o dilogo entre pais e filhos a respeito da leso cerebral e suas
consequncias e sobre o futuro de um adolescente com leso cerebral. Questes relacionadas
ao comportamento disruptivo, frequentemente relacionado ao TDAH (Custo resposta,
Usando castigos e Controlando o comportamento em locais pblicos) no se fizeram
presentes neste grupo e, portanto, no foram includas. A proposta de adaptao do protocolo
mostrou-se til no contexto da reabilitao neuropsicolgica de adolescentes com leso
cerebral por ser um programa estruturado e facilmente replicvel em outros contextos clnicos.
Fornece um passo-a-passo com diversas tcnicas e estratgias para lidar com o
comportamento e as dificuldades enfrentadas por esta populao. Concluso. Este estudo
constatou a viabilidade da adaptao e aplicabilidade do protocolo originalmente desenhado
para pais de filhos com TDAH para pais de filhos com leso cerebral na infncia. A presente
proposta ressalta os benefcios da interface entre a TCC e a neuropsicologia clnica.
Estudos Preliminares de Consistncia Interna do Questionrio de Controle Atencional
(QCA) na Perspectiva da Teoria Clssica dos Testes
Karla Sassi1, 3, Mariana Esch1, 3, Alberto Filgueiras1, 2.
1. Psicologia, PUC/RJ, Rio de Janeiro, Brazil, 2. Instituto Brasileiro de Neuropsicologia e
Comportamento, Rio de Janeiro, Brazil, 3. Instituto de Psiquiatria da UFRJ, Rio de Janeiro,
Brazil.
O controle voluntrio da ateno demanda diferentes mecanismos motores e cognitivos. Os
instrumentos de medida para a ateno automtica e voluntria so diversos em sua natureza
e paradigmas experimentais, dentre eles: paradigmas computadorizados de Tempo de Reao
(TR), testes padronizados e escalas comportamentais. Uma conhecida escala comportamental
para a mensurao do controle atencional a Attentional Control Scale (ACS) que foi traduzida
e adaptada para o Brasil como Questionrio de Controle Atencional (QCA). O QCA uma
escala com 20 itens de autopreenchimento na qual o respondente atribui valor s questes
atravs de uma escala do tipo Likert de 4 categorias. O instrumento nasce nos Estados Unidos
na Universidade Estadual do Oregon atravs dos pesquisadores Douglas Derryberry e Marjoire
Reed. O presente estudo tem por objetivo analisar a consistncia interna do QCA em sua
verso adaptada para a cultura brasileira com base no paradigma da Teoria Clssica dos
Testes. Metodologia: Coletamos os dados da verso brasileira do QCA em 42 participantes. A
amostra foi por convenincia, sendo todos os sujeitos eram alunos da graduao da PUC-Rio,

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tendo assinado Termo de Consentimento Livre e Esclarecido concordando em participar da


pesquisa. Analisamos a consistncia interna pelo paradigma de Lee J. Cronbach. O coeficiente
alfa () aponta o quanto os itens de uma escala convergem para uma mesma direo a partir
da matriz de correlaes. O valor esperado para considerar uma escala de itens convergentes
0,70. Resultados: A amostra foi dividida entre 7 homens (16,7%) e 35 mulheres (83,3%), com
mdia de idade de 25,0 (DP = 9,9) anos e escolaridade de 16,1 (DP = 4,1) anos de estudo. A
escala apresentou consistncia interna de = 0,80. Na estatstica de item-total, observamos
que a escala se beneficiaria se exclussemos os itens 9 e 20, apresentando uma variao entre
0,31 e 0,73. Em ambos os casos o valor do subiria para 0,82. A correlao com o teste
Ateno Concentrada para verificar a validade preditiva do instrumento foi de 0,71, o que
consideramos adequada para a situao. Discusso: O QCA se mostrou um instrumento
consistente, apresentando valores para o alfa que se aproximam da literatura internacional. Os
dados desse ndice cujo objetivo medir a consistncia da verso brasileira do QCA sugerem
que a adaptao dos itens foi adequada, com exceo dos itens 9 e 20 que parecem ser
deletrios para a confiabilidade global do questionrio.
Psicopata y fenmenos cognitivos asociados Psychopathy and associated cognitive
phenomena
Marcela Scarafia1, Maria Fabiana Boerr1, Roco Calvo Pesini2, Marcela Scarafia1, Marcela
Montironi2.
1. Poder Judicial, Crdoba, Argentina, 2. Poder Judicial, Crdoba, Argentina.
Las ciencias neurocognitivas han tenido un gran desarrollo en los ltimos decenios. Las
tcnicas de neuroimgenes nos han permitido visualizar las disfunciones neuronales que ya se
apreciaban en el comportamiento, cognicin y emocin en la psicopata. Sin embargo y a pesar
de estos avances, an no se logra disear un tratamiento eficaz para los predadores sexuales.
Los nuevos hallazgos han modificado las concepciones puramente comportamentales de
antao, casi nica mirada del psicpata. Hoy, podemos realizar un enfoque multiaxial e
integrado de este trastorno.
Aspecto descuidado de este fenmeno ha sido el complementario del psicpata, cuya
funcionalidad en esta dada relacional resulta fundamental para el xito en los objetivos
utilitarios de los sujetos portadores de estos trastornos. En este simposio analizaremos las
caractersticas de personalidad esenciales y necesarias del complementario para establecer
lazo vincular con el psicpata, as como la modificacin de las conductas, autoestima,
autoconcepto y aspectos cognitivos del complementario en esta relacin.
Alteraciones Neurocognitivas en Psicpatas: predadores sexuales
Neurocognitive impairment in psychopaths: sexual predators
Mgter. Marcela Scarafia
Se estima que el 25% de la poblacin carcelaria est compuesta por Psicpatas. El 50% de los
delitos mas graves y aberrantes han sido provocados por este porcentaje de recluidos. Se
calcula que entre el 1 y el 3% de la poblacin mundial est conformada por psicpatas, muchos
de los cuales estn aparentemente adaptados a las normas, sociales. Sin embargo producen
en sus vnculos y lugares de trabajo situaciones altamente perturbadoras, en virtud de sus
necesidades especiales. Los ltimos estudios neurocognitivos permiten inferir disfuncin
ejecutiva en los psicpatas, especialmente en lo que hace al proceso de toma de decisiones.
Los hallazgos de neuroimgenes muestran alteraciones funcionales en distintas zonas frontales
(orbito frontal, medial y dorsolateral), as como tambin alteraciones en las vas aferentes y
eferentes entre sistema lmbico y crtex prefrontal.
Estos hallazgos relativizan la influencia familiar y social en el desarrollo de la psicopata,

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especficamente en la modalidad predadora, ya que se han encontrado tambin psicpatas


predadores provenientes de familias funcionales pertenecientes a mbitos socio-econmicos
estables y sin dificultades relevantes.
Hasta el momento las tcnicas de resocializacin y los enfoques teraputicos aplicados a estos
sujetos no han dado los resultados necesarios para disminuir de una manera aceptable el
riesgo de reincidencia. Por el contrario, por ejemplo, se ha demostrado que cuando las terapias
son grupales, los psicpatas predadores reinciden antes que los no tratados.
An no est todo dicho en este trastorno de personalidad. An quedan muchas conquistas por
hacer en lo que hace a tratamiento y varios conocimientos por profundizar en relacin al
mecanismo de desarrollo de la psicopata. Es un desafo digno de ser afrontado.
El Complementario del Psicpata
The Complementary Person of the Psychopath
Lic. Fabiana Boerr
Es sabido dentro de la literatura psicopatologica y del anlisis de la casustica que el psicpata
debe captar a una vctima para satisfacer sus necesidades especiales. Estas son intereses o
tendencias atpicas y/o exacerbadas en relacin a personas con estilos funcionales
adaptativos. El objetivo del psicpata no es el complementario. Este ltimo resulta ser el medio
necesario a travs del cual satisfacer sus necesidades. Debe captarlo, seducirlo y luego
parasitarlo.
Resulta importante en este caso centrarnos en las caractersticas de personalidad y en el
funcionamiento cognitivo del complementario.
Como su nombre lo indica, este complementa, se acopla y acompaa al psicpata en su gesta
con conocimiento o sin l.
En el primer caso, el complementario suele disponer en su personalidad de mecanismos
adaptativos de tipo psicopticos (muchas veces larvados), que se activan, despliegan y
expresan frente a la presencia e influencia del psicpata. As se forma una dada psicopticoperversa, frecuentemente con conductas antisociales en donde ambos participan con diferentes
roles.
En el segundo caso, el complementario tiene caractersticas diferentes: suelen ser personas
emocionalmente vulnerables, que atraviesan una situacin de crisis o la han atravesado
recientemente, son omnipotentes, contenedores, complacientes y tienen una escala de valores
morales y sociales adaptativas. En este caso el complementario inicia esta relacin
deslumbrado por el psicpata que viene a cubrir todas las necesidades emocionales de su
vctima y la hace sentir especial. As, una vez captado y seducido, el psicpata comienza a
mostrar su otra cara, y por su puesto sus necesidades especiales, de las que el
complementario termina siendo vctima. A ello se agrega el tiempo que transcurre hasta que el
complementario cobra conciencia de que es objeto de manipulacin del psicpata.
El desafo se plantea frente al deseo de escape del complementario de esta relacin, ya que
ste queda afectivamente adherido, y siente que sufre con el psicpata, pero ms sufre sin l,
ya que en su ausencia dejar de sentirse especial.
Trastorno Por Estrs Postraumtico y alteraciones cognitivo-comportamentales en nios
vctimas de predadores sexuales
PTSD and cognitive-behavioral disorders in child victims of sexual predators
Lic. Rocio Calvo Pesini
El abuso sexual infantil ha sido definido como la situacin de exposicin de un menor a
prcticas sexuales de distinta ndole, que el nio no tiene libertad para consentir o evitar, en
virtud de su inmadurez cognitiva y emocional.
Resulta notable en nuestra sociedad el incremento en los casos de abuso sexual infantil
(A.S.I.). Las razones son debatibles y an estn por explorarse. Una de las caractersticas ms

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relevantes, y condicin sine qua non para la produccin del ASI la constituye la asimetra de
poder. Gran parte de la sintomatologa postraumtica hallada se relaciona con esta asimetra.
En el espectro postraumtico de la casustica con la que habitualmente trabajamos pueden
diferenciarse tres grandes grupos de predominancia sintomatolgica, a saber: emocional,
cognitiva y conductual, sin perjuicio de la ntima relacin e interaccin que existe entre estos
aspectos.
A ello se agrega como factor de no menor influencia la disociacin, fenmeno que afecta
profundamente las funciones cognitivas, as como la eficacia en los incipientes patrones de
resolucin de conflictos. Es menester aclarar que la disociacin, ya sea en su forma primaria,
secundaria o terciaria, no es esperable en nios y/o adolescentes que no hayan estado
expuestos a situaciones traumticas.
Las afectaciones emocionales, conductuales y cognitivas del Trastorno por Estrs
Postraumtico (TPEPT), que en principio pueden detectarse como reactivas y posteriores a
situaciones traumticas, pueden afianzarse como estilo personal de afrontamiento de la
realidad a travs del tiempo, si no media un proceso teraputico con un enfoque pertinente al
tipo de trastorno emergente. As, con el correr del tiempo, puede observarse en estos nios ya
adultos la dificultad para desarrollar niveles de alerta adecuados a situaciones potencialmente
peligrosas. Este fenmeno resulta evidente cuando, en algunos casos, frente a la evaluacin de
un nio abusado nos encontramos con una madre que tambin ha sido abusada (en
oportunidades por el mismo predador sexual que el nio).
La eleccin del enfoque y de la tcnica teraputica debe ser apropiada a esta casustica, y
especficamente al espectro sintomatolgico del TPEPT.
En nuestro medio profesional e institucional - asistencial encontramos pocos expertos en esta
temtica, y que adems puedan adoptar el enfoque teraputico necesario para paliar este
trastorno. Las terapias ms frecuentemente utilizadas toman a la palabra como herramienta
primordial, factor que, se ha demostrado acabadamente, no tiene la misma eficacia que otros
enfoques alternativos.
Por ello, es necesario un redireccionamiento hacia las tcnicas y abordajes especficos que han
demostrado xito en esta problemtica.
How Do You Feel When You Cant Feel Your Body? : Interoception, Functional
Connectivity and Emotional Processing In a Patient with Chronic Depersonalization
Disorder
Lucas Sedeo1, 3, Blas Couto1, 4, Margherita Melloni1, 3, Marcelo Cetkovich2, 3, Alicia Lischinsky3,
Fernando Torrente2, 3, Eduar Herrera5, Rafael Kichic2, 3, Agustin Ibanez1, 4.
1. Laboratory of Experimental Psychology and Neuroscience-INECO, Buenos Aires, Argentina,
2. Anxiety Clinic - INECO, Buenos Aires, Argentina, 3. Institute of Cognitive Neurology (INECO),
Buenos Aires, Argentina, 4. National Scientific and Technical Research Council (CONICET),
Buenos Aires, Argentina, 5. Universidad Autnoma del Caribe, Barranquilla, Colombia.
BACKGROUND: Chronic Depersonalization (CDP) is a disorder characterized by a disruption of
self-awareness involving the feeling of disembodiment and subjective emotional numbing as two
main symptoms. Despite of these abnormal experiences, patients are not delusional given that
they are aware of the subjective nature of these phenomena, rather than being objective reality.
A neuroscientific approach to this disorder is to study whether there is any impairment of the
representation of the bodily homeostatic state. Interoception, which refers to the perception of
the physiological condition of the body, is a process related with the generation of the cortical
representation of that homeostatic state. Besides, interoception is related to emotional
processing because subjective emotional feelings -that colour our thoughts in response to
emotive stimuli- are proposed to arise from the perception of bodily physiological changes
[Craig, 2002, Nat Rev Neurosci]. Consistently, recent studies have found positive and significant

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correlations between interoceptive accuracy and higher sensitivity arousals in response to


emotional pictures presentation [Critchley et al., 2004, Nat Neurosci]. Moreover, results from
self-report questionnaires suggested that indices of both negative (Critchley, 2009, Int J
Psychophysiol; Critchley et al., 2004, Nat Neurosci] and positive emotional experience [Weins et
al., 2000, Cogn. Emot] correlate with interoceptive accuracy. OBJECTIVE: The purpose of this
study is to investigate whether there are systematic differences in interoception and in emotional
processing between a patient with CDP and healthy subjects. METHODS: The patient and five
healthy controls performed a behavioral interoceptive task (heartbeat detection task) and
underwent an fMRI resting-state paradigm that drives subjects attention to their physiological
body sensations (heartbeat and breathing). The last, allowed us to compare the functional brain
connectivity while participants attention was focused on their body sensations. They were also
assessed using a battery of multimodal basic emotion recognition tests, an emotional inference
disambiguation task using social contextual clues, an empathy for pain task (EPT) and a theory
of mind test. To compare the patients performances with control sample, we used a modified
one-tailed t-test [Crawford and Howell, 1998, Clin Neuropsychol]. This methodology allows the
assessment of significance by comparing multiple individuals test scores with norms derived
from small samples RESULTS: Patient with CDP showed a deficit while performing the
heartbeat detection task when compared to controls. Furthermore, the patient exhibited different
patterns of functional connectivity during the interoceptive resting condition. Related to
emotional processing, patient evidenced no impairment in emotion recognition and social
emotions despite a pattern of delayed reaction times (RTs) in recognition. He also presented a
particular pattern of impairments in EPT associated with deficits in the empathic concern and
degree of discomfort. DISCUSSION/CONCLUSION: These behavioral and neurophysiological
results suggest that interoceptive deficits may be a possible impaired mechanism underlying
two of the main symptoms of depersonalization disorder: feelings of disembodiment and
subjective emotional numbing. To our knowledge, this is the first experimental research
assessing the relationship between interoception and CDP. Our results suggest the potential
role of interoception as a theoretic framework linking the changes in resting state brain
functioning and CDP phenomenology, as revealed by correlations of symptoms with behavioral
and neurophysiological changes.
Relationship Between Controllability of Lucid Dreaming and Affect in Dream
Yasuhide Sunada1, Yoshinori Ito1, Kazuo Matsuoka2.
1. education, University of the ryukyus, Okinawa, Japan, 2. Iwate University, iwate, Japan.
Although there are various strategies for coping with stress, it is pointed out effects differ
depending on whether the strategy is controllable or not (Sugiura, 2006). In recent years, some
researches suggest that dreaming that is experience under sleep also have the system of mood
regulation and can be adaptive coping with stress (Hartmann, 1998; Cartwright, 2004). Lucid
dreaming, a form of dreaming, is experience of being consciously aware of dreaming while still
dreaming (Laberge, 1985). During the lucid dreaming, person has the controllability for the
contents of dream. And it is pointed out that there is possibility that lucid dreaming may be able
to enhance well-being during wakefulness. However, it is expected that there are the occasions
that controlling of the dream is difficult although one is being consciously aware of dreaming,
and such dreaming has the possibility to be developed into anxiety dream or nightmare. Thus,
we can regard Lucid dreaming as a cognitive coping strategy that has the similar function with
worrying or rumination in respect of its positive effect on stress, while it may also have negative
impact on health. Therefore, in this study, we ascribed lucid dreaming to one of the cognitive
coping strategy, and conducted the preliminary investigation aimed at investigating the
relationship of controllability of lucid dreaming and mental health from the perspective of stress

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coping. We developed original lucid dreaming questionnaire by using to Laberge (1985),


Matsuoka (1993), Okada (2001) as the reference and 223 undergraduate students completed it.
To investigate relationships between the controllability of Lucid dreaming and the affect in lucid
dreaming or application of Lucid dreaming, Pearsons correlation coefficients were calculated.
The results were as follows: (1) controllability of Lucid dreaming was positively correlated to
positive affect, (2) controllability of Lucid dreaming was negatively correlated to negative
affect,(3) controllability of Lucid dreaming was positively correlated to effectiveness of
enhancement of well-being. To investigate the impact of controllability and reality of Lucid
dreaming on the affect aroused in lucid dreaming, two-way ANOVA was conducted with reality
of Lucid dreaming and controllability of Lucid dreaming as independent variables (High and
Low group) and positive affect and negative affect as dependent variables. The results of
ANOVA for negative affect, interaction was significant. A simple main effect analysis indicated
that controllability of Lucid dreaming have simple main effect on High group of reality of Lucid
dreaming, and reality of Lucid dreaming have simple main effect on Low group of
controllability of Lucid dreaming. The result of this study suggests that higher Controllability to
lucid dreaming was related to positive affect in lucid dreaming and the enhancement of Wellbeing by lucid dreaming. Result of the ANOVA suggests that those who experience vivid and
realistic lucid dreaming have uncontrollability, more negative affect will evoke. These results
support our hypothesis that Lucid dreaming have a function of stress coping. The experience
dreaming which is apparently different from cognition during waking consciousness is consider
to be similar mechanism to worrying or rumination in the aspect of uncontrollability being
problem. In the future research, it will be necessary to examine more explicit relationship
between controllability of Lucid dreaming and mental health, by using the standardized
measurement.
Its Outside My Control: Role of Automatic Cognitive Processing in Psychopathology
Bethany Teachman1, Reinout Wiers3, Colin MacLeod2, Peter de Jong5, Christopher Beevers4.
1. University of Virginia, Charlottesville, VA, USA, 2. University of Western Australia, Perth, WA,
Australia, 3. University of Amsterdam, Amsterdam, Netherlands, 4. University of Texas at
Austin, Austin, TX, USA, 5. University of Groningen, Groningen, Netherlands.
This panel discussion will feature internationally renowned researchers on the role of automatic
cognitive processing in various forms of psychopathology. Why is it that a person with social
phobia sees only the one scowling face in a room full of smiles; why does the heavy drinker feel
so drawn to alcohol even when he knows drinking is costing him his job and his marriage; and
why is the person with panic disorder convinced that the 300th panic attack is the one that will
bring on a heart attack? To understand these common clinical phenomena, we need to consider
the role of automatic processing of emotional and disorder-relevant information in these
disorders. It is now well established that many disorders are associated with thought patterns
and linked behaviors that appear to occur very rapidly, unintentionally and uncontrollably, even
sometimes occurring outside conscious awareness. Yet, many questions remain about the
functional role of these automatic cognitive processes for the development, maintenance, and
reduction of psychopathology. Panelists include 1) Dr. Colin MacLeod, a world expert on
processing biases associated with emotion dysregulation and one of the founders of cognitive
bias modification interventions to directly shift automatic processing; 2) Dr. Reinout Wiers,
internationally renowned for his research on dual process theories of alcohol use disorders and
reflexive responding by heavy drinkers; 3) Dr. Christopher Beevers, a leading expert on
uncontrollable processing in depression and the interaction between automatic and strategic
depressogenic biases; and 4) Dr. Peter de Jong, a world leader in the study of automatic
processing biases across anxiety and mood disorders, including prospective longitudinal studies

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on automatic cognitive bias measures as predictors of onset and change in symptoms over
time. Each of the panelists will briefly introduce their work on automatic cognitive processing in
psychopathology, and then we will open discussion among the panel and the audience. The
panelists will be asked to discuss how automatic processing varies across different disorders,
what we can learn from measures of automatic processing tied to psychopathology that we do
not learn as readily from explicit, strategic measures, as well as treatment implications following
from this research, and how automatic processing in psychopathology can help us understand
mechanisms of change tied to psychopathology onset and recovery. The panelists will be asked
to consider in what ways automatic processing biases, particularly those illustrating
uncontrollable responding, reflect a transdiagnostic vulnerability marker that leaves people at
risk for many forms of mental illness. Finally, in line with the conference theme of "Bringing
Cultures Together for a Better Quality of Life," the panelists will discuss whether automatic
cognitive processing in psychopathology operates similarly across cultures or manifests
differently as a function of unique sociocultural norms and learning.
Descripcin de los factores de riesgo pre y perinatales en los subtipos combinado,
inatento e hiperactivo del trastorno por dficit de atencin e hiperactividad
Oscar Utria, Adriana Quintero.
Psicologa, Universidad de San Buenaventura, Bogot, Colombia.
El trastorno por dficit de atencin e hiperactividad (TDAH) es un trastorno del neurodesarrollo,
que se caracteriza por un patrn persistente de inatencin, hiperactividad e impulsividad; segn
predominen los sntomas el DSM-IV ha definido tres subtipos, con predominio del dficit de
atencin, con predominio de hiperactividad/impulsividad y con predominio combinado. Se ha
propuesto que en su origen pueden estar implicados factores de riesgo pre y perinatales, como
las complicaciones en el embarazo y parto. El objetivo de este estudio retrospectivo es describir
los factores de riesgo pre y perinatales presentes en las madres de nios con TDAH en los tres
subtipos, como resultado de la revisin de 87 historias clnicas a las cuales se les aplic el
Cuestionario Materno de Riesgo Perinatal -CMRP (Lpez, 2003). Los resultados de esta
investigacin indican la presencia de factores de riesgo prenatales en los tres subtipos como
antecedentes de abortos voluntarios y enfermedades durante el embarazo. As mismo se
identificaron porcentajes relevantes en las variables nauseas, vmitos, edema, sangrados
vaginales, y complicaciones por golpes fuertes. En los factores de riesgo psicosocial y estado
emocional se encontr presencia de actividad fsica y mental agotadora as como estrs y
sentimientos de tristeza. Y finalmente en la dimensin de factores de riesgo perinatales se
encontr un porcentaje importante de partos por cesrea. En la en anlisis no se observaron
diferencias significativas en los tres subtipos.
Estudio de Prevalencia de Trastornos de la Lectura y la Escritura en un Grupo de
Estudiantes de Psicologa UNINCCA Cartagena
Irina Villafae Bermdez, Ivan Cadena Ramos.
Psicologa, Pediacenter, Cartagena, Colombia.
El presente estudio, enmarcado en la Lnea de Investigacin: Neurociencias, Educacin y
Desarrollo cognitivo, surge por el inters docente dadas las notorias deficiencias en la habilidad
lecto-escritura, de los estudiantes del Programa de Psicologa de la Universidad INCCA de
Colombia, extensin Cartagena, manifiestas en problemticas como bajo desempeo
acadmico, bajos resultados en pruebas institucionales, dficit en la lectura y escritura de
textos, dificultades en el procesamiento de la informacin, reprobacin de asignaturas y
semestres, apata o poco inters por el estudio, entre otros; de acuerdo a lo anterior, se

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consider pertinente el objetivo de determinar el nivel de prevalencia de las dificultades en


lecto-escritura, en un grupo de Estudiantes del Programa Psicologa de la Universidad INCCA
de Colombia, extensin Cartagena. El proyecto tuvo como orientacin epistemolgica la
emprico-analtica, un enfoque cuantitativo y tipo descriptivo en un diseo de campo transversal
contemporneo. Los mtodos especficos de recoleccin de informacin empleados, fueron las
siguientes Pruebas Neuropsicolgicas -tipo test-:Test de Trazados, Test de Smbolos y Dgitos,
Test STROOP y Test Auditivo-Verbal de Rey, acompaados de una Ficha Tcnica Descriptiva,
para conocer algunos datos sociodemogrficos de los participantes, previa firma del
consentimiento informado, por parte de los padres, en el caso de los menores de 18 aos y por
los mismos participantes, cuando eran mayores de edad. Los principales resultados muestran
un significativo porcentaje de dificultades en la lecto-escritura, asociado en especial a
rendimientos deficientes en funciones neurocognitivas esenciales en este proceso, tales como:
funcin nominativa del lenguaje, memoria incidental, discriminacin, en la habilidad de lectura,
mientras que en la de escritura, fueron significativas, el seguimiento de secuencias,
razonamiento, la agilidad y la asociacin oculo-motora.
Attributional retraining group therapy versus selective serotonin reuptake inhibitors:
effect on plasma brain-derived neurotrophic factor
Chun Wang, Ning Zhang, YaLin Zhang, JiJun Li, Hua Yang.
Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Abstract: Objctive: The aim of this study was to compare the effect on brain-derived
neurotrophic factor (BDNF) of attributional retraining group therapy (ARGT) versus selective
serotonin reuptake inhibitors (SSRI) for major depressive disorder (MDD), generalized anxiety
disorder (GAD) and obsessive-compulsive disorder (OCD). Methods: Outpatients with MDD,
GAD and OCD were divided into ARGT group (n=63) and SSRI group (n=66) according to the
sequence of entering the study. At the end of the study, 54 outpatients in ARGT group and 55
outpatients in SSRI group completed the study. MDD, GAD and OCD patients were respectively
measured with Hamilton Depression Scale, Hamilton Anxiety Scale, and Yale-Brown Obsessive
Compulsive Scale before and after 8 weeks treatment. Subjects were detected of plasma BDNF
by enzyme-linked immunosorbent assay (ELISA) before and after treatment. Results: After
treatment, all symptom scores were reduced significantly in both ARGT group and SSRI group
(p<0.001). SSRI group patients improved plasma BDNF significantly (p<0.01). ARGT group
patients did not reduce plasma BDNF significantly (p>0.05). There was no significant difference
between reduce scores of ARGT group and SSRI group (p>0.05). Conclusions: SSRI can
upmodulate plasma BDNF level. It may take effect by targeting on neural plasticity. Our study
did not advocate the hypothesis that ARGT had an effect on neural plasticity via modulating
BDNF.
Attributional retraining group therapy versus selective serotonin reuptake inhibitors:
neurobiological effects
Chun Wang, Ning Zhang, YaLin Zhang, JiJun Li, Hua Yang.
Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Objective The aim of this study was to compare the effectiveness of attribution retraining group
therapy (ARGT) versus selective serotonin reuptake inhibitors (SSRI) in the treatment of major
depressive disorder (MDD), generalized anxiety disorder (GAD) and obsessive-compulsive
disorder (OCD). Methods 109 patients with MDD, GAD and OCD were recruited from the
outpatient department of a tertiary referral hospital between 2007 and 2008. Subjects were

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sequentially recruited and randomized into ARGT group (n=63) and SSRI group (n=66) for an 8week treatment period. 54 outpatients in ARGT group and 55 outpatients in SSRI group
completed the study. All subjects were assessed using the Hamilton Depression Scale,
Hamilton Anxiety Scale before and after treatment. The 10-item Yale-Brown Obsessive
Compulsive Scale was employed only for OCD subjects. Plasma hormone levels of serotonin,
norepinephrine, cortisol, and adrenocorticotropic hormone were measured at baseline and at 8
weeks. Results Symptom scores were reduced significantly in both ARGT and SSRI treatment
groups (p<0.001) at the end of the treatment course. However the patients in the ARGT group
had significantly lower plasma cortisol concentrations compared to baseline (p<0.05). On the
other hand, patients receiving the SSRIs showed significantly increased plasma levels of
serotonin (p<0.05). Conclusions Our findings suggest that ARGT may modulate plasma cortisol
levels and take effect to the HPA axis as opposed to SSRIs which may up-regulate serotonin via
a different pathway to produce an overall improvement in the clinical condition of patients.
Cognitive underpinnings in anxiety and depression and how to use them in treatment
Sabine Wanmaker, Elke Geraerts, Elke Geraerts, Danielle Remmerswaal, Peter Muris, Jorg
Huijding, Sabine Wanmaker, Marieke van Meggelen, Kevin van Schie, Elke Geraerts, Colin van
der Heiden, Colin van der Heiden, Marien Lievaart.
Psychology, Erasmus University Rotterdam, Rotterdam, Netherlands.
The life of individuals with a depressive or anxiety disorder changes significantly. These
disorders change the way people feel and how they perceive themselves as well as the world
around them. According to the World Health Organisation (WHO), around 12% of the population
is suffering from clinical depression or anxiety, making both one of the most prevalent
psychiatric disorders causing disability for all ages in men and women. In addition to the distress
depression and anxiety cause to individuals and their families, these internalizing emotional
disorders also incur extensively direct and indirect economic costs, which for instance in the
Netherlands exceeds one billion Euros annually and in the United States of America 65 billion
dollars. Clearly, more research is needed to increase the understanding of the causes and
maintenance of these disorders, and to enhance prevention and treatment.
Cognitive theories propose that cognitive biases are involved in the onset and maintenance of
anxiety and depression. For example, numerous studies demonstrate that interpretation bias
(Mathews & MacLeod, 2005) and rumination (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008)
are potential vulnerability factors for depression and anxiety. Another line of research shows
that high levels of anxiety and depression are associated with a reduced ability to perform
complex cognitive tasks (Mueller 1992, Watts & Cooper 1989; as described in Mathews &
MacLeod, 1994). Researchers state that these reductions are being caused by a depletion of
capacity-limited cognitive resources, especially working memory (Eysenck & Calvo 1992, Ellis &
Ashbrook 1988; as described in Mathews & MacLeod, 1994). Taken together these findings
suggest that these cognitive vulnerability factors might be important aspects which should be
targeted in order to enhance the effectiveness of treatment.
Recent studies show cognitive biases can be modified and that working memory can be
improved by training. These studies, originally designed as experimental research, holds strong
potential in treatment of anxiety and depression, for example as addition to cognitive
behavioural therapy. This symposium focuses on whether and how symptoms of anxiety and
depression can be reduced by training and/or targeting these specific cognitive deficits.
In the first part we discuss the relationship between cognitive biases and depression. In part two
we focus on the treatment of depression and anxiety by training working memory. Part three
focuses on reducing anxiety by training parents to modify interpretation bias of their fearful and

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anxious children. Finally, we present a Virtual Reality Therapy to tackle post traumatic stress
symptoms of adults with experiences of childhood sexual abuse.
The combined cognitive bias hypothesis tested within a clinically depressed sample:
associations between interpretation bias, rumination, overgeneral memory and
depressive symptoms.
One of the main problems of depression is the high recurrence rate after successful treatment.
More than 50 percent of depressed people experience a recurrence within five years following
recovery (Boland & Keller, 2009). This high recurrence rate in depression suggests the
existence of specific vulnerability factors which are either not targeted directly by broad
treatment approaches, or which disrupt the effect of the treatment (Baert, Koster & De Raedt,
2011). In order to enhance the effectiveness of treatments, more insight in specific vulnerability
factors, and their interplay, for depression is needed.
There is ample research demonstrating that biases in cognitive processes, such as negative
interpretation bias, rumination, and overgeneral memory, are potential vulnerability factors for
depression (Joormann & DAvanzato, 2009; Nolen-Hoeksema, Wisco & Lyubomirsky, 2008;
Williams et al., 2007). However, this research has usually not been conducted on clinically
depressed patients receiving treatment for their problems. This leaves the question whether
such results can be generalized to clinical practice. Furthermore, a key limitation is that most
studies conducted so far have studied cognitive biases in depression in isolation (Everaert,
Koster, & Derakshan, 2012). Because of this, we still have little insight into how cognitive biases
are associated with each other or how they might collectively influence the etiology and
maintenance of depression.
The present study explored whether or not interpretation bias, overgeneral memory, and
rumination are interrelated in depressive outpatients (N =41). According to our expectations a
negative interpretation bias and rumination were associated with depressive symptoms.
Although overgeneral autobiographical memory (OGM) was not related to the severity of
depression, OGM was associated with the diagnosis of depression. Finally, a negative
interpretation bias, autobiographical memory, and rumination were not significantly related with
each other in this study, suggesting that they are distinct vulnerability factors for depression.
Taken together with other literature, the above-mentioned results have implications for treating
depression. Interventions targeting rumination, overgeneral memory and interpretation bias, or
their underlying factors, in addition to cognitive behavioral therapy, might lead to enhancements
in treatment effectiveness for depression. Furthermore, we suggest that future clinical trials
might find an added benefit from targeted treatments.
Tackling depression: a working memory intervention
Increasing evidence shows that a deficit in working memory could be the cause of biases in
attention, memory and interpretation in depression (Joormann, 2010). This results in rumination
and sustained negative mood, the core symptoms of depression. This lack of working memory
ability could be solved with a working memory training. Recent research has shown that a
working memory training leads to an improvement in executive processes (Klingberg,
Forssberg, & Westerberg, 2002). Moreover, Klingberg et al. (2005) showed that such a training
resulted in a significant reduction in the severity of ADHD symptoms in children suffering from
this disorder. Recent studies showed working memory training decreased alcohol consumption
in people with excessive alcohol abuse (Houben, Nederkoorn, Wiers & Jansen, 2011) and
improved reality monitoring in schizophrenic patients (Subramaniam et al., 2012).
In this presentation several studies to working memory training with promising results will be
discussed.
Parent-offspring transmission of a fear-related cognitive bias: An experimental study.

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Two experiments were conducted to explore the role of parents in the development of a fearrelated cognitive bias and subsequent fear levels in children. In the first experiment, non-clinical
children aged 8 to 13 (N = 122) underwent a training during which they worked together with
their mothers on an information search task. Mothers received instructions to induce either a
positive or negative cognitive bias. Results demonstrated that mothers had a significant impact
on childrens negative reasoning strategy and fear. More precisely, children who had received a
negative parental training displayed an increase in cognitive bias and fear, whereas children
who had received the positive parental training showed a decline in bias and fear. In experiment
2, it was investigated to what extent mothers spontaneously pass on their own cognitive bias to
their offspring. Mothers of 49 children (aged 9 to 12) received no explicit training instructions
before working together with their child on an information search task. Results indicated that
childrens cognitive bias after working together with their mother was predicted by their mothers
initial cognitive bias scores, which can be taken as evidence for the intergenerational
transmission of cognitive bias from mother to child.
Virtual Reality Therapy as treatment for Post Traumatic Stress Disorder
Victims of childhood sexual abuse (CSA) often suffer from symptoms of anxiety and depression
as an adult. The processing of their traumatic memories seems vital for recovery. In this study,
we focus on a new treatment which is aimed to help victims of CSA to process their traumatic
memories. In doing so, we developed a new virtual reality exposure therapy (VRET). In this
therapy individuals are taught to retrieve specific memories of their trauma. Gradual exposure in
the course of four weeks is central, with people recreating a virtual world of their abuse
memories. For instance, individuals built a 3D version of the place where the abuse took place.
Pilot results show that, after four weeks of this treatment, individuals suffer 60% less of
symptoms of posttraumatic stress disorder and depression. In this presentation we will describe
the therapy, compare it with more standard treatments and discuss applications on the work
floor.
Ethnic Differences in Affective Processing of Emotional Information as Measured by
Pupil Dilation
Tony Wells1, Alissa Ellis2, Christopher Beevers3.
1. Department of Psychology, Oklahoma State University, Stillwater, OK, USA, 2. University of
California, Los Angeles, Los Angeles, CA, USA, 3. University of Texas at Austin, Austin, TX,
USA.
Abstract Central: Over the last decade there has been a substantial body of research
examining how emotional disorders (i.e. depression and anxiety) affect the processing of
emotional information. However, few of these studies have examined how ethnicity may impact
measures of affective processing despite past research demonstrating ethnic differences in
affective perception. Increases in pupil dilation have been associated with affective arousal and
neural response to emotional stimuli. Thus, pupil dilation represents an excellent
psychophysiological marker of affective processing. We examined ethnic differences in affective
processing of emotional stimuli as measured by pupil dilation in a psychologically healthy
sample in order to eliminate potential confounding effects of psychopathology. Participants had
no history of psychopathology as indicated by structured clinical interview and self-reported
ethnicity. The sample was comprised of 45 Asian/Asian-American, 12 Black/African-American,
49 Hispanic/Latino/a, and 94 White/European-American individuals. Participants completed 10
trials of a passive viewing task wherein they viewed neutral, dysphoric, positive, and threatening
images. Each trial was 30 seconds and contained one image from each emotional category.
Pupil dilation was sampled every 16 ms and mean pupil dilation was calculated for each of the
emotional stimulus categories. Mean pupil dilation for neutral images was subtracted from the

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mean pupil dilation for the three other stimulus categories in order to correct for baseline pupil
dilation. There was a main effect for stimulus category (p =.048, partial eta^2 = .01) and for selfreported ethnicity (p <.001, partial eta^2 = .05) on affective processing as measured by pupil
dilation. Ethnicity effects remained significant when education level and income were entered
into the model (p < .001). Post hoc analyses revealed significant differences between ethnicity
groups for positive (p = .007, partial eta^2 = .06) and threat stimuli (p = .007, partial eta^2 = .06),
but not for dysphoric stimuli (p = .11). Bonferroni-corrected comparisons, revealed that these
differences were driven by greater pupil dilation in response to positive and threat stimuli by
Black participants compared to Asian and White participants. There were no differences
between Hispanic, Asian, and White participants in affective processing. This study found a
relationship between self-reported ethnicity and affective processing of emotional stimuli as
measure by pupil dilation, a psychophysiological measure of neural affective response.
Specifically Black/African-American participants demonstrated greater affective processing of
both positive and threatening stimuli compared to Asian/Asian-American and White/EuropeanAmerican participants. These effects remained significant when controlling for education and
income levels. These results point to the importance of investigating and reporting potential
effects of ethnicity when studying how individuals process emotional information.
Anxiety and Distraction: Is Working Memory Capacity a Protective Factor?
Caitlin Wright, Keith Dobson, Christopher Sears.
University of Calgary, Calgary, AB, Canada.
According to Eysencks attentional control theory (Eysenck, Derakshan, Santos, & Calvo, 2007),
high anxious individuals experience reduced attentional control as compared to low anxious
individuals due to an imbalance between the goal-directed and stimulus-driven attentional
systems. One consequence of this imbalance in attentional systems is that high trait anxious
individuals have difficulty resisting distraction, as compared to low trait anxious individuals (e.g.,
Derakshan, Ansari, Hansard, Shoker, & Eysenck, 2009). Similarly, the research on individual
differences in working memory predicts that individuals with a high working memory capacity
are better able to resist distraction than individuals with a lower working memory capacity due to
their superior attentional control (Unsworth, Schrock, & Engle, 2004). The present study
examines the relative contribution of both trait anxiety and working memory capacity on the
ability to resist distraction, as measured by the antisaccade task (Hallet, 1978). Specifically, we
examine the hypothesis that a high working memory capacity will decrease the negative
influence of trait anxiety on the ability to resist distraction, thereby acting as a protective factor.
Eye movement latencies, target identification response times, and errors on the pro- and antisaccade tasks are reported. Implications for future research are discussed.
Paradigmas Sociales y Emociones: Del Cambio Mental al Cambio Emocional
Renny Yagosesky.
Prctica Privada, Caracas, Venezuela.
Los seres humanos somos en esencia seres sociales. Aunque nacemos con predisposiciones
constitucionales, configuradas por la naturaleza en nuestro cdigo gentico, aprendemos en la
convivencia, grupos de creencias y valores (mapas mentales) que influyen en nuestra accin
diaria y nos permiten regular nuestras tendencias primarias egostas. Algunas de esas
creencias se instalan en nuestra mente como paradigmas, en mbitos importantes como la
familia la escuela y los medios. Un paradigma, es, segn Kuhn: una lgica dominante, un
modo de ver las cosas y de actuar en relacin con este particular modo de verlas. El

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paradigma opera como un filtro y orienta pensamientos, razonamientos y respuestas


emocionales. En esta ponencia se propone que en numerosas sociedades modernas, existen
cuatro matrices paradigmticas que promueven un frecuente e intenso sufrimiento, y que
demandan la revisin y abordaje de filsofos y profesionales de la salud mental. Estos son: - El
paradigma del pasado y el futuro. - El paradigma del control del cambio - El paradigma de la
autonoma. - El paradigma de la causalidad externa de las emociones. El paradigma del
pasado y del futuro, asume que pasado y futuro son entidades reales u objetivas. Sin embargo,
sabemos que se trata de estados mentales, de representaciones que carecen de una
correspondencia externa tangible, pues todo acontece siempre en el momento presente. El
paradigma del control del cambio, niega o ignora la inminencia del cambio y nos sumerge en
una ilusin de control, en la creencia de que podremos mantener las cosas como estn o
conservar aquello que nos gusta, de forma inalterable. As, ofrecemos una activa e intensa
resistencia al cambio, y el resultado suele ser: decepcin, frustracin y estrs. Al final,
descubrimos que nos toca lidiar, como todos, con el sufrimiento la vejez y la muerte, superar el
apego y comprender que todo es pasajero. El paradigma de la autonoma nos hace vernos
como seres aislados y/o autnomos, pese a que nada tiene existencia autnoma: no hay
padres sin hijos o maestros sin alumnos, el fuego no vive sin el aire, y sin semilla no hay fruto.
Existe una multi-causalidad para cada evento. Todo se encuentra relacionado en niveles y
formas diversas. A decir de Chopra: respiramos hoy el aire que otro exhal ayer, y segn
Capra: vivimos en red, y nada hay que pueda operar por s solo. El cuarto paradigma, el de la
causalidad externa de las emociones, nos induce a pensar que nuestros sentimientos surgen
de los eventos forneos y de la conducta ajena, cuando emanan de patrones biolgicos y
procesos subjetivos. Esta concepcin externalista nos victimiza, debilita nuestra capacidad de
respuesta y limita el despliegue de respuestas ms adecuadas y creativas. Resumiendo:
existen paradigmas falaces, socialmente aprendidos, que generan confusin, inducen malestar
emocional y deben ser revisados en pro de la salud mental y emocional de las personas. Rutas
como: la confirmacin objetiva de supuestos, las hiptesis alternativas, la valoracin del
presente, la responsabilidad emocional y la visin sistmica, pueden generar una vida ms
adaptada, sana y de mayor calidad. Descriptores: Paradigmas, creencias, emociones, cambio.
Psicopatologa y Trastornos Mentales: Una Propuesta Terica Desde la Neuropsicologa
Cognitiva
Jonathan Zegarra Valdivia.
UNSA, Arequipa, Peru.
Abstract Central: La siguiente comunicacin libre tiene por finalidad desarrollar y exponer un
modelo terico desde la neuropsicologa cognitiva, que explica la conducta humana consciente;
pero especialmente proporciona aportes al entendimiento de la psicopatologa mental desde un
marco unitario, atribuyendo que algunas caractersticas diagnosticas actuales son poco tiles
para describirla y ms aun para entender su etiologa; la analizamos como una escisin del
procesamiento metacognitivo de alto nivel que debilitara la estructura del Self, desarrollando
distintos sntomas y signos relacionados, propias de los trastornos mentales actuales y que
tomaran caractersticas especiales en base a las historias personales de estos sujetos; dentro
de los principales puntos analizados estn: 1) Aportes tericos desde la neuropsicologa: la
neuropsicologa histricamente a investigado las relaciones cerebro-mente, especialmente en
pacientes con dao cerebral; la neuropsicologa cognitiva al utilizar modelos sobre el
procesamiento de informacin de sujetos normales, en contraste con pacientes de dao
cerebral especfico han motivado un gran avance en esta rea frtil de la psicologa cognitiva
y en especial de las neurociencias; pero porqu no aplicar estos estudios y modelos
cognitivos a los trastornos mentales?; aqu se analizan los principales constructos y modelos

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tericos que explican la conducta humana consciente desde la neuropsicologa cognitiva, como
las funciones ejecutivas, la cognicin social. 3) Anlisis de los trastorno mentales: Se ha
encontrado distintos dficits en el procesamiento cognitivo de la cognicin social adems del
funcionamiento ejecutivo y el lenguaje; entre estos trastornos destacan el autismo, la
esquizofrenia; el Trastorno Bipolar, el Trastorno Obsesivo-Compulsivo, los Trastornos de
Personalidad, el consumo de sustancias y adiccin, la anorexia y el Trastorno por Dficit de
atencin e hiperactividad (TDAH). 4) Desarrollo terico, modelo desde la neuropsicologa
cognitiva: El desarrollo, adquisicin y funcionamiento cognitivo-emocional, el YO del sujeto,
surgira como una construccin social, desde factores ontogenticos y filogenticos, mediada
por aspectos tan importantes como el lenguaje, el funcionamiento ejecutivo y la cognicin
social, este ltimo, junto con la mentalizacin sera el prerrequisito para la capacidad de
participar de forma deliberada y consciente en un mundo social compartido, esto pondra de
manifiesto el vinculo entre ser consciente del ser (el propio YO) y ser consciente de los dems;
un procesamiento que ocurre sobretodo de manera inconsciente en nuestro cerebro.
Efecto de la Difenhidramina en la Memoria Relacional de Ratas Wistar
Milciades Ziga1, Fernando Cardenas2.
1. Universidad Distrital, Bogot, Colombia, 2. Universidad de los Andes, Bogot, Colombia.
Este trabajo se realiz con el fin de determinar los efectos de la difenhidramina en la memoria
relacional en las ratas de laboratorio. El principal objetivo de este trabajo fue determinar los
efectos de la difenhidramina en la memoria relacional en las ratas de laboratorio. La aplicacin
de las dosis de difenhidramina y de solucin salina se hizo de manera intragstrica, a dieciocho
sujetos de ms de dos meses de edad. Luego de llevar a cabo los ensayos en el test de
reconocimiento de objetos, y su posterior anlisis estadstico, los resultados arrojaron que no
se hallaron diferencias estadsticas significativas entre el grupo control y los sujetos que
recibieron difenhidramina. Sin embargo se observaron algunos de los efectos causados por la
accin psicomotora de este antihistamnico en la memoria relacional de los roedores. Sea esta
perspectiva cientficamente cierta o no, lo que est claro es el papel de la histamina en la
regulacin del estado de alerta. Este efecto ha sido vivido por todos los que han experimentado
somnolencia causada por la accin de los antihistamnicos clsicos. Palabras clave: Test de
reconocimiento de objetos, memoria relacional, difenhidramina, consolidacin de la memoria,
actividad psicomotora, receptores H1, antihistamnicos.
A Relao Entre a Teoria Darwiniana e os Processos Cognitivos Comportamentais na
Gnese da Resilincia
Allan de Oliveira, Giliane Gomes, Spencer Jnior.
Universidade de Pernambuco, Recife, Brazil.
A ideia adotada por Darwin foi fundamental para repensar a prpria racionalidade moderna
voltada para uma compreenso do viver, pondo em evidncia fenmenos entendidos
inicialmente como resposta ao meio ambiente, e posteriormente, como resultado de aes do
meio interior. Essa pesquisa apresenta a relao entre a Teoria Darwiniana, que trata da
evoluo do indivduo e sua adaptao s diversas situaes com os processos Cognitivos
Comportamentais, como forma de manter sua equilibrao biopsicossocial, utilizando-se da
lgica e conceitos da Terapia Cognitivo Comportamental. O objetivo relacionar as ideias da
teoria da evoluo e adaptao de Darwin, com a finalidade de mostrar como a mudana nos
processos cognitivos bsicos modifica os comportamentos e possibilita ao indivduo adaptar-se
ao meio no qual vive, desenvolvendo o comportamento de resilincia. De acordo com os

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conceitos psicolgicos, resilincia a capacidade de uma pessoa lidar com seus prprios
problemas, vencer obstculos e no ceder presso, independente da situao. A teoria diz
que resilincia a possibilidade do indivduo de tomar uma deciso quando tem a chance de
tomar uma atitude que correta, e ao mesmo tempo tem medo do que isso possa ocasionar, e
esse sentimento quando a pessoa mostrar se sabe, ou no, lidar sob presso. Para esta
pesquisa foi necessrio visitar os pressupostos tericos da Terapia Cognitivo Comportamental
e entender como se desenvolve o processo de resilincia, atravs de uma pesquisa de reviso
qualitativa, integrativa, com visitas nos bancos de dados do Scielo e da Pudmed, onde foram
consideradas publicaes entre os perodos de 1991 e 2011. Por fim, esta pesquisa mostrou
que certas caractersticas novas so adquiridas por imposio do ambiente. Traando um
paralelo com o conceito da resilincia admite-se que certas caractersticas como a resilincia
so previamente existentes, so apenas selecionadas pelo ambiente e no geradas pelo
mesmo.
Linguagem da Alma no Processo de Envelhecimento em Santarm - Par - Brasil
Izaura A. cardoso, Lucivnia de Souza.
Instituto Esperana de Ensino Superior (IESPES), Santarm, Brazil.
Abstract Central: A arte tem um falar. Nenhuma arte ou qualquer desenho, por mais simples
que seja no deixa de revelar uma linguagem da alma. Proporciona, s pessoas que esto na
idade avanada, expressar sentimentos, emoes, medos e angstias acerca do seu processo
de envelhecimento, possibilitando, alm do resgate de situaes de vida que no foram
devidamente elaboradas, um canal de escuta, de ateno por parte dos outros, bem como,
lazer. O presente trabalho tem como objetivo possibilitar a expresso de sentimentos e
rememorao das experincias de vida dos idosos atravs de tcnica. E objetivos especficos
resgatar as lembranas, pensamentos e histrias de superao dos idosos atravs da roda da
conversa, estimulando, dessa maneira, suas habilidades cognitivas; Oportunizar aos idosos a
expresso da auto-imagem; Proporcionar aos idosos um momento para expressarem suas
necessidades, sentimentos, emoes, medos e angstias, no processo de envelhecimento,
atravs da arte terapia. Pblico alvo: Idosos que participam do grupo de idosos do bairro
Ipanema, em Santarm - Par- Brasil, com a idade a partir de 60 anos, no perodo de maro a
dezembro de 2011, totalizando 30 participantes regulares. Com a tcnica da roda da conversa,
junto com a arte terapia foi observado a necessidade que os idosos tem de se expressar,
falando de suas preferncias, satisfaes ou frustraes, expondo suas lembranas,
pensamentos e histrias de superao estimulando, dessa maneira, suas habilidades
cognitivas, onde foi observado que a problemtica mais citada foi a solido e o medo da morte.
Diversity (Gender, GBLT, Issues)/ Diversidad (Gnero, Asuntos GLBQT)/ Diversidade
(Gnero, GLBQT)
Indigenous People and CBT: Bringing Healing Cultures Together in New and Thoughtful
Ways
Arthur (Art) Blume.
Washington State University, Vancouver, WA, USA.
Abstract Central: Cognitive behavioral therapy (CBT) as an empirically derived practice has
been extremely helpful to mainstream societies in the Western hemisphere, but largely untested
and underutilized in indigenous communities. Behavioral and cognitive principles (examples
include but not limited to the importance of context, seeking balance and moderation in

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behavior, and learning through life experiences) in many ways align well with indigenous
community values. The use of CBT could be of great value, especially for disorders that
commonly occur among indigenous people, such as depression and suicide, IPV, PTSD, and
substance abuse. However many barriers exist that prevent CBT researchers from working with
indigenous communities, (examples include but not limited to distance from indigenous
communities, lack of understanding and exposure to indigenous people, academic pressures
and expectations, and the complexities of conducting research in indigenous communities); and
many barriers exist that prevent indigenous communities from seeking out collaborators from
the CBT scientific community (examples include but not limited to differences in language,
worldviews, and culture; and distrust of research and researchers). On the other hand, the
principles of CBT have been developed, implemented, assessed, and tested in the context of
Western psychological and scientific models. The third wave of CBT has broken with the
Western Eurocentric historical roots by creatively incorporating Asian meditation and
mindfulness practices. Most scientists and practitioners would agree that infusing Eastern
practices into CBT has been helpful to many people and has enriched the practice of CBT.
Interestingly, although indigenous practices in the Western hemisphere are much more proximal
to CBT theorists and researchers than Asian practices, they have been largely ignored. Since
the development of CBT, societies have changed from isolated and autonomous to
interconnected and global. The psychological health of many citizens is potentially at risk as a
result of global scale stressors unforeseen by the pioneers of CBT (e.g., sustainability of
growth/prosperity, global warming, etc.). Traditional Western values such as individualism and
autonomy may not be effective means to address psychological issues related to communal
problems. Work to examine and potentially infuse Indigenous values into CBT may enhance its
healing capabilities for a rapidly changing world. The thesis of this proposal is that both
indigenous communities and CBT have been diminished by a lack of dialogue, and that both
would benefit greatly from an exchange of ideas. In this theoretically oriented yet pragmatic talk,
I propose to discuss specific barriers that have prevented greater collaborations, and suggest
possible strategies for bridging the barriers. In addition, I will suggest ways in which indigenous
values and strategies may be infused into CBT in ways that may help even non-indigenous
clients, enrich the practice of CBT, and enhance the capacity of CBT to address psychological
issues of a global scale.
Diversidad Social: Una Visin Desde La Inclusin
Andrea Parrado.
practica privada, Barquisimeto, Venezuela.
Abstract Central: Los enfoques psicosociales a lo largo de los aos han proyectado las
necesidades y las relaciones ms relevantes de una sociedad, sin embargo, fue hasta hace
poco tiempo que la diversidad encabez la lista como un problema, ya que ha generado ciertas
preguntas e inquietudes con respecto al tpico de inclusin, integracin y aceptacin social de
cada individuo. Ahora bien, con el pasar del tiempo las sociedades han logrado avanzar a
pasos agigantados marcados por la necesidad de globalizacin y no de multiculturalidad y la
pluralidad, dejando as aspectos importantes fuera de orbita y alejados de la realidad global,
siendo esto un motivo para que cada individuo agobiado por el da a da perciba un mundo
homogneo en necesidades de autorrealizacin y olvide la heterogeneidad innata de los seres
humanos. Del mismo modo, haciendo referencia a ese sentido de heterogeneidad, se rescata
el trmino de diversidad que tal como lo expone Mariana Bruzzo (2010) es la abundancia de
distintas cosas, por lo que se toman en cuenta la variedad de etnias, capacidades, creencias y
costumbres que la humanidad representa como tal. Al referirnos a la diversidad de destrezas y
capacidades es importante mencionar el proceso de inclusin e insercin en la sociedad todas

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aquellas personas que poseen caractersticas peculiares, como lo son las personas con
discapacidad que desde la mitad del siglo pasado han llamado la atencin para hacer valer sus
derechos. (Giddens, 1986; 1991). Luego de ciertas polticas de diferenciacin que aplicaban y
an aplican individuos en sociedades particulares, se ha empezado a analizar el movimiento de
la discapacidad desde un punto de vista de un nuevo movimiento social moderno.
Especialmente, se nota en la actualidad que han dirigido crticas a personas con dificultades de
aprendizaje, homosexuales, con discapacidades, que con todo lo necesario se sienten atrados
por el nuevo movimiento como un grito social de desahogo hacia la aceptacin. (Oliver, 1990;
Shakespeare, 1993). Contrario a lo que podra pensar la mayora, actualmente se vive en un
mundo que funciona de un manera dependiente de la marginacin, opresin y abuso cuando
no se delimita el espacio de desarrollo de cada ser. (Cross, 1994). Por lo tanto, es posible
llegar a una sociedad discapacitada en pensamiento y accin, cada vez que se enfrenta a un
cambio o situacin particular brinda pocas opciones y apoyo a quienes lo necesitan.
Particularmente pueden dar testimonio de esto, todas las personas que pertenecen a la
llamada comunidad homosexual, que llevan sobre s discusiones sobre gnero y orientacin
sexual que les ha dado una etiqueta que no permite en algunas sociedades su integracin. La
identidad individual es la dimensin ms ntima de nuestro ser, que en cierto modo esta
delimitada a lo externo e integrada orgnicamente a la pertenencia a un gnero y sentirse como
tal, lo que pudiese tomarse como aprender a ser psicolgicamente sexuados as como lo es
nuestro cuerpo. En este sentido, la sociedad sigue indiferente ante todas aquellas personas
que han construido su propia identidad de gnero sin relacin alguna con sus atributos
biolgicos, lo que podra generar un estancamiento en las relaciones sociales.
Diversidade Comportamental e Transexualidade
Vnia Lucia Sant Ana, Aline Valentim.
Psicologia, Universidade Estadual de Maring, Maringa, Brazil.
Abstract Central: Os padres comportamentais entre os homossexuais no so uniformes, da
mesma maneira que os das pessoas com orientao heterossexual. Pode-se dizer que os
padres apresentados por qualquer grupo - minoritrio ou no - dependem de prescries e
proscries culturalmente determinados. Assim, ao se falar de caractersticas
comportamentais, deve-se ter em conta que aquelas apresentadas pela populao
homossexual no so inerentes orientao sexual, mas sim decorrentes de contingncias
organizadas pelo ambiente no qual cada um dos indivduos homossexuais viveram e/ou vivem.
importante salientar que a diviso das pessoas em homossexuais e heterossexuais parece
demonstrar um profundo desconhecimento da amplitude e variabilidade da resposta sexual
humana, pois desde o final da primeira metade do Sculo XX, o comportamento sexual
considerado como um continuum dentro de uma escala de sete pontos, que varia de 0 a 6.
Apenas os valores zero (0) e seis (6) referem-se a indivduos com uma histria de
comportamento sexual exclusivamente heterossexual (0) ou homossexual (6); os demais
valores referem-se aos indivduos com uma histria de variadas combinaes de desejos e
expectativas tanto heterossexuais quanto homossexuais (Kinsey,1948). A classificao do
comportamento sexual em homo/hetero parece refletir a presso social para que os indivduos
se declarem como pertencentes a um ou outro grupo, excluindo a possibilidade de
comportamentos sexuais intermedirios. Assim, existiria uma cobrana de ambos os grupos
para que as pessoas que tiveram ou tenham relacionamentos ou episdios homossexuais
declarem-se pertencentes a um dos grupos. A exigncia, por parte do grupo homossexual de
que pessoas com experincias homo assumam-se ou saiam do armrio um indicador de
que as aprendizagens de padres culturais so semelhantes para ambas as populaes
(hetero e homo). Dentre as variaes do comportamento sexual que mais se distanciam da

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classificao dicotmica hetero/homo est a transexualidade. Tal padro refere-se a um desejo


persistente e duradouro de pertencer ao sexo oposto ou a sentir-se como pertencendo ao este
sexo e a uma profunda rejeio das caractersticas primrias e secundrias de seu prprio
sexo biolgico. No Brasil a cirurgia para redesignao sexual passou a ser autorizada apenas
em 1997, apenas, em instituies de ensino aps um perodo mnimo de dois anos de
acompanhamento para emisso do laudo psicolgico. Na Universidade Estadual de Maring
(UEM) tm sido atendidos casos de transexualidade de pessoas em busca de um laudo que
lhes possibilite a realizao da cirurgia de transgenitalizao. Para este trabalho foram
selecionados trs casos que demonstram a diversidade de padres comportamentais quando
avaliados sob a perspectiva da Anlise do Comportamento.
Prevalencia de la Violencia Fsica y Psicolgica en el Noviazgo de Adolescentes y
Jvenes Espaoles
Julia Sebastin, Alba Verdugo, Beatriz Ortiz, Liliana Diaz.
Psicologa Biolgica y de la salud, Univ. Autnoma de Madrd, Madrid, Spain.
La violencia en parejas jvenes es un dato actualmente constatado en numerosos estudios
multiculturales. Aunque la violencia fsica es la ms estudiada los estudios muestran que es la
violencia psicolgica la ms frecuente. Sin embargo, casi todos los trabajos se centran en la
primera, debido, en muchos casos, a la utilizacin de instrumentos que recogen
fundamentalmente este tipo de violencia y a la dificultad mayor de definir la violencia
psicolgica. Nuestro trabajo tiene como objetivo a) analizar la prevalencia de la violencia y sus
tipos en las relaciones de jvenes y adolescentes espaoles tanto en lo que se refiere a
victimizacin como a perpetracin, b) analizar su diferencia por sexos mediante estadsticos
que nos sealen la presencia y la frecuencia de estos comportamientos y c) indagar la
importancia de la edad en los patrones de violencia. Los participantes fueron 579 sujetos con
una edad comprendida entre 12 y 22 aos (319 chicas y 260 chicos), procedentes de cinco
institutos de enseanza de la Comunidad de Madrid (Espaa). La participacin en la
investigacin era voluntaria y annima. Los instrumentos utilizados fueron respondidos tanto
desde el rol de agresor/a como en la vctima y fueron los siguientes: la Escala de Tcticas de
Conflicto modificada (m-CTS) que evala las formas de resolver los conflictos en pareja y mide
de forma especfica agresin fsica y agresin verbal, la Escala de Tcticas Dominantes y
Celosas que recoge las tcticas dominantes que pueden emplearse para establecer el control
en las relaciones de noviazgo y una serie de comportamientos celosos. El diseo fue
transversal. Los resultados mostraron una alta prevalencia de la violencia bidireccional en las
relaciones de pareja, siendo las chicas las que ejercan ms violencia fsica leve y psicolgica.
Estos datos refrendan otros resultados publicados. Sin embargo, en cuanto a la victimizacin,
no se han encontrado diferencias entre chicos y chicas en ningn tipo de violencia. Con
respecto a la edad, el colectivo de adolescentes (12-17 aos) ejercan y sufran de forma
significativamente mayor el comportamiento celoso que los jvenes (18-22 aos). Estos
resultados ponen de manifiesto a) la necesidad de estudiar este fenmeno, especialmente la
mayor frecuencia de conductas violentas por parte de las chicas que quiz estn buscando
aproximarse a una serie de caractersticas (masculinas?) que parecen asociarse a una mayor
valoracin social y de seguridad personal, b) la necesidad de utilizar instrumentos ms
sensibles a la realidad que se quiere medir, especialmente, la violencia psicolgica, concepto
complejo y amplio que adolece, segn nuestra opinin, de una medida adecuada, c) sera til
facilitar a los adolescentes y jvenes la incorporacin a programas de prevencin de la
violencia en la relaciones afectivas con objeto de reducir su prevalencia.

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La Violencia Sexual en Parejas de Adolescentes y Jvenes Espaoles: Datos de


Victimizacin y Perpetracin
Julia Sebastin, Alba Verdugo, Beatriz Ortiz, Laura Corrochano.
Psicologa Biolgica y de la salud, Univ. Autnoma de Madrd, Madrid, Spain.
En los ltimos aos se ha intensificado el estudio de la violencia en las relaciones afectivas de
adultos y jvenes. En lneas generales se ha establecido que si bien la violencia es ms
frecuente en las parejas de jvenes, tambin es cierto que es menos intensa y grave. La
sociedad en general est ms concienciada sobre este tipo de fenmeno en las relaciones
entre jvenes y, por ello, se han ido elaborando programas preventivos. Aunque la violencia
fsica es la ms estudiada, la violencia sexual ha sido y es objeto de estudio cada vez mayor.
Nuestro trabajo tiene como objetivo a) analizar la prevalencia de la violencia sexual en las
relaciones de jvenes y adolescentes espaoles tanto en lo que se refiere a victimizacin como
a perpetracin, b) analizar su diferencia por sexos mediante estadsticos que nos sealen la
presencia y la frecuencia de estos comportamientos y c) indagar la importancia de la edad en
los patrones de violencia sexual. Los participantes fueron 579 sujetos con una edad
comprendida entre 12 y 22 aos (319 chicas y 260 chicos), procedentes de cinco institutos de
enseanza de la Comunidad de Madrid. Todos ellos cumplan el criterio de haber mantenido al
menos una relacin de pareja. La participacin en la investigacin era voluntaria y annima.
Los instrumentos utilizados fueron un cuestionario sobre datos sociodemogrficos e historial de
relaciones afectivas, elaborado por el equipo de investigacin y el Cuestionario de Agresin
Sexual en Adolescentes y Adultos Jvenes, que mide la frecuencia con la que los adolescentes
son sometidos y someten a sus parejas a presin o fuerza fsica para mantener relaciones
sexuales no consensuadas. El diseo es transversal. Los resultados muestran que el
porcentaje de adolescentes y jvenes que se declaran vctimas de alguna de las conductas
recogidas como violencia sexual es muy superior al porcentaje que declara ser ejecutor de
alguna de estas conductas, lo cual nos lleva a pensar, entre otras cosas, en la dificultad de
asumir este tipo de conductas o en la falta de sinceridad. Con respecto a las diferencias
significativas entre sexos, los chicos ejercan ms violencia sexual que las chicas. Estos datos
refrendan otros resultados publicados. Sin embargo, en cuanto a la victimizacin, no se han
encontrado diferencias entre chicos y chicas en ningn tipo de violencia sexual. Otro dato de
inters con respecto a la edad es que los jvenes (18-22 aos) cometen y sufren ms violencia
sexual que los adolescentes (12-17 aos). Finalmente, entendemos que la violencia sexual se
observa en un alto porcentaje de relaciones afectivas de jvenes y que sera til facilitarles la
incorporacin a programas de prevencin; adems, creemos tambin que habra que
perfeccionar los instrumentos que intentan medirla.
Construccin y Validacin Psicomtrica de una Escala de Calidad de Vida Asociada al
Medio de Transporte Pblico
Gerardo Soria-Rodrguez.
Medicina Conductual, UNAM, Mxico, D.F., Mexico.
Soria-Rodrguez, Gerardo & Reyes-Lagunes Isabel. Universidad Nacional Autnoma de
Mxico. Facultad de Psicologa El objetivo de este trabajo es presentar la metodologa con la
que se construyeron un conjunto de sub escalas que buscaron medir de una forma confiable la
Calidad de vida de habitantes de la ciudad de Mxico y reas conurbadas que realizan
desplazamientos de ms de una hora desde su casa a su centro de trabajo y viceversa. La
Calidad de Vida entraa la percepcin del individuo de su posicin en la vida en el contexto de
su cultura y sistema de valores, en relacin con sus metas, expectativas, estndares e
intereses. En psicologa incluye la funcionalidad y el bienestar cuando la salud es una variable

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que afecta componentes vitales como trabajo, ocio, autonoma, relaciones sociales, etc. En
concordancia con la tendencia mundial, la Ciudad de Mxico ha evolucionado en el marco de
un crecimiento desmedido, nunca previsto, provocado en mayor parte por el crecimiento
poblacional natural y por una dinmica migratoria de poblacin proveniente de otros estados a
este centro urbano en bsqueda de mejores expectativas de vida. Esto ha generado diversos
problemas urbanos, entre ellos podemos mencionar las mayores densificaciones de masas
humanas por las que han colapsado los servicios pblicos existentes, tal como las vialidades y
el medio de transporte pblico; y la formacin de asentamientos precarios con diferentes
grados de marginalidad, teniendo como resultado situaciones de fuerte inequidad y mala
habitabilidad. La investigacin enfocada en la medicin de la calidad de vida relacionada al
medio de trasporte es limitada y enfocada a la Ciudad de Mxico en particular, es nula. El
instrumento original se construy a partir de la tcnica de redes semnticas naturales, para
posteriormente ser aplicado a la mencionada muestra . Los datos recabados fueron validados
segn las reglas psicomtricas propuestas por Lpez, Reyes y Uribe (2011). Se comprobaron 9
sub escalas enfocadas en abarcar la satisfaccin, el impacto y las preocupaciones que genera
el uso del medio de transporte pblico en la economa, el yo mismo y la familia del usuario. El
alpha de Cronbach total de la prueba final fue de .87.
Eating Disorders/ Trastornos Alimentarios/ Transtornos Alimentares
Thoughts, Cognitive Distortions and Eating Disorders in Adolescents
Amanda Arajo, Tatiana Bertulino S, Camila Stor.
UFPE, Recife, Brazil.
Transtornos alimentares so desordens psiquitricas com etiologia multifatorial, os quais
afetam o indivduo em sua integralidade. Um dos fatores com grande relevncia para o
diagnstico a importncia que os indivduos acometidos pelo transtorno do imagem
corporal. A insatisfao com o corpo, fator comum aos transtornos alimentares, refere-se a um
componente afetivo sobre preocupaes em relao a um padro de corpo criado, afetando,
portanto aspectos como o comportamento alimentar, engajamento social, autoestima, dentre
outros fatores. O modelo cognitivo de Aaron Beck sugere que os pensamentos influenciam
emoes e comportamentos de forma recproca dentre eles. Os modos de pensar acerca de si,
do mundo e do futuro, quando interpretados de forma errnea (distorcida) so o que
configuram os pensamentos disfuncionais, gerando aspectos mantenedores da doena. Diante
disso, o objetivo deste estudo avaliar os pensamentos de duas populaes: 1) adolescentes
que tem o diagnstico de transtornos alimentares e 2) adolescentes que no tem o diagnstico,
mas que apresentam a insatisfao corporal, apontando-se para a possvel vulnerabilidade que
os adolescentes podem ter para o diagnstico de transtornos alimentares. Utilizando o
questionrio de Esquemas de Young para rastreamento dos principais pensamentos; o
WHOQOL, para avaliar a qualidade de vida em relao a diversos aspectos; e, a Escala de
autoestima de Rosenberg, para avaliar a autoestima dos participantes em adolescentes
previamente triados pelo EAT-26 e BITE para sintomas de transtornos alimentares e pelo BSQ
para a insatisfao corporal. Os dados sero analisados estatisticamente para avaliar a
prevalncia dos pensamentos e realizao da comparao entre as duas populaes. Esperase que nos resultados percebamos os pensamentos disfuncionais encontrados nos transtornos
alimentares, levando-se em considerao a identificao destes pensamentos para uma
interveno e conduo mais apropriadas com relevncia profiltica.
Anorexia Nervosa-Refractory and CBT - Social Skill Program: A Case Study

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Vanessa Baptista, Aparecida Christianini, Raphael Cangelli.


Institudo de Psiquiatria da Faculdade de Medicina da Universidade de So Paulo - IPq HCFMUSP, So Paulo, Brazil.
RESUMO: Introduo: A anorexia nervosa (AN) um transtorno alimentar (TA), cujo sintoma
consiste na recusa persistente em manter um peso corporal na faixa normal mnima, um temor
intenso em engordar e uma perturbao significativa na percepo da forma corporal. Dividida
em dois subgrupos: restrita e purgativa. As comorbidades e incio tardio do tratamento em TA
conduzem a um pior prognstico. O tratamento regular em TA indica a recuperao de: 40%
das pacientes; melhora sensvel em 30%, 20% so crnicas e 10% morrem. O conceito de
paciente refratrio em TA, refere-se situao de no-resposta aos tratamentos
farmacolgicos, psicoterpicos e nutricionais. A melhora da habilidade social (HS) em
pacientes com TA contribui para uma melhor qualidade de vida (QV), sendo a QV no TA pior
que em outros transtornos psiquitricos. Objetivo: O presente trabalho teve como objetivo
descrever um estudo de caso de paciente com diagnstico em AN-purgativa (refratria) e
automutilao submetida a um programa de HS de 20 semanas, num comparativo evolutivo
entre comportamentos compensatrios e inventrios. Mtodo: Aplicao do programa de
treinamento em HS (abordagem Cognitivo-Comportamental) destinado a pacientes com
diagnstico em TA (AN/BN) pertencentes ao PRADA/AMBULIM (Programa de Atendimento
Intensivo aos Distrbios Alimentares do Ambulatrio de Bulimia e Transtornos Alimentares do
IPq-HC-FMUSP). O programa foi estruturado em 20 semanas, com durao de 90 minutos,
aplicado por um terapeuta e co-terapeuta, com manejo em TCC. Utilizou-se como medida de
avaliao a anotao dos comportamentos compensatrios e impulsivos em trs momentos
distintos (1. 10. 20.) e Beck Depression Inventory (BDI), Beck Ansiety Inventary (BAI), Barratt
Impulsiveness Scale (BIS-11) e Whoqol-Bref. Estudo de caso: A, 19 anos, solteira, estudante
de biologia (2.ano), 5 irmos, sendo 3 do primeiro casamento (pai), e mais 2 irms do segundo
casamento. Tem uma irm gmea univitelina, da qual muito prxima e que tambm
apresenta TA. Pai provedor exigente e crtico e me conciliadora. Paciente rgida, metdica,
introvertida, fala baixa. Devido a sua auto-exigncia trancou a faculdade por acreditar que no
atingiria o desempenho esperado, apesar das notas estarem acima da mdia. TA iniciou-se aos
14 anos, diagnstico inicial de BN, migrando para AN tipo purgativo. Ingressou aos 18 anos no
AMBULIM, e depois de um ms foi encaminhada ao PRADA (maio/2012). Recebeu tratamento
em TA na adolescncia. Passou por duas internaes (2009/2010), sendo uma delas com 6
meses de durao. Resultados: A anlise comparativa entre as 3 medidas indicou uma
significativa diminuio nos comportamentos compensatrios entre a 1 e 20 semana,
principalmente no uso de laxantes (CV 0.68) e na automutilao (CV 0.79). Concluso: Um
programa especfico de HS para TA, de aplicao continua em pacientes graves e refratrias
pode contribuir na melhora geral do quadro de TA e numa QV mais satisfatria. Palavraschaves: Anorexia nervosa, refratria e habilidades sociais. E-mail: vanpsicris@gmail.com,
cidrchris@uol.com.br, rcangelli@hotmail.com
The Relation Between Food Addiction and Emotion Regulation: Influences of Emotion
Regulation Skills on Eating Attitudes and Food Addiction
Feyza Bayraktar.
Bogazici University, Istanbul, Turkey.
Abstract Central: Objective: Cognitive behavioral approaches for treatment of eating disorders
mainly focus on emotions when working with clients in therapeutic settings. Negative affectivity,
emotional dysfunctions as well as body image disturbances influenced by disordered eating are
the main issues elaborated in treatment sessions with eating disorders patients (Gupta, et al,

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2008). In fact, emotional dysfunctions are mainly related to certain mental disorders such as
substance abuse, anxiety as well as depression. Linking emotions with food has been studied
especially in accordance with cognitive behavioral approaches of eating attitudes and behavior
of individuals. The purpose of the study is to examine the influence of skills of emotion
regulation on eating attitudes in Turkish clinical and nonclinical samples. Method: Data
collection was maintained with both clinical and nonclinical samples among Turkish adult
population. For the study, nonclinical sample were recruited from Bogazici University, Faculty of
Education. (N=60). The study was conducted with clinical group which were selected by the
information obtained from clinical interview about the conditions of individuals. Clinical samples
were diagnosed as having eating disorders with different types which are mostly binge eating
disorder and compulsive overeating. (N=60). Data collection was maintained with two
instruments: Yale Food Addiction Scale and Difficulties in Emotion Regulation Scale. Score
comparison and correlation between overall scores were among the data analysis methods for
this study. Results: Results indicated that there is a significant correlation between overall
scores of instruments r = .518 (p<.001). Comparison of scores between clinical (CG) and
nonclinical groups (NCG) demonstrated that there is statistically significant difference between
total scores of clinical and nonclinical groups. The scores of Yale Food Addiction Scale and
Difficulties of Emotion Regulation Scale are compared with mean comparison (t score for Yale
food Addiction Scale = 5.351 p<.002; t score for Difficulties of Emotion Regulation Skills =
7.270, p<.002). Discussion: According to results, there is a positive relationship between the
scores of two measures. Thus, it can be said that difficulties of emotion regulation skills are
linked with addictive eating behavior. Clinical sample demonstrated the correlation between
emotional dysfunction and disordered eating behavior with addictive features. Nonclinical
sample did not indicate any linkage between emotions and eating attitudes. However, only
limitation about the study is the sample size. Larger sample will provide broader view relating to
relationship between emotion and eating behavior. References Gupta, S., Rosenthal, M.,
Mancini, A., Cheavens, J., & Lynch, T. (2008). Emotion regulation skills mediate the effects of
shame on eating disorder symptoms in women. Eating Disorders, 16(5), 405-417.
Comportamento de Risco Para Anorexia Nervosa em Universitrias
Luciana Bernardes da Rosa1, 2, Camila Belentani1.
1. Universidade Paulista, So Jos do Rio Preto, Brazil, 2. Instituto de Psicoterapia CognitivoComportamental - IPC, So Jos do Rio Preto, Brazil.
Abstract Central: Os transtornos alimentares so considerados um problema de sade pblica
e sua incidncia alta, especialmente em adolescentes e jovens adultos do sexo feminino. Foi
objetivo deste estudo a avaliao de comportamentos de risco para a anorexia nervosa em
universitrias dos cursos de graduao em Moda e Nutrio de duas universidades do interior
do estado de So Paulo. Participaram desta pesquisa 40 alunas do curso de Moda (GM) e 40
alunas do curso de Nutrio (GN). Primeiramente, foi aplicado um questionrio de dados gerais
para traar o perfil das participantes e, em seguida, foram utilizados o Teste de Atitudes
Alimentares (EAT-26) e o Body Shape Questionnaire (BSQ) para avaliar os comportamentos de
risco para anorexia nervosa e a imagem corporal, respectivamente. Pde-se observar maior
prevalncia de comportamentos anorxicos (EAT +) entre as alunas do curso de Moda
(47,5%). Em relao ao BSQ, 45% das alunas de Moda e 40% das alunas de Nutrio
apresentaram algum grau de distoro da imagem corporal. A partir dos resultados obtidos,
conclui-se que as universitrias do curso de Moda apresentam alta incidncia de
comportamentos anorxicos, o que as torna mais vulnerveis ao desenvolvimento de anorexia
nervosa quando comparadas s universitrias de Nutrio.

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When does Perfectionism Translate into Eating Disorder Pathology? An Examination of


the Moderating Role of Body Dissatisfaction using an Experimental and Longitudinal
Approach
Liesbet Boone, Bart Soenens.
Ghent University, Ghent, Belgium.
Abstract Central: Although research has shown that perfectionism is strongly associated with
elevated risk for the development of eating disorder pathology, not all perfectionists experience
problems in the domain of eating. The question can be raised then when perfectionistic people
become vulnerable for the development of eating disorder symptoms. We hypothesized that
adolescents and young adults who already experience difficulties in terms of accepting their
own body in confluence with a perfectionistic attitude will be more at risk for the development of
a diverse range of eating disorder symptoms. First, this hypothesis will be examined using a
two-wave longitudinal study (449 adolescent girls, mean age 13.24 years) in which we
investigate whether perfectionism, body dissatisfaction, and the interaction term will predict
increases in ED symptoms one year later. Second, we also used an experimental study (46
women, mean age 20.7 years) in which perfectionism was manipulated. We expected that
participants with pre-existing levels of body dissatisfaction who were allocated to the
perfectionistic condition would experience more ED symptoms compared to those in the nonperfectionistic condition. In both studies, we found evidence for the moderating role of body
dissatisfaction in the relation between perfectionism and a diverse range of eating disorder
symptoms (i.e. restraint, eating and weight concerns, over-evaluation of weight and shape),
indicating that especially those perfectionistic women with high levels of body dissatisfaction are
more at risk for the development of eating disorder symptoms over time.
A Behavioral Contract-Based Family Therapy Strategy Using Concurrent Olanzapine for
Adolescent Anorexia Nervosa
Timothy Brewerton.
1. Medical University of South Carolina, Charleston, SC, USA, 2. Carolina Children's Home,
Columbia, SC, USA.
Abstract Central: Introduction: Family therapy as originally developed at the Maudsley Institute
in London is an empirically validated treatment for anorexia nervosa (AN) in adolescents and
children. Yet in many cases this approach is either not acceptable or feasible for patients or
parents. It is also not always successful. An alternative, effective family-based approach is often
required, particularly for adolescents who are resistant to relinquishing control over their eating
to their parents. Methods: Patients and their parents signed written weight gain treatment
contracts describing specific positive and negative reinforcements and consequences (including
use of concurrent, low dose olanzapine) that were contingent upon weight gain of at least 1
pound (lb.) per week. Elements of contingency management were built into the treatment
program. The primary negative reinforcement was avoidance of inpatient hospitalization or
residential care. In addition, a positive reinforcement for weight gain (the big carrot) was
individually negotiated in the family therapy. Sessions were generally 1.5 to 2.0 hours every 1-2
weeks in which the author met with the patient for weigh-in and discussion, followed by a family
meeting. The patients included a series of 15 patients (13 females, 2 males; 9 with DSM-IV
defined AN-restricting type, 6 with AN-binge purge type) (mean age = 15.4 yrs). Goal weight
range (5 lbs.) was determined using a combination of U.S. Center for Disease Control pediatric
growth charts, Frisch tables (50th percentiles), and premorbid weights and heights. Results:
Overall, patients gained a mean of 22.3 lbs or 4.8 BMI points (kg/m2) over a period of 12.9
weeks and remained weight stable an average of 39 weeks. Mean BMI was 16.0 kg/m2at initial

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evaluation, 20.8 kg/m2 at weight restoration. Fourteen of the 15 cases (93%) attained their predetermined goal weight range. The 15th patient, who had severe PTSD from rape/physical
abuse, attained 98% of goal weight and left treatment early. One patient required hospitalization
and 10 received olanzapine. The dosage range was from 0.625 mg to 10 mg per day with a
mean dose of 3.6 mg per day. Conclusions: This contract-based form of BFT appears to be a
successful alternative method of outpatient weight restoration for children and adolescents with
AN that warrants further study. It combines a number of approaches that have shown merit in
the treatment of AN, including behavioral, cognitive, and family therapies, as well as
pharmacotherapy (relatively low doses of the atypical antipsychotic olanzapine when needed). It
is particularly useful in cases where the Maudsley BFT is unacceptable or unfeasible. This
approach allows patients to maintain a sense of control and autonomy and it is less demanding
of parents.
Os Transtornos Alimentares e Sua Relao com o Comportamento de Esquiva
Bruno Cardoso, Samily Aquino, Ilara Nogueira da Cruz.
Faculdade Pitgoras, So Luis, Brazil.
Os Transtornos Alimentares se referem s perturbaes no comportamento alimentar que
podem variar do emagrecimento extremo obesidade, os mesmos so instalados e resultam
da interao de diversos fatores, como: biolgicos, cognitivos e culturais. possvel observar
uma relao direta com o comportamento de Esquiva, onde os esquemas de pensamentos
idealizados por estes indivduos so semelhantes e condicionais entre si. As distores
cognitivas representam parte significativa nos Transtornos Alimentares, onde o afeto negativo e
as formas de interpretaes disfuncionais perpetuam o quadro, e so elaboradas estratgias de
auto reforo contribuindo para um quadro situacional do problema de forma prolongada e
gerando prejuzos no repertrio comportamental destes indivduos. Dentre os Transtornos
Alimentares encontra-se a Anorexia Nervosa, caracterizada pela busca da imagem corporal
idealizada de forma disfuncional pelo individuo como fora do padro da normalidade. Para a
obteno desta perda de peso, a pessoa elabora esquemas de pensamentos rgidos e
inflexveis respeito da sua auto imagem cobrando de forma exacerbada a conquista de
possveis perdas de peso. Sendo assim, o indivduo sofre de uma negao do baixo peso
corporal, perturbaes no modo de vivenciar o peso ou a forma do corpo, estabilizando desta
forma um fluxo negativo de pensamentos que reforam o estado atual corporal. Pode-se
relacionar a Anorexia Nervosa ao comportamento de Esquiva, pois a busca pela autoimagem
ideal, aparentemente tambm produz como consequncia a remoo de possveis situaes
desagradveis onde sejam criticados ou rejeitados. Por este motivo, cobram-se
demasiadamente de maneira a alcanar uma imagem socialmente aceitvel. Desta forma,
indivduos anorxicos elaboram sistemas de crenas centrais de extrema coero, tornando o
ganho de peso, por mais que de forma saudvel, como um fracasso na sua dieta e uma perca
na meta que foi elaborada por eles pela busca do corpo perfeito. Outro Transtorno Alimentar
que merece destaque a Bulimia, esta se caracteriza pela ingesto compulsiva de alimentos
marcada por um sentimento de falta de controle sobre esta ingesto, no qual o comportamento
compensatrio est sempre presente atravs de estratgias de eliminao destes alimentos, a
saber: induo de vmitos, uso de laxantes, diurticos, dentre outros. Fazendo um paralelo
com o comportamento de fuga/esquiva, indivduos bulmicos so reforados a manterem este
pensamento disfuncional, como fuga, pois ao comer demasiadamente naquele momento o
enfoque sobre o ato de comer e no nos demais problemas que possam existir para o
mesmo, mas logo em seguida esse comportamento seguido do sentimento de culpa, o que
afeta mais ainda o fator emocional do indivduo, tornando-se um ciclo de fuga e esquiva, pois
pensar sobre isso tambm aversivo e novamente o indivduo precisa comer para "sentir-se

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bem". Conclui-se, atravs de levantamento bibliogrfico, que os Transtornos Alimentares,


possuem uma relao direta com o comportamento de esquiva, pois indivduos que possuem
estes transtornos elaboram sistemas de crenas disfuncionais de esquiva para ideaes
errneas que geram comprometimento nas relaes sociais, e na sua auto percepo.
Increased Wait-List Time Predicts Dropout From Outpatient Enhanced Cognitive
Behaviour Therapy (CBT-E) for Eating Disorders
Olivia Carter1, Louise Pannekoek1, Anthea Fursland2, Karina Allen1, Susan Byrne1, 2.
1. The University of Western Australia, Perth, WA, Australia, 2. The Centre for Clinical
Interventions, Perth, WA, Australia.
Abstract Central: BACKGROUND AND AIMS Between 30 and 70% of patients with eating
disorders dropout from outpatient treatment. However, research has been unable to identify
factors that consistently predict dropout. Most studies have exclusively investigated the role that
individual patient characteristics play in dropout and have ignored more process-based factors
such as expectations about treatment, the therapeutic alliance, or time spent on a treatment
waiting list. This study aimed to investigate the roles of both individual patient characteristics
and process-based factors in dropout from outpatient treatment for eating disorders. METHODS
The study involved data collected from consecutive eating disorder referrals to the only public
specialist eating disorder service for youth and adults in Perth, Western Australia. The standard
treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual
basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty
five percent of this sample dropped out of treatment. RESULTS Multivariate analysis of
individual factors found that lowest reported weight and Distress Tolerance Scale (DTS)
Avoidance of Affect subscale score were significant predictors of dropout (p < 0.05). Those with
a lower minimum weight and higher pre-treatment scores on the Avoidance of Affect subscale of
the DTS were more likely to drop out of treatment. In the process-based multivariate model,
wait-list time was the only significant predictor of dropout to enter the model (p < 0.05). The final
multivariate model including both individual and process-based factors was significant 2 (df =
3) = 23.68, p < 0.05, and all three variables entered into the model significantly (p < 0.05). This
model correctly classified 78% of those who completed treatment and 46% of those who
dropped out. Secondary analyses provided support for these findings. Dropouts reported a
significantly lower minimum weight than completers (M [SD] = 44.22 kg [9.01] vs. 50.14 kg
[10.13], t (166) = 3.94, p < 0.01) and had a significantly higher mean pre- treatment score on the
DTS Avoidance of Affect scale (M [SD] = 1.60 [0.66] vs. 1.39 [0.66], t (176) = -1.97, p < 0.05).
With regard to wait-list time, the mean wait for the full sample was 149.83 days (SD = 100.46)
with some individuals waiting over 400 days for treatment. Dropouts spent a significantly longer
time on the wait list than did completers (M [SD] = 170.91 days [106.04]) vs. (M [SD] = 133.29
days [93.06], t (180) = -2.54, p < 0.05). CONCLUSIONS These findings are valuable because a
process-based factor, such as wait-list time, may be easier to address and modify than a
patients weight history or the trait of mood intolerance. Increased resources for eating disorder
services may reduce waiting list times, which would help to reduce dropout and maximize
treatment outcomes. KEY WORDS Eating disorder; dropout; wait-list.
Emotional Eating and Emotion Regulation: Eating in Response to Sadness in a Sample of
Emotional Eaters
Ausias Cebolla1, 2, Ernestina Etchemendy2, Paloma Rasal3, Cristina Botella1, 2, Rosa Baos2, 3.
1. Universitat Jaume I, Castell, Spain, 2. CIBER Fisiopatologia de la obesidad y la nutricin,
Santiago de compostela, Spain, 3. Universitat de Valencia, Valencia, Spain.

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Emotional eating is defined as a dietary pattern where the people eat in response of negative
emotions with the main or relieving distress, disregarding the internal physiological signals of
hunger and satiety. However, the efficacy of eating as emotion regulator remains unclear,as
results so far are scarce and contradictory.The objective of this study is to analyze the effect of
eating over mood after a sad induction in a sample of high and low emotional
eaters.Participants were recruited from a pool of students taking courses at the University of
Valencia(Spain). The final sample was composed by 30 participants, 13 high emotional eaters,
and 17 low emotional eaters(according toDutch Eating Behavior Questionnaire-DEBQ).All
participantstook part ina sad induction procedure (via a Virtual Reality-Mood Induction
Procedure, VR-MIP) and then 7 types of food werepresented, and participants were asked to
eat all they want. Participants fulfilled Visual Analog Scale (VAS) and the Positive Affectivity and
Negative Affectivity Scale (PANAS)before and after VR-MIP, and after eating. Several
ANCOVAs were applied and results showed a significantsadness increase after VR-MIP and a
significant sadness decrease after eating(T1=1.67; T2=4.50 ; T3= 2.5). The ANCOVA did not
report any significant interaction effect over sadness [F(2,52)=.184; p=.832; 2=.00], but for
Negative affect (from PANAS) a significantinteraction effect [F(2,52)=3.242; p=.029; 2=.25]
was reported, meaning that negative affect decreased more after eating in high emotional
eaters compared to low emotional eaters. Results of this study show that eating could bean
effective strategyto regulate negative emotions in high emotional eaters compared to low
emotional eaters.This study suggests that eating alleviates negative affect in emotional eaters,
and this reduction may reinforce the eating behavior when these individuals feel negative
emotions.
Disordered Eating and Muscle Dysmorphia in a Representative Sample of College
Students in Buenos Aires
Emillio Compte1, 3, Ana Rosa Seplveda2.
1. Anxiety and Stress Clinic, Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina,
2. Universidad Autnoma de Madrid, Madrid, Spain, 3. Universidad Favaloro, Buenos Aires,
Argentina.
Abstract Central: Concern about body image has extended to males of a wide age range. This
concern is manifested through eating disorders and inappropriate weight control methods,
different from those observed in women. Men feel cultural pressure to develop an athletic,
muscled body. Psychopathologically, this is expressed as a continuum that goes from eating
disorders to muscle dysmorphia. Preliminary results from a sample of 150 male undergraduate
students are presented of a two-stage study on a representative sample of Argentinian
university students. At the first stage, a battery of questionnaires was provided that screened an
eating disorder risk (EAT-26), tendency to worry (PSWQ), exposure to the media (SMQ), social
interaction (PACS) and masculine attitudes towards the body (MBAS, DMS). At the second
stage, EDE 12 and YBOCS, adapted to Dysmorphic Disorders, was provided to the participants
with an EAT-26 score of 15 or above, and to a random control group with participants below that
score. Examining characteristics associated to body image disorders in men will allow to provide
these patients with appropriate psychological aid.
Insatisfaccin Corporal, Autoestima y Depresin en Nios con Obesidad de 5 y 6 de
Primaria
Jos-Alfredo Contreras, Miguel-ngel Freyre, Laura Hernndez-Guzmn.
Facultad de Psicologa, UNAM, Distrito Federal, Mexico.

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Abstract Central: En aos recientes, la obesidad infantil se ha convertido en un problema de


salud alarmante a nivel internacional. Adems del gran nmero de complicaciones fsicas que
esta enfermedad provoca, el componente psicolgico del obeso se muestra afectado. El ideal
de la delgadez que persigue la sociedad actual ocasiona que los nios con obesidad
desarrollen insatisfaccin hacia su propio cuerpo. Adems, se ha propuesto que estos nios
sufren discriminacin, rechazo y burlas, lo que conduce a problemas psicolgicos como la baja
autoestima y la depresin. A pesar de la aparente lgica que pudiese existir entre la obesidad y
sus consecuencias sobre la dimensin afectiva, los estudios de esta lnea de investigacin en
el plano mundial han arrojado resultados contradictorios. En Mxico, los escasos trabajos que
indagan acerca de este tema no logran esclarecer dicha polmica. Por lo tanto, el propsito de
la presente investigacin fue conocer la asociacin entre la obesidad y los constructos
psicolgicos insatisfaccin corporal, autoestima y depresin. Particip un total de 520
estudiantes (251 nias y 269 nios) de nueve escuelas primarias de la Ciudad de Mxico. El
rango de edad observado fue de 9-13 aos. Se utiliz los criterios propuestos por la OMS
(2012) para clasificar a la muestra en cuatro grupos de acuerdo a su ndice de masa corporal
(IMC): obesidad, sobrepeso, peso normal y bajo peso. Este ltimo grupo se excluy del anlisis
de datos. Se emple el Cuestionario de Imagen Corporal (BSQ), la Prueba de Autoestima
Infantil (PAI) y la Escala de Depresin del Centro de Estudios Epidemiolgicos (CES-D) para
medir las variables en cuestin. El ANOVA demostr que la obesidad se relacion con la
insatisfaccin corporal, pero no con la autoestima ni con la depresin. Mediante los pasos
propuestos por Baron y Kenny (1986) se determin que la insatisfaccin corporal no fungi
como variable mediadora entre la obesidad y la autoestima. Finalmente, por medio de un
ANOVA se encontr que la insatisfaccin corporal de los obesos redujo la autoestima e
increment la depresin. Por s misma, la obesidad parece no afectar el componente afectivo,
no obstante, la autoestima disminuye y los sntomas de depresin se elevan cuando aumenta
el nivel de insatisfaccin corporal de los nios obesos. [Este estudio fue posible gracias al
financiamiento que la Universidad Nacional Autnoma de Mxico otorg, mediante su
Programa de Apoyo a Proyectos de Investigacin e Innovacin Tecnolgica, a la Dra. Laura
Hernndez-Guzmn para desarrollar el proyecto IN305512. Se agradece el apoyo recibido.]
Efectos del tipo de instruccin de acuerdo con estilos parentales sobre la conducta
alimentaria de nios Effects of Type of Instruction with Parenting Styles on Children's
Eating Behavior
Lady Crdenas, Andres Santacoloma, Alexa Murillo, Maribel Hernandez.
Universidad Catlica de Colombia, Bogot, Colombia.
El presente trabajo pretendi identificar el efecto de las instrucciones en relacin con los estilos
educativos de los padres, sobre la conducta alimentaria infantil. Los estilos educativos fueron
evaluados a travs del Child Feeding Styles Questionary, de la entrevista semiestructurada,
con padres y/o acudientes, de la evaluacin mdica y psicolgica. Se utiliz el CFSQ, formatos
de registro de entrevista psicolgica y mdica, registros de alimentacin diaria, bsculas,
balanzas y cmaras de video. Se instal un laboratorio mvil en la escuela donde reciban
clases los nios participantes del estudi, los cuales correspondieron a 34 nios entre 6 y 8
aos de edad, quienes a su vez, fueron distribuidos en 4 grupos, a) autoritario, b) democrtico,
c) permisivo y d) negligente. La conducta alimentaria fue medida en trminos de la ingesta de
alimento, su frecuencia, cantidad de comida ingerida y el tipo de alimento consumido. La
participacin de cada nio o nia, fue autorizada por sus representantes legales quienes fueron
informados previamente del estudio y accedieron a colaborar en el mismo. El anlisis de los
datos indic que las instrucciones afectaron negativamente el consumo de alimentos

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saludables y por ende, potencializaron la ingesta de alimentos artificiales, en tres de los grupos,
excepto en el grupo que se encontraba bajo estilo educativo democrtico.
Efectos del Tipo de Instruccin de Acuerdo con Estilos Parentales Sobre la Conducta
Alimentaria de Nios
Lady Crdenas, Andres Santacoloma, Alexa Murillo, Maribel Hernandez.
Universidad Catlica de Colombia, Bogot, Colombia.
El presente trabajo pretendi identificar el efecto de las instrucciones en relacin con los estilos
educativos de los padres, sobre la conducta alimentaria infantil. Los estilos educativos fueron
evaluados a travs del Child Feeding Styles Questionary, de la entrevista semiestructurada,
con padres y/o acudientes, de la evaluacin mdica y psicolgica. Se utiliz el CFSQ, formatos
de registro de entrevista psicolgica y mdica, registros de alimentacin diaria, bsculas,
balanzas y cmaras de video. Se instal un laboratorio mvil en la escuela donde reciban
clases los nios participantes del estudi, los cuales correspondieron a 34 nios entre 6 y 8
aos de edad, quienes a su vez, fueron distribuidos en 4 grupos, a) autoritario, b) democrtico,
c) permisivo y d) negligente. La conducta alimentaria fue medida en trminos de la ingesta de
alimento, su frecuencia, cantidad de comida ingerida y el tipo de alimento consumido. La
participacin de cada nio o nia, fue autorizada por sus representantes legales quienes fueron
informados previamente del estudio y accedieron a colaborar en el mismo. El anlisis de los
datos indic que las instrucciones afectaron negativamente el consumo de alimentos
saludables y por ende, potencializaron la ingesta de alimentos artificiales, en tres de los grupos,
excepto en el grupo que se encontraba bajo estilo educativo democrtico.
Dficits em Habilidades Sociais em Mulheres com Bulimia Nervosa
Juliana D'Augustin1, 2, Eliane Falcone1.
1. Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, 2. Policlinica Piquet
Carneiro, Rio de Janeiro, Brazil.
Abstract Central: As Habilidades Sociais so de grande importncia para a sade e a
qualidade de vida. A literatura sugere que as dificuldades ligadas s situaes sociais estariam
relacionadas a diversos transtornos psiquitricos, como por exemplo, a bulimia nervosa (BN). A
BN um transtorno alimentar debilitante, que afeta cerca de 2% das mulheres jovens, e
acarreta um impacto considervel na vida do indivduo e de suas famlias. caracterizada pela
presena de episdios de compulso alimentar recorrentes seguidos de mtodos
compensatrios inadequados. Alm das complicaes clnicas associadas ao transtorno,
encontramos tambm graves problemas interpessoais. A literatura mostra que essas pacientes
freqentemente apresentam deficincias na assertividade, na percepo de redes de apoio
social e na formao de vnculos satisfatrios. Alm disso, vrios estudos mostram que dficits
nas habilidades sociais estariam associados maior freqncia de episdios de compulso
alimentar. Dessa forma, o objetivo do estudo foi investigar as relaes entre habilidades sociais
em indivduos com BN. A amostra foi composta por 33 indivduos com BN, comparados a 31
indivduos sem transtornos alimentares, pareados por idade, sexo e anos de estudo. Os
instrumentos utilizados foram: 1- Teste de investigao bulmica de Edinburgh; 2- Inventrio de
Empatia (IE) e 3- Inventrio de Habilidades Sociais (IHS). A anlise dos dados foi feita no
pacote estatstico SPSS e os testes utilizados foram: Teste T e correlao de Pearson. Os
resultados encontrados mostraram que as mdias obtidas no IHS foram menores para o grupo
de bulmicas quando comparadas ao grupo controle. Tal diferena foi estatisticamente
significativa para todos os fatores assim como para o escore total. J em relao ao IE, os

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grupos s diferiram significativamente em relao ao fator tomada de perspectiva, com um


escore superior para o grupo controle. Os resultados mostraram tambm uma correlao
negativa entre o Teste de investigao bulmica de Edinburgh e o IHS, IE, indicando que
quanto menores os nveis em habilidades sociais, maior a gravidade da BN. A partir dos dados
encontrados nesse estudo, pode-se fazer algumas consideraes sobre o tratamento da BN.
Dficits em habilidades sociais podem comprometer a capacidade da mulher bulmica de
manter uma rede de apoio social. Portanto, o desenvolvimento de um repertrio competente de
habilidades sociais pode melhorar a sua capacidade de se relacionar com os outros de forma
significativa, permitindo-lhes tirar proveito do apoio social, e aumetando sua qualidade de vida
e bem-estar psicolgico. Os efeitos do treinamento dessas habilidades tambm podem reduzir
a freqncia de episdios de compulso alimentar. Dessa forma, a incluso ao tratamento
psicoterpico, do treinamento de habilidades sociais, atravs de procedimentos cognitivos,
afetivos e comportamentais, pode ser til.
Trastornos Alimentarios. Evaluacin del Funcionamiento Familiar. Avance de
Investigacin
Milagros Fernandez.
Universidad Catlica del Uruguay, Montevideo, Uruguay.
Si bien parece no haber un patrn especfico de funcionamiento familiar asociado a los
Trastornos Alimentarios, estas familias generalmente tienden a ser ms disfuncionales que las
familias control y la calidad del funcionamiento familiar juega un rol importante en el curso y la
recuperacin del trastorno. Cook - Darzens,S.,Doyen,C, Falissard, B &Mouren, M.C ( 2005).
Dancyger,I, Fornari,V., Scionti;L., Wistsky,W., & Sunday,S. (2005) encontraron diferencias
estadsticamente significativas entre pacientes y padres al comparar la percepcin del
funcionamiento familiar que tenan sus hijas con TA con la percepcin de sus padres. Las
madres consideraban que el funcionamiento familiar era significativamente saludable y poco
catico, en cambio las hijas no coincidieron con tal reporte. En otro estudio realizado por
Vidovic, V., Juresa, V., Begovac, I., Mahnik, M. & Tocilj, G. (2005) se evaluaron 76 pacientes
con TA y a 29 madres, con el fin de investigar la percepcin que amabas tenan respecto a
diversas caractersticas familiares (cohesin, comunicacin y adaptabilidad) Tras aplicar el
Family Adaptability and Cohesin Scales y el Parent - Adolescent Communications Form,
encontraron que las pacientes con TA, salvo las pacientes con AN restrictiva, consideraban a
su familia con menor cohesin y menor adaptabilidad que la percepcin que tenan de sus
familias un grupo de control. Objetivo general Evaluar el funcionamiento familiar con un
miembro con un Trastorno Alimentario especfico y comparar los resultados con poblacin
general de Montevideo, Uruguay. Mtodo La muestra estuvo conformada por diecisis familias
que concurran a una clnica especializada en trastornos alimentarios con una hija
diagnosticada con Anorexia Nerviosa o Bulimia Nerviosa, segn los criterios del DSM IV. La
media de edad de las pacientes fue de 19 (edad mnima 17 aos y edad mxima 20 aos). Se
trat de un estudio descriptivo con un diseo trasversal. Para evaluar las caractersticas
familiares se tom como herramienta el cuestionario FACES IV, de David Olson en su
adaptacin al Uruguay (Costa et al.; en prensa). Esta escala se basa en el Modelo Circunflejo
tomado las dimensiones de Cohesin, Adaptabilidad y Comunicacin, buscando encontrar
similitudes y diferencias en el funcionamiento familiar segn el rol que cumple en la familia
(madre, padre, hermanos, paciente identificado). Procedimiento: Se administr el cuestionario a
las pacientes y a todos los miembros de la familia que fueran mayores de 12 aos y se realiz
el consentimiento informado. Resultados Los resultados indican que estas familias poseen
poca cohesin y flexibilidad mostrndose en su gran mayora con un funcionamiento catico y
desligado en comparacin a integrantes de familias normativas de Montevideo. A nivel

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descriptivo podemos notar que existe un menor nivel de de la cohesin, flexibilidad,


comunicacin y satisfaccin familiar entre los padres y el paciente identificado, confirmando las
investigaciones descritas anteriormente. Nos proponemos encontrar diferencias y similitudes
significativas en el funcionamiento familiar segn el rol que cumple en la familia. As como
tambin evaluar el funcionamiento familiar segn el Trastorno Alimentario. Palabras Clave:
Trastornos alimentarios, Funcionamiento familia.
Cognitive-Behaviour Therapy Response and Drop-out Rate Across Bulimic Disorders:
Therapy and DSM-5 Implications
Fernando Fernandez-Aranda1, 2, Susana JImenez-Murcia1, 2, Zaida Aguera1, 2, Nadine Riesco1,
Isabel Sanchez1, Mohammed Islam1, Roser Granero5, 2, Eva Peas-Lledo3, Jon Arcelus4, Jose
Menchon1.
1. University Hospital of Bellvitge, Barcelona, Spain, 2. CIBER Fisiopatologia Obesidad y
Nutricin, ISCIII, Barcelona, Spain, 3. University of Extremadura, Badajoz, Spain, 4. Leicester
General Hospital, Leicester, United Kingdom, 5. University Autonoma Barcelona, Barcelona,
Spain.
Abstract Central: Objectives: The aims of this study were to determine differences in treatment
response and drop-outs rates following Cognitive Behavioural Therapy (CBT) across the three
bulimic diagnostic groups [binge eating disorder (BED); bulimia nervosa-purging type (BN-P)
and bulimia nervosa-non purging type (BN-NP)] Method: The sample comprised of 454 females
(87 BED, 327 BN-P and 40 BN-NP) diagnosed according to DSM-IV criteria who were treated
with 22 weekly outpatient sessions of group CBT therapy. Patients were assessed before and
after treatment using a food and purging diary. Full remission was defined as total absence of
eating disorders symptoms to a level no meeting diagnostic criteria. Results: Full remission rate
was found to be significantly higher in BED (69.5%) than in both BN-P (p<0.005) and BN-NP
(p<0.001), which presented no significant differences between them (30.9% and 35.5%). The
rate of dropout from group CBT was also higher in BED (33.7%) than in BN-P (p<0.001) and
BN-NP (p<0.05), which were similar (15.4% and 12.8%, respectively). Conclusions: Results
suggest that purging and non-purging BN have similar treatment response and dropping out
rates, whereas BED appears as a separate diagnosis with better outcome for those who
complete treatment. The results support the proposed new DSM-5 classification.
Abordaje Teraputico del Trastorno por Atracn basado en Mindfulness o Conciencia
Plena
Marina Galimberti, Aquiles Perez Delgado, Geraldine Lojda, Gloria Reyna Barajas.
Centro IPPC de Psicoterapia Cognitiva, Ciudad Autnoma de Buenos Aires, Argentina.
Introduccin: El Programa Mindfulness-Based-Eating Awareness Training, por sus siglas en
ingls MB-EAT, desarrollado por Kristeller y Hallett (1999), eficaz para el tratamiento del
Trastorno por Atracn (Trastorno No Especificado de los Trastornos de la Conducta
Alimentaria, segn el DSM IV), integra elementos de la Terapia Cognitiva Conductual y
meditaciones guiadas con contenidos relacionados con el peso, la imagen y procesos de autoregulacin. Este estudio preliminar otorg base emprica a este tratamiento. Un ltimo estudio
realizado por Kristeller en el ao 2010 concluy la necesidad de expandir el tratamiento a un
total de 10 sesiones (Kristeller & Wolever, 2011). Jon Kabat-Zinn (2003) define Mindfulness
como prestar atencin deliberadamente al momento presente, sin juzgar. La prctica de
Mindfulness es conceptualizada como un modo de entrenar la atencin con el objetivo de
ayudar a los pacientes a incrementar la conciencia sobre patrones automticos de respuesta y

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sobre aspectos saludables de funcionamiento, relacionados con la alimentacin, como el


hambre y la saciedad (Kristeller, 2003). Objetivo: Describir el abordaje y la eficacia del
Programa MB-EAT empleado en el Trastorno de la Conducta Alimentaria por Atracn realizado
por Kristeller y Hallett (1999) y la ltima versin planteada por Kristeller (2010). Investigaciones
y Resultados: Kristeller y Hallet (1999) realizaron un estudio preliminar con 18 mujeres, (46.5
aos de edad promedio y peso promedio de 238 libras) quienes reunan los criterios para
Trastorno por Atracn y Obesidad. Realizaron 7 sesiones grupales para completar un total de 6
semanas de tratamiento, 3 semanas de evaluacin previas al mismo y 3 de seguimiento. Luego
del tratamiento, los episodios de atracones disminuyeron de 4 a 1.5 (en magnitud y cantidad).
No se registraron cambios en el peso de las participantes. Adicionalmente, los niveles de las
medidas de depresin y ansiedad tambin disminuyeron. Este estudio otorg base emprica al
programa mencionado. Un ltimo estudio llevado a cabo por Kristeller en el ao 2010 extendi
las sesiones a 10 y agreg dos sesiones de seguimiento. Este programa incluye componentes
adicionales como informacin sobre caloras y pautas nutricionales. Este tratamiento est
estructurado para introducir gradualmente, en paralelo, los elementos de la prctica de la
meditacin mindfulness, el acto de comer con conciencia plena, y temas de auto-conciencia y
aceptacin de s mismo (Kristeller & Wolever, 2011). Conclusin: La evidencia cientfica
demuestra la eficacia del Programa MB-EAT para el Trastorno por Atracn. Dicho tratamiento
provee a los individuos un aumento en la capacidad de observar sentimientos,
comportamientos y experiencias, y la posibilidad de abandonar la reactividad automtica y
disfuncional, permitindoles desarrollar relaciones ms equilibradas consigo mismos, su comer,
y sus cuerpos. Referencias Bibliogrficas: Kristeller, J. L., & Hallett, C. B. (1999). An exploratory
study of a meditation-based intervention for binge eating disorder. Journal of Health
Psychology, 4(3), 357-363. Kristeller, J.L. (2003) Mindfulness, wisdom and eating: Applying a
multi-domain model of meditation effects. Journal Of Constructivism In the Human Sciences. 8
(2), 107-118. Kristeller, J. L., Baer, R. A., & Quillian-Wolever, R. (2006). Mindfulness-based
approaches to eating disorders. In Baer (Ed.), Mindfulness-based treatment approaches (pp.
75-91).New York: Guilford Press. Kristeller, J.L. & Wolever, R.Q. (2011). Mindfulness-Based
Mindfulness-Based Eating Awareness Training for Treating Binge Eating Disorder: The
Conceptual Foundation. DOI: 10.1080/10640266.2011.533605.
Os Transtornos Alimentares e Suas Repercusses No Comportamento das Pessoas
Gabriela Garms, Priscila Basseto, Carmen Andrade.
Unimar, Marilia, Brazil.
GARMS, Gabriela Sampaio de Souza*; BASSETO, Priscila*; ANDRADE, Crmen Valria dos
Santos**. Linha de Pesquisa: Transtornos Alimentares No se pode entender alimentos
somente como alimentos. Alimentar-se o ato de nutrir-se, comer um ato social que
representa atitudes ligadas aos usos, costumes, condutas e situaes de uma cultura, o modo
de ser de um povo. Nenhum alimento que entra em nossa boca neutro. O comportamento
alimentar dos seres humanos demonstra ter, desde a origem da espcie, inmeros
determinantes. Este estudo tem por objetivo investigar os transtornos alimentares e suas
repercusses no comportamento das pessoas. Est sendo desenvolvido tendo como base uma
reviso bibliogrfica sobre o tema dos transtornos do comportamento alimentar. A alimentao
nos dias atuais mudou muito devido globalizao de informaes e passou a no mais
identificar-se com o territrio, com a cultura, com os costumes, pois se adapta s circunstncias
que o mundo atual impe. O fast food passou a fazer parte da vida das pessoas, no s fora de
casa, mas tambm nas refeies realizadas com a famlia. Observa-se tambm que com a
inveno do forno microondas, houve uma diminuio do contato social, pois com seu uso, as
pessoas simplesmente aquecem qualquer refeio semi-pronta ou congelada. Os transtornos

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alimentares so severas perturbaes no comportamento alimentar de um indivduo que pode


lev-lo ao emagrecimento extremo, caquexia, devido a grande diminuio na alimentao ou a
obesidade, devido ingesto de grandes quantidades de alimentos, alm de vrios outros
problemas fsicos e de sade que podem ocorrer. Os principais transtornos alimentares
conhecidos so: Anorexia nervosa e a Bulimia nervosa, mas existem outros menos conhecidos:
Transtorno da Alimentao da Primeira Infncia; Transtorno de Pica; Transtorno de
Ruminao; Transtorno do Comer Compulsivo; Vigorexia e Transtorno Alimentar Noturno. Este
estudo ainda se encontra em andamento, mas, atravs das pesquisas realizadas at o
momento percebe-se que para os psiclogos estudar os transtornos alimentares um
elemento para o entendimento da sociedade e de seu desenvolvimento. A terapia cognitivocomportamental um excelente recurso para o tratamento das pessoas com transtorno
alimentar. As pessoas tm diferentes formas de comunicar o sofrimento aos outros, para os
profissionais da sade, a doena uma das formas que o ser humano utiliza para externalizar
os problemas biolgicos, psicolgicos como tambm os econmicos e sociais. Palavras-chave:
Transtornos Alimentares. Comportamento. Sociedade Contempornea.
_________________________________ *Acadmica do curso de Graduao em
Psicologia/UNIMAR *Acadmica do curso de Graduao em Psicologia/UNIMAR **Docente do
curso de Graduao em Psicologia/UNIMAR - andradecarm@gmail.com
Attention and Memory Biases to Body-Related Information among Individuals with Body
Image Concerns
Michelle Jiang, Lenny Vartanian.
School of Psychology, The University of New South Wales, Sydney, NSW, Australia.
Abstract Central: Body dissatisfaction is a well-established risk factor for eating disorders and
dysfunctional eating behaviours. In recent years, research in this area has placed increasing
emphasis on examining the role of cognitive processing biases in the development and
maintenance of such body image concerns. For example, according to the cognitive model of
eating disorders proposed by Vitousek and Hollon (1990), individuals with eating disorders show
attention and memory biases toward information that is relevant to their concerns, such as
body-related words (e.g., Lee & Shafran, 2004). Moreover, previous research has shown that
individuals with dysfunctional eating behaviours (e.g., chronic dieters), who share similar
heightened body image concerns as individuals with eating disorders, also tend to show the
same processing biases toward information related to body shape, weight, and diet. Relatively
little is known, however, about the association between attention and memory biases toward
concern-relevant information in these populations. The current studies addressed this
association. The aims of Experiment 1 were to examine the relationship between attention and
memory biases toward body-related images, and to determine whether that relationship differs
between dieters and non-dieters. Attention allocation during a visual search task containing
body-related and control images was measured by tracking participants eyegaze. This was
followed by a recognition test assessing participants memory for the images presented during
the visual search task. Results showed that both dieters and non-dieters attended more to bodyrelated images than to control images. However, despite exhibiting the same attentional bias,
dieters showed better recognition of body-related images than did non-dieters, suggesting that
dieters are more efficient at processing body-related information. Experiment 2 tested this
processing-efficiency hypothesis by inducing cognitive busyness in dieters and non-dieters.
Cognitive busyness was induced by giving half of the participants an additional 4-digit numbercounting manipulation to perform during the visual search task. Results showed that dieters
were not able to sustain the memory advantage for body-related images when given a cognitive
load that interfered with their processing, thus failing to support the processing-efficiency

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hypothesis. These findings have implications for our understanding of the relationship between
attention and memory biases, as well as for the utility of attention-retraining interventions (such
as attention bias modification) in eating disorders.
Mindfulness-Based Eating Awareness Training (MB-EAT): Evidence for Adaptation to
Different Populations
Jean Kristeller.
Psychology, Indiana State University, Terre Haute, IN, USA.
Abstract Central: Mindfulness approaches to treating obesity and compulsive overeating offer
substantial promise. At their core, they engage shifts in attentional and cognitive processes that
promote self-regulation across a number of domains, including improvement in behavioral,
emotional, and physiological regulation. The core Mindfulness-Based Eating Awareness
Training (MB-EAT) incorporates several types of meditative and mindfulness practices in a 12week treatment program for binge eating disorder, a syndrome characterized by disregulated
behavior, cognitions, hunger and satiety mechanisms, emotions and sense of self. The paper
will briefly review the meditative approaches that are integrated into our manualized treatment,
including general meditation training, focused mindfulness exercises related to hunger
awareness, taste-specific satiety, emotional triggers, and forgiveness. The MB-EAT program
has been used effectively with individuals with compulsive eating problems and obesity
(Kristeller & Hallett, 1999; Kristeller et al., in press; Daubenmier et al., 2012; Miller et al., 2012).
An overview of three completed NIH-randomized clinical trials with obese binge eaters, nonbinge eaters, and overweight to obese individuals with Type II diabetes will be presented. Our
research to date supports the value of MB-EAT in significantly decreasing binge eating patterns,
promoting weight loss in relation to amount of meditation practice, and normalizing emotional
eating. Mindfulness meditation appears to act by rapidly promoting self-awareness,
internalization of control and self-acceptance. Therefore, this approach may be useful not only
for treatment for eating problems, but may help expand understanding of how selfawareness/mindfulness may contribute to emotional, behavioral and physiological selfregulation. The theoretical basis of MB-EAT will be covered, along with a brief review of the
components of the 12-session program, its adaptation to different populations (for weight loss;
stress-related eating; and Type-II diabetes), and a brief summary of research findings to date.
Comparacin de un Tratamiento Cognitivo Conductal Grupal contra Ejercicio Aerbico
Controlado Para Evaluar la Disminucin de Ideas Distorsionadas Relacionadas con la
Obesidad e imc en Mujeres y Hombres Adultos con Obesidad
Gerardo Leija Alva.
Psychology, Instituto Politecnico Nacional, Tlalpan, Mexico.
Abstract Central: El propsito del estudio fue el de evaluar las diferencias entre dos
tratamientos en personas con obesidad, especficamente en lo que respecta a los hbitos,
pensamientos, y actitudes hacia esta. Es un estudio con diseo pre - post, cuasi-experimental y
aleatorio simple. Los participantes se dividieron en forma aleatoria en un grupo de Terapia
cognitivo conductual y otro de ejercicio sistematizado. Ambos tuvieron apoyo nutricional. La
duracin total fue de 3 meses. La muestra inicial fue de 60 individuos con obesidad en grado I y
II entre 18 y 60 aos de edad ambos sexos. Se aplic el Cuestionario de sobre ingesta
alimentaria (antes y despus del tratamiento). Los resultados demuestran que la terapia
cognitivo conductual grupal dirigida a la adquisicin de hbitos alimentarios y de actividad
fsica, es ms til para modificar los hbitos, pensamientos, y actitudes hacia la obesidad , y

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que el ejercicio incrementa la motivacin y los hbitos de salud, lo que indica que los
participantes tuvieron la capacidad de darse cuenta de los beneficios de cambiar a hbitos de
alimentacin y activacin fsica, lo cual es un indicador favorable en cualquier tratamiento de
obesidad.
Abuso Sexual Infantil y Trastornos de la Condcuta Alimentaria
Analia Losada.
Universidad Catolica Argentina, Rafael Calzada, Argentina.
Abstract Central: El abuso sexual infantil representa a uno de los ms graves problemas de
salud pblica que tiene que afrontar la sociedad, especialmente los nios y jvenes. Entre las
consecuencias a largo plazo, este trabajo seala la relacin entre el abuso sexual infantil y las
patologas alimentarias, especficamente en aquellas personas que transitaron los cincos
estadios del sndrome de acomodacin al abuso sexual infantil descripto por Summit (1983)
como modelo explicativo del abuso sexual infantil. En relacin, se ha hallado de los sujetos
consultantes por patologas alimentarias del Instituto Argentino de Trastornos de la
Alimentacin durante el periodo Mayo 1999- Mayo 2009 han atravesado los cinco estadios del
sndrome de acomodacin al abuso sexual infantil en un 72,5 %, sobre un total de 2076
historias clnicas relevadas.
New approaches for the management and treatment of Obesity and Eating disorders
Renate Neimeijer1, Renate Neimeijer1, Peter de Jong1, Caroline Braet2, Sandra Verbeken2,
Saskia Van der Oord3, Fernando Fernandez-Aranda4, 5, Susana JImenez-Murcia4, 5, Roser
Granero5, 6, Conxa Perpi5, 7, Mara Roncero7, Carmen Carrio8, Fernando Fernandez-Aranda4,
5
.
1. Dept. of Clinical Psychology and Experimental Psychopathology University of Groningen,
Groningen, Netherlands, 2. Department of Developmental, Personality and Social Psychology,
Ghent University, Ghent, Belgium, 3. Clinical Psychology, Leuven University, Leuven, Belgium,
4. University Hospital of Bellvitge, Barcelona, Spain, 5. CIBER Fisiopatologa Obesidad y
Nutricin, ISCIII, Barcelona, Spain, 6. Laboratory of Applied Statistics, Department of
Psychobiology and Health Science Methodology, Universitat Autnoma de Barcelona,
Barcelona, Spain, 7. Psychology School, University of Valencia, Valencia, Spain, 8. Agencia
Valenciana de Salud, Valencia, Spain.
Increasingly, more health professionals are becoming interested in innovative and cost-effective
treatment approaches. Due to this reason, new technologies for treatment and therapeutic
support of various mental disorders are being commonly developed and applied, from cognitive
training to video games. Although, to date, the use of new technologies has progressively been
applied in several mental disorders, including obsessive-compulsive disorders, ADHD,
schizophrenia, eating disorders, obesity, addictive behaviors and anxiety disorders, there is a
lack of new technological tools specially addressed for treating dysfunctional personality traits,
emotional lability and dysregulated cognitive functioning. Within severe eating disorders and
obese patients, impulse-related disorders, shared dysfunctional emotional regulatory processes
and disinhibited personality traits are among the most difficult core symptoms to address, even
with well-established evidence-based psychological therapies. Due to the lack of effective
strategies and adequate psychotherapy tools to remediate these cognitive and emotional
processes, we have decided to consider in this symposium innovative approaches based on
new technologies, namely brain training (both attention training and memory training), serious

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games or combination of different elements. Capacity and limitations of these new technological
strategies will be discussed.
Cognitive bias modification as a new treatment for Anorexia Nervosa?
The leading therapy for anorexia nervosa (AN) is cognitive behavioral therapy (CBT), which is
assumed to influence the more deliberate processes. However, recent dual process models
emphasize the importance to differentiate between more deliberate, rule based (i.e. explicit) and
more automatically, unconscious processes. These automatic food-associations are assumed to
be simple links between food and associated concepts in memory, which can be activated
directly in response to relevant stimuli. For instance, one can direct their attention towards or
away from a food cue, which is called an attentional bias. Furthermore, food-relevant stimuli can
directly activate approach or avoidance-related associations via the spreading of activation from
one concept to associated concepts. This is called an approach bias. Current dual system
models, propose that automatic and controlled processes independently and jointly influence
behavior (e.g., Strack & Deutsch, 2004). The successful restriction of food intake in AN patients,
even under conditions that typically impair self-control (e.g., time pressure, cognitive depletion,
stress), may thus be explained by assuming that automatic responses toward food are less
favorable among restricting AN patients than among normal eaters. Therefore the question is
raised, whether it would be helpful to add a therapy that taps more directly on the more
automatic processes. This relatively new type of intervention has been called Cognitive Bias
Modification (CBM). In the context of addiction, a study on reducing approach bias has already
shown that this training is effective in reducing drinking behavior. As a first step to answer the
question whether CBM would also be a promising new add-on treatment for eating disorders, it
would be critical to know whether an attentional bias and approach bias are critically involved in
the persistence of AN. Therefore we subjected 100 AN patients to a Affective Simon Task (to
test approach/avoidance bias) and a Exogenous Cuing Task (to test attentional bias) during
baseline. To test whether these biases are related to treatment outcome and/or can predict
treatment success patients where tested again after 1 year follow up. On the basis of the results
clinical relevance of CBM in the context of AN will be discussed.
Executive function training with game elements in an inpatient setting for obese children:
A randomized controlled trial.
Introduction For the severe obese children behavioural treatment results in only small changes
in relative weight and frequent relapse. The current study investigated the possible role of an
Executive Functioning (EF) training with game-elements on weight loss maintenance in obese
children, over and above the care as usual. Methods Forty four children (aged 8-14 years) in the
final months of a one year inpatient treatment program in a medical paediatric centre were
randomized to either the EF training condition or to a care-as-usual control group. The EF
training consisted of a 25-session training of inhibition and working memory. Treatment
outcomes are child performances on EF-tasks and childcare worker ratings on EF symptoms as
well as weight loss maintenance after leaving the clinic. Results The children in the training
condition showed significantly more improvement than the children in the care as usual group
on EF-tasks and on the childcare worker reports, and were more capable to maintain their
weight loss until 8 weeks post-training. Conclusions This study shows promising evidence for
the efficacy of an EF training as weight stabilization intervention in obese children.
Usefulness of a Videogame designed to train emotional regulation in Bulimia Nervosa
and Binge Eating Disorders: PLAYMANCER a Multicenter EU-Project.
Objectives: Based on the current difficulty to treat specific areas (e.g. some personality traits,
attitudinal and emotional aspects, and uncontrolled behaviors), in Eating Disorders (ED), the
purpose of this study was to test the effectiveness of using a specifically designed videogame

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(VG, Playmancer) to train emotional regulation (Fernandez-Aranda et al., 2012). Within this
serious game, several components are interacting and influencing subjects performance, such
as physiological reactivity and emotional expression (speech and face)(Claes et al., 2012;
Kostoulas et al., 2012). Method: 16 ED patients were treated with a combination of CBT+VG
and 18 ED patients without (CBT-VG) and were compared in this study. All the subjects were
females and were diagnosed according to the DSM-IV criteria. Assessment measures included
the STAXI, STAI, EDI2 and SCL90R, as well as a number of other clinical and
psychopathological indices, before and after the therapy program. The CBT approach consisted
of 16 weekly outpatient sessions, whereas VG was composed of 10 parallel sessions using
Playmancer. Results: In both groups, significant decrease was observed between pre-post
values on binge-vomiting weekly frequency (p<.001). In the CBT+VG group, a higher reduction
in Anxiety (p<.05), Somatization (p<.05), trait Anxiety (p<.03) and Emotions control (p<.007)
than in the CBT-VG was observed. Conclusions: Cognitive-behavioral therapy combined with an
emotional regulation VG task (CBT+VG), seems to help patients reduce impulsivity, even more
than just using CBT. Short demonstration of video-recorded session and feedback of patients
after using VG strategies and its pro-cons will be discussed.
Normalization of Eating Patterns in Eating Disorders and Obesity using virtual reality
techniques
Introduction. Virtual Reality (VR) is a computer tool that allows the patient to experience a virtual
but clinically significant situation applicable to his/her disorder within a safe environment and
under the supervision of a therapist. This tool, considered a step prior to the real or in vivo
exposure, can be customized and adapted to the needs of each patient. In addition, virtual
environments are less likely than other treatments, such as exposure therapy, to affect or cause
patients to reject their doctors orders, as has been noted in the use of VR for patients suffering
from anxiety disorders. The aim of the present presentation was to analyze the usefulness and
effectiveness of a virtual environment as a complementary tool to cognitive-behavioral treatment
in normalizing the food intake of patients with eating disorders and obese patients with
disordered eating. Method. First, data (obtained from ED patients and healthy controls) about
the clinical validation of a VR Environment (VRE) designed to elicit emotions in contexts related
to food/eating and to normalize eating patterns are shown. In a second stage, previous pilot
studies with obese and binge eating disorder patients, and two case reports with patients with
AN, focus in the use of VRE in the treatment of the stabilization of their intake and weight were
commented. Results. Virtual experiences were evaluated as very real and positive by patients.
The VR component helped ED patients reduce fear and avoidant behaviors, and all patients
developed healthier eating patterns. Discussion and conclusion. The level of satisfaction and
degree of usefulness of the VR component as part of the treatment were rated highly.
Differences among diagnosis and the need to explore new therapeutic strategies in order to
increase adherence and motivation in these kinds of patients and disorders are discussed.
Temporal Attentional Bias for Visual Food Stimuli in Restrained Eaters
Renate Neimeijer, Peter de Jong.
University of Groningen, Groningen, Netherlands.
Objectives: Although restrained eaters intend to limit their caloric intake, they often indulge in
exactly the foods they want to avoid. It has been proposed that they are more attentive to food
than healthy individuals. Selective attention for food could be related to an approach-related
motivational state and elicit craving, which may subsequently be responsible for maintenance of
a dysfunctional eating pattern. Relevant stimuli may not only be readily detected, but may also
remain longer in the centre of attention, or may more easily enter working memory. Both types
may enhance the processing of food cues, thereby lowering the threshold for craving and

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subsequent overeating. The present study examined temporal attentional bias in unsuccessful
dieting. Methods: 3 different types of Rapid Serial Visual Presentation Task (RSVP) were
administered in 80 female psychology students who varied in their motivation to restrain from
food. The RSVPs consisted of series of picture streams (118 msec/item) that contained 1 or 2
target pictures. Participants had to identify the content of the target. Temporal AB was indexed
by the pattern of missed targets. There were 2 types of dual target RSVPs. In the first version
T1 was neutral whereas T2 was food or neutral, allowing to test whether food would diminish
the attentional blink and whether there was an interference effect of identifying food targets on
the identification of preceding neutral targets. To test whether identification of food would
enhance the attentional blink, in the second type the T1 was food or neutral, whereas the T2
was always neutral.Finally, a single neutral target RSVP with food or a negative picture as
distracter was used to test whether specifically for restrained eaters food would automatically
attract attention thereby hampering subsequent target detection. Results: Results indicated that
1) food cues did not diminish the attentional blink in restrained eaters when presented as
second target; 2) specifically restrained eaters showed an interference effect of identifying food
targets on the identification of preceding neutral targets; 3) for both restrained and unrestrained
eaters, food cues enhanced the attentional blink 4) specifically in restrained eaters, food
distracters elicited an attention blink in the single target trials. Conclusion: In restrained eaters,
food cues get prioritized access to limited cognitive resources, even if this processing priority
interferes with their current goals. This temporal attentional bias for food stimuli might help
explain why high restrained eaters typically have difficulties in maintaining their diet rules.
Adaptation and Validation of the Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS):
Self-Report Version in a Spanish ED Patients Sample
Conxa Perpi, Martha Giraldo-OMeara, Mara Roncero.
University of Valencia, Valencia, Spain.
Introduction. The relationship of Eating Disorders (ED) with other clinical syndromes has been
investigated for a long time, particularly with mood and anxiety disorders including obsessivecompulsive disorder (OCD). Some characteristics as rigid thoughts about thinness, concerns
and ruminations about food and body shape, repetitive behaviors such as excessive exercise,
counting calories, and food avoidance are similar to the intrusions and rituals in OCD. One of
the instruments used to measure the presence and severity of these symptoms in the ED is the
Yale-Brown-Cornell Eating Disorders (YBC-EDS), adapted from the Yale-Brown ObsessiveCompulsive Scale (Y-BOCS ), which is a semi-structured interview administered by the clinician,
which evaluates the main rituals and concerns related to ED. Aim. To adapt and validate the
Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) (Mazure et al., 1994) transformed into a
self-report in a Spanish sample. Method. The sample consisted of 83 patients who met DSM-IV
criteria for an ED recruited from the mental health service at the Dr Peset Hospital of Valencia,
Spain (Anorexia Nervosa Restricting Type:13; Anorexia Nervosa Purging Type:11; Bulimia
Nervosa Purging Type:20; Bulimia Nervosa non Purging type :6; Eating Disorder Not Otherwise
Specified:21; and Binge Eating Disorder:12). The mean age was 25.94 years (96.4% women),
and mean BMI 22.17 (SD = 6.2, range 13.18 - 42.52). The 8 YBC-EDS core items regarding
preoccupations (4 items) and regarding rituals (4 items) were presented as self-report rating in a
likert scale of 5 points and adapted to Spanish (forward and backward translation). Patients
fulfilled The Clark-Beck Obsessive-Compulsive Inventory (C-BOCI), the Eating Attitudes Test
(EAT), the Penn State Worry Questionnaire (PSWQ), and the YBC-EDS Self-report version (retest 2 weeks later). Results. Principal components analysis with orthogonal rotation Varimax
showed two factors corresponding to the subscales of Preoccupations and Rituals that together
accounted for 73% of the explained variance. However, the Rituals control item, had a

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significant loading in the Preoccupations subscale (0.515), which also happens to the
Preoccupations time item that also saturated in the Rituals subscale (0.545). This study
revealed excellent internal consistency (Cronbach's alpha Total score 0.90;
Preoccupations:0.86; rituals =.86) and test-retest reliability (range from 0.80 to 0.90, p <0.001).
The Total Score has very strong convergent validity with the instruments studied, especially the
C-BOCI and EAT (C-BOCI: r:0.61 to 0.77; PSWQ: r:0.43; EAT: r:0.68). Conclusions and
discussion. Findings suggest that The YBC-EDS self-report is a reliable and valid instrument to
identify the symptoms and assess the severity of eating disorders, and can be used as a faster
and less costly alternative to the YBC-EDS interview. The results above are similar to those
obtained for Bellace and colleagues (2012) with the recently developed YBC EDS self-report
version. Limitations with the factor structure were found and will be subject of further analysis in
future studies. Supported in part by MINECO(PSI2009-10957).
Addressing Pathological Doubt in Cognitive Inference-Based Therapy for Bulimia
Nervosa: A Clinical Case Study
Magali Purcell Lalonde1, 2, Marie-Eve Delorme1, 3, Kieron O'Connor1, 2.
1. Centre de Recherche Fernand-Seguin, Montral, QC, Canada, 2. Universit de Montral,
Montreal, QC, Canada, 3. Universit du Qubec Montral, Montreal, QC, Canada.
Introduction Eating Disorders (EDs), namely anorexia nervosa (AN) and bulimia nervosa (BN),
are life-threatening mental illnesses characterized by an obsession with food and weight. AN
and BN are the main EDs that have been associated with obsessive-compulsive disorder
(OCD). A recognized overlap between EDs and OCD exist in phenomenology, epidemiology,
comorbidity, and psychological characteristics related to the disorder. Distinguishing reasonable
doubt from pathological doubt is a key component in the treatment of obsessive-compulsive
disorder (OCD). In treating OCD, solving obsessional doubt facilitates the subsequent
diminishing of anxiety and other feared consequences. Given these marked similarities, a
cognitive inference-based therapy (IBT) program shown to be effective in treating OCD was
adapted to treat EDs by tailoring therapy around doubts specific to EDs and addressing issues
of self doubt and reasoning about the self. Objectives The present case study describes the
application of the cognitive IBT program to the treatment of a 24-year-old woman diagnosed
with BN. Results During a 24-week treatment period, her obsessive thoughts and compulsive
behaviors significantly decreased. Specifically, scores on the Eating Disorder Inventory-2, the
Eating Disorder Examination, the Yale-Brown-Cornell Eating Disorder Scale and the Overvalued
Ideas Scale became subclinical at the 6-months follow-up. Discussion Within the IBT conception
of obsessions as inferences of doubt, BN possesses clear obsessional-compulsive
characteristics where doubt is also the source of distress. Conclusion The single case study
suggests that IBT can be effective in treating BN and in decreasing particularly strong
overvalued ideas by addressing doubt and focusing on self cognitions and reasoning about self
in therapy.
Obesidad Bajo la Perspective Cognitivo Conductual RGR
Raquel del Socorro Riebeling, Ana Lilia Muoz Corona.
Carrera de Psicologa, Universidad Nacional Autnoma de Mxico Faculta de Estudios
Superiores Zaragoza, Mxico, D.F., Mexico.
Abstract Central: Uno de los grandes problemas de Salud a nivel mundial es la Obesidad, en
Mxico el primero en infantes y segundo en adultos. Representa altos costos individuales y
sociales. Las estrategias en prevencin y atencin se han centrado en el tratamiento

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multidisciplinario (NOM, 2010). La perspectiva cognitivo conductual desarrolla las siguientes


actividades: Diagnstico diferencial: donde se determina si la obesidad o el exceso de peso es
el mayor problema que el paciente presenta con el fin de verificar que el tratamiento sea el
adecuado. Diagnstico de la obesidad: este se lleva a cabo en estndares, que dividen a la
obesidad en las siguientes categoras: ligera, moderada y severa. Diagnstico funcional: se
realiza a travs de la evaluacin multimodal ERIC-PSIC. Intervencin y evaluacin continua: se
realiza durante el transcurso del tratamiento para verificar si los objetivos del programa se han
cumplido. Las reas psicolgicas son: clnica: El paciente utiliza el sntoma como signos
clnicos-biolgicos; educativa: por los hbitos alimentarios que pasan de una generacin a otra.
Y social: la obesidad se convierte en un problema individual-social y cultural por los
estereotipos culturales y sociales que llevan al individuo a rechazar su propia imagen corporal y
su apariencia fsica; porque no se ajusta a los cnones y estticas dominantes. Los objetivos
teraputicos son; Especificar el problema de cada paciente; Determinar los elementos a
modificar; planteando claramente los objetivos; Aplicar una serie de tcnicas de intervencin;
Evaluacin contina; Realizar un seguimiento para verificar los logros y mantenerlos. Los
lineamientos son: Modificacin de la conducta alimentara; Reforzamiento de conductas
adecuadas al comer; Reestructuracin cognitiva; Desarrollo de sistemas de apoyo; Programa
de ejercicio de actividad fsica. Y Programa de orientacin alimentaria. El presente trabajo
muestra el perfil de mujeres y hombres obesos (10 de cada sexo, 20 sujetos en total), bajo el
modelo cognitivo conductual, sus modalidades ERIC-PSIC, y emociones de culpa y vergenza
relacionados con la condicin de peso: sobrepeso y obesidad, personas obesas asistentes al
programa, con participacin voluntaria y habitantes de la zona oriente de la zona metropolitana
de la Ciudad de Mxico.
A Randomized Controlled Trial Examining the Efficacy of a Cognitive Behavioural
Treatment for Relapse Prevention in Eating Disorders
Sarah Royal1, 2, Traci McFarlane2, 1, Rachel Strimas1, Danielle MacDonald1, 2, Michelle Dionne1,
Marion Olmsted2.
1. Ryerson University, Department of Psychology, Toronto, ON, Canada, 2. Eating Disorder
Program, Toronto General Hospital, Toronto, ON, Canada.
Abstract Central: Weight-Related Self-Esteem (WRSE) refers to the strong association of
weight and/or shape to self-evaluation. WRSE is described as the core psychopathology of
eating disorders (Fairburn, Cooper, & Shafran, 2003) and higher levels following intensive
treatment have been associated with greater relapse risk (McFarlane, Olmsted, & Trottier,
2008). Given that relapse is a significant problem for patients with eating disorders, researchers
have suggested that WRSE be directly targeted (McFarlane et al., 2008). A cognitivebehavioural therapy (CBT) protocol focused on WRSE that was developed through the Toronto
General Hospital Eating Disorder Program has shown promise in a pilot study using 12
participants (Royal et al., 2010). The 10-week CBT protocol is individual-based and focuses on
maintaining symptom control, mindfulness, behavioural goals, core belief work, and other
strategies to decrease WRSE. The purpose of the current study is to examine the efficacy of the
CBT protocol for relapse prevention in eating disorders using a randomized controlled trial.
Forty seven patients diagnosed with primary eating disorders who achieved behavioural
symptom control through intensive outpatient treatment were recruited for the current study.
Participants completed questionnaires assessing WRSE and relevant constructs, such as body
checking, body avoidance, general avoidance, mindfulness, rumination, fat talk, and general
self-esteem. They were then randomly assigned to either the experimental condition (10 weeks
of the CBT protocol and treatment as usual [TAU]) or the control condition (TAU). Following
treatment completion (or 10 weeks for control), participants completed the same questionnaire

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package and a diagnostic interview (Eating Disorder Examination). Recruitment for the study is
complete and final data will be collected by January 2013. It is hypothesized that participants in
the experimental condition will report significantly greater decreases in WRSE, body checking,
body avoidance, general avoidance, rumination, and fat talk compared to participants in the
control condition. Furthermore, it is predicted that participants who received the additional
treatment will report higher levels of mindfulness and self-esteem compared to participants in
the control condition. Preliminary longitudinal data on relapse will also be reported. It is
predicted that participants in the experimental condition will be less likely to have relapsed at six
months post-treatment compared to those in the control condition. Results from a pilot study
found that our CBT protocol focused on WRSE led to significant decreases in relevant
psychological variables. The next step in the research process is to examine the impact of the
addition of our CBT protocol to TAU. The current study examines this step using a randomized
controlled trial. This study will extend our understanding of the efficacy of the CBT protocol
compared to a control group using a larger sample and preliminary follow-up data on relapse
prevention. These data would provide further support for the implementation of a relapsefocused CBT intervention in treatment programs to decrease the psychological burden and
public health costs related to eating disorders.
Aplicacin del Modelo Cognitivo Conductual en el Tratamiento de Obesidad en Nios
Mexicanos
Reyna Santilln1, Dulce Serrano1, Gustavo Zazueta2, 1, Elizabeth Pea Fernndez2.
1. Instituto Tecnolgico de Sonora, Cd. Obregn, Mexico, 2. Psicologa, Universidad Nacional
Autnoma de Mxico, Mxico, D.F., Mexico.
Abstract Central: La obesidad es un problema multifactorial que se caracteriza por un
aumento del peso corporal debido a una acumulacin excesiva de grasa. La obesidad infantil
deteriora la salud pues se relaciona con enfermedades crnico degenerativas en la adultez.
(Guzmn & Madrigal, 2003) Los factores que intervienen en la obesidad son: genticos,
ambientales y psicolgicos. Se ha identificado que los pensamientos disfuncionales guan la
conducta alimentaria compulsiva con la finalidad de contrarrestar las emociones desagradables
(Faith, 1999; Burrows, 2000). En Mxico, se report en la Encuesta Nacional de Salud y
Nutricin 2012, una prevalencia de sobrepeso y obesidad de 34.4% en nios de 5 a 11 aos.
En adultos la prevalencia fue de 69.4% en hombres y 73% en mujeres. En cuanto a las
enfermedades asociadas con obesidad, hubo una prevalencia de 22.4 millones con
hipertensin y 6.4 millones con diabetes. Con la finalidad de prevenir la presencia de
enfermedades crnico degenerativas en la adultez, se sugiere realizar cambios en la conducta
alimentaria en la infancia. Mtodo Participantes Participaron 3 nios con obesidad, entre 9 y 12
aos de edad. Instrumentos Inventario de autoestima de Coopersmith para nios mexicanos,
Cuestionario de Depresin para nios, Cuestionario de autoevaluacin STAIC, Cuestionario
biogrfico, Cuestionario de sobrepeso y Anlisis funcional, autorregistros de comida, bebida,
ejercicio, cadena cognitivo-conductual y peso. Procedimiento Se identificaron nios con
obesidad en una institucin educativa. Los padres que decidieron participar, firmaron un
consentimiento informado. A los padres de los participantes se les imparti un programa de
promocin de la salud y alimentacin saludable previo a la intervencin con los nios. El
programa dur 2 sesiones de 2 horas cada una. El programa de reduccin de peso en nios,
fue de 3 fases: Evaluacin inicial, Tratamiento y Evaluacin final. El nmero de sesiones oscil
entre 25 y 31. Durante las sesiones con los nios se trabajaron las siguientes tcnicas cognitivo
conductuales: entrenamiento en relajacin, identificacin de pensamientos y emociones,
identificacin y modificacin de pensamientos disfuncionales, identificar la diferencia entre
creencias y hechos, bsqueda de evidencia, modificacin cognitiva mediante cambios en la

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conducta. Finalmente se registr semanalmente el peso y la talla de los nios. Resultados Se


observ una disminucin de peso del 6 al 23 por ciento en todos los participantes. Se identific
un estilo de alimentacin saludable (hbitos de lugar, eleccin de alimentos, tamao de
porciones y preparacin de los alimentos). Se increment la actividad fsica y autoestima y
disminuyeron los niveles de ansiedad y depresin. Con la aplicacin del modelo cognitivoconductual en el tratamiento de la obesidad infantil, se consigui modificar los pensamientos
irracionales asociados a la conducta de sobre-ingesta. Una de las tcnicas con la que se
trabaj constantemente a la par de las tcnicas cognitivas fue modificar pensamientos
disfuncionales por medio de cambios en la conducta. Como se mencion en la introduccin, la
obesidad es un problema multifactorial en el que los aspectos genticos, psicolgicos y
sociales intervienen en la aparicin y desarrollo de la misma.
Trastornos del Comportamiento Alimentario en Varones: Mitos y Errores de Diagnstico
y Evaluacin
Ana Rosa Seplveda, Melissa Parks, Dimitra Anastasiadou, Pilar Garcia, Miriam Blanco, Carla
Bustos, Carmen Garcia-Rosado.
Psicologa Biolgica y de la Salud, Universidad Autnoma de Madrid, Madrid, Spain.
Abstract Central: El objetivo general es revisar los aspectos de los trastornos alimentarios en
los adolescentes y adultos jvenes varones, que dificultan un cribaje en estudios en poblacin
general y un diagnstico fiable. Los estudios muestran que la prctica deportiva en personas
insatisfechas con su imagen corporal se caracteriza por realizar ejercicio fsico de manera
obsesiva, en detrimento de la vida social, laboral y de sus relaciones sociales, donde la
valoracin excesiva y persistente de esta imagen corporal funciona como un regulador de la
propia estima de las personas (Barlow y Durand, 2006; Toro, 1996). Se trata de valorar
aspectos comunes y diferenciadores del trastorno segn gnero, dificultades y mitos a la hora
de diagnosticar y entender este trastorno en los varones, con el fin de valorar reas de
investigacin e intervencin. Se va a presentar dos instrumentos que recogen las
preocupaciones masculinas y que han sido validados en una muestra espaola adolescentes
de 212 varones de 12 a 17 aos, la Escala de Obsesin por la Musculacin (DSM) y la Escala
de Actitudes Masculinas hacia el Cuerpo (MBAS), presentando sus propiedades psicomtricas
a travs del anlisis factorial confirmatorio. Se espera que los resultados sean tiles como
herramientas de evaluacin fiable y se orientarn intervenciones preventivas adaptadas a las
necesidades de los varones.
Can we improve communication between families and patients with eating disorders:
Advances in family intervention in Eating Disorders
Ana Rosa Seplveda2, Elena Gutierrez1, Cristina Medina-Pradas2, Ana Rosa Seplveda2.
1. Psiquiatria, CSM Usera. Hosptal 12 de Octubre, Madrid, Spain, 2. Psicologa Biolgica y de
la Salud, Universidad Autnoma de Madrid, Madrid, Spain.
Expressed Emotion (EE) directed toward patients with eating disorders, is a predictor of relapse.
However, little is taken into account that the attitudes of the EE cycles are associated with
bidirectional and mutually influential interaction between patients and their families. Therefore, it
is considered essential redirect the EE processing to and from a dyadic view, both in research
and in intervention. Psychoeducational program and coping skills program as a family
intervention in eating disorders represents a challenge in advancing an integrated treatment to
patients. We will present two structured interventions (psychoeducational program versus
Communication skills Mausdley model) aimed at improving the knowledge and beliefs of

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families on eating disorders and to reduce the negative impact of caregiving. Describe
preliminary data on the feasibility and acceptance about how each program work among
Spanish families. 1. Speaker 1: Towards a dyadic view of Expressed Emotion: Communication
cycles 2. Speaker 2: Presentation of a structured psychoeducational family intervention and
their feasibility and acceptance 3. Speaker 3: Presentation of a family intervention based in
communication skills and the results of the comparison of both models
Caloric Restriction Reduces Binge Eating: A Systematic Review
Evelyn Smith.
University of New South Wales, LEICHHARDT, NSW, Australia.
Abstract Central: Objective: Dieting, the restriction of caloric intake with the aim of losing
weight, has been proposed to play a causal role in the onset and maintenance of binge eating.
This article aims to review the studies which promote caloric restriction and also measure binge
eating. Method: A systematic review was conducted and included dieting interventions, whether
successful or unsuccessful, supported or unsupported, which also measured binge eating.
Results: Twenty-six dieting interventions produced either no significant effect or significant
reductions in binge eating in normal weight, overweight and obese individuals, in participants
with binge eating disorder and in one sample with bulimia nervosa. This reduction in binge
eating was maintained at follow up in many of these studies. Discussion: Caloric restriction was
found to be safe, and even when dieting was unsuccessful a significant increase in binge eating
was not demonstrated. Implications of the findings on eating disorder theories are discussed.
Family Relations & Domestic Violence/ Relaciones Familiares y Violencia Domstica/
Relaes Familiares e Violncia Domstica
Papel das Mes na Comunidade do Bairro da Esperana em Santarm-PA, Brasil
Izaura A. cardoso, Lucivania Souza.
IESPES, Santarm, Brazil.
Abstract Central: O Projeto Interdisciplinar do curso de Psicologia do Instituto Esperana de
Ensino Superior realizado no Bairro da Esperana no decorrer de cada semestre, mudando o
eixo temtico de seis em seis meses, tendo como proposta a integrao dos acadmicos com a
comunidade visando conhecer a realidade do local e propor sugestes de solues e
desenvolvimento social para a comunidade. um trabalho que faz parte do Projeto Pedaggico
da Instituio e tem dois objetivos: a prtica da responsabilidade social e o aprendizado do
acadmico, e tambm a oportunidade de vivenciar na prtica os contedos ministrados na
Academia. Teremos como pblico alvo as mes, que residem no bairro Esperana. As aes
desenvolvidas so de discusso sobre a higiene pessoal, DSTs (Doenas Sexualmente
Transmissveis), ,otivao e liderana, violncia contra mulher, construo de identidade de
gnero, alm de outros temas que se baseiam com o eixo temtico colocado. Estas temticas
so trabalhadas atravs de rodas de conversa, palestras, vdeos, oficinas de beleza e arte,
comemorao do dia da mulher, das mes, et. O objetivo geral destas atividades
desenvolvidas o de servir como benefcio para o aprendizado das mes sobre o seu papel
naquela comunidade. os objetivos especficos o de trazer um olhar amplo para as mes
referentes sade das mesmas, contribuir com o aprendizado na relao pessoal e
interpessoal proporcionando novos conhecimentos, mostrando um pouco da atuao especfica
do profissional psiclogo na comunidade. Estamos h trs anos trabalhamos com as mes do
bairro da esperana e visvel a evoluo do clube de mes do bairro da esperana, criado por

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elas, juntamente com uma lojinha que j existia quando comeamos nosso trabalho, elas
confeccionam pelcias e artesanatos, e depois de nossas palestras voltadas para o
empreendedorismo percebemos um aumento da produo e na variedade dos produtos que
elas fazem, muito gratificante ver o quanto elas participam das nossas reunies interagindo
com a gente e valorizando o nosso trabalho, em meio esses resultados refletimos sobre um
futuro bem melhor na comunidade diante a sociedade.
Psicologia na Comunidade: Uma Ao Necessria. Comunidade do Amap, Santarm,
Par- Brasil
Amasa Carvalho, Lucivnia Incia de Souza, Izaura A. cardoso, Maria Emilia de Assis, Cileuma
Mara Linhares.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Atualmente a Psicologia Social Comunitria utiliza-se do enquadre terico
da psicologia social, privilegiando o trabalho com grupos, colaborando para a formao da
conscincia crtica e para a construo de uma identidade social e individual orientadas por
preceitos eticamente humanos. O presente trabalho teve como pblico alvo 30 moradores da
comunidade de Amap em Santarm - Pa-Brasil, com o intuito de trabalhar nessa comunidade
de maneira que possibilitasse uma relao interpessoal mais proveitosa entre os moradores da
Comunidade, bem como promover aos comunitrios momentos de reflexo para que houvesse
coeso nas relaes, exercitando a criatividade para que se desenvolvesse a motivao do
trabalho cooperativo de benefcios e interesses de todos, oportunizando um exerccio de
aceitao de forma prtica e objetiva das opinies dos membros a cerca dos eventos
realizados dentro da comunidade. Atravs de instrumentos utilizados para interveno, e
tambm construdos no desenvolvimento do trabalho, foram utilizadas entrevistas, conversas,
visitas s casas da populao e palestras. Ao realizar uma pesquisa de campo na Comunidade
do Amap nos deparamos com uma sociedade que precisa ser orientada e sensibilizada em
relao busca de solues e melhorias comunitrias de acordo com o desejo dos moradores,
para que atravs dessa possam empreender as mudanas necessrias em benefcio mtuo. O
trabalho do psiclogo de facilitador nesse processo para que ocorra o entendimento de forma
satisfatria.
Psicoterapia de Autocontrol de Sntomas Depresivos en Mujeres Sobrevivientes de
Violencia Domestica
Erick Acevedo.
Centro Guerrerense de Terapia Cognitivo Conductual S.C., Iguala, Guerrero, Mexico.
Abstract Central: El llamado monstruo del milenio,la depresin, est presente en diversos
conflictos de la vida cotidiana sabemos que nadie est exento de vivir en carne propia
experiencias que hieren a nivel psicolgico y emocional, sin embargo no todos presentamos las
caractersticas de una depresin clnica, de acuerdo a lo que nos dicen los manuales
establecidos. Por las diferencias que caracterizan a los seres humanos nicos e irrepetibles, en
relacin a algunas teoras, las personas damos un significado a nuestras experiencias
cotidianas por mltiples factores. Se han dado diversas definiciones acerca de la depresin sin
embargo desde un enfoque clnico cientfico la depresin debe cumplir con algunos
lineamientos para poder diagnosticarse. En la presente investigacin se abord la presencia de
sntomas depresivos en mujeres que han sufrido el delito de violencia familiar as como el
procedimiento utilizado para modificarlos. La intencin principal fue conocer los resultados
encontrados en aquellas personas que son atendidas en psicoterapia grupal as como en

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psicoterapia individual. La Terapia de Autocontrol practicada tuvo como objetivo el que las
participantes pudieran dirigir su propia conducta por medio de habilidades que se les fueron
enseando con el paso de las sesiones por medio de un proceso psicoeducativo y colaborativo.
Un aspecto muy interesante en el que la investigacin fue til, es en que se analiz
detalladamente el grupo cultural con el que se trabaj, considerando que es realmente escasa
la investigacin sobre este tema en Guerrero, Mxico, estado donde se ha llevado a cabo la
investigacin. As tambin, esta investigacin ha apoyado diferentes teoras que han surgido de
investigaciones ms amplias relacionadas con la Depresin, la Violencia Domestica y la
Terapia de Autocontrol antes mencionada y que ha sido investigada ampliamente.
Psicologia na Comunidade: Uma Ao Necessria. Comunidade do Amap, Santarm,
Par- Brasil
Amasa Carvalho, Lucivnia Incia de Souza, Izaura A. cardoso, Maria Emilia de Assis, Cileuma
Mara Linhares.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Atualmente a Psicologia Social Comunitria utiliza-se do enquadre terico
da psicologia social, privilegiando o trabalho com grupos, colaborando para a formao da
conscincia crtica e para a construo de uma identidade social e individual orientadas por
preceitos eticamente humanos. O presente trabalho teve como pblico alvo 30 moradores da
comunidade de Amap em Santarm - Pa-Brasil, com o intuito de trabalhar nessa comunidade
de maneira que possibilitasse uma relao interpessoal mais proveitosa entre os moradores da
Comunidade, bem como promover aos comunitrios momentos de reflexo para que houvesse
coeso nas relaes, exercitando a criatividade para que se desenvolvesse a motivao do
trabalho cooperativo de benefcios e interesses de todos, oportunizando um exerccio de
aceitao de forma prtica e objetiva das opinies dos membros a cerca dos eventos
realizados dentro da comunidade. Atravs de instrumentos utilizados para interveno, e
tambm construdos no desenvolvimento do trabalho, foram utilizadas entrevistas, conversas,
visitas s casas da populao e palestras. Ao realizar uma pesquisa de campo na Comunidade
do Amap nos deparamos com uma sociedade que precisa ser orientada e sensibilizada em
relao busca de solues e melhorias comunitrias de acordo com o desejo dos moradores,
para que atravs dessa possam empreender as mudanas necessrias em benefcio mtuo. O
trabalho do psiclogo de facilitador nesse processo para que ocorra o entendimento de forma
satisfatria.
Desafios de Aplicao e Manejo de um Grupo de Orientao de Pais em Contexto de
Promoo de Sade: Um Relato de Experincia
Marcella Cassiano, Thalita Martins, Carmem Neufeld.
Universidade de So Paulo, Ribeiro Preto, Brazil.
A Orientao de Pais (OP) uma modalidade de interveno voltada especificamente para
pais de crianas e adolescentes. Envolve programas estruturados voltados para mudanas de
padres familiares e desenvolvimento de novas prticas educativas. Por ser considerada o
primeiro e mais importante contexto social da criana, a famlia, e, mais especificamente, os
pais servem como figuras de referncias especiais, influenciando a aquisio e manuteno do
repertrio cognitivo e comportamental da criana, a adaptao social infantil, a qualidade da
interao social e a sade mental dos filhos. Apesar da importncia do papel dos pais,
comum que recebam pouco preparo para educar, alm de sua prpria experincia.
Intervenes em OP realizadas em grupo possibilitam um maior acesso, reduzindo custos e

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corroborando com a poltica de preveno e promoo de sade. A OP desenvolvida no


enfoque de promoo de sade visa a preveno de psicopatologias na infncia, um
desenvolvimento infantil mais saudvel e melhores relaes familiares. O objetivo deste estudo
apresentar a aplicao e desafios de adaptao e manejo de um Programa de OP CognitivoComportamental em contexto de promoo de sade com pais de crianas de 7 a 12 anos de
uma ONG de educao complementar. Durante 6 sesses, foram trabalhadas noes de
desenvolvimento infantil, leis do comportamento, comunicao eficaz, manejo de emoes,
modelo e distores cognitivas e resoluo de problemas. O grupo foi avaliado antes e ao final
da interveno com instrumentos mensuradores de qualidade de interao familiar, habilidades
sociais educativas parentais e comportamentos infantis. O grupo teve a participao de 5 pais e
contou com a coordenao de um terapeuta e um coterapeuta. O maior desafio consistiu na
formao do prprio grupo, uma vez que se mostrou muito difcil conseguir contato com os pais
e sensibiliz-los para a importncia do trabalho. Apenas um tero dos pais convidados
participou efetivamente do grupo, mesmo os demais tendo relatado interesse. Para garantir a
adeso, foram adotadas estratgias como ligaes semanais e bilhetes. No decorrer dos
encontros, alguns pais apresentaram dificuldades de implementar em casa as tcnicas
discutidas, uma vez que j traziam hbitos bastante incorporados e pouco flexveis. Alm disso,
sabe-se que para que ocorra uma mudana efetiva de comportamento e cognio necessrio
um tempo maior de trabalho e reflexo, o que pode ter sido um fator limitante para o grupo.
Todo o trabalho foi adaptado em termos de linguagem e prticas para melhor se adequar ao
cotidiano dos pais, que tinham filhos de diferentes faixas etrias. Apesar das diferentes crenas
e percepes dos pais sobre a melhor forma de educar os filhos, o grupo conseguiu abarc-las,
garantindo uma boa coeso e o comprometimento dos participantes. Clinicamente, as melhoras
observadas e relatadas pelos pais centravam-se em: aumento da percepo dos
comportamentos e sentimentos dos filhos; maior autocontrole, reflexo e cuidado nas
interaes com as crianas; aumento de comportamentos educativos positivos. Apesar da
pequena amostra, as evidncias indicam a importncia de se desenvolver mais estudos
semelhantes.
Clinical Case Study in Therapy by Contingences of Reinforcement: The Affection and
Attention on the Relationship between Mother and Daughter
Camila Comodo, Hlio Guilhardi.
Instituto de Terapia por Contingncias de Reforamento, Campinas, Brazil.
Abstract Central: A prtica clnica foi enriquecida pelas contribuies das Terapias
Comportamentais, que trouxeram novos conceitos e novos procedimentos que possibilitaram
uma melhor atuao do psiclogo clnico e propiciaram ganhos para os clientes. H vrias
verses de terapias comportamentais, e o presente estudo pretende apresentar as
contribuies de uma delas, a Terapia por Contingncias de Reforamento (TCR),
desenvolvida por Guilhardi (2004). A TCR radicalmente comprometida com os pressupostos,
conceitos e procedimentos da Anlise do Comportamento e do Behaviorismo Radical. A TCR
se preocupa em identificar, analisar e modificar as contingncias de reforamento das quais,
quaisquer comportamentos e sentimentos so funo. Estudos de casos clnicos conduzidos
dentro do modelo da TCR tm mostrado que ele eficaz no tratamento de mltiplos problemas
comportamentais O presente trabalho tem como objetivo apresentar um estudo de caso dentro
da perspectiva da Terapia por Contingncias de Reforamento (TCR). A cliente foi uma garota,
que no incio do estudo, tinha dez anos de idade e morava com a me. A me procurou terapia
para a menina relatando que a filha tinha cimes da relao dela com o namorado, sofria por
antecipar aversividade em eventos sociais que ainda no haviam acontecido e se queixava da
falta do pai, o qual morava em outra cidade. A menina relatava que passava muito tempo

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sozinha e que gostaria de morar com o pai. Todas as sesses (com a me e com a cliente)
foram gravadas e os dados apresentados foram extrados das transcries dos atendimentos
realizados: dificuldades comportamentais e reservas comportamentais de ambas e a histria de
contingncias que produziu os comportamentos atuais da cliente. Foram adotados
procedimentos teraputicos nas sesses, tais como modelagem, modelao, instruo verbal e
reforamento diferencial que consistiam em expor a cliente a novas contingencias de
reforamento ambientais, visando a alterar comportamentos, instalar classes comportamentais
mais funcionais, com potencial de aumentar consequncias reforadores positivas, e amenizar
consequncias aversivas. Foram programadas, alm de interaes verbais, variadas atividades
ldicas com o propsito de colher informaes e criar contextos para a introduo e
desenvolvimento dos procedimentos teraputicos. Os resultados foram: aumento de repertrio
comportamental evocado e mantido por outras pessoas alm da me; maior independncia
para emisso de comportamentos sob controle de eventos no sociais do ambiente cotidiano
da cliente; e diminuio de repertrio de fuga-esquiva indesejado substitudo por padres
comportamentais mais funcionais.
Strengthening Families: The Australian Experience of Family Resilience
Bianca Denny, Susana Gavidia-Payne, Andrew Francis, Kate Davis, Merv Jackson.
Psychology, RMIT University, Bundoora, VIC, Australia.
Abstract Central: Family resilience can be defined as the ability of a family to respond
positively to adversity, and is typified by emerging from a challenging event feeling strengthened
and more resourceful. Congruent with Walshs (2011) conceptualization of effective family
processes being indicative of family resilience, the present study explored the potential for
resilience among 200 Australian families impacted by risk factors associated with adversity,
including mental illness and low socio-economic status. Using the outcome measure of the
Family Assessment Device (FAD), we investigated the relationship between social
connectedness, perceived parenting competence, and child temperament and important family
processes that promote resilience, such as problem solving, communication, and affective
engagement. Results revealed important insights into the distinct processes of families at risk of
adversity, indicating that intervention at the level of day-to-day family interaction may provide a
protective mechanism for families facing hardship. Implications of these findings are discussed,
together with recommendations for strengthening family processes and promoting resilience
among high-risk families.
Incidence of the link to the first object of love in teen dating relationships
Ma de la luz Diaz Hurtado.
instituto de ciencias de la educacin, UAEM, Cuernavaca, Mexico.
M.P.C. Ma. De la luz Amalia Daz Hurtado Summary In this research, we identify if the first love
object (mother), affects dating relationships that are emotionally violent adolescents 15 to 18
years at a public high school. To which, in a sample of 216 participants from all three grades,
four instruments were applied to identify, understand and analyze the existence of emotional
violence. The bonding level current in the teen with her first love object is known, also the
existence of emotional violence that occurs in that link, family dynamics and we analyze the
impact of the link to the first object of love and level establishing emotional violence in
adolescent dating relationships. Through the results, we found a high rate, of the bond of
emotional violence by the first object of love with the adolescent existence of emotional violence
in dating relationships. This allows us to glimpse a questionable reality; the adolescent tends to

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reproduce the form of bond according to their childhood experiences, during development and
family environment where he lives, with his new love objects. (Relationships). Keywords: first
love object; Violence emotional Courtship; Adolescence. Introduction The place of the mother
and the maternal role, plays vital importance in the psychic constitution of a man, what is
transmitted to a defenseless being, it is actually the double of what she says to the child (a) on
what is and what is not, lies, denials, devaluation, the possessions of another, manipulations,
etc..; many expressions in the flow of this function. In dating relationships the adolescent
behaviors that are seen are the exercise of control, power, confidence, dependence, blackmail,
rejection, custom, self-pity, masochism, membership, jealousy, feelings, attitudes and emotions
contradictions etc. It is through his speech, where libido is seen placing on the other, the need
for recognition psychic, symbolic death for the life of another, the game of not belonging and the
endless quest for identity, generating psychic discomfort transformed into invisible violence both
to himself and hidden in the other. Conclusion It is important to emphasize that violence is
experienced as something that comes naturally from generation to generation within the family.
The teenager brings a story full of life experiences frustrating and rewarding, pleasant and
unpleasant, lived from identification and attachment with the mother figure, which does not want
to come off mentally, looking for someone to represent her or him and perform the maternal
role. The teen has to endure this violence with the mother because of the bond he has with her.
On one hand the first love object holds emotionally and otherwise is living with you more,
operating two ways to proceed in the dating relationship: Exercising the maternal function / the
boyfriend (a) and he / she subjected to the maternal role. At this stage the finding is paramount
object of love, the mystery of sexuality operates at its best, the eyes of others, finding who and
who hold psychically dump libido, emerging a state of ambivalence which unifies ideal ego and
the ego ideal and producing an encounter disagreement with him.
Incidencia del Vnculo con el Primer Objeto de Amor en las Relaciones de Noviazgo en
Adolescentes
Ma de la luz Diaz hurtado.
instituto de ciencias de la educacin, UAEM, Cuernavaca, Mexico.
INTRODUCCIN-JUSTIFICACIN Uno de los principales problemas que enfrentan los
adolescentes es vivir dentro de un ambiente familiar donde existe la violencia fsica y /o
emocional. En una investigacin sobre la violencia concluye Fernndez (2007) que Las
personas que sufren cotidianamente situaciones de violencia, es precisamente que la aceptan
como algo normal, se acostumbran, creen que se lo merecen, o la justifican como una forma de
educacin. La funcin materna es una puesta en escena donde la madre es el primer objeto
de amor, en esta esfera impera el deseo, la demanda, la necesidad, la fantasa, la completud,
el placer-displacer y el avatar de la relacin con la pareja. A partir de lo que la madre transmite
al hijo (a) inicia otra historia con su propia historia, se entrelazan sus demandas, su goce, su
femineidad y sus futuros vnculos. El adolescente se encuentra en una situacin ambivalente,
por un lado su yo ideal es la base para construir su ideal del yo y por otro lado la bsqueda de
identificacin con los roles, ya sea de la madre o padre o ambos y la suya propia. Por lo
anterior, considero que es menester y de suma importancia indagar sobre la dinmica familiar,
la relacin con las figuras parentales y principalmente la importancia del vinculo afectivo con el
primer objeto de amor. En un estudio en el Estado de Morelos I.N.S.P.(2006) Concluyen Que
las mujeres sufren violencia de pareja desde las relaciones de noviazgo Objetivo General
Identificar si el vnculo con el primer objeto de amor incide para que las relaciones de noviazgo
en el adolescente de 15 a 18 aos sean violentas emocionalmente, en una Preparatoria
Pblica. Objetivos Especficos a).- Conocer la relacin afectiva del adolescente con su primer
objeto de amor y la existencia de violencia emocional en su ambiente familiar. b).- Analizar la

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incidencia entre el vnculo con el primer objeto de amor y el nivel de violencia emocional que
establecen los adolescentes en las relaciones de noviazgo. MUESTRA En el estudio
participaron 216 adolescentes (hombres-mujeres) su edad flucta entre los 15 y 18 aos de
edad. Se aplicaron cuatro instrumentos. RESULTADOS Escala de Strauss. Presencia de
Violencia en el Noviazgo (216 Participantes) 164 participantes no se encontr violencia 41
participantes, se encontr violencia 11 participantes, omitieron respuesta Cuestionario I.N.S.P.
(216 Participantes) 153 participantes presentan afecto con la madre y 63 no 149 participantes
presentan violencia con la madre y 67 no 60 participantes presentan afecto con el novio(a) y
156 no 130 participantes presentan violencia con el novio(a) y 86 no Ficha Psicopedagogica
(149 Participantes) 69 participantes presentan afecto con la madre 122 participantes presentan
violencia con la madre 25 participantes, omitieron respuesta Cuestionario estructurado (149
participantes) 94 participantes presentan similitudes en cualidades novio(a)- madre 100
participantes presentan similitudes en defectos novio(a)- madre CONCLUSIONES Entre el
adolescente y el primer objeto de amor existe un vnculo afectivo significativo y se percibe la
presencia del ejercicio de violencia emocional por parte del primer objeto de amor hacia el
adolescente. Por lo tanto ste ltimo tiende a repetir la dinmica aprendida en sus nuevos
objetos de amor (noviazgo).
Conselho Tutelar e Psicologia - Relato de Experincia
Rosana Garcia.
1. UNIVERSIDADE PAULISTA - UNIP, So Jos do Rio Preto, Brazil, 2. Instituto de
Psicoterapia Cognitivo comportamental - IPC, So Jos do Rio Preto, Brazil.
Abstract Central: Com a promulgao do Estatuto da Criana e do Adolescente no Brasil (Lei
8069/90), os direitos das crianas e dos adolescentes passaram a ser defendidos em polticas
pblicas de defesa de direitos, colocadas em prtica e protegidas pelos Conselhos Municipais
dos Direitos da Criana e do Adolescente, bem como os Conselhos Tutelares. De acordo com
o ECA, (Brasil, 1990, art. 132) cada cidade deve ter pelo menos um Conselho Tutelar (CT), o
qual formado por cinco conselheiros eleitos pela populao. Os conselhos tutelares devem
funcionar de forma autnoma e tm como funo receber e acolher denncias de situaes
que violem as prescries do ECA, assim como orientar e encaminhar casos para os rgo
jurdicos competentes. A demanda de casos atendidos pelos Conselhos Tutelares de
crianas e adolescentes que tenham tido seus direitos violados ou em risco de serem violados
por outros ou pela sua prpria conduta. So eles: violncia fsica, psicolgica e sexual,
negligncia, evaso escolar e atos infracionais. Tendo em vista que grande parte desta
demanda inclui questes sociais e psicolgicas envolvidas, o trabalho do psiclogo
importante e permite ao conselheiro uma atuao mais pontual e direcionada a problemtica
observada, possibilitando um trabalho multiprofissional. O objetivo do presente trabalho
descrever o trabalho da Psicologia nos Conselhos Tutelares, demonstrando sua atuao,
encaminhamentos e orientaes. Durante as observaes realizadas foi grande o nmero de
pais que procuraram o conselho em busca de orientaes com relao aos filhos, geralmente
adolescentes que no queriam ir escola ou que fugiam de casa e passavam a usar drogas
demonstrando que os plantes psicojurdicos oferecem um espao de acolhimento e escuta do
sofrimento da comunidade, o que faz do Conselho Tutelar, uma instituio de proteo social.
Adoo - Relatos de Experincias dos Pretendetes Adoo
Rosana Garcia1, 2, Fernanda Costa1.
1. UNIVERSIDADE PAULISTA - UNIP, So Jos do Rio Preto, Brazil, 2. INSTITUTO DE
PSICOTERAPIA COGNITIVO-COMPORTAMENTAL - IPC, So Jos do Rio Preto, Brazil.

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Abstract Central: Sobre o tema adoo podemos observar que, apesar de ser pouco
divulgado, vem crescendo aos poucos a procura por pessoas ou casais interessados em
adotar. O presente trabalho fez um levantamento sobre os tipos de adoo e os procedimentos
habituais a serem seguidos pelos interessados em adotar. Este estudo foi realizado com o
propsito de conhecer relatos de experincias para compreender a viso destes futuros pais
diante das funes parentais. A coleta de dados ocorreu no curso preparatrio para inscritos no
cadastro de pretendentes adoo, realizado no Salo do Jri da Vara de Famlia em uma
cidade do Noroeste Paulista (Brasil), ministrado por Psiclogas e Assistentes Sociais. Houve a
participao de 24 pessoas, ou doze casais pretendentes, sendo dois casais homoafetivos. Ao
trmico das observaes pode-se concluir que ainda existem muitas dvidas em relao ao
tema adoo e a delimitao do papel parental, bem como dos procedimentos esperados para
a concluso efetiva da adoo, o que evidenciou a necessidade de um mais cursos e
orientaes para estas famlias em diversos momentos desta nova fase.
Experiencia de dos Grupos de Mujeres Vctimas de la Violencia Domstica
Claudia Giraldo, Janneth Molina, Jaime Moreno.
Universidad Catlica, Bogot, Colombia.
Abstract Central: El presente estudio tuvo como objetivo comprender las percepciones que
sobre la violencia domstica tienen un grupo de mujeres vctimas de la misma. Para tal fin se
llev a cabo una investigacin de tipo cualitativo bajo la tcnica de grupos focales. Los
participantes de la investigacin fueron 9 mujeres vctimas de la Violencia Domstica con
edades comprendidas entre los 25 y 60 aos atendidas en una ONG de la ciudad de Bogot.
Las categoras orientadoras para la interpretacin de la informacin fueron: Tipos de violencia
domstica, redes de apoyo, estrategias de afrontamiento y consecuencias. En los testimonios
se identifica; patrn de maltrato variado de tipo fsico, sexual, psicolgico y econmico, y de
diversa intensidad . Las mujeres han tenido que soportar puos, patadas, golpes, amenazas,
palabras soeces, humillaciones, violaciones. La carencia en redes de apoyo, se constituye en
factor de riesgo y de mantenimiento de las relaciones violentas por cuanto genera en las
mujeres un sentimiento de indefensin y vulnerabilidad frente al maltrato. Al respecto de
estrategias de afrontamiento, en los discursos de las participantes, algunas, optan por ceder a
sus peticiones con el fin de evitar ser agredidas lo que refuerza el rol autoritario del hombre y
aumenta el grado de control que este ejerce. Se refiere llanto, agresividad y aislamiento,
tratando de evitar ser juzgadas por el medio familiar y social. Otras se auto inculpnbilizan y
normalizan la situacin. En relacin con las consecuencias, se dan, a nivel fsico, psicolgico y
social. Entre las fsicas, reportan cefaleas, dolores lumbares y en casos extremos, infecciones
de tipo sexual tales como gardenela, hongos y virus del pailoma humano. A nivel psicolgico,
hay presencia de emociones de tristeza y ansiedad, desconfianza en s mismas y hacia su
pareja, temor a malos tratos, temor al futuro. La infidelidad repercute en un alto impacto
psicolgico. El abandono, las desventajosas comparaciones y la crtica sistemtica y reiterada,
lesionan la autoimagen, el autoconcepto y la autoestima de estas mujeres. A nivel social, estn
relacionadas con el empobrecimiento y disminucin de las redes sociales, se les controla y
restringen en forma directa las interacciones con familiares, amigos o compaeros de trabajo. A
partir de los relatos, se devela un cuadro bastante complejo de la violencia domstica donde se
ponen en tensin las relaciones sujeto-sociedad estando esta, regulada por la cultura la cual
prescribe los guiones de interaccin entre los gneros, an en los espacios del llamado mundo
privado. Si se quiere hacer prevencin eficaz, en cualquiera de sus niveles, de la violencia,
resulta imprescindible partir del nalisis de lo enunciado anteriormente y atender a la propuesta
de Molina, Moreno y Vsquez (2010) de cmo las opciones teraputicas dirigidas a

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proporcionarles a las mujeres la ayuda que necesitan, deben estar orientadas a que ellas
tengan la posibilidad de reencontrarse con ellas mismas, de reconciliarse con la vida y de
recobrar el valor, que les fue arrebatado fruto de las situaciones vividas con su pareja, a tal
punto de experimentar minusvala e incapacidad para enfrentar el mundo de manera
independiente (p. 146).
Psicologia na Comunidade: Uma Ao Necessria. Comunidade do Amap, Santarm,
Par- Brasil
Amasa Carvalho, Lucivnia Incia de Souza, Izaura A. cardoso, Maria Emilia de Assis, Cileuma
Mara Linhares.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Atualmente a Psicologia Social Comunitria utiliza-se do enquadre terico
da psicologia social, privilegiando o trabalho com grupos, colaborando para a formao da
conscincia crtica e para a construo de uma identidade social e individual orientadas por
preceitos eticamente humanos. O presente trabalho teve como pblico alvo 30 moradores da
comunidade de Amap em Santarm - Pa-Brasil, com o intuito de trabalhar nessa comunidade
de maneira que possibilitasse uma relao interpessoal mais proveitosa entre os moradores da
Comunidade, bem como promover aos comunitrios momentos de reflexo para que houvesse
coeso nas relaes, exercitando a criatividade para que se desenvolvesse a motivao do
trabalho cooperativo de benefcios e interesses de todos, oportunizando um exerccio de
aceitao de forma prtica e objetiva das opinies dos membros a cerca dos eventos
realizados dentro da comunidade. Atravs de instrumentos utilizados para interveno, e
tambm construdos no desenvolvimento do trabalho, foram utilizadas entrevistas, conversas,
visitas s casas da populao e palestras. Ao realizar uma pesquisa de campo na Comunidade
do Amap nos deparamos com uma sociedade que precisa ser orientada e sensibilizada em
relao busca de solues e melhorias comunitrias de acordo com o desejo dos moradores,
para que atravs dessa possam empreender as mudanas necessrias em benefcio mtuo. O
trabalho do psiclogo de facilitador nesse processo para que ocorra o entendimento de forma
satisfatria.
El uso del Juego en una Muestra de Familia Puertorriquea
Aida Jimenez1, Carmen Rivera2.
1. Clinical Psychology, Carlos Albizu University, San Juan, USA, 2. University of Puerto Rico,
San Juan, USA.
Abstract Central: El juego es una herramienta para el desarrollo psicolgico, intelectual, fsico
y emocional de un nio, a la misma vez que es el medio por el cual el nio desarrolla su
identidad. Es a travs del juego que el nio asume roles e internaliza normas que la sociedad le
prescribe. La familia o figuras de apego son los que facilitan y exponen al nio al juego durante
los primeros aos de vida. El juego entre los miembros de la familia tambin contribuye a la
cohesin y comunicacin familiar. Sin embargo, existe poca literatura sobre el juego en la
familia puertorriquea. El propsito de esta presentacin es exponer los hallazgos de una
encuesta realizada a una muestra de padres/madres puertorriqueos con hijos menores de
dieciocho aos de edad. La muestra consisti de 141 adultos/as puertorriqueos con al menos
un hijo/a menor de dieciocho aos. La muestra fue obtenida por disponibilidad. Se utiliz una
encuesta que recopilaba datos sociodemogrficos, frecuencia y tiempo de juego con sus
hijos/as, y el tipo de juego que realizaban. Se presentarn los factores relacionados con un
aumento de tiempo de jugar con hijos y de los factores que obstaculizan o minimizan el jugar

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entre los miembros de la familia. Tambin se compartir datos descriptivos del tipo de juego
mas frecuente reportado y las caractersticas de los padres que mas juegan con sus hijos. A
travs de estos hallazgos se pretende crear conciencia sobre la importancia del juego en el
contexto de la familia.
Psicologia na Comunidade: Uma Ao Necessria. Comunidade do Amap, Santarm,
Par- Brasil
Amasa Carvalho, Lucivnia Incia de Souza, Izaura A. cardoso, Maria Emilia de Assis, Cileuma
Mara Linhares.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Atualmente a Psicologia Social Comunitria utiliza-se do enquadre terico
da psicologia social, privilegiando o trabalho com grupos, colaborando para a formao da
conscincia crtica e para a construo de uma identidade social e individual orientadas por
preceitos eticamente humanos. O presente trabalho teve como pblico alvo 30 moradores da
comunidade de Amap em Santarm - Pa-Brasil, com o intuito de trabalhar nessa comunidade
de maneira que possibilitasse uma relao interpessoal mais proveitosa entre os moradores da
Comunidade, bem como promover aos comunitrios momentos de reflexo para que houvesse
coeso nas relaes, exercitando a criatividade para que se desenvolvesse a motivao do
trabalho cooperativo de benefcios e interesses de todos, oportunizando um exerccio de
aceitao de forma prtica e objetiva das opinies dos membros a cerca dos eventos
realizados dentro da comunidade. Atravs de instrumentos utilizados para interveno, e
tambm construdos no desenvolvimento do trabalho, foram utilizadas entrevistas, conversas,
visitas s casas da populao e palestras. Ao realizar uma pesquisa de campo na Comunidade
do Amap nos deparamos com uma sociedade que precisa ser orientada e sensibilizada em
relao busca de solues e melhorias comunitrias de acordo com o desejo dos moradores,
para que atravs dessa possam empreender as mudanas necessrias em benefcio mtuo. O
trabalho do psiclogo de facilitador nesse processo para que ocorra o entendimento de forma
satisfatria.
Preveno do Trauma Cerebral Abusivo: Avaliao de Diferentes Materiais Educativos
Nahara Lopes, Lcia Williams.
Universidade Federal de So Carlos, So Carlos, Brazil.
Abstract Central: A violncia contra crianas e adolescentes um problema frequente e grave
em nossa sociedade. Dentre as formas de maus-tratos, destaca-se o Trauma Cerebral
Abusivo, tambm conhecido por Sndrome do Beb Sacudido (SBS). Esta forma de maustratos consiste em sacudir violentamente um beb, usualmente em resposta ao seu choro
inconsolvel. Sacudir um beb pode acarretar em consequncias gravssimas para o
desenvolvimento infantil, podendo levar at morte da criana. Entretanto, apesar de sua
gravidade, a SBS pode ser prevenida por meio da educao parental. No Brasil, apesar da alta
incidncia de maus-tratos infantis, no h estudos que enfoquem aes preventivas da
Sndrome do Beb Sacudido. Este estudo parte da dissertao de Mestrado da primeira
autora, que tem como objetivo avaliar a eficcia de diferentes materiais educacionais para
preveno do Trauma Cerebral Abusivo. Foram utilizados um panfleto informativo sobre a SBS,
um vdeo sobre segurana infantil e o vdeo Respondendo ao Choro do Beb, desenvolvido
pela equipe do Projeto de Preveno da Sndrome do Beb Sacudido do Hospital da Criana
de Westmead, Austrlia e traduzido para o espanhol e o portugus pelo Laboratrio de Anlise
e Preveno da Violncia (Laprev). Tanto o vdeo Respondendo ao Choro do Beb, como o

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panfleto sobre a SBS apresentam informaes sobre o choro do beb, os efeitos negativos de
sacudi-lo, bem como estratgias que podem auxiliar os pais a lidarem com o choro de forma
saudvel. O vdeo sobre segurana infantil traz informaes sobre como prevenir afogamento,
envenenamento e queimaduras em crianas. O estudo est sendo atualmente desenvolvido,
sendo este um recorte do mesmo. Participaram do estudo 90 pais de recm-nascidos que
estavam na maternidade por ocasio do nascimentos dos filhos. Estes pais foram
aleatoriamente divididos em trs condies experimentais: (1) vdeo experimental, (2) vdeo
controle e (3) panfleto. O grupo vdeo experimental assistiu exclusivamente ao vdeo
informativo Respondendo ao Choro do Beb. O grupo vdeo controle assistiu
exclusivamente a um vdeo sobre segurana infantil e o grupo panfleto leu o panfleto
informativo sobre a SBS. Os participantes responderam um questionrio sobre o Choro do
Beb antes (pr-teste), logo aps a interveno (ps-teste) e pelo menos aps trs meses da
interveno (follow-up). Aps anlise estatstica, observou-se que entre o pr-teste e o psteste houve um aumento significativo do conhecimento para os grupos vdeo experimental e
panfleto, sendo que este ltimo grupo apresentou o maior aumento no conhecimento. Tais
dados corroboram a literatura, que aponta que materiais educativos so capazes de aumentar
o conhecimento de pais sobre a SBS. Sero apresentados tambm os resultados do follow-up
(em coleta, no momento), que indicaro se h manuteno de alterao do conhecimento e
para qual material ela maior.
Programa Educativo para la Intervencin de los Malos Tratos en el Noviazgo
Jorge A Martinez Gmez1, Cesar Armando Rey Anacona2.
1. Boyaca, Universidad Pedagogica y Tecnologica de Colombia, Tunja, Colombia, 2.
Universidad Pedagogica y Tecnologica de Colombia, Tunja, Colombia.
Abstract Central: Autores con respectiva afiliacin institucional: - Jorge Arturo Martnez
Gmez, psiclogo, estudiante de la Maestra de Psicologa Clnica de la Pontificia Universidad
Javeriana, integrante del Grupo de Investigacin de Psicologa Clnica y de la Salud de la
Universidad Pedaggica y Tecnolgica de Colombia. - Cesar Armando Rey Anacona,
psiclogo, Doctor en Psicologa Clnica y de la Salud, docente de la Escuela de Psicologa de la
UPTC, coordinador del Grupo de Investigacin en Psicologa Clnica y de la Salud de la
Universidad Pedaggica y Tecnolgica de Colombia. RESUMEN DE LA PRESENTACIN Se
presentar los resultados preliminares de un programa piloto con una metodologa de
intervencin psico-educativa, para intervenir la violencia de noviazgo en parejas universitarias
desde un enfoque cognitivo-conductual, el cual se desarrollar durante el primer semestre de
2013. El objetivo del programa es promover en los participantes actitudes, destrezas y
conocimientos que favorezcan relaciones de pareja satisfactorias y libres de violencia. Est
dirigido a parejas de adolescentes o adultos jvenes en donde se han presentado malos tratos
reportados por uno de sus integrantes o los dos. El programa est diseado para ser
implementado en un mes y medio y est organizado en 10 sesiones con una intensidad horaria
de dos horas por sesin, una sesin por semana, bajo la modalidad de taller grupal,
abordndose los siguientes temas: (a) Presentacin del programa, aclaracin de expectativas y
establecimiento de normas, (b) educacin sobre violencia de pareja, (c) la justificacin de la
violencia, (d) creencias y expectativas sobre relaciones de pareja, (e) el efecto de la exposicin
a violencia entre los padres, (f) habilidades de comunicacin, incluyendo escucha activa y
resolucin de problemas, (g) empata, (h) manejo de la ira e (i) manejo de los celos. La
metodologa incluye actividades como dinmicas de activacin, anlisis de pelculas, debates,
juego de roles, prctica de habilidades con retroalimentacin en sesin y asignacin de tareas.
Para evaluar los resultados se utilizar un diseo experimental de grupo control pre-postest con
medidas de seguimiento de tres y seis meses, valorndose las siguientes variables: (a)

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frecuencia de malos tratos a la pareja de tipo fsico, psicolgico, emocional, sexual y


econmico; (b) habilidades asertivas; (c) actitudes a favor de la violencia; (d) ira y (e)
adaptacin y satisfaccin de tratamiento.
Violncia Contra a Gestante e Fatores Associados: Uma Viso Analtico-Comportamental
Nilzangela Medeiros1, Maria Teresa Seabra Soaresde Alves2, Maria Nilza Medeiros1.
1. Psicologia, Universidade Ceuma, So Lus, Brazil, 2. Universidade Federal do Maranho,
So LUS, Brazil.
Abstract Central: A violncia contra a gestante tem ganhado relevncia como um problema de
sade pblica de grave dimenso no Brasil e no mundo. O estudo analisou a violncia contra a
gestante e fatores associados, sob a perspectiva terica da anlise do comportamento. Estudo
de recorte transversal com 1447 usurias dos servios de sade do municpio de So Lus,
Maranho, Brasil. As mulheres foram entrevistadas durante o segundo trimestre de gestao,
utilizando-se um questionrio adaptado do Estudo Multipases sobre a Sade da Mulher e
Violncia Domstica da Organizao Mundial de Sade. Foram realizadas anlises descritivas
e medidas de associao com regresso de Poisson. A prevalncia de violncia psicolgica foi
48,8% (n=706) e 14,5% (n=210) de violncia fsica/sexual. Residir com companheiro
apresentou associao com violncia geral (RP 0,75; IC 95% 0,68;0,84), psicolgica (RP 0,73;
IC 95% 0,66;0,82) e fsica/sexual (RP 0,73; IC 95% 0,56;092). Renda familiar entre um a trs
salrios mnimo esteve associado violncia geral. A violncia fsica/sexual mostrou-se
associada com renda familiar menor que um salrio mnimo e gestante no residir com filho.
Constataram-se altas prevalncias para os diferentes tipos de violncia contra gestantes e
fatores associados, sinalizando a complexidade do fenmeno e necessidade de criao de
mecanismos de enfrentamento da questo.
Evaluacin de un Tratamiento Psicolgico para el Estrs Postraumtico en Mujeres
Vctimas de Violencia Domstica en Ciudad Jurez
Priscila Montaez1, 2, Rosa Raich2, Teresa Gutierrez2.
1. Pshychology, Universidad Autonoma de Ciudad Juarez, Ciudad Juarez, Mexico, 2.
Universidad Autnoma de Barcelona, Barcelona, Spain.
Abstract Central: Resumen. Objetivo: El presente estudio evalu la eficacia de un tratamiento
psicolgico breve, para el Trastorno de Estrs Post-traumtico (TEPT) en mujeres vctimas de
violencia domstica. Mtodo: Se entrevistaron a 72 mujeres, con las cuales se form una
muestra de 48 mujeres. El tratamiento se administr en formato grupal, a lo largo de ocho
sesiones semanales, donde se trabaj con psicoeducacin, entrenamiento en control de la
activacin, terapia cognitiva y terapia de exposicin. Los instrumentos utilizados fueron: Escala
de Gravedad de Sntomas, Escala de Autoestima de Rosenberg, Inventario de Depresin de
Beck, Inventario de Cogniciones Postraumticas y Escala de Cambio Percibido. La evaluacin
se llev a cabo en cinco momentos: Previo y posterior a la intervencin, al primero, tercero,
sexto y doceavo mes. Resultados: Las puntuaciones de gravedad de sntomas de estrs
postraumtico, autoestima, depresin, inadaptacin y cambio percibido presentaron cambios
estadsticamente significativos en todas las evaluaciones. Palabras clave: Trastorno de estrs
postraumtico, violencia domstica, terapia cognitiva, terapia de exposicin. Introduccin El
trastorno de Estrs Postraumtico (TEPT) (APA, 2005) es el desorden de mayor prevalencia
asociado a la violencia de pareja. En Mxico, existen pocos datos acerca de este problema
social. Los publicados revelan que en una muestra de 34, 184 mujeres encuestadas, de entre
15 y 49 aos y que en ese momento tenan pareja y conviva con ella, el 38.4% sufra de

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violencia psicoemocional, violencia econmica el 29.3%, violencia fsica el 9.3% y sexual el


7.8%. Mtodo: Diseo cuasi experimental de dos grupos independientes (grupo de tratamiento
y grupo de no tratamiento) con medidas repetidas (pretratamiento, postratamiento, seguimiento
al mes, tres, seis y doce meses), en el que slo para las evaluaciones pretratamiento y
postratamiento hay una condicin de no tratamiento. Participantes Se evalu a 48 mujeres de
Ciudad Jurez (Mxico), con este tipo de problema. Trece conformaron el grupo control y se
aplic el tratamiento a las treinta y cinco que conformaron el grupo experimental. Procedimiento
Se estableci contacto y autorizacin de las directoras de las diferentes instituciones para la
conformacin de los grupos teraputicos. Anlisis Anlisis de covarianza. Se introdujeron como
covariables los puntajes de preevaluacin de cada escala antes de la intervencin para
controlar por posibles diferencias y se compararon los niveles en el pre y postratamiento del
grupo experimental y grupo control. En el caso de la escala de cambio percibido (nicamente
evaluado en el grupo experimental), se analizaron los datos con un anlisis de varianza de
medidas repetidas. En todas las escalas se analiz la magnitud de las diferencias utilizando la
d de Cohen (Cohen, 1977).
Developing CBT practice in 3rd world Caribbean and Latin American Countries
Krish Nath.
Out-Patient Clinic, The Priory Hospital, London, United Kingdom.
Over the last decade, successive United Nation commission on Human Rights reports have
identified a continuous increase in the incidents of domestic violence committed on females by
their male partners in Guyana. Guyana is an English speaking south american country,
bordered by Brazil, Venezuela and suriname (Dutch Guyana) on the South american atlantic
coastline. It has a population of 750,000 made up from 6 ethnic groups. As working patterns
changed over the years to accommodate market driven economies, so too has living patterns,
resulting in greater exposure to increase stressors. One of the main changes in working
patterns is the need for both partners in a family to be in employment whilst raising a family to
ensure a comfortable standard of living. Over the last decade, various task forces were set the
responsibility to address the issues of the high incidence of domestic violence and male suicide.
(approximately 40 per year). The reason cited are alcoholism and drug abuse, partner morbid
jealousy, uncontrolled anger and skills deficit in resolving conflicts. The need for behavioural
and cognitive counselling was clearly identified as a means to prevent domestic violence and
suicide rates but as yet with a shortage of Psychological expertise, no plans are in place to
develop such practices. The panel will discuss options for training, are these problems observed
in other south american countries and if so, how is it managed. What difficulties do other
countries experience in attempting to organise new training programmes in CBT? At the 2004,
WCBCT, in Kobe, Japan, Professor Marks commented that all practitioner groups have a
responsibility to participate in the development of CBT, so that it reaches across the globe to all
those in need.
Efectos Biopsicosociales en Mujeres Victimas de la Violencia de Pareja
Falcuneri Ocaa Alfaro, Pablo Vera Villarroel.
Psicologa, Universidad de Santiago de Chile, Santiago, Chile.
Abstract Central: Resumen Se presenta, en este trabajo los resultados de una investigacin
que aborda sobre los Efectos Biopsicosociales en Mujeres Victimas de Violencia de Pareja. Es
una investigacin correlacional-explicativa de diseo no experimental. La variable
independiente es la violencia de pareja y la variable dependiente es el efecto Biopsicosocial

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(Sociodemogrficas, psicolgicas y fisiolgicas) en las mujeres. .Es una muestra no


probabilstica, accidental o sujeto voluntario y compuesto por 100 mujeres, 66 al grupo de
vctimas y 34 al grupo de no vctimas de violencia de pareja, de edades 18 a 65 aos, que
reciben atencin en salud, sin riesgo vital, en los consultorios de la Municipalidad de San
Ramn - Chile. Se utiliz Cuestionario sociodemogrfica de autoreporte, Inventario de
Cogniciones Postraumticas de Foa y Cols., 1999, inventario de Ansiedad Estado / rasgo
(STAI) (Spielberger et al, 1970), Escala de Autoestima de Rosemberg, 1965, Test de
Orientacin Vital (LOT - R, 1994), Escala autoaplicable de Zung, 1965, Escala de autorregistro
de somnolencia Epworth y Monitor Digital de presin Sangunea REF CH-302B. Las tcnicas
estadsticas utilizadas para el anlisis de resultado fueron t de Student, Coeficiente de
correlacin, y MANOVA. Segn los resultados se concluye que existen diferencias entre los
grupos a nivel sociodemogrficos y la violencia de pareja afecta a la mujer en su salud integral;
fsica. Psicolgica y Social. Palabras Clave: Biopsicosocial, Violencia de pareja, Vctimas y No
Vctimas Abstract Presented in this paper are the results of an investigation on the Biopsychosocial effects of women victims who have experienced intimate partner violence. The
research presented here is correlational-explanatory and a non-experimental design. The
independent variable is the presence of intimate partner violence and the dependent variable is
the resulting Bio-psychosocial (Sociodemograpihc, Psychological and Physiological) effect of
the victim. This is a nonrandomized sample, accidental or voluntary participation group
composed of 100 women, 66 victims of intimate partner violence and 34 non-victims of intimate
partner violence with an age range of aged 18-65 years, receiving health care without risk to life,
in the offices of the Municipality of San Ramon - Chile We used a self-report socio-demographic
questionnaire, Posttraumatic Cognitions Inventory of Foa et al., 1999, inventory of state / trait
anxiety (STAI) (Spielberger et al, 1970), Rosenberg Self-Esteem Scale, 1965, Life Orientation
Test (LOT - R, 1994), self-report Zung Scale, 1965, Scale and Epworth sleepiness Self
Registration Digital Blood Pressure Monitor CH-302B REF. The techniques statistics used for
the analysis were Student t test result, correlation coefficient, and MANOVA. According to the
results of the investigation we have concluded that there are significant differences between
groups at socio-demographic that have and have not experienced intimate partner violence in
their overall health; physical, psychological and social. Keywords: Bio-psychosocial, intimate
partner violence, victims and non-victims.
Violncia de Gnero na Perspectiva de Homens que Infringiram a Lei "Maria da Penha"
Cristiane Oliveira1, 2, Dbora Rodrigues1, Rosana Garcia1.
1. Universidade Paulista, So jos do Rio Preto, Brazil, 2. Centro Regional de Ateno aos
Maus Tratos na Infncia - CRAMI, So jos do Rio Preto, Brazil.
Abstract Central: Um dos tipos de violncia mais frequente no Brasil a violncia de gnero,
que se define em qualquer ao fsica, sexual ou psicolgica, incluindo a ameaa contra a
mulher. A presente pesquisa preocupou-se em discutir esse tipo de violncia e teve como
objetivo investigar e analisar a violncia de gnero na perspectiva de homens que infringiram a
Lei Maria da Penha. O estudo foi realizado com um grupo de homens que praticaram violncia
contra mulher em uma cidade do interior de So Paulo (Brasil). Os participantes foram
observados e os mesmos responderam a um questionrio contendo questes semiestruturadas abordando temas como: a violncia na perspectiva pessoal, tipos de violncia
sofrida e sentimentos gerados pela violncia. Pode-se concluir que a definio e utilizao de
violncia contra mulher na perspectiva dos participantes sofreu alteraes significativa ao longo
do grupo, visto que os participantes verbalizaram sentirem mais maduros para enfrentar
conflitos da sociedade e identificaram a violncia como algo ruim, o que refora a necessidade
de intervenes focadas nesta populao.

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Projecto Reflexivo - Uma Possibilidade de Atendimento a Autores de Violncia


Domstica Contra Crianas e Adolescentes no Brasil
Cristiane Oliveira1, 2, Valdete Andrade1, 2, Danieli Pichioni2, Gabriela Coimbra2, Hevelin Batista2,
Viviane Amaral2.
1. Universidade Paulista, So jos do Rio Preto, Brazil, 2. CRAMI - Centro de Regional de
Ateno aos Maus Tratos na Infncia de So Jos do Rio Preto., So Jos do Rio Preto, Brazil.
Abstract Central: A violncia uma das principais causas de morbimortalidade no Brasil, sua
origem e formas de expresso esto associadas a uma diversidade de fatores culturais,
sociais, histricos, polticos, religiosos entre outros. O CRAMI - Centro Regional de Ateno
aos Maus Tratos na Infncia foi implantado no municpio de So Jos do Rio Preto, cidade do
Noroeste Paulista no ano de 1988, por iniciativa da Fundao Faculdade de Medicina FUNFARME. Esta Organizao No Governamental representou um marco na interveno
frente s situaes de violncia contra crianas e adolescentes e possibilitou o
desenvolvimento de vrias estratgias de atuao atravs de projetos e parcerias que foram
representativos no fortalecimento social da comunidade. Este trabalho tem como objetivo
apresentar a metodologia de trabalho do Projeto Reflexivo que atua com as violncias
psicolgica, fsica e negligencia bem como apresentar os dados quantitativos relativo aos
atendimentos de 2011 e 2012. O Projeto Reflexivo foi implantado em 2005 em parceria com o
poder publico municipal, atravs da Secretaria Municipal da Assistncia Social. Atualmente
conta com duas tcnicas psiclogas e trs assistentes sociais, bem como uma coordenadora/
supervisora. A metodologia de trabalho inicia-se com o recebimento de notificaes advindas
dos Conselhos Tutelares, Vara da Infncia e Juventude e DDM (Delegacia de Defesa da
Mulher). Aps uma triagem individualizada o plano de atendimento a famlias traado em
equipe, com atendimentos realizados no CRAMI (individual, familiar ou em grupo de orientao
para pais) e em visitas domiciliares e institucionais. O objetivo central oferecer apoio,
orientao e proteo social a crianas, adolescentes e suas famlias que vivenciam violaes
de direitos por ocorrncia de violncia fsica, psicolgica e negligncia, prevenindo a
reincidncia destas violaes de direitos. O CRAMI em 2011 recebeu 354 notificaes,
relativas a todos os tipos de violncia contra a criana e adolescente deste municpio, sendo
designados ao Projeto Reflexivo 176 casos, todos atendidos. Os dados relativos aos
atendimentos de 2012 ainda se encontram em delimitao.
Esquemas Iniciais Desadaptativos na Violncia Conjugal
Kelly Paim1, 2, Marcela Madalena1, Denise Falcke1.
1. Unisinos, So Leopoldo, Brazil, 2. WP, Porto Alegre, Brazil.
O presente estudo prope uma compreenso sobre a violncia conjugal e seu ciclo de
perpetuao, utilizando a perspectiva da Teoria dos Esquemas de Jeffrey Young. Foi
investigada a correlao entre a violncia conjugal e os Esquemas Iniciais Desadaptativos,
assim como a correlao entre os esquemas e as habilidades de negociao. Para este fim, foi
utilizado um delineamento correlacional. A amostra foi constituda por 163 sujeitos de ambos os
sexos, casados ou com unio estvel. Os instrumentos utilizados para coleta de dados foram:
Young Schema Quetionnaire (YSQ-S3) e Revised Conflict Tactics Scale (CTS2). Os dados
foram analisados atravs de anlise de correlao de Pearson. Verificou-se uma relao
positiva e significativa (p<0,05) entre violncia conjugal e os esquemas de desconfiana/abuso,
isolamento social/alienao, defectividade/vergonha, dependncia/incompetncia,
emaranhamento, auto-sacrifcio, padres inflexveis, grandiosidade/arrogo,

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autocontrole/autodisciplina insuficientes e postura punitiva. Considerando as habilidades de


negociao, identificou-se correlao negativa com os esquemas de privao emocional,
defectividade/vergonha, fracasso, emaranhamento, subjugao, autocontrole/autodisciplina
insuficientes, autosacrifcio e dependncia/incompetncia. Os resultados remetem a existncia
de um padro de esquemas de personalidade entre os indivduos que experienciam violncia
na relao conjugal, assim como a associao desses com as habilidades de negociao.
A Influncia da Tipologia Familiar no Desenvolvimento de Bebs com At Seis Meses de
Idade
Olga Maria Rodrigues, Renata Tirelli.
UNESP, Bauru, Brazil.
O modelo tradicional de famlia entendido como um grupo composto por pai, me e filhos
naturais desta unio. Entretanto, este modelo de famlia nuclear, ao longo do tempo, comeou
dividir espao com diferentes tipos de famlia. Todas estas diferentes formas requerem
investigaes, pois pouco se sabe sobre suas implicaes para o desenvolvimento infantil. A
famlia o primeiro sistema no qual um padro de atividades, papis e interaes interpessoais
so vivenciados pela pessoa em desenvolvimento, providos pelos cuidados e estmulos
necessrios ao crescimento e desenvolvimento (Silva et al., 2008; Sigolo, 2004; Dessen &
Polnia, 2007). Estudos tem relacionado a configurao familiar e o comportamento materno
(Piccinini; Marin; Alvarenga; Lopes. & Tudge, 2007; Bronstein; Clauson; Frankel, & Abrams,
1993). Eles indicaram que a presena do pai na famlia nuclear, bem como a presena de uma
av ou outro adulto que residia com famlias de mes solteiras, estaria associada com
comportamentos maternos positivos e com o favorecimento do desenvolvimento infantil. Isso
refora que o tipo e a fonte do apoio esto sendo considerados como fatores importantes na
compreenso do desenvolvimento infantil. A presente pesquisa buscou relacionar as tipologias
familiares: Nuclear - me, pai e filhos (T1), Me solteira residindo com famlia de origem (T2) e
Famlia - me, pai, beb residindo com famlia de origem e/ou agregados (T3), com o
desenvolvimento de bebs de at seis meses. Participaram da pesquisa 212 mes e seus
bebs de at seis meses de idade. Para a investigao dos dados demogrficos da me e sua
famlia, foi aplicada uma entrevista inicial. Na avaliao do desenvolvimento dos bebs,
utilizou-se o Inventrio Portage Operacionalizado (IPO) (Williams & Aiello, 2001), que avalia o
desenvolvimento infantil em cinco reas do desenvolvimento (Linguagem, Autocuidados,
Cognio, Socializao e Desenvolvimento Motor). Os resultados apontaram que, na amostra,
57,5% dos bebs eram integrantes de famlias T1, 22%, T2 e, 20,5%, T3. Na rea de
Linguagem o desempenho foi melhor para os bebs da famlia T1 em trs dos meses avaliados
no terceiro (p=0,074), no quarto (p=0,027) e quinto ms (p=0,034). Na rea de Autocuidados, o
melhor desempenho foi para os bebs da famlia T3 no quarto (p=0,008), quinto (p=0002) e
sexto ms (p=0,019). Em Cognio, as maiores mdias foram dos bebs integrantes de
famlias T2 (segundo, terceiro e quarto ms) e T3 (primeiro, quinto e sexto ms), no existindo
diferenas significantes entre os grupos. Em Socializao, as maiores mdias foram dos bebs
de famlias T2 (segundo ao sexto ms), no existindo diferenas significantes. E, finalmente,
em Desenvolvimento Motor no primeiro, segundo, quarto e quinto ms os bebs integrantes de
famlias do tipo T2 apresentaram maior mdia, sendo que no segundo ms (p=0,032) e no
quarto ms (p=0,058) observou-se diferenas significantes. Os dados obtidos neste estudo
indicam que os bebs integrantes de famlias menos extensas (T1) apresentaram destaque em
seu desenvolvimento na rea de Linguagem, confirmando os achados de Piccinini et al. (2007).
Nas demais reas o desempenho melhor foi observado para os demais tipos de famlia (T2 e
T3). Estes dados chamam a ateno para o papel da rede de apoio como fator importante no
processo de desenvolvimento do beb, cabendo destacar os estudos de Silva e Salomo

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(2003) sobre o papel das avs e de Motta et al. (2004), indicando que o fato de a criana
receber apoio de todo crculo familiar onde a me se insere, pode contribuir para que exista um
processo de reorganizao de sua vida, sendo as prticas de cuidado com a criana,
executadas pelos demais membros da famlia. A rede familiar em diferentes contextos deve ser
melhor investigada para auxili-las enquanto promotoras do desenvolvimento infantil.
Violencia Familiar: Reestructurando Pensamientos a Travs de la Terapia CognitivoConductual
Martha Ruiz Garca, Azucena Mendoza Galindo, Clementina Garca Martnez.
Universidad Autonoma de Baja California, Ensenada, Mexico.
Abstract Central: A travs de este estudio, se presenta un caso de violencia familiar donde la
consultante es referida por el Centro de Ejecucin de Medidas para Menores, de la Ciudad de
Ensenada, al programa de terapia de cognitivo-conductual para ser atendida en forma
individual, su hijo de 16 aos y su esposo. Son remitidos debido a que el hijo de la consultante
amenaz en la escuela con un arma blanca a uno de sus compaeros porque constantemente
lo molestaba y se burlaba de l. Al iniciar la atencin de la consultante se encontr que por 22
aos ha experimentado una vida de violencia familiar. El objetivo de este estudio de caso es
determinar la eficacia del programa de terapia cognitivo-conductual. Su proceso teraputico
estuvo basado en 13 sesiones donde se le brind las herramientas necesarias para que
encontrara mejores alternativas de solucin a sus situaciones. Mtodo: El presente trabajo es
una investigacin de tipo correlacional, utilizando el mtodo de test-retest, as como diversos
instrumentos. Sujeto:La consultante es una mujer de 45 aos que vive en una relacin de
pareja en unin libre desde hace 22 aos. Instrumentos: Se utiliz la aplicacin del test y retest
Gestltico Visomotor de Lauretta Bender Lecturas psicoeducativas relacionadas a la
comunicacin asertiva, autoestima, perdn hacia los semejantes. As como la aplicacin del
cuestionario de creencias irracionales de Albert Ellis. Resultados De acuerdo a los datos
obtenidos en la primera aplicacin del test visomotor de Lauretta Bender, presentaba ansiedad
debido al ambiente violento en el que se encontraba, perciba sus relaciones interpersonales y
a su medio como un agente amenazante. En la aplicacin del retest se observaron notables
cambios en la persona. Se encontr una mejor distribucin de las figuras y una mayor
flexibilidad ante los aspectos rutinarios. Su agresividad comienza a exteriorizarla de una
manera ms dirigida hacia un objetivo; tambin, una mejor integracin en la percepcin de su
interaccin con el ambiente. Los indicadores de depresin no se hicieron presentes. Con la
figura materna se trabaj el duelo y su relacin con el evento de abuso sexual.Las figuras
relacionadas con la sexualidad estn ms proporcionadas en su tamao, es decir que el
recuerdo de la situacin de abuso sexual se reestructur de una manera positiva y comprensiva
en su pensamiento. Del cuestionario de creencias de Albert Ellis se encontraron cambios en la
reestructuracin del pensamiento. Adems, al utilizar lecturas sobre la comunicacin asertiva y
de autoestima, la participante encontr mejores maneras de expresar sus emociones y
pensamientos sin ser agresiva con su esposo al querer defenderse por el maltrato recibido.
Conclusiones Durante el proceso teraputico se observaron diversos cambios en la paciente,
los cuales repercutieron en el fortalecimiento de su autoestima y en su estado de nimo. La
aplicacin de tratamiento psicolgico resulta una herramienta importante que permite observar
la evolucin y la transformacin lograda por una persona. Se puede concluir que la terapia
cognitivo-conductual resulta efectiva a corto plazo logrando un proceso de re-educacin en los
pensamientos automticos y las creencias irracionales, disminuyendo, en este caso, la
violencia familiar.

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Estrategias Cognitivo Comportamental en la Prevencin del Maltrato Infantil en Lafamilia


Perla Marina Santana Vsquez Gobierno Autnomo Municipal de La Paz Bolivia
Perla Santana Vasquez.
La Paz, Gobierno Municipal de La Paz, La Paz, Bolivia.
Abstract Central: El propsito de la presentacin es proponer una alternativa de intervencin
cognitivo comportamental de prevencin destinada a eliminar o disminuir el riesgo de maltrato
infantil en familias bolivianas tales como carencia de tcnicas afectivo emocional por parte de
los padres con el objetivo de reducir conductas indeseadas en los hijos a falta de conocimiento
del desarrollo infantil por lo tanto un programa de intervencin para padres tiene el objetivo de
promover habilidades de conduccin de los hijos y manejo de estrategias de afrontamiento para
regularizar respuestas cognitivas afectivo emocionales y comportamentales positivas The
purpose of the presentation is to propose an alternative cognitive behavioral prevention
intervention to eliminate or reduce the risk of child abuse in Bolivian families such as lack of
emotional affective techniques by parents in order to reduce unwanted behavior in children to
lack of knowledge of child development so a parent intervention program aims to promote
leadership skills and management of children coping strategies to regulate emotional responses
and cognitive behavioral positive affective
La Decisin de Dejar Una Relacin Violenta: Miedos Asociados en las Mujeres
Maltratadas
Julia Sebastin, Beatriz Ortiz, Alba Verdugo, Liliana Diaz.
Psicologa Biolgica y de la salud, Univ. Autnoma de Madrd, Madrid, Spain.
Estudios cualitativos y cuantitativos han desarrollado modelos que intentan explicar el complejo
intrincado de factores que llevan a una mujer maltratada a abandonar una relacin violenta
(Pilkington, 2000) desarrollando modelos explicativos de la misma y estableciendo sta como
un relacin cclica (Walker, 1978) en la cual las mujeres se encuentran en diversas fases hasta
que toman la decisin de terminar con la relacin (Bosch, Ferrer, Alzamora 2006) El presente
estudio analiza los miedos que estn asociados a la toma de decisiones de permanecer o
abandonar una relacin en la cual est teniendo lugar violencia de gnero. Los estados del
Modelo de etapas del cambio (Prochaska & DiClemente, 1984), en el cual se basa nuestro
estudio, sugieren que las personas necesitan tiempo para contemplar los costos y los
beneficios de quedarse o dejar una relacin, lo que se relaciona fuertemente con el Health
Belief Model (Roser, 1990) que sugiere que la tomas de decisiones depender de las barreras
percibidas por la vctima. El estudio ha tenido lugar con 139 mujeres que han tomado la
decisin de dejar la relacin violenta y 36 mujeres que, sufriendo violencia de gnero, han
tomado la decisin de mantener la relacin. Todas las mujeres respondieron a la escala DSL
Decisition to leave scale creada por Hendy, Eggen, Gustitus, McLeod y Ng (2003) en la cual
se pregunta a travs de 30 tems los miedos que las vctimas de violencia de gnero tienen a la
hora de tomar la decisin de romper o mantener una relacin violenta. Los resultados han
mostrado diferencias significativas en la comparacin de medias de los dos grupos de
mujeres.En el grupo que ya tom la decisin de abandonar a la pareja sta se ha asociado en
nuestra muestra a un mayor miedo al dao, un mayor miedo a que el maltratador daara a su
familia, un mayor miedo a perder la custodia de los hijos e hijas, un mayor miedo a echar de
menos el sexo con la pareja, un mayor miedo a que nadie la crea, una mayor creencia de que
esa es al mejor relacin que la mujer tendr en su vida, una mayor creencia de que le puede
ayudar a cambiar y una mayor creencia de que los hijos e hijas son pequeos para poder
ponerse ella a trabajar. Estos datos seran consistentes con los estudios que indican que en la
decisin de dejar la relacin, las preocupaciones acerca de las necesidades de los hijos e hijas,

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del dinero y del apoyo social suponen el cambio de fase de la contemplacin hacia la accin
de dejar una relacin violenta (Hendy, Eggen, Gustitus, McLeod, Ng, 2003) En el grupo que no
ha abandonado la relacin violenta y por lo tanto se encuentra en la fase de pre-contemplacin
o contemplacin, esta decisin se ha asociado a un mayor miedo a la prdida de ingresos, una
mayor vergenza por contrselo a alguien y por una mayor preocupacin de perder beneficios
fiscales y econmicos. No se han encontrado diferencias significativas entre los dos grupos en
otros miedos que se han considerado importantes en la literatura a la hora de la toma de
decisiones de dejar una relacin violenta como son: el miedo a la soledad, el miedo a echarle
de menos, el miedo a tomar las propias decisiones, el miedo a perjudicar a los hijos e hijas de
la pareja con la decisin de abandonar la relacin o la esperanza de que el maltratador cambie.
Los resultados de este tipo de investigacin son importantes para poder actuar en aquellas
cuestiones que deben ser resueltas convenientemente para que las mujeres maltratadas
puedan tomar la decisin con mayor facilidad y xito.
Ansiedad, Depresin y Autoestima en Mujeres Maltratadas: Su Relacin con la Historia
de la Convivencia y con Variables Biogrficas
Julia Sebastin, Irene Lpez, Beatriz Ortiz, Raquel Rodriguez.
Psicologa Biolgica y de la salud, Univ. Autnoma de Madrd, Madrid, Spain.
El maltrato a la mujer en las relaciones de pareja es hoy por hoy un tema de salud pblica
preocupante, si consideramos los datos que se van haciendo pblicos en todos los pases
occidentales. Esta violencia que tambin ha recibido el nombre de violencia de gnero, se basa
en factores culturales, sociales e individuales, haciendo especial nfasis en los primeros. Son
numerosos los estudios publicados que se centran en las consecuencias relacionadas con la
salud mental de la situacin de malos tratos, muchas de estas publicaciones versan sobre el
sndrome de estrs postraumtico y sobre ansiedad y depresin. Con respecto a estas dos
ltimas variables, en la mayora de los trabajos se pone de manifiesto que las mujeres
maltratadas muestran altos niveles en ambas, pero son escasos los trabajo que analiza la
relacin de estas variables con la historia y caractersticas de la relacin. Nuestro trabajo tiene
como objetivo analizar,en mujeres maltratadas, a) las relaciones entre variables de la historia
de convivencia con variables relacionadas con la salud mental (ansiedad, depresin y
autoestima) y b),relacionar estas ltimas con variables sociodemogrficas y personales de la
vctima y del maltratador. En concreto, con respecto a la primera cuestin, intentamos averigua
la relacin entre ansiedad y depresin con la duracin de la relacin de malostratos, los tipos
de malos tratos sufridos,la frecuencia e intensidad del maltrato, secuelas o lesiones, la
existencia de maltrato en los hijos, etc. Con respecto a la segunda cuestin, intentamos
averiguar la relacin entre ansiedad y depresin con antecedentes de maltrato en la familia,
consumo de drogas, antecedentes de victimizacin, etc. Las participantes fueron 80 mujeres
maltratadas con una edad media de 45.8 aos. Todas ellas vivan en sus hogares, ninguna
proviene de casas de acogida. La participacin en la investigacin era voluntaria y annima.
Los instrumentos utilizados fueron un cuestionario para la recogida de datos sociodemogrficos
y de historia de la convivencia, elaborada por el equipo de investigacin, el HAS (Hospital
Anxiety and Depression Scale, Zigmond y Snaith, 1983) y la Escala de Autoestima (Rosenberg,
1975). El diseo fue transversal. Los resultados mostraron una relacin positiva entre los
diferentes tipos de maltrato y la aparicin de depresin, ansiedad y problemas de autoestima,
siendo ms elevada la asociacin que se produca entre estas variables y el maltrato sexual.
Adems se hall una relacin igualmente positiva entre las secuelas del maltrato y el nivel de
ansiedad y depresin, siendo sta relacin negativa con la autoestima. Por otra parte, la
existencia de maltrato y/o abusos sexuales durante la infancia, tanto de la vctima como del
maltratador, se relacionaba de forma importante y directa con los niveles de depresin y

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ansiedad, siendo esta relacin negativa con la autoestima. Estos datos refrendan algunos de
los resultados obtenidos por diversos autores y que relacionan igualmente la historia de
convivencia y de la relacin de la pareja y variables sociodemogrficas con la ansiedad,
depresin y autoestima y ponen de manifiesto la importancia del estudio de las relaciones entre
estas variables con el fin de una prevencin e intervencin ms eficaz.
Adolescents Exposed to Domestic Violence and Involved in Bullying: Possibilities of
Application of Cognitive Behavioral Therapy
Luciana Senra1, 2, Llio Loureno1, 2.
1. Psycholgy, Federal University of Juiz de Fora City, Juiz de Fora, Brazil, 2. Center for
Research on Violence and Social Anxiety - NEVAS, Juiz de Fora, Brazil.
Abstract Central: The Domestic Violence-DV reaches the world's population by acts and
omissions, to the detriment of the welfare of the physical and psychological integrity, freedom
and the right to the full development of a family member, especially children and adolescents,
regardless of cultural characteristics, social and economic. These victims, directly and indirectly
exposed to the phenomenon and the observation of models of patterns of aggressive and
violent domestic relationships, tend to adopt and reproduce such behaviors in interpersonal
situations and resolve conflicts when they have to. The losses are evident for different segments
of society, due to the problems of physical and mental health, early involvement with illicit
activities and truancy. Regarding the involvement of adolescents in aggressive behavior among
classmates, has been highlighted in the literature to bullying, a phenomenon seen as
aggressive with various acts and abuse of power and systematic actions performed
intentionally, persistent and continuous. The attacks are physical (slapping, punching and
kicking), verbal (name calling and nasty jokes) and psychological (isolation and threat) and are
led by one or more assailants, with the aim of causing damage or harm to someone and/or
group perceived as fragile, with physical characteristics, cultural, economic, ethnic and sexual
specific, unable to defend themselves or reverse the situation. Bullying also offers health risks,
interpersonal relations, and school performance and academic children and adolescents.
Among these losses, we emphasize mood disorders and anxiety, insecurity, eating disorders,
enuresis, exclusion, restlessness, poor school performance, social isolation, use of tobacco,
alcohol and drugs, and engaging in anti-social behavior and crime. The cognitive-behavioral
therapy-CBT has been reference in approaches to individual and group support for those
involved. CBT allows specific approaches with victims, aggressors (bullies), and family. The
approaches of CBT with victims involve assertiveness training and social skills, identifying
coping strategies, monitoring of misconduct and its consequences and identification of
dysfunctional beliefs and dichotomous. With aggressors, the focus should be on the acquisition
of cooperation and empathy, impulse control, the ability of acceptance and frustration, analysis
of the consequences of aggressive behaviors and attitudes and inadequate leadership
promoting and encouraging the positive attention. Work with families of CBT should involve
clarification of parenting styles, the role of children and adolescents in the family, conflict
mediation and problem solving, practice empathy, assertiveness and social interaction,
development of positive attitudes and behaviors, and clarify generalized rules to avoid
punishment. Therefore, regardless of the focus of CBT approaches, the therapist must prioritize
three areas: behavior and bullying for DV (what and how it does), cognitions about bullying and
DV (what and how to think and feel), and environmental conditions donates phenomena (how to
structure and organize the environment in which we live).

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Contribuies de Albert Bandura para Compreenso da Violncia contra o Idoso na


Famlia
Cirlene Francisca Silva.
UNICAP - Universidade Catlica de Pernambuco, Recife, Brazil.
O trabalho apresentado tem como objetivo analisar a contribuio da Teoria Social Cognitiva,
desenvolvida por Albert Bandura, para compreenso da violncia contra o idoso na famlia.
Fenmeno que tem tomado projees alarmantes com a exploso mundial da terceira idade e
chamado a ateno de autoridades mundiais. Para a Organizao Mundial de Sade (2005), a
violncia contra o idoso, um ato nico ou repetido, ou omisso, que ocorre em qualquer
relacionamento em que haja uma expectativa de confiana, que cause dano e angstia a uma
pessoa idosa. Ela considerada uma violao aos direitos humanos e, em todas as culturas
tem sido pouco denunciada. O Instituto Brasileiro de Geografia e Estatstica (IBGE, 2011),
afirma que nos ltimos 10 anos diminuiu o nmero de crianas e aumentou o de idosos, e
consequentemente cresceu a quantidade dos idosos que sofrem violncia no Brasil. Segundo
suas estimativas, em 2020, o Brasil dever ser o sexto pas com mais idosos no mundo. Vrias
necessidades tm emergido por conta deste crescimento, entre elas a questo de minimizar a
violncia praticada contra esta populao. No Brasil, segundo Minayo (2005), 90% dos casos
de violncia contra idosos acontecem no ambiente familiar e em sua prpria casa. Dois teros
dos agressores so filhos, noras ou genros e cnjuge. No Recife, at maio de 2011, o Disquedenuncia contabilizou 363 casos tendo sido divulgado um folder explicativo alertando a
sociedade quanto ao problema e ressaltando que a denncia aos rgos competentes,
autoridades policiais, Ministrios Pblicos e Conselhos de Idosos obrigatria por parte da
populao. Torna-se necessrio, portanto, dar visibilidade a esta questo atravs de pesquisas
e aprofundamento dos estudos, alm de esclarecimentos e intervenes com o objetivo de
minimiz-la. O conceito de Desengajamento Moral, proposto por Bandura, contribui para a
compreenso dos mecanismos, legitimados socialmente, que as pessoas utilizam para justificar
a prtica de atos considerados antissociais ou desumanos sem se sentirem culpadas ou
censuradas por isso. Da o uso do termo desengajamento, mostrando que possvel
desprender-se ou desengajar-se dos prprios padres morais para cometer atos antissociais
deliberadamente, sem autocondenao. Partindo deste pressuposto, na trilha dos estudos
sobre agressividade, Bandura nessa linha de raciocnio, props oito mecanismos de
desengajamento moral para explicar as aes prejudiciais que os indivduos realizam:
justificativa moral; comparao vantajosa; linguagem eufemstica; minimizao, ignorncia ou
distoro das consequncias; desumanizao; atribuio de culpa; deslocamento de
responsabilidade; e difuso de responsabilidade (AZZI, 2011). Neste sentido, pretende-se a
partir das reflexes de Bandura, contribuir para dar visibilidade ao problema; propiciar a
compreenso acerca dos fatores que podem levar a prtica da violncia contra o idoso;
beneficiar as famlias e os profissionais que lidam com essa temtica; promover a
compreenso e possvel minimizao do ato de agredir o idoso dentro de sua prpria casa,
colaborando proativamente para uma sociedade mais humanizada. Palavras chave: Violncia
contra idoso, famlia, desengajamento moral.
Domestic Violence: The Experience of Women Who Currently Live with an Abusive Male
Maxine Symes.
Curtin University, Perth, WA, Australia.
Intimate partner violence (IPV) has an impact on an estimated 10-30% of women worldwide and
occurs across all cultures and social status (Bargai, Ben-Shakhar, & Shalev, 2007; PicoAlfonso, 2005). Research investigating women in IPV has primarily focused on understanding

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how to support women who are leaving or have left their abusive relationship, with less research
attention given to understanding and supporting women who choose to stay (Cluss et al., 2006).
This lack of research conducted with women who choose to stay means that we currently do not
understand the unique needs of this population (Lewis et al., 2006). As it is estimated that half
the women exposed to IPV remain in the relationship, and of those who leave, up to 75% return
to the abuser (Brown, 1997; Strube, 1988; Wuest & Merritt-Gray, 2008) an understanding of the
unique needs of this population (Lewis et al., 2006) would seem warranted. Therefore the
current study aimed to explore the experience of women currently living with an abusive partner.
The objective was to explore the meaning of IPV in the participants lives and how they manage
their situation. Method Semi structured interviews were conducted with 15 women (ages ranging
from 21 to 69 years), at a location of their choosing. The interviews were transcribed then
analyzed using Interpretative Phenomenological Analysis (IPA). IPA was appropriate for this
study as I was attempting to gain an insight into the lived experiences of the participants and
how they make sense of these experiences. As one cannot fully know the experience of
another, the gaining of insight, into the participants sense making, involved me not only fully
immersing myself in the transcripts but also making interpretations of the participants reports.
This process is referred to as the double hermeneutic where the researcher is trying to make
sense of the participants sense making (Smith, 2011). Results Analysis is currently ongoing
with an anticipated finish date of early 2013 at which time results will be presented/available.
Discussion Previous research on IPV has focused on women who have left or are attempting to
leave their relationship and results from this research have led to the establishment of
numerous services to assist women who leave (Brown, 1997). However, little is known of the
experiences of those who remain in the IPV relationship (Herbert et al., 1991). Because leaving
the abuser is considered to be socially sanctioned (Brown) research has focused on the cost
associated with staying in the IPV relationship without consideration of any positive aspects that
may be present (Herbert et al., 1991) With researchers and service providers focusing on the
cost of the IPV relationship and a focus on leaving, it is likely that women who wish to remain
are in danger of experiencing attitudes of victimization not only from their partner, but also the
service providers and social supports they attempt to access (Herbert et al., 1991). In order to
provide appropriate support to women remaining, researchers, service providers and policy
makers need to be aware of how women living with IPV understand and manage the IPV in their
lives and the most appropriate way to assist them. Therefore, it is anticipated that the
information gleaned from this study will aid clinicians to identify strategies to assist them to
manage or reduce the negative outcomes that may arise for women seeking help while currently
living with IPV (Matheson et al., 2007). Further, in gaining a more accurate understanding of
what is occurring for women living with IPV more appropriate theories to underpin clinical
strategies and policy development will be developed that will assist those women who choose to
remain in the IPV relationship (Rhatigan et al., 2006).
Estudo Piloto a Cerca da Correlao entre Empatia e Assertividade e os Estilos Parentais
Priscila Tenenbaum.
PGPS, UERJ, Rio de Janeiro, Brazil.
Abstract Central: Afim de correlacionar os Estilos Parentais com a assertividade e a empatia,
64 pais, 21 homens e 43 mulheres, responderam aos: Inventario de Habilidades Sociais (IHSDel Prette), Inventario de Empatia (IE-Falcone) e Parental Autority Questionary (PAQ). Foram
efetuadas correlaes r de Person entre os fatores do PAQ e os fatores do IHS e do IE . O fator
Enfrentamento e Auto-afirmao do IHS correlacionou-se positivamente com e estilo
Autoritartivo (0,31) e negativamente (-0,24) com o estilo Autoritrio. Uma correlao positiva
entre o estilo Autoritativo e os fatores Tomada de Perspectiva (0,33), Sensibilidade Afetiva

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(0,25) e Altrusmo (0,25) do IE. O Altrusmo correlacionou-se negativamente com fator


Autoritrio. Os resultados apresentados so discutidos a luz da psicologia do desenvolvimento
e neuropsicologia. ABSTRACT: With the aim of correlating Parental Style and Assertivity and
Empaty Social abilities, sixty four parents, 21 men and 43 women filed in 3 questionaries:
Inventario de Habilidades Sociais (IHS-Del Prette), Inventario de Empatia (IE-Falcone) e
Parental Autority Questionary (PAQ). r of Person correlation were done, between PAQ factors
and IHS and IE factors. IHSa Factor Enfrentamento e Auto-afirmao positively correlate with
authoritative Style (0,31) and negatively with Autoritarian style (-0,24). Posituve correlation
between Autoritative style and empatic factores were found: Perspective Taking (0,33), Afect
sensibility (0,25) and Altruism (0,25). Altruism was negatively correlated with Autoritative style.
The results are discussed throuth the light of development psychology and neropsychology. Key
words: assertiveness, empathy, parental style.
Trabalhando Com os Pais: Buscando o Equilbrio entre Limites e Afetos
Priscila Tenenbaum.
PGPS, UERJ, Rio de Janeiro, Brazil.
Abstract Central: Culturally, the bounce between limits and affects in raising children differs
greatly in different countries. While Eastern cultures favor the development of the relational self
and thereby excel in respect and limits the education of their child (mother TIGER) in most
Western countries, the development of an autonomous self has become so prevalent that
freedom emotional expression and meeting the needs of the child became a slogan in childcare.
Recent research in the field of developmental psychology point to the importance of the balance
between these extremes. Since the development of Cognitive Behavioural Therapy with
Children tripod (child - parent-therapist) are presented as maximum and can be understood as
the key to successful therapy. We know that changing a behavior, the maintenance and
generalization of the results of working with children depends on a good intervention with
parents. However, parents strategies are often focus on behavior therapy and behavior
management. In order to present an integrated model of parental guidance, it has been done a
literature review on the selected area and effective strategies beyond the traditional ones. It is
known that parental mental health, family happiness, knowledge about child development and
disorder presented by the child, or complaint concerned behavioral, health and wellness
(encompassing sleep, diet and physical activity) of the child, as well as your routine, are
perceived as important as the traditional skills of managing child behavior. In the present study,
we conducted a review and relatives goals of building self and presented a guideline for parents
to treatment and prevention of depression and anxiety disorders in childhood, incorporating the
latest research from Cognitive Behavioral Therapy as mindfullness, selfsuthing, empathy and
altruism.
La Violencia Domstica, una Realidad Difcil su Implicancias y Acompaamientos
Diana Zilberman.
prctica privada, San Martn, Argentina.
Abstract Central: La violencia domstica, resulta una realidad difcil de detectar, problemtica
para abordar y compleja para resolver, ya que la misma constituye un elemento cotidiano, en la
vida de miles de familias, es un ejercicio de poder del fuerte sobre un dbil, adems por la
tendencia histrica de encubrir, invisibilizar negar, minimizar su frecuencia y silenciar sus
efectos. Para poder detectar, intervenir y resolver cuestiones de violencia domstica, se
necesita de un enfoque interdisciplinario e interinstitucional y la capacitacin de todos aquellos

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agentes que estn en contacto con cualquier integrante de las familias, sin importar a que
disciplina pertenezcan. Para poder proteger en forma integral, prevenir, sancionar y erradicar la
violencia contra las mujeres en los mbitos en que desarrollen sus relaciones familiares, ser
necesario lograr visibilizar este problema en toda la sociedad. Domestic violence is a reality
difficult to detect, to address complex problems to solve, since it is an everyday, in the lives of
thousands of families, is an exercise of power of the strong over weak, and the historical
tendency to cover up, invisible deny, minimize the frequency and effects mute. In order to
detect, intervene and resolve issues of domestic violence, it takes an interdisciplinary and
interagency training and all agents in contact with any member of the family, no matter what
discipline they belong. In order to comprehensively protect, prevent, punish and eradicate
violence against women in the areas where they develop their family relationships will be
necessary to achieve this problem visible throughout society.
Psicologia na Comunidade: Uma Ao Necessria. Comunidade do Amap, Santarm,
Par- Brasil
Amasa Carvalho, Lucivnia Incia de Souza, Izaura A. cardoso, Maria Emilia de Assis, Cileuma
Mara Linhares.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Atualmente a Psicologia Social Comunitria utiliza-se do enquadre terico
da psicologia social, privilegiando o trabalho com grupos, colaborando para a formao da
conscincia crtica e para a construo de uma identidade social e individual orientadas por
preceitos eticamente humanos. O presente trabalho teve como pblico alvo 30 moradores da
comunidade de Amap em Santarm - Pa-Brasil, com o intuito de trabalhar nessa comunidade
de maneira que possibilitasse uma relao interpessoal mais proveitosa entre os moradores da
Comunidade, bem como promover aos comunitrios momentos de reflexo para que houvesse
coeso nas relaes, exercitando a criatividade para que se desenvolvesse a motivao do
trabalho cooperativo de benefcios e interesses de todos, oportunizando um exerccio de
aceitao de forma prtica e objetiva das opinies dos membros a cerca dos eventos
realizados dentro da comunidade. Atravs de instrumentos utilizados para interveno, e
tambm construdos no desenvolvimento do trabalho, foram utilizadas entrevistas, conversas,
visitas s casas da populao e palestras. Ao realizar uma pesquisa de campo na Comunidade
do Amap nos deparamos com uma sociedade que precisa ser orientada e sensibilizada em
relao busca de solues e melhorias comunitrias de acordo com o desejo dos moradores,
para que atravs dessa possam empreender as mudanas necessrias em benefcio mtuo. O
trabalho do psiclogo de facilitador nesse processo para que ocorra o entendimento de forma
satisfatria.
Health Psychology/ Psicologa de la Salud/ Psicologia da Sade
Una Experiencia de Voluntariado dentro del Hospital Escuela en Salud Mental
Agustina Abraham, Basconcello Keila, Mara Gabriela Caligiore Gei, Cristian Giusepponi,
Jimena Gonzalez, Mara Beln Gonzalez, Justel Jorge, Mara Emilia Lucero, Mara Valeria
Magre, Leslie Martin, Erika Olgun, Emiliano Sanchez, Belen Nasazzi, Margarita Videla, Carla
Martin Zuin, Julieta Bottaro.
Hospital Dr. Carlos Pereyra, Mendoza, Argentina.
Se presenta un programa de voluntariado perteneciente al Departamento de Rehabilitacin del
Hospital Escuela en Salud Mental Dr. Carlos Pereyra, ubicado en la ciudad de Mendoza,

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Argentina. Dicho programa apunta a la incorporacin de personas de la comunidad, con el


objetivo de desarrollar actividades que favorezcan la inclusin social de personas con
padecimiento mental, tales como talleres recreativos y didcticos, estimulando y mejorando su
calidad de vida. El grupo est conformado por jvenes profesionales y estudiantes de la carrera
de psicologa y afines, que ofrecen parte de su tiempo para realizar estos talleres comunitarios,
como una forma de accin y participacin social, en la cual, el hecho de ayudar a otros se
relaciona con numerosos beneficios para quien la recibe, tales como desarrollo de emociones
positivas, satisfaccin con la vida, bienestar subjetivo, disminucin del estrs; potenciando de
este modo sus aspectos sanos. As mismo, esta experiencia ofrece un espacio de formacin a
sus integrantes para el desarrollo de habilidades sociales (comunicacin, empata, resolucin
de conflictos, asertividad) favorecedoras de la relacin teraputica en el ejercicio del rol
profesional basada en el respeto del derecho del paciente como ciudadano.
El Autocuidado Como un Elemento Teraputico Para el Cuidado Emocional Del Personal
de Salud
Militza Alvarez Machuca.
Lima, Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchy", Lima, Peru.
Abstract Central: El presente tema tiene como propsito presentar la estructura de un plan
innovador diseado para trabajar el autocuidado en el personal de salud, a partir de un enfoque
personal - grupal. Para lo cual se han estructurado cuatro fases de trabajo donde se hace uso
de herramientas teraputicas desde los enfoques fenomenolgico, conductual, bioenergtico y
terapia racional emotiva, teniendo como marco de fondo a la psicologa positiva; usando el
diseo metodolgico del AMATE el cual brinda un trabajo motivador, flexible y dinmico. Cabe
mencionar que este ha pasado en una primera instancia por la validacin del instrumento de
entrada (Escala de conductas de autocuidado para personal de salud (EAPS/KMMEL)); as
como de las actividades que conforman cada fase. Tanto el instrumento de entrada como las
actividades a seguir han reflejado su validez interna y externa, lo que hace de este un modelo
de trabajo aplicable y replicable.
Mindfulness Techniques for Reducing Emotional Exhaustion at Work and Stress Related
Symptoms
Alberto Amutio-Kareaga, Cristina Martnez-Taboada.
Social Psychology, University of the Basque Country, Donostia-San Sebastian, Spain.
Se presentan los resultados de un programa de intervencin grupal basado en las tcnicas
mindfulness -MBSR- (Krasner y cols, 2010; Kabat-Zinn, 2004) aplicado a profesionales mdicos
de diversas especialidades interesados en la reduccin de los niveles de cansancio emocional
en el trabajo, el aumento del bienestar personal, y en la mejora de la comunicacin mdicopaciente. La muestra se compuso de 42 profesionales mdicos del Pas Vasco (Espaa) en
activo que participaron durante 8 semanas con una sesin semanal de dos horas y media de
duracin. Se realiz una evaluacin sistematizada a travs de varios instrumentos: el FFMQ
(Baer, y cols., 2006) para evaluar los niveles de mindfulness, el Inventario MBI de Maslach para
evaluar el burnout, y el PANAS para medir los niveles de afectividad positiva-negativa. As
mismo, se realizaron registros de tasa cardiaca y presin arterial. Por ltimo, se utiliz un
cuestionario cualitativo de evaluacin del programa y de su efectividad en la mejora de las
relaciones interpersonales y en la comprensin de los pacientes. Al cabo de 8 semanas de
entrenamiento, los resultados revelaron un aumento significativo en los niveles de mindfulness
o atencin plena y afectividad positiva, a la vez que descensos estadsticamente significativos

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en los niveles de cansancio emocional en el trabajo, afectividad negativa y estrs percibido,


comparado con el pre-tratamiento. Adicionalmente, se lograron disminuciones significativas de
la tasa cardiaca y la presin arterial. Por ltimo, la muestra estudiada report una mejora en las
relaciones interpersonales en general y en la comunicacin y comprensin de los pacientes en
particular. Posteriormente, se realiz una segunda fase de tratamiento durante un periodo de
10 meses (fase de mantenimiento), a una sesin mensual. Los resultados se mantuvieron, e
incluso mejoraron en varias de las variables estudiadas. Consideramos estos resultados
relevantes tanto por su impacto, la brevedad de la intervencin y lo econmico del formato de
grupo, como por la novedad del encuadre.
A Relao Entre Depncia de Internet e Habilidades Sociais em Universitrios
Rossana Andriola, Luciane Piccoloto, Kelly Paim.
WP, Porto Alegre, Brazil.
Com o advento da internet, efeitos inesperados comearam a indicar seu uso nocivo,
despontando como um novo problema de sade mental. A Dependncia de Internet tem sido
considerada como uma nova psicopatologia, a qual tem trazido diversos danos
funcionalidade do indivduo. Dentre os prejuzos, se destaca a negligencia das conexes
sociais em detrimento de maior quantidade de tempo no mundo virtual. Considerando esta
nova realidade, o presente estudo verificou a existncia de relao entre a Dependncia de
Internet e as Habilidades Sociais em universitrios. Participaram desta pesquisa quantitativa
200 universitrios de ambos os sexos, sendo 104 homens e 96 mulheres provenientes de
Instituies de Ensino Superior da regio metropolitana de Porto Alegre, com idades entre 18 e
60 anos, separados em quatro grupos de acordo com a faixa-etria. Os dados foram
analisados estatisticamente atravs do programa SPSS 16.0, procedendo anlises descritivas,
comparativas (teste t e ANOVA one way) e, finalmente, anlises correlacionais (Correlao de
Pearson). O presente estudo evidenciou uma correlao negativa entre Dependncia de
Internet e Habilidades Sociais altamente significativa (p < 0,01).
Diseo de una Gua Psicoeducativa Sobre Perfeccionismo para Estudiantes
Universitarios Argentinos
Fernan Arana1, 2, Adriana Lago1, Andres Partarrieu1, Mariana Miracco1, 2, Marina Galarregui1, 2,
Patricio Nusshold1, Lorena DeRosa1, Eduardo Keegan1.
1. UBA, Buenos Aires, Argentina, 2. CONICET, Buenos Aires, Argentina.
Se puede definir al perfeccionismo como un estilo de personalidad caracterizado por una
bsqueda de la excelencia y la tendencia a establecer altos estndares de desempeo,
acompaado de una tendencia auto-evaluativa hipercrtica y una creciente preocupacin por
cometer errores (Stoeber & Childs, 2011; Flett & Hewitt, 2002; Frost, Marten, Lahart, &
Rosenblate, 1990). Diversas publicaciones cientficas sealan la relevancia de este constructo
en el mbito acadmico, informando que aproximadamente un 70% de la poblacin
universitaria presentara rasgos perfeccionistas (Rice & Slaney, 2002; Suddarth & Slaney,
2001). A su vez, el perfeccionismo ha sido considerado un factor de causacin y mantenimiento
de diversos trastornos mentales como la depresin, la fobia social, el trastorno de ansiedad
generalizada, el trastorno obsesivo-compulsivo, y la anorexia nerviosa (Enns & Cox, 1999; Flett
et al., 2002; Kawamura, Hunt, Frost, Martin, & DiBartolo, 2001; Stumpf & Parker, 2002). En este
sentido, se ha planteado desde la psicologa clnica y la psicologa preventiva la necesidad de
desarrollar tratamientos transdiagnsticos para este tipo de problema, as como tambin
intervenciones psicoeducativas destinadas a reducir el impacto del aspecto disfuncional

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asociado a este rasgo. A estos fines, nuestro equipo de investigacin ha diseado una gua
psicoeducativa sobre perfeccionismo destinada a estudiantes universitarios Argentinos. El
objetivo de la gua es el de ayudar a los estudiantes a identificar dichos rasgos y generar
estrategias de afrontamiento para los mismos. Nuestro proyecto comparar la utilizacin de la
gua dentro de un formato grupal versus un formato individual. Se discutir sobre el diseo de
la gua y se presentarn resultados preliminares de la utilizacin de la misma en formato grupal.
Combinacin de la Hipnosis y la Terapia Cognitivo-conductual en la reduccin del dolor
y los sntomas de la depresin en pacientes diagnosticadas con Fibromialgia
Carlos Araya.
Psicologa, UNIBE, Tibs, Costa Rica.
La fibromialgia es una enfermedad que se caracteriza principalmente por el dolor crnico
generalizado, que con frecuencia llega a ser discapacitante. Actualmente, la medicacin resulta
insuficiente, por lo que se requiere un abordaje interdisciplinario en el cual las estrategias
psicolgicas como la hipnosis y las tcnicas cognitivo-conductuales representan una opcin
bastante prometedora. Esta investigacin muestra los resultados obtenidos en una intervencin
grupal que consisti en 8 sesiones en el que se utiliz tcnicas hipnticas bsicas en la
disminucin del dolor, bajo un enfoque cognitivo conductual, a un grupo de ocho personas con
fibromialgia en Heredia, Costa Rica. Cada sesin fue estructurada en dos partes; una didctica
y otra orientada a la prctica de la hipnosis, reestructuracin cognitiva, entre otras.dems. Se
entregaron dos Cds, como material de tarea para la casa, uno con sugestiones de seguridad y
autocontrol y otro de disociacin y disminucin en la percepcin del dolor. Se realiz un diseo
de tipo A-B en donde se aplicaron el Cuestionario de Mc Gill sobre dolor, la Escala de Hamilton
para la ansiedad y el Inventario de la depresin de Beck. Los resultados muestran una
disminucin significativa del dolor, as como un nivel muy bajo de ansiedad y la remisin total
de los sntomas de depresin que presentaron en cinco de las participantes del programa.
La Epidemiologa Conductual y los Retos de la Investigacin en Salud
Claudia Astudillo Garca.
Instituto Nacional de Salud Pblica, Cuernavaca, Mexico.
Abstract Central: La epidemiologa conductual es un rea del anlisis de la conducta y de la
psicologa de la salud cuyos objetivos son la identificacin y cuantificacin de la prevalencia e
incidencia de un hecho o comportamiento dado en un tiempo determinado, as como evidenciar
la relacin entre estos cambios conductuales y las alteraciones en los patrones de morbilidad o
mortalidad de una poblacin determinada. En este sentido, la conducta y la salud debe tomarse
como categoras analticas mediante las que se expresan eventos que se relaciona con la
preservacin de la salud o con la aparicin de la enfermedad, donde adems de expresar su
ocurrencia, se debe determinar su frecuencia y modo. Es importante considerar a la conducta
no como agente causal, sino como un medio que regula los estados de salud o enfermedad del
individuo. Por lo que es importante que las polticas y prcticas preventivas de la enfermedad,
se dirijan al estudio de las contingencias saludables de un modo cientfico y basado en
evidencia. En esta ponencia se abordar la importancia de la epidemiologa conductual y los
retos que presenta a nivel de investigacin en el rea de promocin de la salud y su impacto en
la salud pblica.

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Optimizing Patients Expectations before Heart Surgery: Treatment Guidelines,


Feasibility, and First Results
Charlotte Auer1, Johannes Laferton1, Meike Shedden Mora1, Rainer Moosdorf2, Winfried Rief1.
1. Division of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany, 2.
Department of Cardiac and Thoracic Vessel Surgery, Heart Centre, Philipps University,
Marburg, Germany.
Abstract Central: Objectives: Patients expectations predict clinical outcomes in coronary heart
disease and heart surgery. Expectations are modifiable through psychological interventions. It
might thus be promising to enhance patients expectations before heart surgery in order to
improve its benefit. Only few studies have tried to actively enhance preoperative expectations.
The purpose of this clinical trial is to optimize patients outcome expectations before undergoing
coronary artery bypass graft surgery (CABG) through a brief psycho-educational program. Our
treatment program, manipulation-check data, feasibility-data and first results of long-term followup will be presented. Design: The study was a randomized controlled trial comparing patients of
3 groups: (1) an expectation-manipulation intervention (EMI), (2) a supportive therapy (SP) and
(3) standard medical care. In group 1 the intervention focused on the expectations concerning
the surgery and the healing process, while the intervention in group 2 focused on talking about
the feelings concerning the surgery. The intervention comprised two sessions 50 minutes and
two telephone calls 20 minutes and took place before the surgery. Method: A total of 86
patients were assessed before and after the psychological intervention and after the surgery.
Patients expectations were measured with the expectation scales of the Brief Illness Perception
Questionnaire. Treatment completers (N=35) were compared to non-completers (number of
sessions obtained < 4; N=23) in terms of satisfaction. Results: At baseline patients preferred to
talk about their expectations (75.4%) than about their feelings (52.8%), while after the
intervention patients in both intervention groups were highly satisfied. However, a dose-effect
analysis showed a significant interaction (p=.04) between intervention group and treatmentcompletion. Patients in the EMI group were more satisfied when they received the full
intervention. For the patients in the SP group, the satisfaction with the intervention is not
dependent on the dose. Expectations in the EMI group improved significantly compared to both
control groups. Only patients receiving EMI showed increased scores on the expectations
concerning disease duration (F=5.80; p =.01; 2=.24) and personal control (F=6.49; p =.01;
2=.27). First long-term outcome data will be presented. Conclusions: This brief psychoeducational intervention leads to optimized preoperative expectations. This effect can be
specifically attributed to the contents of the expectation-manipulation,since only EMI improved
expectations. Patients were highly satisfied with both interventions indicating that our study
succeeded in establishing a comparable active control group. The dose-effect on satisfaction in
the EMI group suggests that patients getting positive information about the surgery are longing
for more of that kind, whereas emotional support satisfies also in small doses. These results
give a first hint that the manipulation of expectations bears a specific effect above that of
standard care and simple supportive intervention. Future follow-up analyses will reveal if this
effect carries on to clinical measures.
Emotional skills training and training in BreathXpress for people, who intend to travel
to the space, either as astronaut, space scientist or tourist, to leverage their resources in
managing conflicts and emotions while improving physical and mental conditions and
emotional stability in their work and personal life
Celia Avila-Rauch.
Psychotherapie and Windrose Coaching, Munich, Germany.

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Avila-Rauch, C., Snchez Planell, L. University Hospital Germans Trias I Pujol. Department of
Psychiatry and legal medicine of the University Autonomous of Barcelona (Spain) Summary:
Emotional Intelligence has emerged as one of the important components of emotional
adjustment, personal well-being, life success, and interpersonal relationship in different contexts
of everyday life. The researches with Experimental Alba Emoting have found that experience
the emotional patterns of the basics emotions (sadness, anger, fear, happiness, erotic and
tenderness) does several positive changes in various areas of the life of the participants
(emotional, social, family etc) In relation to the emotional patterns, Alba emoting stimulates
the emotional modulation, favouring the socializations and learning of the person. Objectives:
Prevention program to improve the quality of selection process and improving emotional skills in
those, who are preparing for to go into the space or being in space for a long time. Methods:
Symptom Check List (SCL-90); MSCEIT Questionnaire of Mayer-Salovey-Carusso; 24 hrs.
Skills training in emotional intelligence designed by team of the basic psychology of the
psychology university of Malaga Spain; TMM24 Scale meta-knowledge about emotional state;
personality test about survival rules of Ph.D. Serge Sulz CIP-Medien Munich and the training in
basic emotions through breathing Alba Emoting Ph.D. Susana Bloch - Chile Design: we recruit
20 people between 27-35 years, active people, different culture, who are trained as astronaut,
and they are working on some of the international space agencies. 10 of these people become
the different trainings and the other 10 people receive no training but the assessment
questionnaires and they are also selected to go into space. All topics will be covered by
confidentiality and the participants date will be encrypted. We create a type of evaluation
impact, and observe if the skills acquired in training are improvements to interpersonal
relationships and resolve conflicts or help to make better decisions in the team, if the skill could
be relevant for improving the quality of life.
Determinants of the Evaluation of Coping Method Appropriateness in a Sociocultural
Context
Naoko Ayabe1, Hiroshi Morimoto2, 3, Rui Hashimoto1, 4, Sayuri Mine1, Miki Yamano-Ikeda1, 5,
Hironori Shimada6.
1. Graduate School of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan, 2.
Faculty of Psychological Science, Hiroshima International University, Higashihiroshima,
Hiroshima, Japan, 3. Advanced Research Center for Human Sciences, Waseda University,
Tokorozawa, Saitama, Japan, 4. Research Fellow of Japan Society for the Promotion of
Science, Tokorozawa, Saitama, Japan, 5. Department of Psychiatry Musashino Red Cross
Hospital, Musashino, Tokyo, Japan, 6. Faculty of Human Sciences, Waseda University,
Tokorozawa, Saitama, Japan.
The psychological process of stress and coping (Lazarus & Folkman, 1984) is influenced by
sociocultural context (Aldwin, 1994). Particularly, when individuals choose coping methods that
fit the sociocultural context, they better adapt to the sociocultural group (e.g., work group) to
which they belong (Aldwin, 1994; Slavin et al., 1991). However, the process of evaluating
whether a given coping method fits with the sociocultural context (appraisal of coping
acceptability, Morimoto et al., in press) is still unclear. This study examined the relationship
between perceived position in a social interaction and choosing an acceptable coping method in
an experimental setting. Japanese undergraduate students (10 men and 15 women, mean age
= 20.96 years, SD = 1.46) participated in the study. They watched two video clips uniquely
created for this study, and appraised coping acceptability for both, before and after negative
feedback was given in the video. Individuals who evaluated the coping acceptability as less
were defined as having correctly evaluated the coping acceptability of the group after negative
feedback was given. The video clips consisted of stressful interpersonal scenes: Scene A

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showed a character who is yelled at by his boss at a part-time job; Scene B showed a character
being made fun of by a friend in the same club. Participants described freely what they paid
attention to in the scenes and judged the coping acceptability. Four graduate students majoring
in clinical psychology coded the free description by KJ method. They identified three categories:
1) expression and manner of neighboring people (e.g., What co-workers said, Cold eyes from
other group members directed at character); 2) group atmosphere (e.g., I felt friends to be cold
and distant, Most group members made fun of the main character even when the character
hated it); and 3) factors of everyday human relationships or group hierarchy (e.g., In work, I
saw the co-worker as harmless, I saw a friend who made fun of the main character be made
more popular than him in the group). Secondly, a one-way ANOVA was performed with the
total items from the three categories as the dependent variables. The participants who
evaluated coping acceptability correctly showed significant differences in the number of items
from Scene A (p < .05) compared with those who did not evaluate coping acceptability correctly.
The results of this study suggest that individuals who evaluate coping acceptability correctly
choose their coping strategies by considering many viewpoints. According to the results of the
K-J method, participants likely did not just consider the relationships with group members, but
considered the group's overall human relations and atmosphere in choosing a coping strategy.
Therefore, it is necessary to examine the relationship between the three categories we identified
and the appraisal of coping acceptability.
Cortisol Secretion and the Influence on Cognitive Function
Andressa Becker da Silva, Marilda Lipp.
Pontifcia Universidade Catlica de Campinas PUCC, Campinas - SPC, Brazil.
INTRODUCTION - With the hectic pace of our everyday lives, the accumulation of jobs and
demands beyond human capacity comes stress, a biopsychosocial imbalance, mainly related to
the perception between the demand and the possibility of resolving and fulfilling these
requirements. It is known that stress, in its phases of exhaustion and near-exhaustion, presents
as the tentative response of the organism to regain homeostasis, with a concurrent increase in
the concentrations of cortisol. Hence the question, in what way does the secretion of cortisol
affect cognitive function? METHODS - In order to perform this study, we searched for
information in the Scielo, Pubmed and Medline databases of the last 10 years, using the
keywords stress, cortisol, cognition and behavior. RESULTS - Cortisol is a glucocorticoid
hormone synthesized in the cells of the cortex in the adrenal glands. The production of cortisol
is controlled by the adrenocorticotropic hormone (ACTH), which is synthesized in the anterior
pituitary gland. Cortisol affects numerous cognitive domains including attention, perception,
memory and emotional processing. Alterations in the size of the hippocampus are linked to the
reduction of cortisol. Selective attention to threatening information varies according to an
individuals level of anxiety or depression. There is some evidence to suggest that the
exogenous administration of corticosteroids impedes selective attention resulting in diminished
acuity of the senses and a reduced capacity to retain information. Therefore, moderate
elevations of cortisol may alter the processing of information. Nevertheless, some studies have
been performed that have not established any connection between attention and cortisol. The
physiological effects of cortisol on cognition and behavior follow the inverted-U curve, where
moderate levels are fine when compared to high and low levels. Cortisol acts on a variety of
regions within the brain. Reductions in mineralocorticoids and glucocorticoids affect the
amygdala, the hippocampus, prefrontal lobe, and thus may alter physiology, behavior and
cognitive function. When emotional stimuli are processed, the amygdala, temporal region and
the prefrontal cortex are important for perception and memory of this type of stimulus. The
amygdala has the main role in the variety of emotional stimulus and electrical stimulations in this

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region result in the growth of cortisol concentrations. The perception of negative affective stimuli
may result in the elevation of this hormone. Regions of the amygdala and hippocampus that
contain mineralocorticoids and glucocorticoids, participate in the system of memory of personal
events. DISCUSSION - Knowing that cortisol presents these psychophysiological reactions, it is
up to future researchers to think about how to reduce this stress and consequently the cortisol
concentrations, to prevent cognitive function from being affected. Email:
andressa_becker@hotmail.com
Adaptacin, Aplicacin y Evaluacin de la Eficacia de Un Programa para la Prevencin
de ITS/VIH en Mujeres Adolescentes (DIVINE II): Conocimiento y Habilidades Sociales
Mari Paz Bermdez1, Maria Teresa Ramiro1, Nickia D. Braxton2, Deja L. Er2, Aaron T.
Vissman2, Gualberto Buela-Casal1, Ralph J. DiClemente2.
1. Universidad de Granada, Granada, Spain, 2. Emory University, Atlanta, Georgia.
Aunque la tasa de nuevas infecciones producidas por el VIH ha disminuido en algunas regiones
del mundo durante la ltima dcada, en Europa Occidental y Central se ha mantenido estable
desde 2004 (ONUSIDA, 2011). En lo referente a la transmisin de ITS/VIH, se han detectado
diversas conductas de riesgo tales como; no usar preservativo de forma consistente y
adecuada, una alta frecuencia de relaciones sexuales y un elevado nmero de parejas
(Beadnell et al., 2005; Kelley, Borawski, Flocke y Keen, 2003), as como un debut sexual
prematuro (Castro, Bermudez, Madrid y Buela-Casal, 2011; Pettifor, Van der Straten, Dunbar,
Shiboski y Padian, 2004). Por ello, el objetivo de este estudio es la aplicacin y evaluacin de la
eficacia de una serie de estrategias preventivas para el riesgo de ETS/VIH, basadas en la
Teora cognitiva social, concretamente relacionadas con el conocimiento y las habilidades
conductuales. Segn la Teora cognitiva social, una vez que se haya actuado sobre el
conocimiento de las normas sociales, y la creencia de que pueden llevar a cabo el cambio
(autoeficacia) se debe aportar informacin a cerca del riesgo que conlleva la conducta que se
pretende modificar, y de las posibles estrategias de cambio. Por ello, se llev a cabo la
adaptacin (Braxton, Bermdez, Er, Ramiro y DiClemente, 2009) de una serie de estrategias
incluidas en un programa de intervencin de probada eficacia en los Estados Unidos
(DiClemente, et al., 2004) a travs del modelo ADAPT-ITT (Wingood y DiClemente, 2008).
Dichas estrategias estn destinadas a promover el conocimiento sobre ITS/VIH, el concepto de
riesgo, vas de transmisin y vas de prevencin, as como el entrenamiento en habilidades
para emitir conductas seguras, como el uso del preservativo. La muestra estuvo formada por
190 mujeres espaolas de edades comprendidas entre los 15 y 18 aos, que fueron
aleatorizadas al grupo experimental, formado por 112 mujeres (M=15,59; DT= 0,82), y al grupo
control, formado por 88 mujeres (M=15,90; DT =1,08). La aplicacin de las estrategias
preventivas se realiz sobre las mujeres pertenecientes al grupo experimental, que se
dividieron en 12 grupos, en un taller de 4 horas de duracin. Por el contrario las mujeres
pertenecientes al grupo control recibieron un dossier informativo con prcticas y hbitos
saludables. Para determinar la eficacia de las estrategias preventivas, se realiz una
evaluacin en diferentes momentos; pre-intervencin, post-intervencin, y seguimiento a los 3 y
6 meses. La evaluacin se realiz tanto al grupo control, como al grupo experimental, y estaba
formada por los siguientes cuestionarios: (1) Cuestionario sobre conocimiento sobre ETS/VIH
(Sikkema et al., 2000); (2) Escala de preocupacin sobre ETS/VIH (Crosby et al., 2001); (3)
Actitudes hacia el uso del preservativo (DiClemente y Wingood, 1998); (4) Barreras para el uso
del preservativo (Wingood y DiClemente, 1998); y, (5) Autoeficacia en el uso del preservativo
(Wingood y DiClemente, 1998). Posteriormente, se realizaron los anlisis estadsticos
pertinentes, y se exponen los resultados estadsticamente significativos.

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Adaptacin, Aplicacin y Evaluacin de la Eficacia de Un Programa para la Prevencin


de ITS/VIH en Mujeres Adolescentes (DIVINE I): Normas Sociales, Autoeficacia y
Reduccin del Riesgo
Mari Paz Bermdez1, Gualberto Buela-Casal1, Maria Teresa Ramiro1, Deja L. Er2, Nickia D.
Braxton2, Aaron T. Vissman2, Ralph J. DiClemente2.
1. Universidad de Granada, Granada, Spain, 2. Emory University, Atlanta, Georgia.
El comportamiento sexual de los adolescentes se ha convertido en una materia de inters en
los ltimos aos, debido a la alta tasa de conductas sexuales de riesgo que esta poblacin
presenta (Guerrero, Garca-Jimnez y Moreno, 2008; Morrison-Beedy, Carey, Crean y Jones,
2011). Las enfermedades de transmisin sexual y los embarazos no deseados en esta etapa
evolutiva muestran unas cifras an alarmantes (Centers for Disease Control and Prevention,
2010; Gonzlez, Snchez-Crespo y Gonzlez, 2009; Internacional planned parenthood
federation, 2007). En 2008, el 40% de las nuevas infecciones por el VIH se produjeron en
personas de entre 15 y 24 aos (ONUSIDA, 2010). Por ello, el objetivo de este estudio es la
aplicacin y evaluacin de eficacia de una serie de estrategias preventivas para el riesgo de
ITS/VIH, basadas en la Teora cognitiva social, concretamente relacionadas con las normas
sociales y la autoeficacia. La teora cognitiva social considera que el cambio de
comportamiento se deriva de un proceso social influenciado por la interaccin con otras
personas en el entorno social. Por ello, previo a otro tipo de intervenciones es necesario
promover el conocimiento de las normas sociales, para fomentar la aceptacin de normas que
apoyen las estrategias de reduccin de riesgos, y adems fomentar la creencia de que pueden
realizar el nuevo comportamiento incrementando su autoestima y estado de nimo
(autoeficacia). Para ello, se llev a cabo la adaptacin (Braxton, Bermdez, Er, Ramiro y
DiClemente, 2009) de una serie de estrategias incluidas en un programa de intervencin de
probada eficacia en los Estados Unidos (DiClemente, et al., 2004) a travs del modelo ADAPTITT (Wingood y DiClemente, 2008). Dichas estrategias pretenden promover los objetivos
especificados, y fueron aplicadas en un mdulo de 4 horas, a grupos de 8-10 mujeres. La
muestra estuvo formada por 190 mujeres espaolas de edades comprendidas entre los 15 y 18
aos, que fueron aleatorizadas al grupo experimental, formado por 112 mujeres (M=15,59; DT=
0,82), y al grupo control, formado por 88 mujeres (M=15,90; DT =1,08). La aplicacin de las
estrategias preventivas se realiz sobre las mujeres pertenecientes al grupo experimental, que
se dividieron en 12 grupos. Por el contrario las mujeres pertenecientes al grupo control
recibieron un dossier informativo con prcticas y hbitos saludables. Para determinar la eficacia
de las estrategias preventivas, se realiz una evaluacin en diferentes momentos; preintervencin, post-intervencin, y seguimiento a los 3 y 6 meses. La evaluacin se realiz tanto
al grupo control, como al grupo experimental, y estaba formada por los siguientes
cuestionarios: (1) Escala de Autoestima (Rosemberg, 1965); (2) Escala sobre el estado de
nimo (Santor y Coyne, 1997); (3) Escala sobre percepciones de normas del grupo de iguales
(Bermdez, Snchez y Buela-Casal, 2000); y, (4) Escala de apoyo social percibido (Zimet,
Dahlem, Zimet y Farley, 1988). Posteriormente, se realizaron los anlisis estadsticos
pertinentes, y se exponen los resultados estadsticamente significativos.
Formas de Enfrentamento e Nveis de Ansiedade de Mulheres Soropositivas
Luciana Bernardes da Rosa.
1. UNIVERSIDADE PAULISTA - UNIP, So Jos do Rio Preto, Brazil, 2. INSTITUTO DE
PSICOTERAPIA COGNITIVO-COMPORTAMENTAL - IPC, So Jos do Rio Preto, Brazil.
Abstract Central: A partir de dados do Ministrio da Sade (2004) desde o incio da dcada de
80 at setembro de 2003, foram notificados 277.154 casos de Aids no Brasil. Diante do

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diagnstico positivo ao HIV/AIDS e das implicaes que ocorrem na vida do portador, surgem
alteraes psicolgicas, entre as mais comuns esto estresse, depresso e ansiedade. As
barreiras de adaptao doena causam impacto significativo na vida desses indivduos em
relao ao cotidiano e s possibilidades de busca por qualidade de vida. Este estudo objetivou
correlacionar estratgia de enfrentamento e nvel de ansiedade de mulheres soropositivas.
Participaram da pesquisa 30 mulheres, com idade entre 25 a 74 anos, com baixa escolaridade
que estavam em acompanhamento mdico na rede de sade pblica e em Organizaes no
Governamentais (ONG). Foram utilizados o Inventrio de Estratgias de Enfrentamento
(Coping) de Folkman e Lazarus, o Inventrio de Ansiedade de Beck (BAI) e Questionrio
Sciodemogrfico. As estratgias mais utilizadas foram centradas na emoo, Resoluo de
Problemas 65,7 Reavaliao Positiva 67,5 e a mais utilizada pela amostra foi a Fuga/Esquiva
73,3%,. Quanto aos nveis de ansiedade, constatou-se que 83% das mulheres apresentaram
sintomas clnicos de ansiedade, sendo que 37% delas apresentaram nvel grave deste sintoma.
Concluiu-se que a ansiedade elevada apresentada pela amostra pode estar relacionada
estratgia de fuga e esquiva que explicaria a dificuldade das pacientes em realizarem
acompanhamento psicolgico e mesmo em aderirem ao tratamento.
Efecto del Curso, Psicologa 430 Terapia Cognitiva Conductual, en las Actitudes
Disfuncionales de los Estudiantes del IV ao de la Facultad de Psicologa de la
Universidad de Panam
Fabio Bethancourt.
Psicologa Clnica y de la Salud, Universidad de Panam, Panama, Panama.
Abstract Central: Objetivo: Evaluar los efectos del programa de la asignatura terapia cognitiva
conductual en las actitudes disfuncionales de los estudiantes que participaron en el mismo.
Mtodo: Se aplico la Escala de Actitudes Disfuncionales ( EAD ) de la Dra.A.Weissman al
inicio, al final del semestre y tres meses y medio despus a un poblacin seleccionada en
forma no probabilstica de 26 y 11 estudiantes con una edad promedio de 20 aos y 19 aos en
el grupo experimental y grupo control respectivamente. Resultados: Se confirma que hubo
diferencias significativas con 0.05 al aplicar la t de student en las siete actitudes disfuncionales
en conjunto en el grupo de estudiantes participantes al comparar los resultados obtenidos en
las medias totales en el pre test y postest en el mismo grupo y en referencia al grupo control.
Consecuentemente, los estudiantes del grupo experimental mantuvieron la disminucin en las
medias totales de la intensidad en las actitudes disfuncionales examinadas durante la fase de
seguimiento de 3 meses y medio. Conclusiones: Programas educativos que incluyen una
metodologa donde los estudiantes bajo supervisin ejercen el rol de consultores dentro del
curso de terapia cognitiva pueden influir en el cambio de las actitudes y creencias hacia un
sentido de funcionalidad en sus propios compaeros cuando estos participan como
"consultantes" en la metodologa de enseanza como en los trabajos de evaluacin. Se
identificaron cambios en las siete actitudes disfuncionales examinadas al compararse las
medias entre grupo experimental y control incluyendo la fase de seguimiento, excepto en la
actitud de aprobacin y autonoma cuando se compararon los pre y post test en el grupo
experimental apareciendo stas como de actitudes disfuncionales que podran constituirse en
metas para prevenir limitaciones en la formacin y en el desarrollo personal de los futuros
psiclogos(as).
Eficacia de un Programa Psicolgico para Dolor Crnico en Pacientes Ambulatorios
Gabriela Blanco1, Rossana Lopez1, Diana Agudelo1, Marixa Guerrero2, Yvonne Gmez Gmez
Maquet1, Mariantonia Lemos1.

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1. Universidad de los Andes, Bogota, Colombia, 2. Instituto Roosevelt, Bogota, Colombia.


El dolor crnico es un problema de salud pblica en el mundo. Segn el Estudio Nacional de
Dolor 2011 en Colombia, 55.3% de los encuestados report dolor en la ltima semana y 81.8%
en el ltimo ao. La mayor prevalencia reportada es en mujeres y aumenta con la edad. Se
indica una alta correlacin con niveles de disfuncionalidad y se constituye en la primera causa
de incapacidad laboral (Andersson, 2004; Diaz et al, 2009; Smith & Torrance, 2012). Asimismo,
se reporta una alta comorbilidad con trastornos mentales (Demyttenaere et al., 2007). Para
evaluar la eficacia de un programa psicolgico orientado al manejo del dolor crnico se hicieron
evaluaciones pre test y post test, utilizando el Inventario de Depresin de Beck, Inventario de
Depresin Estado Rasgo IDER, Inventario de Ansiedad Estado Rasgo STAI, Cuestionario de
Estrategias de Afrontamiento Modificado y Cuestionario de Salud SF36 para evaluar calidad de
vida. Posterior a las ocho sesiones del programa, los participantes mostraron diferencias
significativas en las medidas de depresin (Beck: Me pre-test = 13.5, R.I = 25.25; Me post-test
= 6.50, R.I. = 10.50; IDER Estado: Me pre-test = 23.0, R.I. = 8.50; Me post-test = 15.50, R.I. =
5.50, p<0.05), as mismo en dos subescalas de calidad de vida: funcionamiento social (Me pretest = 43.75, R.I. = 34.38; Me post-test = 62.5, R.I. = 25.0) y dolor (Me pre-test = 22.5, R.I. =
30.63; Me post-test = 40.0, R.I. = 46.88). En las dems escalas de calidad de vida, as como en
ansiedad se observ una tendencia favorable en el post-test. Estos datos evidencian la
importancia de la intervencin psicolgica en los pacientes con dolor crnico, conjuntamente
con la intervencin mdica. Igualmente el trabajo grupal podra favorecer la percepcin de
apoyo social, lo cual ha demostrado ser un amortiguador del estrs en estos pacientes.
Calidad de Vida Relacionada con la Salud en Pacientes del Servicio de Medicina Interna
del Hospital General de Atizapn (Mxico)
Marcelo Archibaldo Bravo Caldern1, 2, Fernando Pascual Vazquez Pindea1.
1. Universidad Nacional Autonma de Mxico, Distito Federal, Mexico, 2. Hospital General de
Atizapan, Atizapn de Zaragoza, Mexico.
El objetivo del presente estudio fue analizar el impacto de distintas enfermedades, sobre la
calidad de vida relacionada con la salud (CVRS). Se analiza el grado de este impacto, de
acuerdo a la evolucin de la enfermedad, la respuesta al tratamiento y de las caractersticas
sociodemogrficas de los participantes. La muestra de participantes estuvo formada por los
pacientes que ingresaron al servicio de medicina interna del Hospital General de Atizapn
(Mxico), a lo largo de 180 das. Se excluyeron del estudio a los pacientes ingresados al rea
de terapia intensiva, los diagnosticados con dao neurolgico, y aquellos que no tuvieran un
estado de conciencia que permitiera la aplicacin del instrumento. Para cada paciente se
recolect la siguiente informacin: edad, sexo, estado civil, ltimo grado de estudios,
ocupacin, motivo de ingreso al servicio de medicina interna, padecimientos mdicos y
psiquitricos prexistentes, y tiempo de diagnstico de los mismos. Posteriormente, a cada
participante se le aplic el EQ-5D-5L (TheEuroQolGroup, 2011; Herdman et al., 2011), el cual
es un instrumento diseado para evaluar la calidad de vida relacionada con la salud. Este
instrumento se ha aplicado a un amplio rango de condiciones de salud, y actualmente ha sido
traducido a 94 idiomas diferentes (www.euroqol.org). El instrumento est compuesto de dos
partes: el sistema descriptivo y la escala visual anloga (EVA). El sistema descriptivo se refiere
a la evaluacin de cinco dimensiones: movilidad, cuidado personal, actividades cotidianas,
dolor/malestar, y ansiedad/depresin. Cada una de estas dimensiones es calificada en cinco
niveles de gravedad (sin problemas, problemas leves, problemas moderados, problemas
graves y problemas extremos). La segunda parte, consiste en una escala visual anloga (EVA),
en donde al participante se le pide hacer una evaluacin general instantnea de su estado de

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salud. La EVA esta numerada de 0 (la peor salud que se pueda imaginar) a 100 (la mejor salud
que se pueda imaginar), y el paciente debe de marcar con un cruz la puntuacin que mejor
refleje su estado de salud actual. Se analiz el impacto de distintas enfermedades sobre el
nivel general de calidad de vida (escala EVA), as como el impacto sobre las cinco dimensiones
que evala el sistema descriptivo del EQ-5D-5L. A partir de ese anlisis, se realizaron
comparaciones entre la enfermedad presentada, y 1) el nivel de dificultades que tena la
persona para moverse, 2) los problemas para realizar conductas de auto-cuidado, 3) los
inconvenientes para llevar a cabo actividades cotidianas, 4) el experimentar dolor o malestar, y
5) la presencia de ansiedad o depresin. Adicionalmente, tambin se analizo el grado de
influencia del nivel de evolucin de la enfermedad, y de las caractersticas sociodemogrficas
de los participantes. En general se observan una variedad de formas de impacto, de grado
variable de discapacidad y funcionalidad derivadas de la enfermedad y su tratamiento, que
compromete el adecuado funcionamiento cognitivo y conductual de la persona, y su capacidad
de relacionarse con su medio. Para concluir, se discuten algunas implicaciones clnicas y se
hacen sugerencias de intervencin cognitivo-conductual, para reducir el impacto de la
enfermedad sobre el nivel de calidad de vida en los pacientes que solicitan atencin al servicio
de medicina interna del Hospital General de Atizapn (Mxico).
Efectos de una Intervencin Cognitivo-Conductual Sobre la Adhesin Teraputica y la
Ansiedad en Pacientes Asmticos
Nancy Caballero Surez1, Ivonne Prez Snchez1, Margarita Fernndez Vega2, Juan Jos
Snchez-Sosa1.
1. Facultad de Psicologa, Universidad Nacional Autnoma de Mxico, Mxico, Mexico, 2.
Instituto Nacional de Enfermedades Respiratorias, Mxico, Mexico.
Abstract Central: Introduccin: El asma constituye un problema serio de salud por su
prevalencia, por el sufrimiento que genera, por el deterioro que causa en la calidad de vida del
paciente y su familia, y por los costos que genera su tratamiento. Se ha documentado que la
adhesin teraputica inadecuada o insuficiente y la presencia sostenida de emociones
negativas intensas interfieren con el tratamiento mdico. Objetivo: Evaluar la efectividad de una
intervencin cognitivo-conductual sobre la adhesin y los niveles de ansiedad de pacientes
asmticos. Mtodo: Participaron 14 mujeres y 1 hombre con diagnstico confirmado de asma.
Se realiz un ensayo clnico con 15 rplicas individuales del efecto del tratamiento. Se utiliz un
sistema de autorregistro conductual para conductas de adhesin, frecuencia de reacciones
emocionales negativas y de sntomas; se hicieron registros de indicadores fisiolgicos y se
aplic el Inventario de Ansiedad de Beck (BAI). Resultados: Se registraron cambios en toma de
medicamento de 75.79% de toma adecuada semanal a 99.04% (p=.001), exposicin a
desencadenantes de 12.27 veces a la semana a 4.40 veces (p=.001), uso de medicamentos de
rescate de 8.20 veces a la semana a 2 veces (p=.018), la frecuencia con la que los pacientes
reportaron preocupacin de 3.60 veces a la semana a menos de una vez (p=.003), el puntaje
del BDI de 20.27 a 7.53 (p=.001), la frecuencia con que los pacientes percibieron los sntomas:
disnea de 5.29 veces a la semana a 1.29 (p=.001), dolor en el pecho de 2.64 veces a la
semana a menos de una vez (p=.001) y flemas de 3.57 veces a la semana a 1.07 (p=.001).
Conclusin: La intervencin result efectiva para mejorar adhesin teraputica y disminuir
ansiedad en pacientes asmticos.
Eficacia de la Distraccin para Modificar el Catastrofismo en Pacientes Postquirrgicos
Kattia Cabas- Hoyos1, Georgina Cardenas-Lopez2, Jos Gutirrez - Maldonado3, Gonzalo
Torres - Villalobos4.

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1. Facultad de psicologa, Universidad Pontificia Bolivariana, Montera, Colombia, 2.


Universidad Nacional Autnoma de Mxico, Ciudad de Mxico, Mexico, 3. Universidad de
Barcelona, Barcelona, Spain, 4. Fundacin Mdica Sur, Ciudad de Mxico, Mexico.
Abstract Central: Un nmero creciente de publicaciones soportan la eficacia de la distraccin
por medio de realidad virtual para controlar o reducir tanto el dolor experimental como clnico.
El presente estudio explora la eficacia de la Distraccin en el manejo del dolor de pacientes
post-quirrgicos. Setting: El estudio fue conducido en un Hospital privado nivel III de la Ciudad
de Mxico. Sujetos: 10 pacientes con edades entre los 18 y 42 aos de edad (22,8) hicieron
parte del estudio. Todos se encontraban hospitalizados debido a ciruga. Intervencin:
Analgsicos estndar y Realidad Virtual Distraccin. Tipo de Diseo: es un diseo Pre - Post
que inclua medidas repetidas. El nivel del dolor y los pensamientos Castastrficos fueron
evaluados. Anlisis estadsticos: Se realiz una prueba MANOVA para determinar la
significacin de los pensamientos catastrficos antes y despus de la ciruga. Los resultados
muestran que la Distraccin result eficaz para modificar dos de los tres subcomponentes del
Catastrofismo. Los resultados se discuten en relacin a la eficacia de la tcnica para reducir el
dolor no solo fsico sino las variables cognitivas implicadas en dolor.
Internet-Delivered Psychological Intervention for Insomnia
Ana Calero-Elvira, Alejandra Montoro, Carlos Marchena-Girldez, Carolina lvarez, Pei-Chun
Shih.
Universidad Autonoma de Madrid, Madrid, Spain.
Insomnia is a highly prevalent health problem with additional consequences that affect the
patient's daily functions. The persistence of the problem impacts negatively in the patient's
psychological well-being and physical health. Evidence shows that the multi-component
cognitive behavioral therapy (CBT) is an effective treatment for chronic and persistent insomnia.
Nowadays, the challenge is no longer efficacy but effectiveness and, specifically, to make CBT
for insomnia more available. In this study, we aimed to investigate the feasibility and
effectiveness of using the Internet to deliver a semi-self-guided CBT intervention for adults with
chronic insomnia. We developed a highly structured multi-component CBT on-line intervention
for insomnia, organized in eight sessions. There were three sections in each session:
Information, Activities and Tools. Therapists also had a web application to follow the patient's
evolution. Patients were recruited from a public mental health clinic. Fifteen patients accepted to
participate in this study. We applied the ISI and the PSQI in the first and the last session of the
program. Several indicators of sleeping problem and patient's emotional state were registered
during the program. Additionally, patients completed a satisfaction rating questionnaire in the
last session. About treatment adherence, only five patients completed the whole program. In
regard to the level of compliance, patients showed a higher difficulty with activation
management using relaxation training. About treatment effectiveness, we observed that the
differences between pre- and post-assessment were significant in both insomnia indices (ISI
and PSQI). We also observed a slight improvement in the patient sleepingquality and their
general emotional state. The results indicate that patients using this internet-delivered
intervention for insomnia improved in solving their sleeping problem. Additionally, they were
satisfied with the program. But the high attrition rate in this on-line intervention is an issue we
have to confront in the future.
Terapia Cognitiva-Comportamental Aplicada em Programa de Reabilitao
Cardiovascular e Metablica de Centro Universitrio do Sul do Brasil

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Prisla Calvetti.
Unilasalle, Porto Alegre, Brazil.
Abstract Central: Diversos sos os fatores relacionados ao desenvolvimento da hipertenso e
diabetes, bem como outras doenas cardiovasculares e metablica. A ateno interdisciplinar a
populao adulta se faz necessria, vista a complexidade das interaes socioculturais e
econmicas, alm das biolgicas, envolvidas no processo sade-doena. Dentre as
intervenes psicolgicas, a avaliao e terapia sob a modalidade cognitiva-comportamental se
destaca para auxiliar em estratgias de identificao de pensamentos, sentimentos e
comportamentos disfuncionais relacionados a hbitos no saudveis. O objetivo do presente
trabalho apresentar a insero da Psicologia sob a modalidade de avaliao e interveno da
terapia cognitivo-comportamental em Programa Interdisciplinar de Reabilitao Cardiovascular
e Metablica de centro universitrio do sul do Brasil. A populao alvo oriunda da rede de
sade municipal em situao de vulnerabilidade social. A interveno constituda de
entrevista motivacional, avaliao da conceitualizao cognitiva, que inclui registro dos
pensamentos, sentimentos e comportamentos disfuncionais. Tambm da identificao de
hbitos saudveis e no-saudveis para mudana de comportamento e/ou fortalecimento dos
saudveis. Dentre as intervenes de avaliao realizadas observa-se que a sade mental
alterada no propicia hbitos saudveis, identificou-se que pensamentos negativos relacionase a baixa auto-estima o que leva o paciente ao descuido alimentar e no realizar atividade
fsica, bem como quando relata baixo suporte social. A equipe de Psicologia constituda por
uma psicloga e duas acadmicas do Curso, visam motivar os pacientes atendidos para a
prtica de hbitos saudveis integrado a perspectiva interdisciplinar e da terapia cognitivacomportamental. A terapia cognitivo-comportamental auxilia no fortalecimento de estratgias de
manuteno de hbitos saudveis para reduo da incidncia e prevalncia de doenas
cardiovasculares e metablica.
Avaliao Cognitiva-Comportamental de Usurios Adultos das Clnicas Integradas de
Sade do Centro Universitrio La Salle (Brasil)
Prisla Calvetti, Darlene Ramos, Raquel Jarquin, Antnio Barbosa.
Centro Universitrio La Salle, Canoas, Brazil.
Abstract Central: Este trabalho de interveno multidisciplinar realizado nas Clnicas
Integradas do Centro Universitrio Unilasalle, tem como objetivo avaliar a sade do adulto para
promoo, preveno e tratamento de doenas cardiovasculares, pulmonar e sndrome
metablica. O pblico alvo dessa aplicao so os colaboradores que trabalham na vigilncia
da Instituio. A interveno multidisciplinar compreende as reas de Enfermagem, Nutrio,
Educao Fsica e Psicologia. A sade mental, envolveacadmicos e professores da rea
psicolgica na aplicao de um questionrio elaborado apartir do mtodo cognitivo
comportamental, abordando trade cognitiva, registro de pensamentos disfuncionais,
sentimentos e comportamentos sobre hbitos saudveis. Alm disso, experincias da infncia
como episdios estressores, percepo sobre auto- estima e qualidade de vida e fatores
motivacionais para mudana e/ou manuteno de hbitos saudveis. A partir desta avaliao
foram identificadas e observadas as necessidades urgentes e emergentes dos usurios para
promoo da sade do corao. Foi constatado que os profissionais que trabalham
principalmente na viglia da noite, tem menor qualidade de vida, tendo menos tempo para o
auto-cuidado. Os usurios atendidos referiram m qualidade do sono, alimentao, dificuldade
de tempo para famlia e lazer. A m qualidade do sono parece evocar emoes e sentimentos
de irritabilidade, agressividade, fadiga e tambm ansiedade, favorecendo comportamentos
compulsivos, inclusive na ingesto de alimentos no saudveis e colaborando para o

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sedentarismo quanto prtica de exerccios fsicos, diminuindo assim a qualidade de vida. Fazse necessrio o investimento em interveno multidisciplinar e na abordagem cognitivacomportamental para avaliao de pacientes para promoo da sade do corao.
Perfil Bio-Psico-Social de Personas con Intento Suicida: Sntesis de Parmetros
Everardo Camacho1, Claudia Vega-Michel1, Luis Sanchez Loyo2, 3.
1. ITESO AC, Tlaquepaque, Mexico, 2. Universidad de Guadalajara, Guadalajara, Mexico, 3.
Unidad de Toxicologa. Servicios Medicos de Guadalajara, Guadalajara, Mexico.
Abstract Central: El objetivo del presente trabajo es resear la construccin de un perfil biopsico-social de las personas con intento suicida, con objeto de generar parmetros de medida
que posibiliten prevenir situaciones de riesgo del intento suicida.Se reporta una investigacin
exploratoria sobre la relacin entre indicadores fisiolgicos de estrs, indicadores de salud
mental y rasgos de personalidad. Se evaluaron a 60 mujeres con edad entre los dieciocho a
cuarenta aos. La mitad de ellas con intento suicida. Se aplicaron instrumentos autoaplicables
sobre ansiedad, depresin, estrategias de afrontamiento, riesgo suicida, trauma infantil y
desesperanza, as como pruebas de desempeo atencional continuo (CPT) Se evalu el perfil
psicofisiolgico de estrs y se tomaron muestras de cortisol salival. Se observa una asociacin
entre los niveles de ansiedad y las estrategias de afrontamiento; entre los niveles de ansiedad y
los niveles de desesperanza, as como entre el rasgo de personalidad de transgresin de
normas y los errores en la tarea CPT. Sin embargo no se observ ninguna relacin entre el
perfil de estrs fisiolgico y los instrumentos autoaplicables, as como tampoco con las tareas
de rasgos de personalidad y CPT. Palabras clave: Estrs, psicofisiologa, cortisol, pruebas de
personalidad, salud mental, ansiedad.
Evaluacin del Ajuste de un Modelo Cognitivo-Comportamental de Cefaleas en
Estudiantes Universitarios
Valentina Candini1, Florencia Crdenas Piani1, Franca Fabbro1, Luciana Moretti1, 2, Leonardo
Medrano1, 2.
1. Laboratorio de Psicologa Cognitiva, Universidad Nacional de Crdoba, Crdoba, Argentina,
2. CONICET, Crdoba, Argentina.
Abstract Central: El dolor es una experiencia desagradable que padece un gran nmero de
personas en la actualidad, por lo que su estudio es fundamental como aporte para el alivio del
sufrimiento humano (Mir, 2006). A travs de los aos se han desarrollado explicativos del
dolor en los cuales las variables miedo y evitacin fueron presentadas como mecanismos
cruciales para explicar cmo se produce la experiencia de dolor. No obstante, stos ltimos no
contemplan el rol de las variables cognitivas y conductuales mediadoras y moduladoras que
han demostrado tener un valor predictivo importante sobre el dolor y la experiencia asociada a
ste (Anarte, Esteve, Lpez, Ramrez & Camacho, 2001; Camacho Martel & Anarte Ortiz, 2003;
Vlaeyen & Linton, 2000; Rodrguez Franco et al., 2000; Moix Queralt, 2005). Por ello, el
objetivo del presente trabajo fue evaluar el ajuste de un Modelo Cognitivo-Comportamental
para la prediccin de la intensidad del dolor en cefalea, en estudiantes universitarios de la
ciudad de Crdoba. De este modo, se determin la contribucin directa e indirecta de creencias
de control, de las creencias y pensamientos hacia el dolor y de estrategias de afrontamiento en
la prediccin de la intensidad del dolor en cefalea, as como el valor predictivo directo de
conductas de dolor y de incapacidad, sobre la intensidad del dolor. Se conform una muestra
de 382 estudiantes de ambos sexos de la ciudad de Crdoba (Argentina), a los que se aplic
una serie de instrumentos que miden las variables propuestas por el Modelo Cognitivo-

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Comportamental de Cefalea. En primer lugar, se realiz un anlisis descriptivo y exploratorio de


los datos; posteriormente, se apel al uso del Modelo de Ecuaciones Estructurales. Los anlisis
realizados revelaron un ajuste aceptable del modelo, aunque con valores inferiores a los
criterios propuestos por Hu y Bentler (1998). Por ello, el mismo se re-especific eliminando dos
indicadores, con lo cual se logr un mejor ajuste: los valores de CFI y GFI fueron de .91 y .95
respectivamente (un valor de .95 da cuenta de un ajuste excelente), mientras que el ndice
RMSEA fue ptimo con un valor de .05. Este nuevo modelo explica un 47% de la varianza de la
intensidad del dolor en estudiantes con cefaleas. Todas las variables poseen una relacin
directa con la intensidad del dolor, dando cuenta de su prediccin sobre la misma. Cabe aadir
que las creencias y pensamientos hacia el dolor son las variables que mostraron mayor valor
predictivo (.68).
Recent Advances of Cyberpsychology in Mexicoo
Georgina Cardenas-Lopez1, Lorena Flores1, Georgina Cardenas-Lopez1, Ximena Durn-Baca1,
Georgina Cardenas-Lopez1, Georgina Cardenas-Lopez1, Anabel De la Rosa - Gmez1, Samuel
Jurado1, Jos Gutirrez - Maldonado4, Kattia Cabas- Hoyos2, Georgina Cardenas-Lopez1, Jos
Gutirrez-Maldonado4, Gonzalo Torres - Villalobos3, Georgina Cardenas-Lopez1, Giuseppe
Riva5, Gonzalo Torres - Villalobos3, Perla Martnez1, Ximena Durn-Baca1, Andrea Gaggioli5.
1. National Autonomous university of Mexico, Mexico, Mexico, 2. Universidad Pontificia
Bolivariana, Montera, Colombia, 3. Fundacin Mdica Sur, Mexico, Mexico, 4. Universidad de
Barcelona, Barcelona, Spain, 5. Istituto auxologico italiano, Milan, Italy.
The use of new technologies in the field of clinical psychology is no longer a possibility,
nowadays these tools have proven to be effective and useful for the different tasks that the
professionals have to perform in this field. The rapid development of information technology,
allows the applications in psychology to be increasingly innovative and flexible. The potential of
the applications of advanced technologies for health has led to the emergence of an area of
research and technological development in the behavioral sciences.
In recent years, the findings and progress made by various researchers, have contributed to the
generation of knowledge to incorporate technologies in this field, in particular its applications to
psychology are amazing and documented as effective and promising. Currently, the field counts
with extensive evidence of the effectiveness of clinical intervention for diverse psychological
disorders. Particularly in Mexico, the implementation of systems based on advanced
technologies for the treatment of psychological disorders, is emerging.
The efforts made by the Virtual Teaching and Cyberpsychology laboratory of the Faculty of
Psychology, of the National Autonomous University of Mexico, have focused on the
technological development of three-dimensional graphic models of virtual reality for disorders
such as agoraphobia, posttraumatic stress disorder obsessive compulsive disorder, and eating
disorders such as obesity. This symposium describes the results of psychological interventions
with the use of virtual reality technologies in the treatment of obesity; complicated grief through
online therapy, psychology teaching through virtual learning environments and virtual
simulators, and a study on the interaction of emotions in online depression programs. It also
discusses the emergence of Cybertherapy as a tool that has been successfully used to optimize
the delivery of psychological services to people who are socially isolated and have social or
geographical barriers
Human Computer Interaction in facial emotion recognition in an evaluation process via
internet.
The ability to generate facial expressions congruent to a mood or situation is a fundamental
aspect of human development. Emotions are complex chains of events (feedback loops) that

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facilitate behavioral regulation in humans, these events include cognitive elements. In terms of
psychology, emotions are related to a series of conceptual derivatives, such as traits and
personality disorders and coping styles. Specifically for mood disorders there are papers that
have studied expressions in patients with depression and other psychological disorders such as
anxiety or schizophrenia
Although advances in Internet interaction in face recognition have been encouraging, the task
has not been entirely straightforward, especially in application areas. Therefore, we propose the
development of this research, which aim to evaluate facial expressions in patients attending an
assessment by videoconference for Psychotherapy Via Internet service.
The results shown are from 27 participants (13 without depressive symptoms and 14 with
symptoms) that were evaluated during three sessions of 60 minutes each. During three
sessions, their facial expressions (presence and intensity) were captured and analyzed with the
tool FaceReader.
Face recognition as one of the main technology has several advantages over other biometric
technologies: such as not being invasive and easy to use.
There is correspondence between the results offered by FaceReader and data collected by
therapists in an evaluation process via the Internet. The study is a contribution to the work
already established in the analyzes of facial emotions and the processes that occurs in human
computer interactions via the Internet in a clinical process and even makes a unique
contribution in research lines that facilitate the automation of diagnoses in a Mexican population
An Online Therapy Intervention for Complicated Grief after a Violent Death
Anyone who has experienced the loss of a loved one is likely to feel that life is complicated due
to the loss. Even under the best conditions, grief is a complex and individual process, but there
are particular types of losses that complicate the grieving process even more, because of the
circumstances surrounding death .Research has identified a number of factors that may
exacerbate mental health problems and adaptation in individuals with mourning, leading to
Complicated Grief, these factors include sudden, unexpected, violent and traumatic death.
Violent dying from homicide, suicide, accident, combat or terrorist attack accounts for nearly
10% of annual deaths worldwide, and clinical studies document the commonality of a syndrome
of combined trauma distress (intrusive thoughts, flashbacks and dreams of the dying - even
though the dying was rarely witnessed) and separation distress (pining and searching for the
deceased) in close friends and family members . A violent death by homicide is more than one
death. It is a death caused by an external action. Violent death, involves the drama of a fatal
human act, someone is killed by someone else. Mexico is currently experiencing one of the
most violent periods in its recent history, it is estimated that during 2010 there were 12 658
executions in the country, representing an increase of 52 percent compared to the cases
reported in 2009.
In addition to the violent death of a significant one the violent situation that exists in the country
has generated among survivors fear and insecurity, thus increasing the chances of developing a
pathological mourning process. This has increased the need for intervention programs for this
population.
The aim of this paper is to show preliminary results of an Online Therapy cognitive-behavioral
intervention for the treatment of Complicated Grief, the treatment consists of 10 to 12 weekly
sessions of 90 minutes, including the evaluation sessions and contains modules, such as,
relaxation, psychoeducation, cognitive restructuring of dysfunctional thoughts, exposure and
relapse prevention. The treatment sessions are carried through the Management System for
Psychotherapy Services via Internet which is a platform for therapy that contains and stores all
the therapeutic tools used in session (assessment, psychoeducation files, exercises, articles,
books, etc.) This work represents an important contribution in addressing a socially relevant
problem; by performing this intervention remotely we were able to overcome problems such as

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distance and insecurity. We described the results obtained from the different assessments and
measures taken of a single case study. And the outcomes and benefits reported by the patient.
Evaluation of Virtual Simulators for Teaching Interview Skills and Clinical Diagnostic in
Psychology Students.
Psychologist and health care professionals have a real demand to have a training that ensures
greater efficiency and competition in solving public health problems. In order to solve this issue,
it requires human resources with professional competence for diagnosis, intervention and
evaluation of health services that can test and implement. These capabilities are generated
through training, which includes mastery of the techniques and procedures for effective
intervention. Simulation is a technique to replace or amplify real experiences of patients with
targeted experiences, artificially planned, evoking or reproduced the substance of the real world
in a fully interactive way. As an educational strategy, simulation provides the opportunity for
learning in both areas: immersive and empirical way. Virtual simulator practice provides security
to make mistakes in a safe environment, learn from those mistakes and improve abilities.
Additionally, virtual simulation has the potential to recreate scenarios that are unlikely to be
experienced, allowing students to try challenging situations, with the opportunity to examine his
actions and interact with the virtual simulator. It is considered a practical teaching tool able to
teach students and professionals to achieve the highest levels of competence and accuracy.
This paper shows the preliminary results of virtual simulator assessment for teaching skills to
conduct a clinical interview and differential diagnosis of psychological disorders for psychology
students. Involved 90 psychology students, who were studying psychodiagnosis and clinical
interview technique subjects, who voluntarily agreed to join the study, aged between 18 and 33
years. A quasiexperimental design was used conformed by two independent groups with
repeated measures before and after simulated practice. An experimental group of students
performed virtual simulator practice during a 2-hour session, the other group belonged to the
control group (traditional classroom lesson). The psychodiagnostic skills assessment data from
before and after session showed the use of virtual environments conducive to learning is
effective as a tool to support teachers in the classroom. The virtual simulators development for
teaching in health psychology field allows students to have a motivating learning. Thus, applying
what they learned in their practice as psychologists
Efficacy of Virtual Reality Distraction to decrease pain after Laparoscopic Bariatric
surgery: A Case Study
One of the advantages of laparoscopic bariatric surgery is the reduced level of postoperative
pain. In some cases, however, the pain level may be high. The use of virtual reality (VR) for pain
management is a relatively new approach that has been proved useful with specific populations
and acute medical procedures . Objective. This case study explores the use of VR distraction in
an 18 year-old patient who had undergone laparoscopic bariatric surgery and who reported pain
during the postoperative period. Setting. The study was conducted in a Level III Private Hospital
in Mexico City where the patient was hospitalized. VR Intervention. The VR intervention
encouraged participants to actively search the correspondence between the experienced pain
and a VR stereoscopic figure, which could be interactively manipulated with the mouse. The
patient was administered standard analgesic during VR distraction, which lasted a total of 40
minutes divided into two sessions. Measures. The scores of three visual analog scales and
catastrophism were the dependent variables of this study. The scales were administered before
and after the VR distraction intervention. Results. Participant demonstrated increases in pain
threshold and pain tolerance. Moreover, the participants during the VR intervention showed a
significant reduction in catastrophizing Conclusion. This study proves that VR distraction can be
effective not only in reducing the physical component of pain (a notion that is already well

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established) but also the cognitive/affective component. More controlled studies of the issue are
required.
Efficacy of a Virtual Reality treatment for Obesity
Obesity represents a serious problem of public health, according to recent studies, this condition
is increasing at an critical rate globally. Nowadays, the results of the treatments of patients with
obesity or overweight appear to be very disappointing. Crawford, Jeffery and French, conducted
a study that examined the success of maintaining weight for 3 years in a sample of 854 patients.
A 53.7% of the patients regained their weight in the first 12 months, and just 1 in 20 (4.6)
managed to keep the changes successfully.
For morbid obesity, bariatric surgery is the only successful treatment; however there's still too
much ethical questions about how that intervention affect the quality of life in the patients at long
term.
Virtual reality (VR) has had important applications in the treatment of several anxiety disorders.
In such treatments the patients are gradually exposed to stimuli that trigger anxiety. Stimuli are
generated by the computer with 3D graphic models with which they can interact in real time.
On the other hand, VR has been used whit success to treat eating disorders, specifically with
people with anorexia or nervous bulimia. Riva demonstrated that using VR as a tool in the
treatment of obesity was even more effective and efficient than treatment through cognitive
behavioral therapy and that such results are maintained in the 6-month follow-up.
Currently Medica Sur Hospital is conducting a collaborative project that has as main goal: to
evaluate the efficacy of a treatment program for obesity with the use of VR. The virtual
environments were developed with the purpose of exposing patients to situations in order to
discover the difficulties that they may face in the real word, also to improve cognitive and
behavior abilities to deal situations that can trigger inadequate behaviors in the weight
maintenance. The obtained results of a randomized clinic trial with three independent groups
with repeated measures within subjects (pre-treatment, pos-treatment and 3 and 6 months
follow-ups) are presented. The participants were assigned randomly to each of the three
conditions: X1 = Traditional treatment program (TT): nutritional groups; X2 = Cognitive
behavioral therapy program (CCT) and X3 = Cognitive experiential program with virtual reality
(CEP-VR). Results will be discussed in the light of background studies.
Sentimentos e Emoes de Mulheres Submetidas Cirurgia do Cncer de Mama
Cristina Cardoso, Carmen Andrade.
Unimar, Marilia, Brazil.
CARDOSO, Cristina Peres*; ANDRADE, Crmen Valria dos Santos**. Linha de pesquisa:
Psicologia da Sade Segundo o Ministrio da Sade, o cncer de mama a neoplasia que
mais acomete as mulheres, sendo um dos cnceres mais comuns entre as mulheres e pode
levar a morte caso no seja detectada logo. Estima-se que h 1.050.000 casos novos
anualmente em todo o mundo. E estima-se que no Brasil em 2006, houve 48.930 casos com
risco estimado de 52 casos a cada 100.000 mulheres. O cncer de mama o segundo tipo de
cncer mais frequente no mundo e o primeiro entre as mulheres, sendo que as taxas de
incidncia do cncer de mama dobraram nos ltimos 30 anos e aumentando tambm a
mortalidade. Portanto a preveno de cncer tornou-se um dos principais objetivos dos
programas de sade pblica como mudana de hbito e vcios alm de imunizaes e controle
de riscos relacionado ao modo de vida destas mulheres. O objetivo desta pesquisa identificar
os fatores de risco mais comuns associados ao cncer de mama em mulheres que foram
submetidas cirurgia; compreender os fatores que levam as alteraes na auto-estima destas
mulheres; identificar as principais alteraes emocionais presentes nas mulheres; identificar as
principais alteraes envolvidas na dinmica familiar; identificar os temas mais relevantes de

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interesse destas pacientes. O estudo foi realizado atravs de uma pesquisa de campo na
Unidade de Radioterapia da Faculdade de Medicina de Marlia - Famema e na Associao de
Combate ao Cncer de Marlia (ACC), interior do Estado de So Paulo, contando tambm com
a aprovao dos responsveis pelas unidades presentes. As mulheres mastectomizadas foram
selecionadas aleatoriamente conforme o retorno Unidade de Radioterapia da Famema ou
fisioterapia na Associao de Combate ao Cncer (ACC) de Marlia no perodo novembrodezembro de 2011 e fevereiro-maro de 2012. Estas mulheres foram convidadas a participar
da pesquisa e orientadas a respeito da finalidade da pesquisa e a importncia da autorizao
do Termo de Consentimento Livre e Esclarecido. O projeto teve aprovao do Comit de tica
em Pesquisa com Seres Humanos da Faculdade de Medicina de Marlia, e a coleta de dados
foi realizada aps aprovao do mesmo. Segundo as normas previstas pela resoluo 196/96
do Conselho Nacional de Sade (CNS) sobre pesquisa com seres humanos. Trata-se de uma
pesquisa descritivo-exploratria, entrevista semi-estruturada, com abordagem quantitativa e
qualitativa. A pesquisa se encontra na fase de tabulao dos dados, mas pretende-se que esta
pesquisa seja publicada em revistas da rea, apresentada em congressos para que suas
concluses sejam conhecidas e utilizadas por psiclogos, profissionais da sade e pela
sociedade, fornecendo subsdios para um melhor entendimento e tratamento das mulheres
submetidas cirurgia de cncer de mama. Palavras-chave: Sentimentos e Emoes. Mulheres.
Mastectomia. __________________________ *Acadmica do curso de Graduao em
Psicologia/UNIMAR cristinacard@terra.com.br **Docente do curso de Graduao em
Psicologia/UNIMAR - andradecarm@gmail.com
Depresin, Estilos de Comunicacin y Adhesin al Tratamiento en Personas con
Diabetes Mellitus Tipo 2: Validacin de Instrumentos en una Muestra Venezolana
Irama Cardozo Quintana, Jose Rondon.
Instituto de Psicologa, Universidad Central de Venezuela, Caracas, Venezuela.
Abstract Central: Las personas a quienes se les diagnostica diabetes presentan riesgo de
padecer depresin, riesgo asociado con factores como el tiempo de evolucin de la
enfermedad, el control sobre los comportamientos de autocuidado y las complicaciones de la
diabetes (Anderson, Freedland, Clouse y Lustman, 2001; Colunga, et.al, 2008). La depresin
usualmente genera alteracin en los hbitos de vida, alimentacin, decremento de
comportamientos sociales, expresin inadecuada de los sentimientos e ideas y puede conllevar
a menor adhesin al tratamiento y menor control de la enfermedad (Ciechanowski, Katon y
Russo, 2000; Buela-Casal, Sierra y Cano, 2001; Jimnez y Miguel-Tobal, 2002). El objetivo de
esta investigacin es analizar la influencia de la depresin, el estilo de comunicacin asertivopasivo-agresivo y la adhesin al tratamiento sobre los niveles de glucosa en sangre en sujetos
con diabetes tipo 2. La primera fase consisti en validar los instrumentos: Cuestionario
Tridimensional para la Depresin CTD (Jimnez y Miguel-Tobal, 2002), Autoinformes de
Actitudes y Valores en las Interacciones Sociales ADCAS (Garca y Magaz, 1992) e
Instrumento para Medir el Estilo de Vida en Diabticos, IMEDIV (Lopez-Carmona, ArisaAndraca, Rodriguez-Moctezuma y Munguia-Miranda, 2003). La muestra para la validacin de
los cuestionarios CTD y ADCAS, estuvo conformada por 202 participantes con diagnstico de
diabetes mellitus tipo II, hipertensin arterial o trastornos anorrectales. Se sometieron los datos
a un anlisis factorial comn de mxima verosimilitud, cuyo objetivo es reflejar las dimensiones
subyacentes que reflejan lo que las variables tienen en comn, adems de una rotacin
ortogonal VARIMAX para maximizar las cargas factoriales. Igualmente, se obtuvo el coeficiente
alfa de los tres instrumentos como ndice de consistencia interna. Finalmente, se observ si los
factores obtenidos se correspondan con las dimensiones sealadas por los autores de los
instrumentos. En lo que refiere al CTD, el anlisis factorial arroj tres factores: motor, cognitivo

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y fisiolgico; los cuales explican un 31,83% de la varianza. La prueba total presenta un ndice
de confiabilidad alpha de Cronbach de 0,85. El anlisis factorial aplicado al ADCAS, arroj dos
factores (heteroasertividad y autoasertividad) que explican un 35% de la varianza, con un
ndice de confiabilidad alpha de Cronbach de 0,92. Por su parte, la muestra para la validacin
del IMEVID estuvo conformada por 134 participantes con diagnstico de diabetes mellitus tipo
II. Los resultados arrojaron ndice de confiabilidad alpha de Cronbach para la prueba total de
0,60. El anlisis factorial arroj ocho factores que explican el 59,56% de la varianza (Adhesin,
consumo de alcohol, consumo de tabaco, tipo de nutricin, emocin, ejercicio, informacin y
cantidad de comida). Se concluye que los instrumentos CTD, ADCAS e IMEVID, son vlidos en
pacientes venezolanos con enfermedades crnicas, por lo que se consideran aptos para ser
aplicados en la siguiente fase de la investigacin: el estudio de la influencia de la depresin,
asertividad y adhesin al tratamiento en la hemoglobina glicosilada de pacientes con diabetes
mellitus tipo 2
Stress da Criana Hospitalizada em Situao Pr-Cirrgica e Sua Relao com Variveis
Sociodemogrficas e Nvel de Informao
Luciana Carnier1, Gimol Perosa1, Olga Rodrigues2, Flvia Padovani1.
1. Hospital das Clnicas da Faculdade de Medicina de Botucatu (Unesp - Botucatu), Botucatu,
Brazil, 2. Universidade Estadual Paulista (Unesp - Bauru), Bauru, Brazil.
A hospitalizao infantil para cirurgia envolve uma sobrecarga emocional para a criana devido
aos possveis procedimentos invasivos e traumticos a que poder ser submetida,
necessidade de enfrentar situaes desconhecidas, causando stress,ansiedade e desamparo.
As fantasias, medos e reaes negativas, que acompanham esses quadros tornam a
hospitalizao algo temido, e pode proporcionar elevados nveis de stress. H estudos na
literatura mostrando que algumas variveis socidemograficas como idade, sexo, escolaridade
materna, ocupao, assim como o nvel de informao oferecidos criana sobre o
procedimento cirrgico e suas conseqncias, podem influir no nvel de stress da criana prcirurgica. A crena que crianas pequenas no compreendem o que ocorre com elas, ou o
medo que se assustem com as explicaes mdicas e venham a sofrer perturbaes
emocionais faz com que pouca informao seja dada, especialmente s mais novas. Assim,
este estudo se props a avaliar o nvel de stress de crianas que seriam submetidas a cirurgias
eletivas, e sua relao com a informao oferecida e com variveis sociodemograficas. Para
tanto, foi aplicada a escala brasileira para avaliao de stress infantil - Escala de Stress
Infantil (ESI) em 63 crianas com idade entre sete e 12 anos, hospitalizadas para cirurgias
eletivas. A escala, alm de avaliar a presena de stress, identifica a sintomatologia
apresentada pela criana (fsica, psicolgica, psicolgica com componente depressivo e
psicofisiolgica). Os acompanhantes responderam a um Questionrio de Levantamento de
Informaes, composto por 15 questes, para obter dados sociodemograficos, da
hospitalizao e as informaes que a criana recebeu acerca da cirurgia. Foi possvel
observar que cerca de 37% das crianas apresentaram stress ou risco para stress, com
prevalncia de sintomas psicolgicos (33,06%). Os maiores nveis de stress estiveram
associados criana ter entre sete a oito anos,ser do sexo feminino, no ter experincia
anterior com cirurgia e receber pouca informao acerca do perodo peri-operatrio. Nota-se
ainda que as crianas menores (7 a 8 anos), as meninas e as crianas sem experincia
anterior com cirurgias foram as que receberam as informaes de forma mais incompleta e
geralmente somente dos cuidadores. Os dados mostram a importncia de haver uma maior
comunicao e preparao pr-cirrgica com as crianas, para que se possa diminuir o
impacto psicolgico dos procedimentos cirrgicos, especialmente das reaes de stress, com a
finalidade de melhorar as condies ps-operatrias destes pacientes.

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Prevalncia de Transtornos Psiquitricos em Queimados: Uma Reviso Sistemtica


Maria Coimbra, Carolyne Juvenil, Ivan Figueira, Paula Ventura.
UFRJ, Rio da Janeiro, Brazil.
A queimadura um dos acidentes que causa maior sofrimento fsico e psicolgico. A vtima de
queimadura passa por um longo perodo de tratamento, constante enfrentamento de situaes
dolorosas como cirurgias e todo processo de internao hospitalar devido ao isolamento
espacial e social, deformao fsica e dependncia fsico-afetiva, alm do persistente
pensamento sobre a morte. Na literatura possvel encontrar diversos trabalhos que discutem
a relao entre internao, ansiedade e dor neste tipo de paciente. Porm, nota-se que por
essa freqente vivncia de momentos extremamente dolorosos, o indivduo se torna mais
exposto ao desenvolvimento de transtornos psiquitricos. O objetivo do presente estudo fazer
uma reviso sistemtica da prevalncia de transtornos psiquitricos na populao de vtimas de
queimadura. Alguns transtornos psiquitricos podem ser fatores de risco para o paciente
passar por uma queimadura grave, como o alcoolismo e o abuso de substncias; assim como a
alta taxa de pacientes queimados com graves sintomas de depresso e transtornos de estresse
ps-traumtico. A base de estudo utilizada para a reviso foi a ISI. Para a pesquisa foram
utilizadas as seguintes palavras-chave: burns, mental disorder, psychiatric morbidity,
depression, posttraumatic stress disorder, anxiety. Foram encontrados 273 artigos e desses, 8
foram selecionados, entre os anos de 1998 a 2012, em portugus, ingls e espanhol; uma vez
que preenchiam os seguintes critrios: estudos com diagnstico com base no DSM-IV,
avaliao realizada logo aps a internao, com pacientes queimados hospitalizados. Estudos
de casos, diagnstico realizado com base em outros instrumentos, revises tericas foram
excludos da reviso. Os artigos apresentaram amostragem mdia de pacientes avaliados logo
aps internao de n=120,6 e apenas um artigo utilizou grupo de comparao (outros traumas
que no envolviam queimadura) e outro comparou os dados encontrados com a populao
geral. Dos estudos apresentados, 7 realizaram a avaliao psiquitrica logo aps a internao,
outros 7 tiveram follow-up no mnimo 3 semanas aps. Sero discutidos os aspectos
metodolgicos dos artigos revisados, bem como as prevalncias de transtornos psiquitricos
ps-queimadura, caractersticas dos pacientes pr-queimadura e diferentes aspectos do
trauma que possam influenciar no desenvolvimento destes transtornos. Os pacientes vtimas
de queimadura apresentam maiores porcentagens de transtornos psiquitricos quando
comparados com a populao geral (ou no vtima de queimadura), e os sintomas de
transtornos como a depresso e o transtorno de estresse ps-traumtico se mostraram mais
graves. Os resultados adicionais da reviso sero apresentados, bem como discusses
relevantes sobre o tema.
Terapia Cognitivo Conductual en Fibromialgia: Eficacia de un Programa Grupal Sobre el
Malestar Emocional
Maria Isabel Comeche1, Jos Ortega Pardo1, Javier Rivera2, Miguel ngel Vallejo1.
1. Psicologa de la Personalidad, Evaluacin y Tratamiento Psicolgicos, UNED - Universidad
Nacional de Educacin a Distancia, Madrid, Spain, 2. IPR - Hospital Universitario Gregorio
Maran, Madrid, Spain.
Abstract Central: Mara Isabel Comeche, Jos Ortega, Javier Rivera y Miguel ngel Vallejo
Muchos pacientes con fibromialgia (FM), adems del dolor y la discapacidad fsica, tienen
alteraciones graves del estado de nimo. Los sntomas ansioso-depresivos parecen estar,
segn datos recientes, significativamente asociados con el perfil sintomatolgico de los

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pacientes de FM, presentndose dichos sntomas en una proporcin ms elevada en


comparacin con otras condiciones de dolor crnico. La literatura cientfica parece confirmar la
eficacia de la Terapia Cognitivo Conductual (TCC) como tratamiento para las personas con FM,
siendo recomendable la intervencin grupal para mejorar los sntomas auto-informados de la
FM, as como los niveles de depresin y ansiedad. El objetivo de este estudio (estudio clnico
aleatorizado a largo plazo) es analizar la eficacia a corto, medio y largo plazo de un programa
de 10 sesiones de TCC, protocolizado y en grupo, sobre el malestar emocional en los pacientes
de FM. Un total de 44 pacientes diagnosticadas con FM (todas mujeres) fueron asignadas
aleatoriamente a una de dos condiciones experimentales: (1) Grupo de Control (tratamiento
ambulatorio habitual) y (2) Grupo Experimental (TCC). Los sntomas depresivos y de ansiedad
se evaluaron mediante las versiones espaolas del Beck Depression Inventory (BDI) y del
Hospital Anxiety and Depression Scale (HADS), medidos antes y despus de la intervencin.
Adems, en el grupo experimental se valoraron estos sntomas en las tres sesiones de
seguimiento programadas (3, 6 y 12 meses despus de finalizar la intervencin de TCC). Los
resultados mostraron una reduccin significativa en los sntomas de ansiedad y depresin en el
Grupo de TCC al final del programa, en comparacin con la evaluacin inicial. Las diferencias
en el Grupo Control no fueron significativas. La mejora registrada en depresin al final del
tratamiento en el Grupo TCC se mantuvo en las sesiones de seguimiento realizadas a los tres y
seis meses despus; sin embargo la mejora en ansiedad fue debilitndose con el paso del
tiempo, retornando a partir de los 3 meses a niveles similares a la lnea base. Al medir los
cambios medios en la gravedad de la sintomatologa depresiva en el grupo experimental se
observa que, tras el tratamiento, se produce un incremento significativo en el porcentaje de
pacientes con niveles de gravedad normal y leve, segn el BDI y normal segn el HADS-D.
Esta mejora, aunque con fluctuaciones, se mantiene durante el seguimiento. Los cambios
observados en los niveles medios de gravedad de la sintomatologa ansiosa, medida con el
HADS-A, aunque significativos, son de menor magnitud, y no se mantienen en el seguimiento.
Los resultados de este trabajo confirmaran la eficacia de este programa de TCC en la
reduccin de los niveles de malestar emocional al final la intervencin y el mantenimiento de la
mejora en los sntomas depresivos a medio plazo. Se discuten finalmente los posibles motivos
de la prdida de mejora en los sntomas ansiosos durante el seguimiento, proponindose ideas
para subsanar dicho aspecto y optimizar este tipo de intervenciones.
Theoretical and Applied Investigations in Social Skills
Camila Comodo1, Catarina Teixeira1, Fabiane Silveira1, Natalia Orti2, Zilda Del Prette1, Almir Del
Prette1.
1. Universidade Federal de So Carlos, So Carlos, Brazil, 2. Universidade Estadual Paulista
"Jlio de Mesquita Filho", Bauru, Brazil.
Social Skills consist in classes of social behavior, which contribute to social competence.
However, the social performances to be considered socially competent must meet the
instrumental criteria - the achievement of objectives, access to positive and negative reinforcers,
approval of verbal community - and the moral-ethical criteria of social competence - balance of
reinforcing consequences to the person and the others, concerning short and long term. The
central reasoning of Social Skills Training (SST) rests on the premise that a wide repertoire of
social skills facilitates more satisfying interactions, whereas interpersonal difficulties are
associated with restrictive relationships which do not produce the expected effects. With this
study, developed by researchers from the Interpersonal Relations and Social Skills group, aims
to contribute to the discussion of this theme, by presenting theoretical investigations, review of
literature and clinical case studies which describe how social skills have been the target of
research and clinical intervention with different populations and clinical complaints. It consists in

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four studies: In the first (1) the objective was to identify and characterize the academic
production of Brazilian studies about assertiveness. There were identified 52 studies published
from 1992 to 2012. The categories of analysis were: theoretical characterization and / or
correlations; interventions; construction, adaptation and validation of instruments and mixed.
The theoretical studies were analyzed from subcategories, while the other categories were
described in terms of population, number of authors, design, objectives and data collection. The
results indicated a predominance of theoretical studies, followed by characterization studies and
/ or correlations. The analysis demonstrated research gaps and provided discussions of
possible investigations. The second study (2) discusses, from the results of an intervention
procedure with mothers, the importance of specific social parenting skills to internalizing
behavior problems clinical treatment, as well as the implications to the strengthening preventive
strategies for mental health. The objective of the third study (3) was to review the studies of SS
and bullying. There were found 41 researches from 1998 to 2012. Both theoretical and
characterization papers discuss the influence of SS in victims and perpetrators repertoire. The
applied research demonstrates intervention programs that have some element of social skills to
treat bullying and evaluates the results. It is discussed the variables which might be responsible
for producing inconclusive data on the relationship between bullying and social skills. In the
fourth study (4) is argued, from evaluation results of social skills in five families of young
offenders, the importance of empathy (inference that other people have in private events
followed by demonstration of acceptance / understanding) and self-control (the choice of larger
reward available after long delay, management of aversive situations) repertoires to the
production of reinforcement in social interactions, which are incompatible with antisocial
behavioral pattern.
Contrato de Contingencia Aplicado a Tecnoestres en Adolescentes Escolarizados
Norma Coppari.
1. Psicologia, Universidad Catlica, Asuncion, Paraguay, 2. Conacyt Paraguay, Asuncion,
Paraguay.
Abstract Central: Resumen Esta investigacin aplicada tiene como primer objetivo presentar,
la correlacin hallada entre el uso de las nuevas tecnologas y las manifestaciones de
tecnoestrs en estudiantes de la educacin media de un colegio pblico (N=154) y un colegio
privado (N=188) de Asuncin. La muestra intencional y auto-selectiva, por consentimiento
informado, fue de 342 estudiantes, 155 varones y 187 mujeres, de la Educacin Media. Los
instrumentos utilizados fueron los cuestionarios: Empleo de las nuevas tecnologas en sus tres
modalidades de uso ms frecuentes y Manifestaciones de tecnoestrs. Se aplic un diseo
descriptivo, correlacional y comparado para la fase de deteccin, y cuasiexperimental para la
de intervencin. Se prueba correlacin significativa, al nivel de 0.01, entre las variables de
estudio. En la fase de intervencin, se convoco a un Taller, a los jvenes y sus padres
interesados en participar de un Contrato de Contingencia para modificar los comportamientos
de excesos en relacin al uso desmedido de las TICs, y sus consecuencias en los mbitos
escolar, familiar y social. Se aplicaron Tcnicas de Autorregulacin como Relajacin y
Respiracin Profunda, Administracin del Tiempo, Principio de Premack y contingencias
positivas. El reporte de lo padres y jvenes es de una disminucin de hasta 30% del tiempo
excesivo de uso, sobre la lnea base de hasta 60%, incremento de las horas de estudio y
socializacin con pares y familia hasta en un 50% de los casos (N=60) para el colegio publico y
(N=75) para el privado, con el mejoramiento de calificaciones en las materias y decremento de
los reportes de conducta no ajustadas a las reglas de la institucin. Palabras Claves: Nuevas
Tecnologas - Tecnoestrs - Estudiantes - Contrato de Contingencias

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Desgaste Profesional y Bienestar Psicolgico en Docentes de la Provincia de de San


Luis, Argentina
Maria Correche, Pamela Robles Ridi, Mara Tapia.
Facultad de Psicologa, Universidad Nacional de San Luis, San Luis, Argentina.
El Burnout describe el estado fsico y mental en relacin con el trabajo, caracterizndose por
incremento del cansancio emocional, despersonalizacin y reduccin de la autorrealizacin
personal (Maslach y Jackson, 1982). Investigaciones han constatado que el estrs tiene un
impacto negativo sobre el Bienestar subjetivo (Caplan, 1983; Pearlin, 1981). El presente
estudio tiene como objetivos explorar las posibles relaciones entre Sndrome de Burnout y
Bienestar Psicolgico en Docentes Universitarios y no Universitarios, comparar ambos grupos
con el objeto de examinar las diferencias y semejanzas en las variables estudiadas. La muestra
total accidental no probabilstica qued conformada por 97 docentes -de ambos sexos- de la
Provincia de San Luis (48 de la Universidad Nacional de San Luis; 49 Nivel Inicial, Primario y
Secundario). Se aplicaron los siguientes instrumentos: 1)- Inventario Burnout (MBI), de
Maslach, C, (1997): evala los sntomas caractersticos del Sndrome (Cansancio emocional,
Despersonalizacin, Falta de Realizacin Personal) 2)-Escala de Bienestar Psicolgico en
Adultos (BIEPS-A) de Casullo, M y cols. (2002) analiza las cuatro categoras del Bienestar
Psicolgico (Control de Situaciones, Aceptacin de S Mismo, Vnculos Psicosociales,
Autonoma). En relacin al Sndrome de Burnout, los resultados indican la ausencia del mismo
en los Docentes Universitarios y no Universitarios, no encontrndose diferencias significativas
para dicha variable en relacin a gnero. Al analizar por Categora en los Docentes
Universitarios, se encontr una diferencia significativa en la dimensin Realizacin Personal,
siendo menor en la Categora Auxiliar que en la Categora Profesor. Con respecto al Bienestar
Psicolgico, tanto en hombres como en mujeres, se observa un nivel medio siendo levemente
ms elevado en Docentes Universitarios pero sin llegar a ser una diferencia significativa. Se
considera que este trabajo, contribuira a la comprensin de los profesionales de la educacin
dirigido a realizar una aproximacin a las prcticas preventivas en el mbito pedaggico. Es un
aporte a nivel preventivo, a fin de detectar a tiempo cualquier indicador que lleve a padecer el
Sndrome de Burnout y afecte el Bienestar subjetivo general de los Docentes Universitarios y
No Universitarios, y, en este sentido, poder contar con estrategias que promuevan la salud
mental en esta poblacin.
Applying Cognitive-Behavioral Interventions in Primary & Specialty Medical Care
Travis Cos.
1. Care Clinic, Public Health Management Corporation, Philadelphia, PA, USA, 2. La Salle
University, Philadelphia, PA, USA.
Abstract Central: There is a high rate of behavioral health problems in primary care medical
settings, especially among clinics that treat the uninsured and underserved populations, such as
individuals with HIV+/AIDS. It is often difficult for primary care providers to accurately detect and
diagnosis mental health problems. Less than 50% of patients referred by their primary care
medical providers follow-through on referrals to outpatient behavioral health. One study recently
predicted that 6% of those with behavioral health problems in America ultimately receive
appropriate evidence-based care for their conditions. This presentation will discuss one clinics
use of a new, growing, population-focused approach toward improved patients' psychological
wellness and enhanced daily functioning. The integrated behavioral health consultant model
involves imbedding a mental health professional (i.e., social worker, psychologist) into the
primary care clinic. Instead of having a traditional practice with a limited caseload, the
behavioral health consultant is available for immediate access to patients, referred by their

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primary care provider, the same day as the patients medical appointment. The focus of the
consultation is to assess, provide brief cognitive-behavioral therapeutic interventions, help
coordinate necessary outpatient referrals, and make recommendations to assist health
providers in managing their patients behavioral health needs. The presentation will address the
development, initiation, financial feasibility, and two years of outcome data from the integration
of the behavioral health consultation model in primary care in one urban, U.S., federallyqualified health center. Special focus will be placed on how this model may be transferred to
other clinic settings, across cultures.
Motivation and Perfectionism
Amlie Cossette, Frdric Langlois.
Universit du Qubec Trois-Rivires, Trois-Rvires, QC, Canada.
In a literature review, Stoeber and Otto (2006) demonstrated that healthy perfectionists display
higher levels of positive characteristics compared to unhealthy perfectionists and nonperfectionists. On the other hand, unhealthy perfectionists show higher levels ofstriving for
perfection and perfection concerns. One way to analyze this continuum is through the lens of
motivational profiles. Motivation is characterized by internal or external triggering direction,
intensity and persistence of behavior (Vallerand, 2006). Behavior differs when it is adopted by
choice (intrinsic) rather than it is acquired as a result of external pressures (e.g. reward).
Intrinsic motivation the level of pleasure and satisfaction feeling. In contrast, extrinsic motivation
is associated with a lack of self-determination and rigidity (Ryan & Deci, 1985). Therefore, these
two motivational sources can be explained in terms of a continuum. However, we know very
little about the motivational processes associated with healthy and unhealthy perfectionism.
Striving for perfection may be perceived as a manifestation of intrinsic motivation. If this is the
case, what kind of motivation underlies unhealthy perfectionism? We applied the selfdetermined motivational model (Vallerand, 1997) to perfectionism to answer this question and
we assessed perfectionism and motivation of 364 adults from the general population.
Participants completed the Perfectionism Questionnaire (PQ measures general striving for
perfection (healthy perfectionism) but also the level of negative manifestationsof perfectionism
(unhealthy perfectionism)), the Global Motivation Questionnaire, the Life Satisfaction
questionnaire, the Anxiety and Depression scale, the Cognitive Flexibility inventory and the
Perfectionist Attitude scale. Results demonstrated that healthy perfectionism is positively
correlated with intrinsic motivation, when negative consequences of perfectionism are
controlled. In contrast, negative consequences of perfectionism negatively correlated with
intrinsic motivation but positively correlated with external regulation and introjected motivation.
Two step-wise regression analyses were used to assess the motivational processes that best
predict PQ subscales. In each regression, the shared variance of both PQ subscale is controlled
first. On one hand, results demonstrated that intrinsic motivation was the best predictor of
healthy perfectionism. Identified and interjected motivations also explain a significant portion of
perfection striving (healthy). On the other hand, the variance of negative manifestation of
perfectionism was best predicted by global external regulation. Results demonstrated that
introjected and intrinsic motivation (in a negative relation) predict variance of negative
manifestation of perfectionism. Generally, our findings confirm that perfectionism can be
associated with some positive characteristics and that different motivational profiles may
underline healthy and unhealthy perfectionism. Clinical implication of these results will be
discussed.
Breaking Boundaries: The Extension Project Behavior Analysis in the Hospital

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Nazar Costa, Holga Cristina Gomes, Jhessica de Oliveira, Leandro Mouzinho, Maressa Braga,
Renata Pinheiro.
Psicologia, Universidade Federal do Maranho, So Lus, Brazil.
Abstract Central: This is an extension project, in progress, approved and financed by the
Federal University of Maranho, Brazil. This project came up from the observation that
academic health training tends to prioritize the biological aspect of the disease process at the
expense of social and psychological aspects. The literature has pointed the importance of
Behavioral Psychology in the formation of health professionals, who would become able to
assist patients in the installation and maintenance of healthy behavioral repertories and modify
health risk behaviors. Other determining variables in the success of treatments which could be
worked with these professionals would be: the use of a speech contextualized to the patients
language; the relationship between patient and the healthcare team; and the rules and self-rules
involving the disease and / or the actual treatment. Therefore, this project has the objective of
training professionals, residents and students in the area of health at the University Hospital
HUUFMA for using the knowledge of Behavioral Psychology in their work. The contents are
divided into modules, totalizing seven: Behavioral Medicine, Acceptance and Commitment
Therapy, Psychiatric Disorders, Death and Bereavement, Social Skills, Treatment Adherence
and Working Companions. Each module is developed in two physical meetings: the first is the
exposition of the topic through lectures and discussions with the participants, and, on the
second, workshops are conducted about the theme previously worked, by the use of group
dynamics techniques, experiences and clinical case discussions. The research is also included
in this project, completing the triad Teaching, Research and Extension. For the data collection,
sociodemographic and post-evaluation module questionnaires are being used, as well as
observation and registration of the meetings for further analysis in conjunction with the
coordinator. At the end of the modules, It will be sought to identify and analyze, especially
through the accounts of the participants, which changes in the target publics and the teams
behavior have been promoted through the training course. Sociodemographic data so far
indicate a younger audience between 20-29 years (90%), predominantly female (80%),
consisting mostly of students from the areas of psychology (75%) and medicine (10%). The
qualitative results indicate a relevant learning by the participants, especially in the development
of an externalist and relational view, with greater understanding of human behavior and the
disease process, which seems to have led to changes in the professional practice, as seen on
the reports associated to the debunking of madness or abnormality, for example. Still regarding
the changes in thought and practices, the importance of taking into consideration the social
environment was placed, not only the biological view. It is believed that the results to be
achieved will focus directly on the population served by the service, since these are the most
benefitted to get a fully health care.
Investigacin de la Ideacin Suicida en Estudiantes Mexicanos de Educacin Media
Superior
Martha Crdova, Jose Rosales.
Psicologa, Facultad de Estudios Superiores. Iztacala. Universidad Nacional Autnoma de
Mxico, Cuautitln Izcalli, Mexico.
La Organizacin Mundial de la Salud ha enfatizado la importancia de la investigacin de la
ideacin suicida como un medio para desarrollar acciones preventivas del suicidio consumado.
Objetivo: Identificar las caractersticas de la investigacin de la ideacin suicida en estudiantes
mexicanos de educacin media superior por medio de la revisin bibliogrfica publicada entre
los aos de 1993 a 2012, considerando: a) el tipo de instrumento utilizado para medir la

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presencia de ideacin suicida y su informe de fiabilidad y validez, b) reporte de la presencia de


ideacin suicida, y c) variables vinculadas a la presencia de ideacin. Mtodo: Se revisaron las
bases de datos de las revistas: Direccin General de Bibliotecas de la Universidad Nacional
Autnoma de Mxico; Centro de Documentacin Cientfica de Psiquiatra y Salud Mental; Red
de Revistas Cientficas de Amrica Latina y el Caribe, Espaa y Portugal (REDALYC); Revista
Mexicana de Psicologa; y Revista de Salud Pblica de Mxico. Con dos criterios de inclusin:
1. como participantes de la investigacin estudiantes mexicanos de educacin media superior
2. la aplicacin a estos estudiantes de algn instrumento de medicin de ideacin suicida.
Resultados: 18 investigaciones han empleado algn instrumento para la medicin de la
ideacin suicida en estudiantes mexicanos de bachillerato. Cinco diferentes tipos de
instrumentos se han utilizado para medir la ideacin suicida: Escala de Ideacin Suicida de
Beck, Escala de Okasha, un factor del Inventario de Riesgo Suicida para Adolescentes, Escala
de Ideacin Suicida de Roberts CES-D, y un instrumento compuesto por ocho reactivos; los
cuatro de la Escala de Ideacin Suicida de Roberts CES-D y cuatro del Cuestionario sobre
Tendencia Suicida de Wilburn y Smith. De las 18 investigaciones, 14 emplearon la Escala de
Ideacin Suicida de Roberts CES-D para medir la ideacin suicida. De estos 14 artculos
solamente seis reportan la fiabilidad del instrumento mediante el alfa de Cronbach; valor que
oscila de .77 a .86. La validez factorial es mencionada en cuatro de las 14 investigaciones, con
la agrupacin de los cuatro reactivos en un solo factor y varianzas explicadas totales que
oscilan de 66% a 69.30%. La presencia de ideacin suicida empleando la Escala de Ideacin
Suicida de Roberts CES-D oscila de 15% a 54%. Con dicho instrumento se ha vinculado la
presencia de ideacin suicida con el consumo de drogas, el uso combinado de drogas y
alcohol, la deficiente comunicacin con el padre, el intento de suicidio, y la sintomatologa
depresiva. Conclusin: La investigacin de la ideacin suicida en estudiantes mexicanos de
educacin media superior tiene el reporte de 18 investigaciones; 14 han empleado la Escala de
Ideacin Suicida de Roberts CES-D. Mediante esta escala, el registro de la presencia de
ideacin suicida tiene un amplio rango de variabilidad as como de variables vinculadas,
demostrando que an empleando el mismo instrumento, no hay acuerdo entre los
investigadores respecto al registro de la presencia de ideacin suicida.
Particularidades Personales y Psicolgicas del Estudiante Mexicano de Bachillerato del
Altiplano Potosino con y Sin Ideacin Suicida
Martha Crdova, Jose Rosales.
Psicologa, Facultad de Estudios Superiores. Iztacala. Universidad Nacional Autnoma de
Mxico, Cuautitln Izcalli, Mexico.
De acuerdo con la Organizacin Mundial de la Salud el suicidio est entre las primeras 10
causas de muerte a nivel mundial. En Mxico en los ltimos 30 aos la tasa de suicidios ha
aumentado un 275%. Entre las poblaciones de riesgo se encuentran los jvenes de 15 a 24
aos. Objetivos. En los estudiantes del Centro de Bachillerato Tecnolgico Agropecuario del
Altiplano Potosino: 1. registrar la fiabilidad y validez factorial de la Escala de Ideacin Suicida
de Roberts, 2. identificar la presencia de ideacin suicida, y 3. describir algunas caractersticas
de identificacin personal y psicolgicas (desde la perspectiva cognitivo-conductual) que
distinguen a los jvenes con y sin ideacin suicida Mtodo. Participaron todos los estudiantes
del Centro de Bachillerato Tecnolgico Agropecuario No. 142. Un total de 313 estudiantes: 138
hombres (44.1%) y 175 mujeres (55.9%), con una edad promedio de 16.85 aos. Instrumento:
integrado por tres secciones: Seccin I. Cuestionario de identificacin personal. Seccin II.
Cinco escalas de constructos psicolgicos; La Escala de Trastornos Emocionales, Escala de
Apoyo Social Percibido, Escala de Desesperanza y Escala de Actitudes y Creencias. Seccin
III. Escala de Ideacin Suicida de Roberts. Resultados. La fiabilidad obtenida en la Escala de

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Ideacin Suicida de Roberts mediante el alfa de Cronbach fue de .83. El anlisis factorial arroj
un solo factor conformado por los cuatro reactivos con una varianza explicada total de 68.31%.
La ausencia de ideacin suicida qued determinada por la obtencin de cero en la puntuacin
de la escala, fueron un total de 218 estudiantes (69.6%). La presencia de ideacin suicida fue
establecida por el punto de corte: puntuaciones iguales o arriba de la media ms dos
desviaciones estndar (puntuaciones de 4 adelante), con un total de 19 estudiantes (6.1%). Las
caractersticas que resultaron significativas en los estudiantes con presencia de ideacin
suicida fueron: Personales; Se ha hecho dao fsico intencionalmente, considera que necesita
ayuda psicolgica, ha tenido experiencias de situaciones humillantes y de sufrimiento en el
ltimo ao, una persona cercana se quit la vida, no tiene religin, y fue disciplinada en la
infancia y adolescencia con muchas reglas y/o castigos. Psicolgicas; Emocin negativa, futuro
negativo, exigencia de comodidad, falta de concentracin e impulsividad. Las particularidades
que resultaron significativas en los estudiantes con ausencia de ideacin suicida fueron:
Personales; Considera que no necesita ayuda psicolgica, no se ha hecho dao fsico
intencionalmente, no ha tenido experiencias de situaciones humillantes ni de sufrimiento en el
ltimo ao, y casado. Psicolgicas; Futuro positivo, apoyo de amigos y apoyo familiar.
Conclusin. Algunas de las caractersticas de identificacin personal encontradas en la
presente investigacin ya han sido reportadas por otras investigaciones. Las particularidades
psicolgicas pueden ser explicadas desde la perspectiva cognitivo conductual.
Intervencion Cognitivo Conductual en Pacientes con Diabetes Tipo 2: El Efecto
Diferencial del Apoyo Social en la Modificacion de Variables Psicosociales
Arturo Del Castillo Arreola1, Rebeca Mara Elena Guzmn Saldaa1, Scarlett Iglesias Hoyos1,
Gloria Solano Solano1, Isabel Reyes Lagunes2.
1. Universidad Autnoma del Estado de Hidalgo, Pachuca, Mexico, 2. Universidad Nacional
Autnoma de Mxico, Ciudad de Mxico, Mexico.
Abstract Central: Los factores psicosociales como las creencias de autoeficacia, depresin,
malestar emocional (distress), bienestar psicolgico y apoyo social son relevantes para
prcticamente todos los aspectos relacionados con el manejo de la diabetes. Sin embargo, en
Mxico existen pocos estudios que hayan abordado el estudio de estas variables y no existen
investigaciones que hayan comparado la efectividad entre intervenciones cognitivoconductuales que involucran a la familia de aquellas que slo trabajan con el paciente para
modificar las variables mencionadas en pacientes con diabetes tipo 2. Partiendo de estos
antecedentes, la presente investigacin tuvo como objetivo el desarrollo y comparacin de la
efectividad entre una intervencin cognitivo-conductual grupal que slo incorpor a pacientes
con diabetes tipo 2 y otra intervencin en dadas paciente-familiar para modificar los niveles de
las variables mencionadas. Se utilizaron el ndice de Bienestar Psicolgico (OMS-5), el
Cuestionario de reas Problema en Diabetes (PAID), el Instrumento de Autoeficacia y del
Instrumento de Apoyo Social, el Inventario de Depresin de Beck (BDI) y el porcentaje de
Hemoglobina Glucosilada (HbA1c) de los pacientes. Participaron 36 pacientes con diagnstico
confirmado de diabetes mellitus tipo 2 que vivan con un familiar, entre 18 y 77 aos de edad,
30 hombres y 6 mujeres, seleccionados de manera no probabilstica intencional en los centros
de salud de la Secretaria de Salud de Hidalgo. Los pacientes se asignaron aleatoriamente a
cuatro grupos, dos grupos experimentales, uno con dadas paciente-familiar y otro slo
pacientes, cuya intervencin comenz inmediatamente despus de la evaluacin y dos grupos
en fase de espera con las mismas caractersticas cuyo inicio se llev a cabo al final de la
intervencin de los primeros dos grupos. Las intervenciones se aplicaron durante 12 sesiones
de dos horas cada una y se llev a cabo un seguimiento a los seis meses de finalizada la
intervencin. Se compararon las medias y desviaciones pre-post-seguimiento por grupo

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utilizando la prueba t de Student para muestras relacionadas y el anlisis de varianza de


medidas repetidas. Los resultados revelaron que la mayora de los pacientes mostraron
ganancias clnica y estadsticamente significativas en las variables estudiadas al final de la
intervencin y durante el seguimiento en cada grupo, sin embargo, no se encontraron
diferencias entre los grupos que slo incorporaron a pacientes y los que incluyeron la dada
paciente-familiar.
Promoting social skills in clinical, educational, community, and work contexts:
Proposals, effectiveness and sociocultural implications
Zilda Del Prette1, Almir Del Prette1, Zilda Del Prette1, Almir Del Prette1, Camila Pereira-Guizzo5,
Fabin Olaz2, Mirta Ison3, 4, Margarette Rocha6, Ana Braz1, Zilda Del Prette1, Fabin Olaz2,
Mirta Ison3, 4.
1. Psicologia, UFSCar, So Carlos, Brazil, 2. UNC, Crdoba, Argentina, 3. Universidad del
Aconcagua, Aconcagua, Argentina, 4. INCIHUSA-CONICET., Mendoza, Argentina, 5.
Universidad SENAC, Salvador, Brazil, 6. UEL, Londrina, Brazil.
The concern with effective programs to promote social skills fall within the scope of the
discussion on Psychological Practice-Based Evidence, i.e. practices that have been proved to
be effective. Although, in Psychology, the concept of Evidence-Based Psychological Practices is
strongly associated with the movement validation of psychotherapy, and only indirectly to Social
Skills Training programs, it is possible, and important, to bring the discussion to this field,
considering the breadth of application of these programs. In this symposium, we introduce some
contexts in which they are being held the evaluation and the conduction of social skills programs
(SSP), with evidence of effectiveness. Besides the specific rationale that guides the social skills
promotion, for each context, we will be exemplify social skills programs that were conducted or
proposed for different contexts, with emphasis on programs based on experiential methodology.
In the therapeutic context, Prof. Dr. Fabin Olaz will discuss the importance of social skills as a
component of therapeutic intervention, as well as core competencies for the cognitive
behavioral therapist. Prof. Dr. Olz will present theoretical and practical designs to promote
social skills in the clinical setting, both for customers as therapists, emphasizing the use of
these skills in the context of Dialectical Behavioral Therapy (DBT, proposed by Marsha Linehan)
for borderline personality disorder. This presentation will focus on programs with clients with
severe disorders and preliminary results on the effectiveness of PHS with the Experiential
Method (proposed by Del Prette and Del Prette). In the context of school education, Ms. Dr.
Mirta Ison will present a program for the promotion of sociocognitive skills in Argentine
schoolchildren to solve interpersonal problems. The purpose of the program is to assess the
cognitive skills of solving interpersonal problems in schoolchildren aged 9 to 11 years old, and
on these results, aiming to implement intervention strategies in order to potentiate and to
promote the development of sociocognitive skills. This proposition takes into account the
characteristics of the psychosocial context of the child and his or her family, focusing
intervention with teachers as central agents of the learning process at school. In the work
context, Prof. Dr. Almir Del Prette will discuss the relationship between special education and
vocational integration of people with disabilities. Prof. Dr. Del Prette will also provide a program
specifically geared to people with physical disabilities and articulated the current policy of
inclusion of such persons in the labor market. This program has produced significant gains in
terms of social skills and employability of participants, with maintenance of acquisitions as
assessed by follow-up four months after the program as well as the generalization of learned
skills to other environments. In the context of social community, Ms. Ana Carolina Braz will
present a Program of Assertive Social Skills (PASS) involving the elderly towards to the
understanding and the exercise of rights by the elderly. Besides discussing social issues

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relating to the Elderly Statute, recently approved in Brazil, and the relationship between law and
exercise of the elderly, the presentation discusses the use of placebo design used in this study,
as well as the results, which indicate t the impact and effectiveness of PASS, its critical
components and the relevance of such interventions for the senior population of in
contemporary reality. In the context of Community Health, Prof. Dr. Zilda A. P. Del Prette focus
on the importance of social skills for parents and other agents of socialization of children and
adolescents. She will present an experiential social skills program conducted with mothers of
children with attention deficit and hyperactivity disorder (ADHD), under experimental design with
a control group of non-treatment. Dr. Del Prette will also discuss its direct impact on the
repertoire of the mothers and the academic and social skills of children as assessed tools for
reporting and direct observation of filming. At the end of the presentations, we will discuss the
social implications of cultural dissemination in large scale programs such procedures as well as
some of the challenges these interventions themselves.
Key Words: Social Skills, Therapy, Education, Labor, Community, Effectiveness, social cultural
and methodological issues
Promoting social skills in the clinical setting
Social Skills have been defined as the repertoire of behaviors that allow the individual effective
relationships with other people. In the clinical setting, they have been considered as a very
important component in mental health and also a component of most behavior modification
interventions and cognitive behavioral psychotherapy. Moreover, these skills are considered
core competencies of cognitive behavioral therapist. In this communication, we present the
theoretical and practical designs to promote social skills in the clinical setting, for both
customers and therapists, with emphasis on the use of these skills in training programs under
Dialectical Behavioral Therapy (DBT). In this therapy, developed by Marsha Linehan for the
treatment of patients with borderline personality disorder, the skills training is an essential
component. Thus, the skills training of Mindfulness, emotional regulation, tolerance displeasure,
Interpersonal Effectiveness and resolution of problems are considered key elements in the
recovery of patients with problems of emotional regulation. Therefore, the therapist must have
interpersonal skills such as empathy and assertiveness, which are considered as the basis of an
effective training process. In this paper, I shall review some of the most important components
for conducting social skills programs for clients with severe disorders, presenting preliminary
results of effectiveness. Additionally, we emphasize some of the essential skills in working with
DBT therapist and the importance of the contributions of the Experiential Method Del Prette and
Del Prette the training programs in this type of customer.
Keywords: Dialectical Behavioral Therapy, Social Skills, Therapist Skills
Promoting socio-cognitive skills for interpersonal problem solving in Argentine school
children
The development of cognitive skills for interpersonal problems solving in schoolchildren
depends on the interrelation between the maturation processes and the possibilities of learning
that different contexts may provide. Experts in this area as D'Zurilla & Nezu (2006) describe the
interpersonal problems solving as a cognitive interpersonal process oriented to identify a
aceptable or healthy solution for the problem, considering the people related to the situation. A
positive and effective solution brings positive changes such as reducing anxiety, pain, distress
and positive consequences tends to maximize and minimize the negative. Thus, the intended
solution should consider negotiations and agreements that facilitate the well being of all people
involved in the problem situation. That is, the positive effects of conflict resolution should be
seen in the short or long term, as well as those which bear the conflict and in all those related to
the problem situation (D'Zurrilla, Nezu & Maydeu-Olivares, 2004, Greco & Ison, 2009). The
students share much of their time with their peers. These interactions promote social, cognitive

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and affective development (Greco & Ison, 2009, Green & Rechis, 2006, Shaffer, 2002). At
times, peer relationships may give rise to negative emotions such as sadness, loneliness and
mood associated with depression and aggressive type of disruptive behavior (Greco & Ison,
2009). Therefore, the aim of this presentation is to analyze the cognitive skills to solve
interpersonal problems in 80 9-11 years of old schoolchidlren from Mendoza . Besides these
results, we will also present implement intervention strategies designed to enhance and
promote the development of their skills socio-cognitive. This approach takes into account the
characteristics of the psychosocial context of the child and family, integrating intervention
programs for teachers as key agents in the process of learning (Ison, 2008, 2011).
Keywords: socio-cognitive skills, promotion, interpersonal problems, schoolchildren
Social skills and professional inclusion of workers with disabilities: Program description
and evidence of effectiveness
Some general questions about work and employability apply also to the inclusion of people with
disabilities in the labor market, establishing thus an interface between Special Education and
Social Skills. Contributing to the social inclusion of people with disabilities implies enabling them
to face prejudice, discrimination, lack of access and lack of adequate working conditions. Many
of these problems are associated with interpersonal demands of that case, since the initial job
search, which implies the enhancement of social skills professionals. Work Social Skills are
"those that meet the different demands of interpersonal work environment targeting the
achievement of goals, the preservation of the welfare of the team and respect the rights of
each" (Del Prette & Del Prette, 2001). Based on this rationale, the authors describe the
planning, conduct and evaluation of a Social Skills Program for Work for job seekers who had
physical disabilities. We adopted a multiple observation design with two groups from different
towns, of people of both sexes, aged between 18 and 36 years, with physical disabilities. Both
groups underwent pre-intervention, during the intervention, immediately after and three months
after the intervention, through Social Skills Inventory (IHS-Del-Prette) and Interpersonal
Problems Scale. The basic procedure was the use of experiential method in a group setting,
designed to teach work social skills, with 16 sessions of approximately 90 minutes each.
Results indicated significant gains in social skills after the program, maintenance after four
months of learning and generalization of learned skills to other environments. Just after the end
of the program, some participants had obtained a job position.
Keywords: Work Social Skills, Social Inclusion, Work, Group Experiential Program, EvidenceBased Practices.
Assertive social skills for the elderly: The effectiveness of a program under a placebo
design
Given the current scenario of social concern with the rights of seniors, this study describes and
evaluates a Program of Assertive Social Skills (PASS) focusing on the understanding and the
exercise of rights for seniors. The sample (two men and 13 women) participated in one of two
intervention groups under a placebo design: Experimental (EG, with PASS) and placebo control
(PC with Dialogued Educational Expositions dialogued, DEE). For the evaluations of pre-, posttest and follow-up one used: Social Skills Inventory (IHS-Del-Prette) Inventory of Recognition of
Rights guaranteed by the Elderly (IRRE). In the post-test it was also used a Questionnaire for
the Assessment of User Satisfaction. Assessments conducted in the pre, post and follow up
with IHS-Del-Prette indicated the acquiring and the maintaining of social skills, especially
assertive for EG, but not for the PC. There were no differences found between the stages pre
and post-test and follow-up to EG or to the PC. For the IRRE, one has observed significant
difference only for EG, between pre-and post-test, for the recognition of rights of older persons,
as weel as for the discrimination situations of violation of rights of the elderly, between post-test
and follow-up for the two groups. In the assessment of user satisfaction, the EG and PC

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presented high means for: (1) satisfaction with the program received (2) importance given to the
procedures of the program, (3) assessment of readiness to perform the social skills taught, and
(4) self evaluation of performance in the program. For this questionaire, PC means were
systematically higher than those from EG. We discuss the impact and effectiveness of the
program THSA as well as the feasibility and importance of using placebo design to assess the
internal validity of THSA programs and its critical components, and the relevance of such
interventions for the population of elderly contemporary reality.
Keywords: Assertive Social Skills, Seniors, Delineation Placebo
Educative Social Skills: Importance and effectiveness of a program with mothers of
children with ADHD.
Disorder and Attention Deficit Hyperactivity Disorder (ADHD) is the result of the confluence of
multiple risk factors and reaches 3 and 7% of school-aged children and is characterized by
three subtypes: inattentive, hyperactive / impulsive and combined, all associated with academic,
emotional and social needs of children. Research shows that mothers of these children have
limited repertoire of educational strategies usually resorting to coercive strategies of control.
Moreover, the therapeutic processes often include mothers as auxiliaries, but there is little
evidence of impact of interventions solely with mothers. We present and describe the planning,
procedures and assessments setps involved in conducting a program for mothers of children
with Attention Deficit Hyperactivity Disorder (ADHD). The program aimed to promote general
social skills and, in particular, social skills and to verify the impact of the intervention on the
repertoire of mothers and children. Under experimental design, the experimental group was
planned and conducted based on the experiential method and relied on the notion of social
skills "behaviors of educators that promote development and learning from each other in formal
or informal situation" (Del Prette & Del Prette, 2001). The impact was assessed by reporting
instruments (especially the IHS-Del-Prette and the Social Skills Rating System) and observation
of filming. The results showed significantly greater gains for the group that went by the
intervention (GE) compared to what has not gone through the intervention (GC) and
maintenance of acquisitions in the follow-up phase. The program had a direct impact on the
improvement of social skills and education of mothers in the experimental group and also
indirect impact on improving social skills and academic performance of children. We discuss the
implications of this type of program in different community settings and health.
Keywords: Educational Social Skills, ADHD, parent-child relationships, Experiential Program
Group, Evidence-Based Practices.
Influencia de Variables Personales y Aquellas Dependientes de la Lesin en las
Quemaduras Infantiles: Relacin con el Impacto Psicolgico Experimentado
Gracia Delgado Pardo, Inmaculada Moreno Garca, Carmen Roldn Blasco.
Personalidad, Evaluacin y Tratamientos Psicolgicos, Universidad de Sevilla, Sevilla, Spain.
Abstract Central: Introduccin: En la bibliografa publicada sobre epidemiologa el patrn de
quemaduras ms comnmente descrito alude a la confluencia de las siguientes caractersticas:
Se trata de lesiones causadas por accidentes domsticos (Peck, Kruger, van der Merwe,
Godakumbura y Ahuja, 2008) con mayor tasa de incidencia en las edades ms tempranas,
especialmente hasta los cinco aos (Dissanaike y Rahimi, 2009) y siendo los nios, varones, el
grupo afectado ms numeroso (Peck, 2011). Son frecuentes las escaldaduras relacionadas con
lquidos calientes (caf, agua hirviendo, sopas, etc.) (Xin et al. 2006) donde la extensin de
superficie corporal afectada (%SCQ) destaca como otro factor relacionado con el tipo de lesin
sufrida, en relacin a gravedad, pronstico y evolucin del paciente (Frans, Keli y Maduro,
2008). Asimismo, es conocida la influencia que ejercen todos estos factores citados en el
impacto psicolgico surgido tras sufrir las quemaduras en cuanto a la reaccin emocional y

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conductual manifestada por el nio a su ingreso en el hospital. Mtodo: Han participado 103
nios/as (1-17 aos) que ingresaron por quemaduras en el Hospital Universitario Virgen del
Roco en Sevilla (Espaa) durante un periodo de cuatro aos. Se han administrado los
siguientes instrumentos: Cuestionario de Ansiedad Estado/Rasgo (Spielberger, 1989), el
cuestionario sobre comportamiento infantil- versin Padres (Achenbach y Rescorla, 2000 y
2001) y la Escala de Observacin de Conductas de Ansiedad durante la Hospitalizacin
(Ortigosa y Mndez, 1997) Resultados: La incidencia de las quemaduras en nuestro contexto,
segn el rango de edad, sigue una tendencia significativa, el mayor nmero de accidentes
causados por este tipo de lesiones se concentra entre los menores de cinco aos que suponen
el 50% del total de los nios estudiados (X2(2) =12,195; p=0,002). Se trata de un tipo de lesin
que afecta mayormente a varones (X2(1) = 10,573; p= 0,001). Las escaldaduras, el tipo de
lesin ms frecuente, les ocurren sobre todo al menor de la casa, cuando el nio tiene ms
edad suele quemarse por llamas (X2(2) =54,141; p <0,001). Segn el contraste de medias
realizado, son los nios frente a las nias, los que manifiestan un mayor nivel de ansiedad (T =
2,011; p = 0,047), siendo las llamas, el agente causal que origina valores significativamente
ms elevados, tambin, de ansiedad (T = - 2,089; p= 0,040). En cuanto a la reaccin
conductual, de nuevo los nios son los que muestran puntuaciones significativas en relacin a
la presencia de problemas de conducta y dificultades relacionadas con la falta de atencin (T=
2,237, p= 0,031 y T=2,128, p=0,040). Resultando ser los menores que tienen ms edad los que
presentan peor reaccin emocional (Fgl= 3,248, p= 0,049) y conductual (Fgl= 4,990; p=0,012).
Conclusiones: En nuestro mbito la descripcin de un patrn de quemaduras peditricas
coincide con lo observado en la bibliografa, se trata de escaldaduras ocasionadas en menores
de 5 aos y mayormente varones. En el caso de los nios de ms edad la lesin predominante
son las quemaduras causadas por llamas. La reaccin emocional observada se caracteriza por
un incremento en la ansiedad percibida, as como presencia de dificultades relacionadas con
conducta disruptiva y de atencin
El Perfil Psicolgico de Riesgo Asociado a las Quemaduras Infantiles. Comparacin de
dos Grupos, Nios con Quemaduras y Menores sin Experiencia de Lesin
Gracia Delgado Pardo, Inmaculada Moreno Garca.
Personalidad, Evaluacin y Tratamientos Psicolgicos, Universidad de Sevilla, Sevilla, Spain.
Abstract Central: Introduccin: La bibliografa destaca entre los factores relacionados con la
posible ocurrencia de quemaduras: a) edad, que influira en el tipo y gravedad de lesin sufrida
(Hai, Jun, Jie, Jun, Feng y Hui, 2011) b) sexo, al tratarse de un tipo de trauma con mayor
incidencia en el sexo masculino (Henderson, Conville, Hhlriegel, Fraser y Kimble, 2003) y
sobre todo, c) personalidad y temperamento del nio, que se relacionan con la presencia de
impulsividad que precipita a estos menores a llevar a cabo conductas temerarias, consideradas
de riesgo (Piazza-Waggoner, Dotson, Adams, Joseph, Goldfard y Slater, 2005). Los informes
de los padres de nios que han sufrido estas lesiones indican que, antes del accidente,
muestran hiperactividad, problemas de conducta, dificultades de atencin y ansiedad. Encender
cerillas, manipular aparatos elctricos, jugar con petardos, etc. son algunas de las conductas
implicadas en las quemaduras peditricas (Fritz y Butz, 2007; Badger, Anderson y Kagan,
2008), que sin embargo, son infrecuentes entre los menores escolares. El objetivo de este
trabajo consiste, en identificar el perfil psicolgico (reaccin emocional y conductual) de los
nios que han sufrido quemaduras a partir de la comparacin con otro grupo de menores sin
experiencia de lesin Mtodo: Han participado 209 nios/as distribuidos en dos grupos
equiparables en cuanto a tamao, rango de edad y procedencia. Se trata de: a) 103 nios
hospitalizados por sufrir quemaduras y b) 106 escolares sin experiencia de lesin (1 - 17 aos).
A todos ellos se les administr los siguientes instrumentos: Cuestionario de ansiedad

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Estado/Rasgo (STAIC) (Spielberger, 1989) y el cuestionario sobre comportamiento de los


nios-versin para padres (CBCL) (Achenbach y Rescorla, 2000 y 2001) Resultados: Los
resultados correspondientes al anlisis de regresin lineal mltiple realizado indican que,
cuando los nios pertenecen al grupo de quemaduras se incrementan las puntuaciones
obtenidas en ansiedad, alcanzando la varianza explicada un valor del 27,8%, al igual que
ocurre en relacin a los sntomas exteriorizados (26%). Se trata de nios con tendencia a
manifestar mayor dificultad para controlar sus impulsos lo que les lleva a presentar, sobre todo,
problemas de conducta disruptiva (24,8% y 25,3%), al igual que dificultades relacionadas con
atencin (15%) elevndose en este caso las puntuaciones adems de por pertenecer al grupo
de quemados, por ser nio. Conclusiones: Se confirma entonces, la existencia de un perfil
psicolgico de riesgo que se relaciona con una mayor ocurrencia de quemaduras en nios,
sobre todo varones, que presentan adems de un nivel ms elevado de ansiedad, dificultades
relacionadas con la falta de control de impulsos y problemas de atencin
Advances in our Understanding of the Response to a Stressor
Vandana Deshmukh.
Pain Medicine, Nepean Hospital, Sydney, NSW, Australia.
Abstract Central: Individuals with chronic pain present a unique window of opportunity to study
the response of these individuals to an ongoing stressor. Various psychometric scales have
been used to evaluate the constructs of stress and distress. The Depression Anxiety and Stress
Scale (DASS), is commonly used in Australia, to assess individuals with chronic pain. The aim
of this study was to identify the response of 108 individuals, with chronic pain (n = 108), to the
items on the DASS. This also included a study of the association of the scores on the DASS
with other pain measures, such as the Pain Disability Index, the Pain -related Self-statements
Scale, the Tampa Scale for Kinesiophobia, and the Pain Self-Efficacy Questionnaire. Frequency
analysis indicated that Inability to relax was the most common item, on the DASS, reported by
participants. Regression and Path Analysis indicated that catastrophic cognition scores had the
most significant relation with constructs of depression ( = + 0.43, p < 0.001), anxiety ( = +
0.24, p < 0.05) and stress ( = + 0.36, p < 0.01). The study suggests further understanding of
the cholinergic component, of the response to pain, as a stressor, identified as inability to relax
(or muscle tension). Further, the study supports relaxation practices and cognitive therapy,
addressing catastrophic cognitions, as fundamental to pain management interventions.
Intervention Program on Coping Strategies for Caregivers and Children with Sickle Cell
Disease: A Study with Family
Tatiane Dias, Felipe Frana, Damila Simi, Luciane Laura Leite.
Psicologia, Universidade Federal de Mato Grosso, Cuiab, Brazil.
A anemia falciforme uma doena gentica que tem como principal sintoma clnico crises
recorrentes de dor crnica, que tendem a ser fator causador de situaes de stress. Dessa
forma, as estratgias de enfrentamento so importantes mecanismos que podem auxiliar no
uso de respostas mais adaptativas s crises de dor. Este estudo desenvolveu e aplicou um
programa de interveno em estratgias de enfrentamento para cuidadores e crianas com
doena falciforme. Participaram do programa dois irmos, um menino (C1) e uma menina (C2),
com idade de 11 e 7 anos; e sua me (M) com 29 anos de idade. O programa foi estruturado
em seis sesses, com as seguintes atividades: 1) crianas: Jogo da Fantasia, Jogo Guerra ao
Stress desenvolvido por Lipp em 2003, Brincadeira de ser mdico, Jogo Enfrentando Desafios
desenvolvido por Oliveira em 2011 e Desenhos para colorir. Com objetivo de avaliar os efeitos

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do programa utilizou-se o Jogo de Avaliao de Estratgias de Enfrentamento a Hospitalizao


adaptado para o contexto de dor (AEHdor) por Oliveira em 2010 e o Kidcope, desenvolvido por
Spirito em 1988; 2) me: Inventrio de Estratgias de Coping adaptado por Savia e
colaboradores em 1996, Inventrio de Sintomas de Stress para Adultos desenvolvido por Lipp
em 2000, Caixinha dos sentimentos, Espelho para atividade de auto percepo e Jogo de
cartas teraputico Enfrentar a Vida. Em relao s crianas os resultados foram: (1) AEHdor:
a) entre o pr e o ps-teste houve diminuio na mdia de comportamentos no-facilitadores
(C1= 1 para 0,6; C2= 1,2 para 1,1); b) mudana nas estratgias de enfrentamento entre o pr
(C1= ruminao f=6, busca por suporte/f=3 e distrao/f=3; C2= distrao/f=11, reestruturao
cognitiva/f=4 e ruminao/f=3) e o ps (C1= soluo de problema/f=2 e distrao/f=2; C2=
busca por suporte/f=3 e distrao/f=4); (2) Kidcope: a) para C1 no houve diferena em seus
resultados; b) C2 apresentou expressiva diferena, a saber: a estratgia reestruturao
cognitiva passa a ser bem eficaz; as estratgias pouco eficazes como autocrtica, distrao e
resignao tornaram-se bem eficazes; estratgias anteriormente bastante eficazes como
resoluo de problemas, regulao emocional e suporte social mantiveram-se aps o
programa. Quanto ao cuidador observou-se mudana nas seguintes estratgias de
enfrentamento: a) as trs mais utilizadas mantiveram-se e aumentaram a frequncia no ps, a
saber: Resoluo de Problemas (de 2,00 para 2,75) e Fuga e Esquiva (de 2,00 para 2,50) e
Reavaliao Positiva (de 2,00 para 2,11); b) mudana na estratgia menos utilizada (pr:
afastamento e ps: confronto). A manuteno das estratgias mais usadas pelo cuidador pode
ter como varivel o longo tempo de doena das crianas, de modo a possibilitar o
desenvolvimento de mecanismos de enfrentamento facilitadores. Quanto s crianas,
observou-se que o AEHdor se mostrou instrumento mais sensvel em identificar mudanas no
repertrio de estratgias. De modo geral, o desenvolvimento de um programa de interveno
para cuidadores e crianas em condio crnica pode auxiliar na forma de lidar com
experincia indesejada de modo a proporcionar melhor qualidade de vida.
Actualizaciones en el Estudio Contemporneo de la Pobreza y la Salud Mental
Angel Elgier1, 2, Ivana Ortega3, Mara Virginia Bidegain3, Sebastin Lipina1.
1. Unidad de Neurobiologa Aplicada (UNA, CEMIC-CONICET), Buenos Aires, Argentina, 2.
CAECIHS-UAI, Buenos Aires, Argentina, 3. Facultad de Psicologa - UBA, Buenos Aires,
Argentina.
Abstract Central: El objetivo de esta ponencia es considerar cmo se relacionan la pobreza y
la salud mental, ilustrando con ejemplos especficos sobre: 1) esquizofrenia, 2) abuso de
sustancias y 3) trastornos psiquitricos en la niez. Por ltimo se discutirn las
recomendaciones de la OMS respecto a las polticas pblicas. La pobreza es un fenmeno
multidimensional y no generalizable entre diferentes poblaciones, que afecta
aproximadamente al 45% de la poblacin mundial y, dentro de ella, al 50% de los menores de
18 aos lo que constituye un panorama de carcter pandmico. Sus efectos directos e
indirectos sobre diferentes aspectos del desarrollo emocional y cognitivo, se asocian a una
mayor probabilidad de incidencia de trastornos conductuales y psiquitricos. En la literatura es
posible verificar diferentes ejemplos de la relacin entre la pobreza y la salud mental. Con
respecto a la esquizofrenia, se encuentra que su prevalencia suele ser mayor en las personas
que se encuentran en las situaciones de mayor vulnerabilidad social. Tal relacin es compleja y
plantea la necesidad de continuar explorando los potenciales mecanismos de causalidad. Por
ejemplo, independientemente de los componentes neurobiolgicos, de acuerdo con la hiptesis
de causalidad social, las personas que viven en condiciones socioeconmicas adversas tienen
mayor probabilidad de adquirir un trastorno esquizofrnico. Sin embargo, tambin hay
disponible evidencia que indica que la distribucin de la clase social de los padres de los

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pacientes con esquizofrenia no se desva necesariamente de la de la poblacin general. El


segundo ejemplo que discutiremos refiere a los trastornos asociados al uso y abuso de
sustancias. Diferentes estudios han indicado que las condiciones sociales adversas suelen
asociarse a una mayor incidencia de alcoholismo y uso abuso de sustancias ilcitas, as como
tambin de la mortalidad. Con respecto a los trastornos psiquitricos durante la niez, el
vnculo con las experiencias adversas asociadas a pobreza es igualmente complejo. Los bajos
ingresos familiares en combinacin con condiciones de crianza deficitarias se asocian a crisis
que ponen a los nios en situacin de riesgo, y precipitan la aparicin de problemas de
conducta y trastornos como el dficit de atencin con hiperactividad. Por ejemplo en Inglaterra,
los ndices de riesgo muestran que los nios de hogares pobres tienen tres veces ms
probabilidades de padecer problemas de conducta que los nios que no estn en situacin de
pobreza. En la actualidad se analiza si lo que se asocia al riesgo es algn aspecto especfico
de la condicin socioeconmica, o bien la respuesta de regulacin del estrs que la pobreza
plantea a los padres y nios. La evidencia actual en las reas descriptas contribuye a continuar
sosteniendo la necesidad de abordar el estudio de la salud mental teniendo en cuenta el
contexto socioeconmico de las personas. Las polticas pblicas de salud mental se vuelven
fundamentales para generar una agenda con objetivos de inters social a largo plazo
orientados a solucionar las problemticas relacionadas con la pobreza. Es importante integrar a
la discusin y al diseo de acciones las estrategias bsicas planteadas por la OMS en el marco
de los determinantes sociales de la salud.
Perception of Barriers to Postpartum Depression Treatment
Kendra Ellway, Randy Fingerhut, Amanda Bordfeld, Florencia Pahl.
La Salle University, Philadelphia, PA, USA.
Postpartum Depression is a psychological disorder than affects approximately 13% of new
mothers during the first year after giving birth (OHara & Swain, 1996). The negative outcomes
of postpartum depression not only affect the mother but can also impact her child and her
relationships with others (Goodman, Broth, Hall, & Stowe, 2008). Research indicates that one
out of four women is likely to have a recurrence of postpartum depression if their symptoms go
untreated (Wisner et al., 2001). In addition, women who have experienced a severe postpartum
psychiatric illness are 300 times more likely to experience an episode of depression in a future
pregnancy (Hamilton & Sichel, 1992). Treatments including Interpersonal Psychotherapy (IPT),
Cognitive Behavioral Therapy (CBT), and Behavior Therapy (BT) have demonstrated efficacy in
the treatment of postpartum depression (Milgrom et al., 2005). Despite efficacious treatments
for postpartum depression, many new mothers who experience depressive symptoms do not
seek help. For example, Mayberry, Horowitz and Declercq (2007) found that nearly 57% of
mothers with moderate to severe depression reported that they did not want to seek help from a
health care or mental health professional. The current study aimed to assess womens
perception of barriers to seeking treatment for postpartum depression. Fifty-three women in their
second and third trimesters were recruited from an obstetrics/gynecology office within a
northeastern United States hospital to participate in an IRB approved study. This study included
predominately low income, minority participants, in order to gather specific information about an
underserved group of pregnant women. Participants completed a demographics questionnaire
and an open-ended survey created by the researchers assessing barriers to seeking treatment.
This study utilized an open-ended self-report response format, similar to that of a focus group,
to allow rich qualitative data to be gathered while increasing the amount of participants that
could be targeted. Survey data was analyzed through Constant Comparison analysis, a process
in which the complete data set was coded by reducing the raw data into chunks to identify
themes that arise throughout the data (Leech & Onwuegbuzie, 2007). Themes derived from in

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the qualitative analysis included stigma, lack of knowledge, fear of losing ones baby, and
wanting to only utilize family members rather than mental health professionals for support.
Identifying perceived barriers to seeking treatment is a critical first step in improving the
accessibility of psychological treatments for postpartum depression. The data collected in this
study will be used to develop and standardize a measure of treatment barriers. It hoped that
creating a standardized measure will improve providers ability to identify and address barriers
in advance of treatment to ensure that mothers can access the services they need.
Empirical research on stress in Brazilian students and young adults
Snia Enumo1, Tatiane Dias2, Marilda Lipp3, Ana Justo1, Luiz Gonzaga1, Luiz Gonzaga1, Ana
Justo1, Marilda Lipp3, Vanessa Gibran1, Claudiane Guimares1, Snia Enumo1, Vivian
Mascella1, Marilda Lipp3, Andressa Becker da Silva1, Snia Enumo1.
1. Pontifcia Universidade Catlica de Campinas, Campinas, Brazil, 2. Universidade Federal de
Mato Grosso, Cuiab, Brazil, 3. Instituto Psicolgico do Controle do Stress, Campinas, Brazil.
Stress has been studied since 1950, based on Physiology and Psychobiology, on a "systemic
theory of stress", proposed by H. Selye. Since then, Psychology has contributed to the area,
offering theoretical approaches to better understand stress responses and the variables and
mediation processes of these variables. The "psychological model of stress", proposed by R.
Lazarus in the '80s motivated studies on its relations with various physical diseases and
emotional problems, as well as the development of instruments to measure it. Among the
various stressors studied are the typical changes of puberty and the social and educational
demands of this period. Thus, adolescents are a population at risk for emotional and physical
problems associated with stress. This condition worsens due to their reaction to parents
behavior, as well as before the cultural imposition of having to choose a profession or a
graduate course. After this stage, young adults must face the stress of having to start living the
chosen professional life at the end of their graduate courses. At this point, even future
psychologists have to deal with this kind of stress. As life goes on, other conditions become a
risk factor for reactions to stress, such as choosing a highly competitive profession. Thus,
professionals such as athletes are subject to much more physical and psychological stressors
than ordinary people. These, in turn, may have chronic diseases, that lead to conditions of
physical disability, affecting social and work relationships, like women who suffer from chronic
headaches. This symposium is being proposed in order to analyze the process of stress with
adolescents and young adults in some specific contexts of professional choice and chronic
disease. Here we will present data of empirical researches that have stress as the main variable
studied. These are studies in post-graduation level that use standardized tools used with
populations with less knowledge in the area, such as teenagers, women suffering from chronic
migraines and athletes performing in teams. Two presentations will discuss stress in a specific
and very little studied age group in Brazil: adolescence. Presentation 1 will analyze how
adolescents perceive parental education practices, as well as the relationship between
parenting styles and levels of stress in a large sample of individuals. Presentation 2 will examine
the choice, vocation or profile of interests, and the level of stress in students who are choosing
their graduate course. In Presentation 3, we will discuss the data obtained from senior university
students in Psychology regarding stress levels and psycho-physiological symptoms of stress, as
well as the coping strategies presented. Presentation 4 and 5 will analyze specific conditions
young adults must face: Presentation 4 will analyze the stress conditions of women who suffer
from migraines and Presentation 5 will present a systematic review of technical literature of the
last 10 years on empirical studies with athletes of team sport modalities analyzing the effects of
stress and their measures in this particular population. It is expected, with these presentations,
to show data of Brazilian researches and their contribution to the study of stress.

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Financial support: CNPq/MCT (research productivity scholarship level 1B; doctorate


scholarship); CAPES (doctoral scholarship).
Keywords: Stress, Adolescence, Occupation, Chronic disease.
Stress and educational practices in adolescence.
Only recently have adolescence stress, its causes and consequences, been studied.
Adolescence is a stressful factor due to puberty fast cognitive and physical changes, which
demand, from the adolescent, psychological flexibility and adjustment skills. The manner the
adolescent deals with stressful situations and their parents' parenting style are mediating
variables to measure stress levels. The last has been studied in 2 dimensions of educational
practices, demands and responsiveness, and gave origin to 4 parenting styles: authoritarian,
authoritative, lenient and negligent, as proposed by the Level of Responsiveness and Perceived
Parenting Requirements (EREPP). Studies lead to a parenting style relationship with normative
development processes and the etiology of psychopathological aspects of the adolescent.
However, researches about those relationships in this level of development are still scarce. A
significant relationship between stress and parenting styles within 100 adolescents (ages 13 to
18), by the collective Stress Level to Adolescents and EREPP, was observed in this study. Most
adolescents showed stress (47% moderate; 26% excessive) - significantly higher among girls,
(p = 0.042). Most mothers followed an authoritative and negligent style (27%), followed by
lenient, (14%), and authoritarian styles (13%). The fathers had an authoritative style, (32%),
followed by negligent (21%), authoritarian (15%), and indulgent (14%), styles. There was a
parenting paternal association with childrens level of stress (p = 0.015). There was found a
negative correlation between stress and maternal (r = -0.285, p = 0.004), and paternal (r = 0.280, p = 0.004) responsive educational practices, showing that the less responsiveness, the
higher the stress, both in symptoms intensity and in period. These data show that high levels of
parenting requirements act, somehow, as a stress source for adolescents, once authoritarian
parents children, (high level of requirements and low level of responsiveness), had a high level
of stress, and indulgent parents children, (low level of requirements and high level of
responsiveness), presented fewer stress indicators. Therefore, high levels of parenting
responsiveness may act as a protective factor against childrens stress. These data make room
for studies in the area identifying features within parents attitudes that favor the proposition of
preventive stress management programs in adolescence.
Financial support: CNPq/MCT (doctorate scholarship); CAPES (doctorate scholarship).
Key words: Stress, Adolescence, Parenting Style.
Profile of interests, professional choice and stress levels in a sample of Brazilian
students.
Literature shows that ones professional choice depends on multiple factors, proving this is a
very complex process. Thus, ones phase of professional choice becomes conflictual, as it
comes, primarily, together with the psycho-physiological processes of change. These are part of
adolescence and of the predisposition to emotional stress some individuals have due to the
great adaptations they must go through during school transition or when choosing a career in
college, which also becomes a stressful factor. In this sense, we aimed at studying the
relationship between the choice made, vocation (profile of interests) and the level of stress in
students choosing a college course. 37 adolescents were selected - 14 boys and 23 girls
between 15 and 18 years old (average: 16; standard deviation: 0.64) - in a private institution in
the city of Campinas, SP, Brazil. They answered to the Self-Directed Search (SDS), to the
Stress Symptoms Inventory of Lipp (ISSL) and to the Professional Self-Evaluation
Questionnaires. Results showed 72.97% of the adolescents in the sample had stress and that
the number of stressed women stress (70.37%) was significantly higher than men (29.63%).
Regarding symptoms of stress, there was a predominance of psychological symptoms

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(42.24%). In the data regarding students professional typology, there was prevalence for the
Artistic type (46%), the lowest being of the Realistic type (34%). In the analysis of the
congruence between professional typology evaluated by SDS and the candidates professional
choice, percentages of 56.76% for congruence and 43.24% for incongruence were found.
Significant differences were also found when comparing the congruence between participants
choice and vocation and their gender, where women presented a smaller congruence between
their choice and their vocation according to the Chi-squared test (Chi-squared = 4; GL=1; p =
0.037). The results of this study confirm other studies in the filled and show adolescence as a
phase vulnerable to stress. The triggering and aggravation of the symptoms will depend on the
coping strategies the individual will use for re-adaptation.
Financial Support: CAPES (doctorate scholarship).
Keywords: Stress, Professional choice, Adolescents.
Stress and coping in Brazilian students finalists graduation in Psychology.
Academic stress is a complex phenomenon analyzed by variables related to academic
stressors, the subjective experience of stress, its moderators and effects in the university
context. Coping with these stressors may work as a protective factor against stress. Coping is
defined as cognitive and behavioral efforts to control, beat, put up with or reduce the internal
and external demands evaluated as exceeding personal resources. The way a person deals
with stressful situations plays an important role in the relationship between stress and healthdisease process. Therefore, this research has evaluated the stress level and
psychophysiological symptoms as well as coping in 26 Brazilian Psychology graduate students.
Those students were 20 - 30 years old, 92% female. Two tools were applied upon agreement:
a) Stress Symptoms Inventory of Lipp (ISSL), which evaluates four levels of stress (Alertness,
Resistance, Semi-Exhaustion and Exhaustion), and the prevalence of symptoms, (physical and
psychological), and (b) the Ways of Coping with Problems Scale, (EMEP), with 45 items
distributed into 4 factors: problem-focused coping, emotion- focused coping, search for social
support and religious beliefs. The answers to EMEP are five - point likert scale based; the score
is reached through the arithmetic average so that a higher score points to a higher frequency of
the coping. Most students show Stress (69.2%), in the Resistance level (46.2%), in the almost
Exhaustion level (15.4%); however, 3.8% were placed in the Exhaustion level and 3.8% in the
Alertness level. There was a predominance of psychological symptoms, (83.3%), followed by
physical symptoms, (11.1%), and 5.6% had both symptom in the same frequency. The most
used coping was problem-focused (61.5% of the students), followed by religious beliefs
(30.7%), and in the same percentage the emotion-focused and the social support search, 3.8%
each. It was observed that students with higher levels of stress used, mainly, the religious
beliefs search, while those with less severe stress levels or even the students who did not show
stress, made use of the problem-focused coping. We need to analyze, in larger samples, the
direction of those relationships, and try to understand if more instrumental coping produces
lighter stress levels, thus prescriptive for intervention with future psychologists.
Financial support: CAPES (doctorate scholarship); CNPq/MCT (productivity research
scholarship).
Keywords: Stress, Coping, College students.
Stress, impairment in the workplace and leisure activities for women with chronic
headache.
Nowadays, chronic headaches are one of the most frequent complaints in medical practice,
being considered a problem of Public Health. It is accepted as a somatic symptom and is
frequently considered worrisome, as it may lead to the reduction and even damage of an
individuals capacities. Most headaches are of primary causes, that is, they are both the
symptom and the disease itself. Among them, the most common are migraines, tensional

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headaches, and other less frequent types. This paper aims at evaluating the damage migraines
in the workplace and leisure activities, as well as the symptoms of anxiety and depression in 16
women with chronic migraine. The participants were between 18 and 72 years old (M= 39.75).
They were sent to psychologist after being diagnosed by doctors and attended in a Neurology
and Neurosurgery clinic in the state of So Paulo, Brazil. In order to collect data, a semistructured routine of interviews was used with 5 questions and the Stress Symptoms Inventory
of Lipp (ISSL), which evaluates stress in four different phases- Alertness, Resistance, SemiExhaustion and Exhaustion. The results revealed that 100% of the women with chronic migraine
presented symptoms of stress. There was predominance of psychological symptoms (81.25%),
followed by both physical and psychological symptoms (12.5%) and physical symptoms
(6.25%). Half of the sample was in the phase or Resistance of stress, followed by 43.75% in the
phase of Semi-Exhaustion and 6.25% in the phase of Exhaustion. Most women felt their work
was seriously impacted (43.75%) or even incapable to work (43.75%), whereas 12.5% claimed
to felt little or no impact in their work. The same pattern was found for leisure activities: 56.25%
felt unable to do their activities and 43.75% of them felt their leisure activities were severely
impacted. Therefore, it could be verified that women with chronic migraine presented serious
levels of stress and felt extremely affected by their headaches both in their workplace and with
their leisure activities. These results corroborate with others in the same field and confirm the
necessity of the development of an adequate treatment for women who suffer of migraines in
order to promote better health and quality of life.
Financial Support: CAPES (doctorate scholarship).
Keywords: Stress, Migraine, Leisure, Work.
Stress in athletes of collective sports: a systematic review.
Stress is a biopsychosocial imbalance that leads psychophysiological responses. In the sports
context, the impact of stress on athletes includes losses in performance and reasoning, lack of
ability to analyze complex situations and difficulty completing tasks. Those effects worsen in
collective sports. The present systematic review aimed to analyze the international and Brazilian
empirical articles, published in the last 10 years (2002-2012), beyond Brazilian theses and
dissertations of the same period, which contained the topic stress in athletes, but focused on
collective sports, because there was a shortage of articles on the subject. The surveys were
found through the journals portal CAPES (Coordination of Improvement Superior Level
Personnel of Brazil)- Multidisciplinary, Health Sciences, Humanities and Linguistics,
Literature and Arts including databases Academic Search Premier, Psycharticles (APA),
SAGE Journals, Science Direct, Springer Link, Scielo, into others, and Theses and
Dissertations Bank of the CAPES. Were used the keywords: psychological stress,
psychophysiological stress, stress physiological, associated with athletes descriptor,
yielding 71 articles and 50 dissertations and theses. After restriction to empirical articles and
involving collective sports, were fully read and analyzed 17 texts, 6 Articles (all Brazilians) and
11 research thesis and dissertations. Measurements of stress over used in athletes of collective
sports were: RESTQ-Sport, salivary cortisol, Borg Scale of Perceived Exertion, the variability of
the heart frequency and blood biochemical variables. The coachs and familys demands, the
uncertainty about the game, the unknowing about the opponents and the pre-competition
period, in addition to high loads training are the main stressors cited. Only one study addressed
a psychological intervention, showing the lag in this area and the importance of implementing
new work toward stress intervention programs with this population.
Financial Support: CAPES (doctorate scholarship); CNPq/MCT (research productivity
scholarship).
Keywords: Stress; Athletes; Collective Sports.
Researches on coping in the context of chronic diseases in Brazilian population

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Snia Enumo1, Vanessa Gibran1, 4, Fernanda Guilabel4, Fabiana Ramos2, Kely Paula2, Snia
Enumo1, Snia Enumo1, Snia Enumo1, Kelly silveira2, Grace Lorencini2, Christyne Oliveira2, 3,
Snia Enumo1, Kely Paula2, Christyne Oliveira2, 3, Snia Enumo1, Alessandra Loss2, Fernanda
Caprini2, Cristiane Rodrigues4, Patrcia Grillo4, Mrcio Garcia4, Tatiane Dias5, Kirlla Dornelas3,
Nayara Miranda3, Ednia Oliveira3.
1. Pontifcia Universidade Catlica de Campinas, Campinas, Brazil, 2. Universidade Federal do
Esprito Santo, Vitria, Brazil, 3. Faculdade Catlica Salesiana do Esprito Santo, Vitria, Brazil,
4. Fundao Educacional de Araatuba, Araatuba, Brazil, 5. Universidade Federal de Mato
Grosso, Cuiab, Brazil.
Studies on reactions to stress have emphasized the mediating role of coping strategies with
stressful events in the analysis of the adaptive process. Their analyses rely on different
theoretical approaches, proposed since the 80s, especially from the Lazaruss psychological
model of stress. This researcher and collaborators proposed a cognitive perspective of the
study of coping. This concept was defined as a process resulting from an interaction between
the individual and the environment, seeking their situational and cognitive determinants, in
contrast to the earlier conception of coping as hierarchical styles related to defense
mechanisms, as studied by Ego Psychology. Coping was then conceived as constant change
on the efforts, cognitive and behavioral, used by individuals in order to deal with specific
demands, internal or external, that are evaluated as taxing or exceeding their personal
resources. In the 90s, coping began to be studied as a regulatory action in a developmental
perspective, as presented by Motivational Theory of Coping (MTC), proposed by E. Skinner et
al., based on studies by B. Compas and followers on aspects of coping in children and
adolescents. The latter approach defines coping as a process of self-regulation of behavior,
emotion and motivational orientation in conditions of psychological stress in order to maintain,
restore or repair basic psychological needs of relationships, competence and autonomy. Based
on these theoretical approaches, research has sought to examine this mediation relationship of
coping, seeking to understand the processes of adaptation to physical illness and emotional
problems. This symposium aims to show how the study of coping with chronic diseases is
presented according to the predominant approach in the area - a cognitive perspective allowing to compare it to the MTC. Data will be presented from empirical research that have
coping as the main variable studied. These studies in graduate level from five universities of two
Brazilian states, with use of standardized instruments, scales and interviews, applied in adults
with cancer and in children with sickle cell disease (SCD) and their caregivers. Presentation 1
will present a brief history of theoretical approaches to coping, highlighting the cognitive
proposal and Motivational Theory of Coping. Presentation 2 will present data from coping,
anxiety and depression in adult patients with cancer, according to the cognitive perspective of
coping. Presentation 3 will examine the coping of hospitalized children with cancer and other
physical disorders, from the perspective of MTC. Presentation 4 will present a program of
assessment and intervention of children coping with SCD, also based on MTC. Presentation 5
will address assessment of coping in children with SCD through two instruments - a
standardized one and another specially adapted for the assessment of the coping with pain. We
expected to show data from Brazilian research and their contributions to the study of coping.
Motivational Theory of Coping: an analysis proposal
The relationship between stress and coping has been widely studied in recent decades because
it is essential to understand the conditions under which stress can bring negative consequences
for physical and mental health. Since then, different theoretical models of conceptualization,
interpretation and evaluation of the phenomenon has been proposed. This paper aims to
discuss a recent perspective of coping analysis, the Motivational Theory of Coping (TMC),
which emerged in the 90s. The coping was initially conceived in the 60s and 70s, from

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psychoanalytic formulations as hierarchical personality styles and not as a process. The second
approach is dating from the 70s and 80s - the Cognitive Perspective of Coping - which sought to
understand the coping process as a result of an interaction between the individual and their
environment, seeking their situational and cognitive determinants. The MTC in turn, defines
coping as the process of self-regulation of behavior, emotion and motivational orientation in
conditions of psychological stress in order to maintain, restore or repair basic psychological
needs of relatedness, competence and autonomy. In this process, the individual assesses the
extent to which the context is contemplating or threatening these three needs, and perceptions
of stressor as damage, threat or challenge is a prerequisite for different interpretations of
events, leading consequently to different answers to stress. Coping is analyzed from this
perspective in 12 "families", considered the highest level of the structure of coping, according to
its adaptive outcome: (a) positive (self-reliance, support seeking, problem solving, information
seeking, accommodation and negotiation), and (b) negative (delegation, isolation, helplessness,
escape, submission and opposition). All members of the same family have in common a
particular type evaluation and a typical pattern of behavior, emotion and orientation
characterizing a tendency of action; allowing different coping strategies are considered as a
single group of participants, based on characteristics common. The MTC has merits as: (a)
address the coping under a developmental perspective, (b) demonstrate bonding of coping with
the adaptive processes, and (c) differentiate the coping strategies of the results of the coping,
one of the great challenges in the area, given the use interchangeably and sometimes confusing
of the two concepts. We discuss the theoretical and methodological advantages of adopting this
perspective in relation to other previously proposed in the literature.
Emotional variables and coping strategies in Brazilian cancer patients
Cancer is a disease that is typically characterized by the loss of control of cell division. It has an
uncanny ability to invade other bodily structures (metastasis), in a very invasive process, often
leading to the formation of tumors. Even today, the disease is seen as sentence on life, whose
diagnosis is accompanied by a multitude of sentiments. Patients implement a myriad of coping
methods to deal with their particular situations. Thus, patients often require psychosocial
support to deal with stress. The coping is indeed a relevant variable to the quality of life of
cancer patients. The objective of this study was to evaluate the psychological aspects and
coping strategies of cancer patients. We used The Beck Anxiety Inventory (BAI), The Beck
Depression Inventory (BDI) and the Ways of Coping Scale during our analysis. This range of
coping is composed of 45 items, divided into 4 primary factors: coping focusing on the problem,
focusing on emotions, seeking religion, and seeking social support. The sample consisted of 20
cancer patients, 10 men and 10 women. The patients were from two institutions: Hospital Santa
Maria and a non-profit organization, Springs Life, both in Araatuba, Brazil. The patients ranged
between 21 and 83 years of age (mean of 60). The study group was comprised of (35%) with
elementary schooling complete, followed by (30%) with higher education, and (25%) with a high
school education. There were no significant differences in relation to the gender of the patients.
Of the individuals tested, 85% experienced a minimal level of depression, while the remaining
15% experienced a light level of depression. In relation to anxiety, 70% experienced a minimal
level, 25% light, and 5% moderate. The most common coping method used was focusing on the
problem at 34.53%, followed by religion coping (magic or religious practices) at 31.67%, seeking
support at 20.12%, and finally coping by focusing on emotion at 13.68%. The data suggest that
for the emotional aspects evaluated, the coping methods were indeed successful (as evidenced
by the relatively low levels of anxiety and depression in most of the patients). Another relevant
factor is the health facilities frequented by the test group. The test group was treated by an
interdisciplinary team, with industry-specific experience in psychology. This teams experience
could be a variable that directly contributed to the low levels of emotional symptoms presented
by the patients.

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Behaviors and coping strategies of child hospitalization


Hospitalization can be an experience adverse development of child and youth, considering how
the patient faces the hospital stay and the aversive events associated with it. Taking the
Motivational Theory of Coping as a reference, this study analyzed the relationship between
behaviors and coping strategies of hospitalization in children with cancer and children suffering
from other diseases. It also analyzed the raw data from three studies that investigated coping
strategies of hospitalization, two of them with children with cancer (G1 = 30), and one of them
with children diagnosed with other physical disorders (G2 = 28). In total, this study examined the
data from 58 children, 41 boys and 17 girls, mean age 9.5 years (6-12 years old). In all studies,
participants comprised a convenience sample at two hospitals in Great Vitria, Brazil. The
Computerized Assessment Instrument Coping with Hospitalization/AEHcomp was used for the
evaluation of behaviors and strategies reported by children for coping with hospitalization. The
AEHcomp evaluates coping behaviors (playing, watching TV, singing/dancing, praying,
studying, talking, listening to music, reading comics, taking medication, seeking information,
crying, anger, hiding, sad, discouraged, blackmail, thinking about running away, guilt, fear and
think of miracle), and coping strategies (ways of coping) related to them (problem solving,
seeking support, avoidance, distraction, cognitive restructuring, rumination, helplessness, social
withdrawal, regulation of emotion, information seeking, negotiation, opposition, delegation). The
data were analyzed in a descriptive way, comparing averages of the groups. The most common
coping behaviors were taking medication (M = 3.7), chatting (M = 2.8), watching TV (M = 2.4),
praying (M = 2.3) and playing (M = 1 7). Children with cancer (G1) had higher frequencies for
playing, studying, blackmailing and hiding, while children with other physical disorders (G2) had
higher frequencies to take medicine. There was a higher frequency of coping strategies related
to distraction, rumination, seeking support, problem solving and cognitive restructuring. The
verification of convergent and divergent characteristics between the evaluated groups
emphasizes the importance of understanding how the resources of the person, the environment
and characteristics of the stressor, relate to affect the coping process of hospitalized children.
Coping with pain: a psychological intervention in children with sickle cell disease
Studies have been conducted in order to examine the coping strategies (CS) that children use
to cope and adapt to adverse situations, so that intervention programs focusing on CS
constitute themselves on measures of protection to child development. To contribute to the
promotion of more adaptive CS to the situation of pain, we designed a Psychological
Intervention Program for Children with Sickle Cell Disease (PIPC-SCD), the most prevalent
hereditary chronic disease in Brazil, characterized by constant, unpredictable pain of variable
intensity, generating emotional, social and cognitive impairment. The PIPC-SCD relies on the
principles of Cognitive-Behavioral Techniques, consisting of 3 steps, with 7 semi-structured
weekly sessions 1h30min in group: 1) Integration (2 sessions) - aims at the presentation of the
children and the adhesion to the program, 2) Identification and expression of feelings (3
sessions) - seeks to promote the development of self-observation skills and identification of
feelings and thoughts; 3) the psychotherapeutic game - especially developed for this study (2
sessions) - seeks to help the child to identify, analyze and reflect on the everyday situations that
may cause him/her fear, pain, stress and induce or increase the sensation of pain as well as
teach strategies to best cope with them. The PIPC-SCD was applied to 7 children (8-10 years
old), checked in the Clinic of Pediatric Hematology of an University Hospital from the Southeast
Region / Brazil. In the pre-and post-test, we evaluated the CS of pain by the Computerized
Coping with Hospitalization Assessment Instrument/AEHcomp adapted to situations of pain.
Comprising 20 scenes of pain coping behavior, the AEHcomp identifies the CS: distraction,
rumination, problem solving, support seeking, emotion regulation, avoidance, negotiation,
information seeking, cognitive restructuring, helplessness, delegation, social withdrawal and

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opposition, which guided the proposition of the board game. The analysis of the effects of the
intervention showed clinical improvement, especially in relation to strategies for problem solving
and seeking support, whose gain rates were above 30%. There was a clinically significant
decrease on the averages of the pre-and post-test in all CS that to facilitate coping with pain,
particularly social withdrawal, avoidance and helplessness. The results are indicative of the
contribution of PIPCSCA for children with SCA, favoring more adaptive responses to the
situation of pain.
Assessment of pain coping strategies in children with sickle cell disease
Chronic illness in childhood may compromise the overall development of children especially
when it is accompanied by pain and a large number of hospitalizations and comorbidities such
as sickle cell disease (SCD). However, the way the child responds to stressful situations
depends on variables of the disease, the environment, and also variables of the child, such as
age, temperament, and coping pattern of adversity. Thus, this study assessed the coping
strategies (CS) of pain of 5 children with SCD, aged 8 and 10, through two instruments: a)
Computerized Coping with Hospitalization Assessment Instrument/AEHcomp adapted to pain
situation enabling the analysis of coping in 13 categories: distraction, problem solving, search
for information, seeking support, cognitive restructuring, avoidance, emotion regulation,
rumination, negotiation_ helplessness, social withdrawal, opposition and delegation, and b)
Kidcope - a self-report measure with 15 items to assess the frequency and effectiveness of the
use of 10 coping strategies, divided into CS of: a) avoidance - distraction, social isolation,
wishful thinking and resignation; b) negative CS - self-criticism and blaming others, and c) active
CS - cognitive restructuring, problem solving, emotional regulation and social support. By
AEHcomp, 44% of respondents were referred to the problem solving strategy, in which the child
reported behaviors directed to the management and control of pain, followed by the search for
support (18%), in the sense of seeking and / or accepting available social support. The CS
negotiation, helplessness, social withdrawal, opposition delegation and avoidance were not
reported by any child. By Kidcope, more frequent and effective use of active strategies for
coping with pain, particularly problem solving and emotion regulation were observed, which
were followed by CS of avoidance, wishful thinking, distraction, and resignation. We observe
that one child reported using the strategy social isolation ("I did not speak about the problem"),
while evaluating this behavior as ineffective to cope with the pain. It is noteworthy that the
children had a higher frequency of facilitative strategies of coping with pain in both instruments,
revealing them as suitable for both clinical and research purposes in this population.
A Physical Activity Program for Obese Children: Efficacy of Three Different Methods of
Delivering
Patricia Escobar Valero1, Ausis Cebolla2, 3, Marta Miragall1, Elia Oliver1, 3, Rosa Baos1, 3.
1. Personalidad, Evaluacin y Tratamiento Psicolgico, Universidad de Valencia, Valencia,
Spain, 2. Universidad Jaume I de Castelln, Castelln, Spain, 3. Ciber Fisiopatologa de la
Obesidad y la Nutricin, Santiago de Compostela, Spain.
Childhood obesity is a serious problem to public health. Diet and physical activity (PA)
prescriptions are the key components in the obesity treatment. However, data on adherence to
PA prescriptions point out low rates, especially in obese and overweight children. The objective
of this study is to compare the efficacy of three different methods to deliver a PA program in a
sample of children in weight loss treatment. The sample was composed by 22 obese and
overweight children (age ranging 9 to 15). The participants were recruited in a cardiovascular
risk unit specialized in childhood obesity and were randomly assigned to one of three different
methods to deliver a PA program (which were designed by pediatricians and physiotherapists to
overweight and obese children): 1) Traditional condition: flyer with the PA routine (N=10), 2)

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Web condition: A web including an exergame with the PA routine (N=7) and 3) Web condition +
email: a web that includes an exergame with psychological support via email, (N=5).
Participants were asked to perform an exercise routine 3 times a week during a 3-month period.
Before and after the 3-month period the percentage of body fat was measured using a
calibrated electronic stadiometer TANITA BC. The findings indicate that the web exergame
platform with weekly psychological support via email decrease more the loss body fat
percentage than the other two methods. However, the difference did not achieve statistical
significance. This study is on progress and it is necessary to expand the sample in order to get
more powerful results. It seems there is a potential on Internet with psychological support to be
a viable method for delivering PA prescriptions on children who are in a weight loss treatment.
Bienestar Psicolgico en Deportistas Trasplantados
Jessica Estalella.
Prctica privada, Mendoza, Argentina.
Abstract Central: El presente trabajo de investigacin cuantitativa tiene como objetivo
investigar el grado de Bienestar Psicolgico en personas que han recibido un trasplante de
rganos y/o tejidos, teniendo en cuenta los aportes realizados desde la Psicologa Aplicada al
Deporte para contribuir al desarrollo del conocimiento cientfico de este campo de la disciplina
psicolgica. Se procura determinar si el deporte puede ser considerado como una herramienta
que contribuye al bienestar psicolgico de personas que han sobrellevado una intervencin
quirrgica vital como un trasplante de rganos o tejidos. Es un estudio exploratorio y
descriptivo, con un diseo trasversal y una muestra intencional y no probabilstica de 30 sujetos
de investigacin, que comparten el hecho de haber sido trasplantados y que practican algn
tipo de deporte. Los instrumentos de evaluacin utilizados fueron un Cuestionario de
construccin propia, compuesta de 8 apartados que indagan sobre diversas reas de la vida de
los sujetos, y la adaptacin espaola de la Escala de Bienestar Psicolgico de Carol Ryff. Los
resultados obtenidos muestran que las personas trasplantadas que realizan algn tipo de
deporte tienden a percibir mayor grado de satisfaccin durante y luego de la prctica deportiva,
mejor estado de nimo y mayor grado de salud, lo que contribuye al bienestar psicolgico.
An Open Trial of Metacognitive Therapy for Emotional Distress in Young Adult Cancer
Survivors
Peter Fisher.
University of Liverpool, Liverpool, United Kingdom.
Abstract Central: Background : Young adult survivors of childhood cancer are at increased risk
for both physical and psychological morbidity. Unfortunately, highly effective psychological
interventions for emotional distress in cancer survivors are unavailable. Aim: To investigate the
potential effectiveness of metacognitive therapy (MCT) for emotional distress in young adult
survivors of cancer. Methods: A small open trial (N=12) with six months follow-up. Each
participant completed a baseline period ranging from 3-6 weeks before treatment commenced.
A generic form of MCT was used, thereby enabling MCT to be applied to a wide range of
presenting complaints. Results: Repeated measures ANOVAs with follow-up pairwise
comparisons were conducted on the outcome variables across pre-treatment, post treatment,
and six months follow-up. There was a significant effect of time for all outcome variables with
significant differences between pre-treatment scores and all post treatment and follow-up
scores. Mean percentage reductions on the HADS and IES-R from end of baseline to posttreatment were 64% and 80%, respectively. Seven of the 10 treatment completers made at least

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a 50% reduction on the HADS and 9/10 made at least a 70% reduction on the IES-R. All gains
were maintained through to six months follow-up Conclusions: This study provides preliminary
evidence of the effectiveness of MCT in alleviating anxiety, depression and trauma symptoms in
young adult cancer survivors. Outcomes are encouraging, with clinically and statistically
significant reductions on all symptom and process measures.
Tratamiento de una Sesin en Cuidadores Primarios Informales de Nios con Asma
Alrgica
Maria Fregoso1, Jurado Samuel1, Javier Gmez-Vera2.
1. Facultad de Psicologa UNAM, Mxico, D. F., Mexico, 2. Hospital Regional Lic. Adolfo Lpez
Mateos ISSSTE, Mxico, D.F., Mexico.
Abstract Central: El objetivo del estudio fue explorar el efecto de un tratamiento cognitivoconductual de sesin nica en cuidadores primarios informales de nios con asma alrgica. Se
emple un estudio cuasiexperimental de serie temporal interrumpida simple con 29 rplicas. Se
aplic la intervencin en forma individual a 30 cuidadores informales de nios de 2 a 12 aos,
con diagnstico de asma alrgica. Se evalu, antes del tratamiento, una semana despus, y a
los dos y seis meses posteriormente. Se realizaron mediciones en sintomatologa depresiva,
ansiosa, percepcin de la calidad de vida de la enfermedad de los nios, adherencia
teraputica, manifestaciones diarias del asma infantil y respuestas psicolgicas parentales. Se
observaron mejoras estadstica y clnicamente significativas en la percepcin de la calidad de
vida F[1497.28 p<.000 df 2]; en sintomatologa depresiva F[13.62 p<.001 df 2] a los dos y seis
meses despus del tratamiento en todos los participantes; respectivamente el tamao y
potencia del efecto fueron de 1.078 r= .474 y -.870 r=.-398 y el ndice de cambio clnico a los
seis meses fue de 3.49 y -2.83. La mejora se mantuvo a los dos y seis meses despus del
tratamiento para 18 de los 30 cuidadores informales que participaron en el estudio. Los
hallazgos se discuten por su relevancia clnica y en relacin con la eficacia del tratamiento de
una sesin.
Psiconeuroinmunologia asociada a la calidad de vida en adultos mayores en situacin
familiar y residentes geritricos, en Mxico
Sergio Galan-Cuevas.
Faculty of Psychology, UASLP, San Luis Potosi, SLP, Mexico.
El propsito de esta investigacin es describir la manera en que perciben la calidad de vida y
su relacin con el sistema inmunolgico dos grupos de adultos mayores en la ciudad de San
Luis Potos, S.L.P. Mxico. Participaron 27 personas mayores de 60 aos, de los cuales
diecisis (59.3%), eran residentes de una institucin pblica geritrica y once (40.7%) vivan
con sus respectivas familias. Mtodo: En ambos grupos se aplic la escala SF-36, para medir
su percepcin de calidad de vida, la cual contiene ocho criterios de evaluacin que son:
funcionamiento fsico, rol fsico, dolor corporal, salud en general, vitalidad, funcionamiento
social, rol emocional y salud mental. Se les tomaron tambin muestras de sangre, con el
propsito de evaluar el sistema inmunolgico celular, contando el nmero de clulas CD3, CD4,
CD8, CD19 y CD56. Resultados: Las diferencias de medias entre los linfocitos de las personas,
son notorias entre aquellos que viven en una institucin geritrica con respecto a los que viven
con sus familias. El conteo de linfocitos totales o CD3 es ligeramente superior a la proporcin
de 2:1. Cuando se separan los CD3, se nota que la principal diferencia se encuentra entre los
CD4, conocidos tambin como linfocitos cooperadores. El nmero de linfocitos citotxicos o
CD8, sin embargo, es similar en ambos grupos. Se encontraron diferencias estadsticamente

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significativas en la sub escala de Funcionamiento fsico, con una t = 3.5, con 25 gl y una p
.002. Cuando disminuye la calidad de vida, se incrementa el nmero de linfocitos CD3, es una
seal de que el SI se prepara para enfrentar amenazas a nuestro organismo. Esto se subraya
al observar la escala de vitalidad, que es la nica que nos muestra una situacin inversa entre
los asilados y no asilados. Se observa que en el grupo de las personas que tienen vida familiar,
en la medida que la vitalidad disminuye, se incrementa el nmero de clulas CD3, sin embargo,
entre las personas que viven en la institucin geratrica, cuando se incrementa la vitalidad,
tambin se incrementa el nmero de CD3. El siguiente paso es garantizar que estos
instrumentos sean sensibles y especficos, esto es que identifique de manera apropiada, si son
positivas o negativas, la mayor parte de las personas a las que se les aplicaron los
instrumentos. Para ello se requiere de un trabajo constante y permanente de calibracin de
instrumentos. Esto solo ser posible si se disean intervenciones en donde participen grandes
grupos poblacionales, que den cuenta de la efectividad de los tratamientos implementados. Las
resultados obtenidos en investigaciones realizadas con diseos transversales deben tomarse
con mucho cuidado, sobre todo al trabajar con pequeas muestran que no necesariamente
reflejan el comportamiento poblacional. Sin embargo se pueden convertir en indicadores
importantes para futuras investigaciones. Tal es el caso del presente trabajo.
Una Revisin de Guas Psicoeducativas Sobre Procrastinacin Dirigidas a Estudiantes
Universitarios
Marina Galarregui1, 2, Andrs Partarrieu1, Fernan Arana1, 2, Guillermina Rutsztein1, Eduardo
Keegan1.
1. Universidad de Buenos Aires. Facultad de Psicologa, Buenos Aires, Argentina, 2. Consejo
Nacional de Investigaciones Cientficas y Tcnicas, Buenos Aires, Argentina.
La procrastinacin ha sido definida como una tendencia irracional para retrasar tareas que
deben completarse (Lay, 1986). Ferrari y colaboradores (1995) la definen como el hecho de
posponer la culminacin de una tarea que usualmente resulta en un estado de insatisfaccin o
malestar subjetivo (Burka & Yuen, 1983). Diversos estudios asocian la tendencia a procrastinar
con caractersticas de personalidad y cuadros clnicos, tales como baja autoestima, baja
confianza en s mismo, impulsividad, perfeccionismo, depresin y ansiedad (Ferrari & DazMorales, 2007; Ferrari & Emmons, 1995; Flett, Hewitt, & Martin, 1995; Van Eerde, 2003).
Asimismo varios estudios sealan que la tendencia a posponer tareas interfiere negativamente
con los logros acadmicos (Moon & Illingworth, 2005), siendo la consecuencia ms frecuente
un bajo rendimiento que interfiere con el funcionamiento y la organizacin individual (Dewitte &
Schouwenburg, 2002). Se estima que la procrastinacin acadmica es un fenmeno comn
entre los estudiantes (Solomon & Rothblum, 1984; Onwuegbuzie, 2000), representado
aproximadamente por un setenta por ciento de la poblacin universitaria (Ferrari et al., 2005).
Dado el impacto de la procrastinacin en el contexto acadmico resulta relevante explorar
intervenciones desarrolladas a los fines de reducir la tendencia a la postergacin y el malestar
asociado. Con dicho objetivo se realiza una revisin de guas psicoeducativas desarrolladas por
los departamentos de Counselling de diversas universidades Internacionales tales como:
Universidad de Cambridge; Universidad de Nottingham; Universidad de Sheffield, Universidad
Tecnolgica de Sydney, Universidad Waterloo de Canad, entre otras. Esta revisin podra
resultar de utilidad en el diseo de futuras intervenciones psicolgicas y contribuir a futuros
desarrollos sobre procrastinacin en nuestro medio.

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Medicion de la Relacion existente entre dos pruebas exploratorias de la Depresion en


Pacientes que ingresan al Programa Auge en Chile Siendo Evaluados a traves del Test
de Beck y la Escala de Riesgo de Suicidabilidad SAD Persons
Maria Garay Moffat.
Hospital Quillota, Quillota, Chile.
Abstract Central: La presente investigacin tiene por objeto explorar la relacin existente entre
el Test de Beck y la Escala de Riesgo de Suicidabilidad (SAD PERSONS) en una muestra de
100 pacientes que ingresan por el Programa de Depresin AUGE en la Unidad de Salud Mental
del Hospital de Quillota , CHILE. Cada uno de los pacientes respondieron en cada test una
serie de preguntas destinadas en primer lugar a detectar en el nivel de Depresin en que se
encontraban dentro de las categoras del test de Beck :Altibajos Normales, Leve perturbacin
del estado de nimo, Estados de Depresin Intermitentes, Depresin Moderada, Depresin
Grave y Depresin Extrema. Por otro lado se complement esta evaluacin con la Escala de
Suicidabilidad SAD Persons, que ubic a los sujetos en las categoras: Alta, Mediana y Baja
Letalidad. Se analiz la distribucin de los datos por porcentajes de acuerdo a las variables de
Sexo, Edad, Procedencia Geogrfica, Estado Civil, Ocupacin, Numero de Sesin, Rasgos de
Personalidad, Intentos de Suicidio, Ideacin Suicida y Bipolaridad. Se observ adems la
pertinencia de ser ingresados segn este instrumento, a un Programa de Depresin Severa
Auge, que tiene como requerimiento encontrarse dentro de un rango de Depresin Grave,
Presentar intento de suicidio, tener un Trastorno Bipolar o una Depresin Refractaria a
tratamiento. Se espera al finalizar este estudio encontrar algn tipo de correlacin o
complementariedad entre los dos instrumentos aplicados y adems lograr una apreciacin
cualitativa a partir de las variables anexas a este estudio, a travs de una revisin de los
porcentajes alcanzados en cada categora. Como una conclusin se espera aportar elementos
de anlisis para el Programa de Depresin Auge en Chile, proporcionando resultados que
ayuden a ver la factibilidad de incorporar estos dos instrumentos, Beck y SAD Persons, dentro
de un protocolo de ingreso para el paciente que presenta caractersticas de Gravedad en su
Depresin y contribuir tambin a la derivacin de pacientes desde la APS segn este criterio de
pertinencia.
Manejo del Estrs en Paciente Crnico-degenerativo Peditrico Hospitalizado
Ma de los ngeles Edith Garca.
Instituto Cognitivo Conductual de Salud Mental de Mxico, Mxico, Mexico.
Abstract Central: En las ltimas dcadas, el estrs se ha constituido como una variable
relevante en el mbito de la salud, en particular en las enfermedades crnico-degenerativas.
Este tipo de enfermedades junto con el proceso de hospitalizacin frecuente que implican, son
tanto afectadas como desencadenadoras de estrs, y tal efecto se observa de manera
importante en poblacin infantil. La respuesta de estrs en el nio se ve mediada por
elementos individuales y de aprendizaje social; no obstante, las enfermedades crnicas son
especialmente estresantes ya que frecuentemente son acompaadas de eventos como el
dolor, las separaciones y restricciones. La experiencia de hospitalizacin implica una crisis
tanto en el paciente como en la familia, provocando potencialmente diversos trastornos
psicolgicos transitorios o a largo plazo; as como el reto institucional que comprende para el
sistema de salud. Es por ello, que el presente estudio se plante como objetivo el identificar los
elementos de estrs ante este tipo de padecimiento en poblacin mexicana, as como disminuir
el nivel de estrs del paciente peditrico, mediante el entrenamiento a sus padres, en tcnicas
cognitivo-conductuales, que susciten la aplicacin de estrategias de enfrentamiento efectivas
ante la experiencia de hospitalizacin. El programa fue instrumentado en pacientes peditricos

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hospitalizados (7 a 12 aos) con diagnstico de enfermedad crnico-degenerativa, y con el


familiar responsable, bajo un diseo de medidas repetidas. Se presentan los principales
estresores en esta poblacin y el anlisis cuantitativo obtenidos, resaltando la importancia de
cada tcnica, las implicaciones de la inclusin de los padres en las intervenciones y la utilidad
de la labor del psiclogo de la salud en este mbito. In recent decades, stress has been
constituted as a significant variable in the health field, in particular in the chronic-degenerative
diseases. This type of diseases along with the process of frequent hospitalization that imply, are
both affected that trigger such as stress, and this effect is important in child population. The
stress response in the child is mediated by individual elements and social learning; however,
chronic diseases are especially stressful because they are often accompanied by events such
as the pain, the separations and restrictions. The experience of hospitalization involves a crisis
in both the patient and the family, potentially causing various psychological disorders transient
or long-term; as well as the institutional challenge that includes, for the health system. It is for
this reason, the present study arose as aimed to identify the elements of stress in this condition
in mexican population, as well as to decrease the stress level of pediatric patient, through the
training to their parents, in techniques cognitive-behavioral, that give the implementation of
strategies for effective in the hospitalization experience. The program was implemented in
hospitalized pediatric patients (7 to 12 years) with a diagnosis of renal chronic-degenerative
disease, and with the responsible parent, under a repeated measures design. Presents the
principal stressors in the children and their parent and quantitative analysis obtained.
Efficacy of Cognitive-Behavioral Therapy for Adjustment Disorder in Oncological
Patients: A Big Enigma
Daniela Gercovich, Pablo Lpez, Diego Bortolato, Patricia Margiolakis, Mirta Morgenfeld, Laura
Rosell.
Instituto William Osler, Ciudad Autnoma de Buenos Aires, Argentina.
Background Previous studies argue that the Adjustment Disorder (AD) is the most prevalent
mental syndrome in patients with cancer. Its prevalence in this population was calculated
around 19.4%. However, in scientific literature the AD has not received enough interest.
Currently we have scarce evidence about the efficacy of different psychotherapy treatments in
AD. In regards to oncological patients, although numerous studies demonstrate the benefits of
psychosocial interventions, specifically Cognitive-Behavioral Therapy (CBT), the evidence about
the efficacy of this treatment is very limited. Therefore, the aim of this study was to examine the
available evidence about the efficacy of CBT in cancer patients with AD. Methods To identify
studies that were published up to 2011, we have searched in the following databases: PubMed,
PsycINFO and the Cochrane Central Register of Controlled Trials. The search strategy included
the following terms: cancer, adjustment disorder, oncology, psychotherapy, psychosocial
interventions, cognitive-behavioral therapy and stress. Additionally, we have searched in
Scholar Google to find gray literature. A set of inclusion criteria were established to include the
study in the review. In the first place, the study population had to be adult patients with cancer.
The patients had to be allocation randomly to the different treatments. Additionally, it was
necessary to include an appropriate control group. Results We found 213 references from
PubMed and 11 from PsycINFO. Addittionally, we found 18 studies from The Cochrane
Controlled Trials Register. Also, we found 2080 less specific references from Scholar Google.
However, only one study fulfilled the inclusion criteria. This study was published by Moorey,
Greer, Bliss, & Law (1998) and it is the only research that randomized the patients to the
different treatment conditions (Adjuvant Psychological Therapy vs. supportive counseling).
These authors found significant differences, in favor of Adjuvant Psychological Therapy, in
different domains such as: anxiety, adjustment to cancer and use of coping strategies.

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According to the authors, Adjuvant Psychological Therapy is a Cognitive Behavioral Treatment


designed especially for cancer patients. This study has reported four months follow up.
Conclusions In the present review we found only one randomized controlled trial that evaluated
the efficacy of CBT for AD in oncological patients. This situation is noteworthy, considering that
the number of studies about the efficacy of psychological treatments grew exponentially the last
50 years. Considering that the AD is the most prevalent diagnosis in oncological patients, the
situation becomes even more relevant. Additionally, previous research has demonstrated the
relationship between anxiety and depression symptoms with the cancers course and these
symptoms are associated with functional limitations in these patients. We think that this situation
configures a public health problem with serious consequences. For example, if we do not know
the benefits of a treatment, we ignore its adverse events too. Therefore, we consider that it is
essential to increase the number of studies that evaluate the efficacy of specific CBT for
patients with cancer.
Sintomas Psicofisiolgicos do Stress Relacionados a Coerncia Cardaca em
Universitrios Brasileiros Iniciantes de Psicologia
Vanessa Gibran2, 1, Vivian Mascella1, Snia Enumo1.
1. Psicologia, PUC- Campinas, Birigui, Brazil, 2. Fundao Educacional de Araatuba,
Araatuba, Brazil.
Abstract Central: O perodo correspondente vida universitria est relacionado a uma srie
de adaptaes, uma vez que os indivduos so expostos a influncias psicossociais que podem
desencadear situaes estressoras, prejudicando sua qualidade de vida, bem como sua sade.
Dessa forma, esta pesquisa teve por objetivo estudar os aspectos psicofisiolgicos do stress
em um curso de Psicologia, para caracterizar as dificuldades encontradas no ambiente de
aprendizagem. Foram analisados os parmetros biolgicos e psicolgicos do stress em
universitrios iniciantes do curso de Psicologia. Neste trabalho, sero apresentados os dados
de 10 estudantes, sendo 5 mulheres e 5 homens. Foram aplicados: a) o Inventrio de Sintomas
de Stress de Lipp (ISSL), que avalia o stress em quatro fases: alerta, resistncia, quase
exausto e exausto, alm da predominncia de sintomas psicolgicos ou fsicos; b) o
Biofeedback, que avalia a coerncia cardaca em baixa, mdia e alta; e c) o nvel de cortisol
atravs de amostra de saliva. A coleta aconteceu em dois momentos: incio do curso e primeira
semana de prova. Nesta amostra, houve predominncia de baixa coerncia cardaca e fase de
resistncia do stress, com predomnio de sintomas psicolgicos nos dois momentos. A
expectativa em relao semana de provas se mostrou fator predominante para as amostras
coletadas que repercutiram em resposta mdia maior de cortisol salivar (0,228) e maior
percentual de baixa coerncia cardaca (71,2%), do que no perodo em que os alunos
efetuaram as provas. Assim, subentende-se que a expectativa das primeiras provas, como
preocupao com a situao desconhecida e de desconforto, repercutiu emocional e
fisiologicamente de forma mais intensa na mdia das amostras coletadas. De acordo com a
literatura, as provas escolares no so em si objetos predominantes do stress, mas podem
contribuir para a elevao do seu nvel. O maior ndice de stress universitrio se caracteriza por
provas que no condizem com as propostas das aulas e com contedos avaliados, como
tambm as provas mal estruturadas e que exigem dificuldade para ser relacionada com o fluxo
natural da aprendizagem. Alm disso, disciplinas especficas, que exigem habilidades
especficas individuais, tambm so fatores predominantes de estresse. Faz-se necessria a
continuao do estudo no decorrer do curso de graduao para se ter resultados mais
conclusivos. Assim, importante a realizao de estudos longitudinais como forma de subsidiar
a proposio de intervenes adequadas voltadas melhoria da qualidade de vida e do

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processo de aprendizagem dos estudantes. Apoio financeiro: *CAPES (bolsa de doutorado)


Palavras-chave: stress, estudantes, cortisol
Programa De Interveno Psicolgica Sob A Abordagem Cognitivo - Comportamental
Para Pessoas Que Vivem Com HIV/Aids
Grazielly Giovelli1, Gabriel Gauer2, Prisla Calvetti3, Margareth Oliveira2.
1. Faculdade do Trabalho, Uberlandia, Brazil, 2. Pontificia Universidade Catolica do Rio Grande
do Sul, Porto Alegre, Brazil, 3. Unilassalle, Canoas, Brazil.
Abstract Central: De acordo com a Organizao Mundial de Sade OMS (WHO, 2010) a
infeco pelo HIV atingiu um estgio de pandemia no mundo. Com a chegada dos
antirretrovirais, as pessoas que vivem com HIV/Aids tiveram um aumento em seu tempo de
vida. Por se tratar de uma doena que carrega consigo uma significativa vulnerabilidade fsica,
emocional e social, muitos portadores de HIV/Aids tambm sofrem impacto em sua qualidade
de vida, tanto pelos fatores prprios s limitaes fsicas, sociais e estticas quanto pelo fato
de que muitos profissionais da rea de sade encontram dificuldades no atendimento a esses
pacientes (Maia, 2006), uma vez que carecem de conhecimentos e habilidades necessrios
para lidar com essa enfermidade. Desta forma as tcnicas da abordagem cognitivocomportamental so peculiarmente indicadas para as pessoas que se encontram frente
necessidade de reorganizar sua vida cotidiana, frequentemente perturbada por causa da
doena, de dificuldades financeiras, da perda do parceiro ou de outras mudanas no interior da
famlia. As pessoas submetidas terapia antirretroviral necessitam modificar o seu plano de
alimentao e o seu ritmo de vida, visando eficcia da terapia medicamentosa. No presente
estudo, as tcnicas da terapia cognitivo-comportamental foram orientadas para a resoluo de
problemas relacionados adeso ao tratamento para a melhora da mesma, identificao de
uma rede de suporte social efetiva e da qualidade de vida dos pacientes HIV. Esta modalidade
de interveno tem-se apresentado efetiva para a clnica em Sade Pblica e tm destaque as
caractersticas breve, focada e psicoeducativa. Neste sentido o objetivo geral deste estudo foi
avaliar a contribuio de um Programa de Interveno Psicolgica sob abordagem da Terapia
Cognitivo - comportamental para a adeso ao tratamento e qualidade de vida em pessoas que
com vivem HIV/Aids. E como objetivos especficos: Conhecer e analisar os pensamentos, as
emoes e os comportamentos em relao ao tratamento de sade dos portadores do
HIV/Aids; identificar e analisar as fontes de suporte social destas pessoas; investigar os
aspectos psicolgicos, adeso ao tratamento e qualidade de vida da populao em estudo.
Identificar na fala destas pessoas, quais so suas maiores dificuldades em seguir o TARV, e
seus sentimentos em relao interveno da terapia cognitivo-comportamental. Os
participantes do estudo foram 11 participantes soropositivos para o HIV, com idade entre 18 e
60 anos, em tratamento antirretroviral, atendidos n rede pblica de sade do sul do Brasil.
Estudo de carter qualitativo e descritivo exploratrio com a gravao e transcrio de oito
sesses e entrevista semi-estruturada para avaliao do programa. As tcnicas utilizadas
foram: registro de pensamentos disfuncionais, reestruturao cognitiva, relaxamento, dentre
outras. Os resultados mostraram que a terapia cognitivo-comportamental teve uma contribuio
importante, tanto para a identificao como para mudanas dos pensamentos, sentimentos e
comportamentos em relao adeso ao tratamento, bem como o suporte social e qualidade
de vida das pessoas atendidas. Palavras-chaves: Terapia cognitivo-comportamental; HIV/Aids;
Adeso ao tratamento; Qualidade de vida.
Musicoterapia Como Intervencion Psicosocial en Familiares de Usuarios de los Servicios
de Salud Mental

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Jesus Gomez.
1. Investigaciones Clinicas, Instituto Nacional de Psiquiatria "Ramon de la Fuente", Distrito
Federal, Mexico, 2. Instituto Mexicano de Musicoterapia Humanista, Distrito Federal, Mexico.
Abstract Central: La Msicoterapia Humanista (MH) es un modelo psicoteraputico de origen
mexicano que utiliza la relacin de la persona con el terapeuta y la msica para lograr cambios
importantes en la calidad de vida de las personas, ya sea que padezcan algn trastorno o no.
Al ser una psicoterapia orientada al trabajo en grupos, creemos que puede facilitar de manera
significativa el aprendizaje de habilidades psico-sociales a travs de la modificacin de la
conducta y el manejo de las emociones, mejorando la calidad de vida de los usuarios de los
servicios de Psiquiatra y sus familiares. En la actualidad se necesitan estudios que validen la
aplicacin de la Msicoterapia Humanista en un contexto clnico y con resultados
cuantificables. En esta intervencin realizada dentro del Instituto Nacional de Psiquiatra
Ramn de la Fuente, utilizamos la msicoterapia humanista en conjunto con la terapia
cognitivo-conductual, en una muestra de 24 personas de ambos sexos, que contasen con un
familiar con algn trastorno psiquitrico en tratamiento, particularmente esquizofrenia.
Recibieron 12 sesiones semanales, en las cuales participaron en ejercicios de Msicoterapia
Grupal receptiva y activa; as como tcnicas de modificacin de la conducta. El efecto de estas
intervenciones se midi con diseo de test-retest, para lo cual contestaron cuestionarios de
Autoestima, Relaciones Familiares, Emocin expresada y General de Salud , antes y despus
de la intervencin. En cuanto a la efectividad del tratamiento con msicoterapia, encontramos
diferencias significativas en los niveles totales de autoestima y emocin expresada, antes y
despus de la intervencin ( t = - 008, gl = 33, p .05 = .008). Estos resultados podrn ser
reproducido y ampliados en estudios posteriores , al incluir grupos control y un seguimiento a
largo plazo, con el objetivo de brindar una mayor validez. Sin embargo podemos afirmar que la
msicoterapia es una herramienta efectiva y segura, que puede ser utilizada en conjunto con
otras tcnicas, para la atencin de problemas psico-sociales y que podra ser replicada en otros
contextos, como el de las adicciones y las conductas anti-sociales.
Reatividade Cardiovascular em Tarefas Experimentais Estressantes - Dados de um
Estudo Piloto
Ricardo Gorayeb.
Faculdade de Medicina de Ribeiro Preto da Universidade de So Paulo, Ribeiro Preto, Brazil.
Doenas cardiovasculares (DCVs) so a principal causa de morte no mundo e representam
uma grande parcela dos gastos com assistncia sade. Possuem etiologia multifatorial,
sendo determinadas por fatores biolgicos, sociais e psicolgicos. Um dos fatores mais
comumente associados ao aparecimento das DCVs a hipertenso arterial sistmica (HAS).
Variveis psicolgicas, como estresse, ansiedade, depresso e Personalidade Tipo D, tm sido
associadas ao surgimento da HAS e das DCVs. Estas variveis tm efeitos sobre a reatividade
cardiovascular atravs das variaes da presso sangunea e frequncia cardaca, que
ocorrem em resposta a situaes especficas, tendo uma capacidade preditiva para o
desenvolvimento de eventos cardacos. Objetivos: Apresentar dados de um estudo piloto
realizado para testar um procedimento de reatividade cardiovascular e avaliar sua adequao
para a produo e reduo de estresse. Aps a finalizao do estudo piloto, ser iniciado o
procedimento do estudo definitivo, que contar com uma amostra de 200 pacientes
hipertensos, os quais sero submetidos tambm a uma avaliao psicolgica. Sero avaliados:
ansiedade e depresso (Escala de Ansiedade e Depresso Hospitalar - HAD), Personalidade
Tipo D (DS 14), percepo de apoio social (Escala de Apoio Social - MOS), e estresse
(Inventrio de Sintomas de Stress para Adultos de Lipp - ISSL). Os resultados da avaliao

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psicolgica possibilitaro a anlise dos efeitos preditivos dos aspectos psicolgicos sobre a
reatividade cardiovascular. Mtodo: Este estudo experimental foi realizado com 21 participantes
normotensos, submetidos a uma tarefa geradora de estresse - fazer um discurso diante de uma
cmera filmadora, sobre um tema definido, a ser assistido por uma audincia - e uma tarefa
redutora de estresse - treino de relaxamento muscular. Na situao experimental, foram
aferidas medidas de presso arterial sistlica (PAS) e diastlica (PAD) e frequncia cardaca
(FC) em 1-linha de base, 2-preparao do discurso, 3-realizao do discurso e 4-relaxamento
muscular. Calculou-se a mdia da PAS, da PAD e da FC em todos os momentos. Foi utilizado
o teste ANOVA para medidas repetidas, com comparaes post-hoc por pares com correo
de Bonferroni (alpha=0,05). Resultados: Observou-se diferena estatisticamente significante
entre as medidas da PAS (F(1,9)=7,5; p=0,02) e PAD (F(1,6)=5,5; p=0,014). A mdia da PAS
foi maior durante as fases de preparao e realizao do discurso do que durante o
relaxamento (p=0,008 e p=0,003). Em relao PAD, a medida de linha de base foi menor do
que durante a preparao (p=0,044) e a realizao do discurso (p=0,024). A medida de PAD na
preparao do discurso foi maior do que no relaxamento (p=0,043). No houve diferena
estatisticamente significante entre as medidas de FC. Concluso: Estes dados indicam a
adequao do procedimento experimental, dado que o aumento e reduo nas medidas
indicativas de reatividade cardiovascular tm significncia estatstica e clnica. (FAPESP
2012/09013-5).
Effectiveness of a Cognitive Behavioral Intervention on Stress, Anxiety and Depression
in Patients with Cardiovascular Disease
Ricardo Gorayeb1, Andr Schmidt1, Giovana Facchini2, Poliana Lima1, Ana Luisa Suguihura2,
Renata Nakao1.
1. Faculdade de Medicina de Ribeiro Preto da Universidade de So Paulo, Ribeiro Preto,
Brazil, 2. Hospital das Clnicas da Faculdade de Medicina de Ribeiro Preto da Universidade de
So Paulo, Ribeiro Preto, Brazil.
Objective: To evaluate the efficacy of group cognitive behavioral psychological intervention on
psychological symptoms (anxiety, depression and stress) and cardiovascular health in patients
with cardiovascular disorders (CVD). Background: Cardiovascular Disorders are the leading
cause of death worldwide. Strong interest has been dedicated to determining the role of risk
factors to CVD, since addressing modifiable risk factors, such as depression, anxiety and
stress, seems to be the most efficient way for preventing CVD and may decrease mortality and
morbidity secondary to these disorders. Studies have also focused on the role of psychological
intervention on CVD outcomes, including the role of cognitive behavioral techniques. However,
in Brazil, studies on the topic are yet scarce. Considering the social and economic burdens of
CVD to the sufferer and to the public healthcare system, obtaining local evidence (e.g. from
Countries such as Brazil) is a mandatory prelude to the development of cost-effective strategies
of care aiming to increase survival, while decreasing morbidity and mortality. Locally obtained
data should also measure procedures that are adapted to the local reality, with the ultimate goal
of estimating the disease in its context, in the setting where it is treated. Methods: This was a
quasi-experimental transverse cohort study, with a convenience sample consisting of 91
patients with heart disease being treated at a University-based public hospital serving a city with
600,000 inhabitants in So Paulo state, Brazil. Patients were assessed at baseline and at study
end, after group intervention. Psychological assessments were conducted using semi structured
interviews, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Lipp's Stress
Symptoms Inventory for Adults. Cardiovascular status was estimated using the Framingham
Score. Interventions had psychoeducational and psychotherapeutic components, with cognitive
behavioral emphasis. Sessions focused on self-knowledge, education on risk factors and CVD,

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stress management, problems resolution and behavioral changes towards risk factors. Themes,
topics and suggestions proposed by the participants were also discussed. Results: Cognitive
behavioral therapy was associated with significant improvement of anxiety, depression, and
stress, as well as with improved attitudes for coping with stress. At baseline, 50 patients were
considered with minimal level of anxiety and 13 with moderate level. After the cognitive
behavioral intervention, 58 patients were at minimal level and 6 at moderate level of anxiety
(t=2.9; p=0.005). Cognitive affective symptoms of depression were present in 28 patients at
baseline and, after cognitive behavioral intervention, they were present in 17 patients (t=2.3;
p=0.024). Several significant changes were also seen when comparing the pre-post intervention
assessments of stress (44 patients with no stress at baseline and 55 after intervention). No
significant differences were seen for the Framingham Scores comparing baseline with postintervention. Conclusion: Group cognitive behavioral intervention seems to be effective in
improving psychological risk factors for CVD. (FAPESP 2009/01058-7).
Intervencin del psiclogo especialista en medicina conductual en el mbito hospitalario
Carmen Mercedes Gutierrez Perez, Jorge Rosas Medina, Maira Hurtado Abril, Yesica Maria
Villanueva Torres, Gerardo Soria-Rodrguez, Xochitl Espinosa Cortes, Yudy Quintero Pulgar.
Universidad Nacional Autnoma de Mxico (UNAM), Mxico DF, Mexico.
La medicina conductual es una campo interdisciplinario que se caracteriza por la
implementacin de tcnicas cognitivo conductuales con eficacia comprobada en la
identificacin y modificacin de factores psicolgicos, involucrados en el proceso de salud enfermedad. Est relacionada con la intervencin en enfermedades crnico degenerativas, en
los aspectos de tipo conductual, dirigidas a la adaptacin del paciente a la enfermedad y su
cronicidad. La residencia en medicina conductual forma parte del programa acadmico del
posgrado de la Universidad Nacional Autnoma de Mxico (UNAM), que en su carcter
profesionalizante tiene como objetivo la intervencin en el proceso de salud - enfermedad en un
contexto hospitalario. Se presentan los datos del trabajo realizado en un periodo de 10 meses
en los servicios de hematologa, oncologa adultos y oncologa peditrica de un hospital de alta
especialidad de la Ciudad de Mxico. La poblacin atendida en estos servicios fue de 1433
pacientes, por gnero el 62% corresponde al femenino y el 38% a masculino , se realizaron
4886 intervenciones. Los diagnsticos mdicos ms frecuentes en los pacientes atendidos
fueron: Cncer cervico uterino, Cncer de colon, Cncer de laringe, Cncer de mama, Cncer
de recto, Cncer de testculo, Cncer gstrico, Leucemia mieloide aguda, Leucemia
linfoblstica aguda, Linfoma, Osteosarcoma y Tumores germinales. Los diagnsticos
psicolgicos de acuerdo a los criterios del DSM-IV-TR, en orden de frecuencia fueron: trastorno
adaptativo, trastornos de ansiedad, factor psicolgico que afecta enfermedad mdica,
trastornos del estado de nimo, incumplimiento teraputico, problemas de relacin y trastornos
de la personalidad. Se realizaron las siguientes modalidades de intervencin: evaluacin inicial
(se utilizo entrevista conductual y examen mental), psicoterapia breve (centrada en objetivos) e
intervenciones en crisis (ante notificacin de diagnostico, pronostico medico y/o muerte del
paciente). Las tcnicas ms utilizadas: psicoeducacin, relajacin, activacin conductual,
solucin de problemas, manejo de contingencias, reestructuracin cognitiva. Se observo
clnicamente que los pacientes atendidos por el servicio de medicina conductual tuvieron una
mejor adaptacin al proceso de enfermedad. Los datos indican la necesidad de intervenir de
una manera interdisciplinaria con cada sujeto que padece una enfermedad crnica, tal
intervencin impactara en su estado cognitivo, emocional y conductual.
A Entrevista Motivacional e a Psicoeducao em Pacientes Cardacos

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Nazar Hayasida, Mara Colombarolli.


Universidade Federal do Amazonas, Manaus, Brazil.
A entrevista motivacional (EM) eficaz para a adoo e manuteno de comportamentos de
sade em pacientes com doenas crnicas, como a cardaca. A entrevista motivacional (EM)
aqui proposta como ferramenta de interveno clnica promotora de adeso comportamental ao
tratamento da doena cardaca, principalmente em doentes resistentes mudana de estilos
de vida. Trata-se de uma reviso bibliogrfica, com o objetivo de criar um modelo de
interveno breve e focal, para aumentar a motivao com vistas a modificao de
comportamentos que consiste em 5 sesses estruturadas. O Modelo Transterico foca a
mudana intencional, ou seja, a tomada de deciso do indivduo; ao contrrio de outras
abordagens, que esto focadas nas influncias sociais. A mudana comportamental acontece
ao longo de um processo, no qual as pessoas passam por diversos nveis de motivao para
mudana. Os estgios so descritos pela literatura de forma bem definida e identificvel. So
eles: pr-contemplao, contemplao, preparao, ao, manuteno e terminao. A
literatura descreve que os pacientes considerados mais difceis no incio do processo so os
que buscam tratamento sem motivao interna, que tm apenas motivos externos, insuficientes
para que haja mudana, principalmente os que vm encaminhados pela justia, pelo trabalho
ou famlia. A ao teraputica em doena cardaca exige ao profissional de sade diversas
competncias tcnicas quanto ao que pode trazer de novo ao doente. Do doente,
competncias pessoais, ao nvel das crenas, atitudes, comportamentos e emoes,
necessrias adoo de comportamentos promotores do sucesso teraputico. Cabe ao
terapeuta transformar esta motivao externa em motivao interna, ou seja, transformar a
obrigatoriedade do tratamento em vontade prpria, de modo que o sujeito perceba os prejuzos
que os fatores de risco causaram, buscando alternativas de mudana e soluo de problemas.
Para que a adeso seja mantida em longo prazo, necessrio que o doente esteja diretamente
implicado nas tarefas teraputicas adequadas, que devem ser propostas numa perspectiva de
compromisso entre o que o ideal teraputico e o que aceito e exeqvel, na perspectiva do
doente. Essa abordagem pode ser utilizada para qualquer problema de sade mental,
dificuldades de relacionamento e desenvolvimento de comportamentos sadios, como a prtica
de dietas saudveis, adoo de prticas esportivas, educao e promoo de sade.
destinada a clientes que no acreditam ter uma questo importante para ser mudada, que no
querem se tratar ou que se sentem numa dualidade (ambivalncia) muito grande em relao
mudana de hbitos. Pode ser usada em uma nica entrevista, mas habitualmente
empregada em quatro a cinco consultas. uma tcnica de abordagem no-confrontativa e
semi estruturada, que identifica e trabalha com a motivao do cliente, sendo centrada nas
suas necessidades e experincias. Estimula a autoeficcia a partir do momento em que o
cliente consegue realizar as mudanas propostas e assim gera um forte impulso para mudar
hbitos e estilo de vida. A psicoeducao uma interveno que visa fornecer informaes
sobre a doena cardaca e sobre os problemas das mesmas.
Effectiveness of a Cognitive-Behavioral Program for self-management of Chronic Pain
from the Pain Evaluation and Treatment Center (CETD)
Lizet Jammet1, 2, Colette Aguerre1, Franoise Laroche2, Christian Guy-Coichard2, Sylvie
Rostaing2.
1. EA 2114, Department of Psychology, Franois Rabelais University, 3 rue des Tanneurs,,
TOURS, France, 2. Pain Evaluation and Treatment Center, Saint Antoine University Hospital
Center, PARIS, France.

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Clinical studies (IASP, 2010) and Meta-analyzes (Cochrane Review, 2009-2011) have shown
the effectiveness of Cognitive and Behavioral Therapies (CBT) for the treatment of chronic pain
and have led to guidelines for fibromyalgia and low back pain. However, there are few clinical
trials in this field of research in France. Aim of our study: Started 20 years ago at the Pain
Evaluation and Treatment Center (CETD) from St Antoine Hospital (Paris) by Dr. Franois
Boureau, the CBT program presented here has been structured and formalized since 2006. The
goals are to promote patientss self-abilities to cope with chronic pain, in order to decrease
emotional distress and enhance quality of life. The Program included three components:
educative (general medical information), behavioral (physical activity, pacing, and relaxation)
and a cognitive-emotional component (reformulation of beliefs, problem solving, and learning of
coping strategies). It consists of 8 weekly sessions of 2 hours, each in groups of 5 to 9 patients,
led by a physician, a psychologist and / or a physiotherapist experienced in CBT. We started a
Chronic Low Back Pain Program associated with a Physical Exercise Training (n=74). A set of
standardized questionnaires were used before and after program: pain intensity (VAS),
depression and anxiety (HADS), emotional distress (DPQ), fear and avoidance belief (FABQ),
pain coping strategies (CSQ), and motivation to change (PSOCQ). The results showed positive
short term effects of continuing exercise associates with CBT program. These findings are in
line with others published data. With the purpose of assessing the therapeutic effects of a CBT
program for patients suffering of fibromyalgia pain, we conducted a pilot study (Jammet F. et al,
6th World Congress of CBT, Boston 2010). (n=30) and now a randomized controlled trial
AQUAVIP (n=115) with one year follow up is ongoing. The pilot study findings (n=30) showed
short term efficacy (3 months) with improvement of quality of life, (FIQ: t = 4.49 p <.0001),
distraction (CSQ: t=3.867, p<0.0006), catastrophism (CSQ: t=3.231, p<0.0031), anxiety level
(HAD: t=3.041 p <.005), depression propensity (HAD: t=3.032, p <.005) and pain intensity (VAS:
t=2.92, p < .008). AQUAVIP trial which included outpatients (n=115, aged 18 - 60), randomized
in CBT program arm and in "control arm (one 2 hours information session, 5 to 9 patients).
Several clinical outcomes were evaluated at baseline and during follow-up at 3-6-9-15 months:
quality of life (FIQ), emotional distress (STAY-A/B, BDI-II), coping skills (CSQ), motivation to
change (PSOCQ), health status (SF12) and pain intensity (VAS).The results will be announced
in December 2012.Conclusion: Our preliminary results are in accordance with previously
published data. AQUAVIP trial should provide long term results (one year). These findings may
potentially help improving clinicians guidance in the use of CBT in the treatment of chronic pain
syndrome in France. Moreover, it could help to identify patients responders and evaluate costseffectiveness benefits.
Intervencion Racional Emotiva Conductual en diagnostico de Infertilidad y Tratamientos
de Reproduccion Asistida
Adela Jara Del Aguila.
Insituto de Psicologia de Lima, Lima, Peru.
Cuando una pareja o cuando una mujer soltera por eleccin, piensa en tener hijos, pocas veces
se pregunta si en el camino a lograr el embarazo tendr problemas para concebir. Y cuando
pasa el tiempo y el embarazo no se logra, o sobrevienen los abortos espontneos, la persona
empieza recin a pensar en la posibilidad de que ser madre/padre sera un proceso de largo
plazo y sin garantias de exito. De que manera podemos ayudar a los pacientes con problemas
de fertilidad? En que consiste la ayuda psicoterapeutica en los Tratamientos de Reproduccion
Asistida? Los problemas de fertilidad son un estimulo para la aparicin de emociones
irracionales que pueden interferir en el proceso medico de los tratamientos de fertilidad, en las
decisiones a tomar frente a la donacin de gametos o de donacion de embriones, y/o tras la
aceptacin de la imposibilidad de tener hijos biolgicos. Como todos los temas a los que se

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enfrenta el ser humano, tambin la percepcin de la fertilidad y por lo tanto de los problemas de
fertilidad y posterior perturbacin, proviene de un conjunto de pensamientos que nos ha
transmitido la sociedad, la familia, la iglesia y en general el entorno y cultura en el que hemos
crecido. Nuestros pacientes darn un significado al hecho de no lograr ser padres y los
psicoterapeutas ayudaremos a investigar y debatir esos pensamientos, de esta manera podrn
regular la intensidad de sus emociones y obtener conductas dirigidas a aquello que si puede
estar bajo su control. En los ultimos 10 aos el % de personas que lograron la paternidad con
tratamientos de baja o alta complejidad se ha incrementado (en muchos casos gracias a la
apertura ante la donacin de gametos y/o de embriones). Algunas de estas personas lograron
transitar por el proceso medico y psicolgico con el menor costo emocional gracias al
conocimiento terico del tema, al debate de sus creencias al respecto y a la aplicacin de
tcnicas cognitivas, emotivas y conductuales. El objetivo es brindar informacin sobre las
tcnicas cognitivas de la Terapia Racional Emotiva Conductual y responder a las interrogantes
sobre el tema. Tambin profundizare en las nuevas concepciones de paternidad y familia, y
enfatizare en la relevancia de ser realistas frente a un proceso que no esta 100% bajo control,
siendo un tema clave la Aceptacin incondicional de la realidad.
CBT for insomnia - what could make it even more effective and available to more
patients?
Viktor Kaldo1, Annemieke van Straten2, 3, Pim Cuijpers2, 3, Gerhard Andersson4, Hanna Tillgren4,
Ewa Johansson4, Martin Forssen4, Tobias Wiklund4, Alexandra Sderstrm4, Robert
Johansson4, Hugo Hesser4, Kerstin Blom1, Susanna Jernelv1, Martin Kraepelin1, Malin Olseni
Bergdahl1, Kristina Jungmarker1, Linda Ankartjrn1, Nils Lindefors1, Charles Morin5, Viktor
Kaldo1, Viktor Kaldo1, Viktor Kaldo1, Susanna Jernelv1, Kerstin Blom1, Kerstin Blom1.
1. Karolinska Institutet, Dep of Clinical Neuroscience, Stockholm, Sweden, 2. VU University
Amsterdam, Dept. Clinical Psychology, Amsterdam, Netherlands, 3. EMGO Institute for Health
and Care Research, Amsterdam, Netherlands, 4. Department of Behavioural Sciences and
Learning, Linkping University, Linkping, Sweden, 5. Universit Laval, cole de Psychologie,
Quebec, QC, Canada.
In the general population, about 10% fulfill the DSM-IV criteria for insomnia, resulting in
substantial individual suffering and costs to society through factors such as increased risk for
long-term sick-leave, and major depression. However, only a small percentage is treated and
the most common treatment is pharmacotherapy despite the fact that cognitive behavioral
therapy (CBT), which has been shown to be effective for insomnia, is considered treatment of
choice. CBT is provided only to a minority of patients, due to the limited availability of CBT
therapists and high initial costs.
Insomnia is not only an important public health concern on its own, but it also shows high levels
of co-morbidity with other psychiatric and somatic disorders. Insomnia is often viewed as the
secondary diagnosis, expected to subside as the primary disorder is treated. This might be one
reason that insomnia has received relatively little attention in the past. However, recent studies
indicate that insomnia might precede and worsen other psychiatric and somatic problems. One
example is the higher relapse rate in patients treated for depression, for individuals with residual
symptoms of insomnia.
To evoke the full potential of CBT for insomnia a few things need to be done. Firstly, more
patients need to be reached. With limited resources, one obvious way to achieve this is through
guided self-help. The effectiveness of guided and unguided self-help has now been evaluated in
a number of trials, and recently the internet has been used to administer the treatments.
Secondly, efforts to further increase treatment effects of CBT for insomnia are needed. This
includes for example investigations of strategies to adapt the treatment and the interaction with

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patients to increase the number of patients that actually use the most potent techniques and
benefit from treatment.
Finally, the increasing awareness that it is not very useful to define insomnia as secondary or
primary to other disorders implies that more studies should investigate the effects of CBT for
insomnia when it is given to patient groups with co-morbid conditions. This might clarify when
CBT for insomnia is optimal and when other interventions should be used. It would also open up
for possibilities to develop specific combined manuals treating insomnia and co-morbidities
simultaneously, which would be important also for reaching the second goal of maximizing
treatment effects.
These issues will all be investigated and discussed in four different studies presented in this
symposium.
Self-help CBT treatments for insomnia: a meta-analysis
Background
Insomnia is a prevalent problem which often leads to a reduced quality of life and diminished
work productivity. Only a minority of patients are treated with effective non-pharmacological
therapies. A self-help intervention, in which a standard treatment is offered in book format,
through audio tapes or the Internet, might be an inexpensive and more accessible alternative to
face-to-face treatment.
Methods
In 2009 we conducted a meta-analysis of randomized controlled studies examining the effects
of self-help interventions for insomnia, identified through extensive searches of bibliographical
databases. We examined the effects of self-help on different sleep outcomes, in comparison
with both waiting lists controls and face-to-face treatments. After 2009 a number of new studies
have been published.
Results
We included 10 studies with a total of 1000 subjects in the formal meta-analysis and
demonstrated moderate improvements in most sleep outcomes (sleep onset latency, number of
awakenings, wake after sleep onset, sleep efficiency, sleep quality) as well as on symptoms of
depression and anxiety. The sleep improvements were maintained over the longer term. The
self-help interventions in the newer studies were mostly Internet based and showed moderate to
large effects.
Conclusion
The effects of self-help treatments are worthwhile and constitute a useful addition to existing
treatment options especially when integrated in a stepped care approach.
Internet-delivered ICBT versus group CBT for insomnia: a randomized controlled trial
Background
Cognitive behaviour therapy is widely regarded as an evidence-based treatment for insomnia
and there is also evidence that insomnia can be treated effectively via guided self-help delivered
over the internet (ICBT). However, it is not known how well guided ICBT works compared to
traditional group treatment.
Methods
In this study we conducted a controlled non-inferiority trial in which we randomized 48 persons
with a diagnosis of insomnia to either guided ICBT or to live group treatment. Both treatments
lasted 8 weeks. All participants were interviewed before and after the treatment and also
completed a 6 months follow-up. The treatments were both manualized and followed a self-help
book. Included were sleep diaries, psychoeducation, stimulus control, sleep restriction, focus on
daily activities and finally two modules on cognition including worry control. In addition a
maintenance plan was included. There were 52% women and the average age of the included
sample was 53 years. Several measures were used including Insomnia severity index and sleep

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diary data.
Results
In terms of dropout, there were 4 dropouts from the group treatment and 7 from the ICBT group.
However, only 3 failed to complete the post-treatment measure and data were analyzed on an
intention-to-treat basis. Results showed an increase in sleep efficiency for the group treatment
68% to 87.6% and also in the ICBT group 75.3% to 85.9%. At 6 months follow-up the results
were similar with sleep efficiency being 84.2 and 84.8% in group and ICBT respectively.
Between group effect sizes were small, but within-group effects were large with a clear
tendency for the group treatment to be better on the sleep efficiency measure, but not on the
other measures.
Conclusion
We conclude that guided ICBT can be as good as live group treatment in the management of
insomnia. Moderators and mediators of outcome and also treatment preferences should be
investigated.
Predicting treatment failure and improving treatment outcome for patients at risk in CBT
for insomnia
Background
CBT for insomnia is considered an evidence based treatment, with high rates of remission.
However, a proportion of patients do not benefit optimally from treatment. The importance of
early change in CBT in general has previously received empirical support and efforts to identify
patients at risk for treatment failure early in psychological treatment have been made by for
example Lambert et al. These studies show that patients at risk for failure can be identified
through continuous evaluation during treatment and that feedback based on this evaluation
helps therapists to adjust the treatment plan and lower the number of actual failures.
In this study we aimed to use data from a previous randomized controlled trial (RCT) to develop
an algorithm for identifying at-risk patients during CBT for insomnia. In a new trial, this algorithm
was used. to evaluate if extra support and treatment adjustments improved treatment outcome
for at-risk patients.
Methods
In the first RCT 148 patients received either standard Internet-based CBT (ICBT) for insomnia
or an active control treatment during eight weeks. All participants filled out sleep diaries, forms,
and were interviewed before, during and after the treatment, as well as at six months and at 12
months follow-up. Weekly measures with the Insomnia Severity Index (ISI) during the first
weeks in treatment was used together with e.g. measures of activity, compliance and
depression to predict outcome.
In the second RCT, using the previously developed algorithm, patients in a 10-week ICBTprogram for insomnia identified as being at risk of treatment failure were randomized either to
enhanced treatment with extra therapist support or to continued regular treatment.
Results
In the first RCT, attrition varied from 14-27%. ICBT produced significantly better outcome on ISI
and sleep diary variables than the control treatment at post-treatment and follow-up when
calculated as intention-to-treat. Also, a combined algorithm could predict outcome and detect atrisk patients. This algorithm was complemented with e.g. measures of motivation and alliance
and used in the second RCT.
Conclusion
We conclude that a combination of several factors seem to best predict treatment outcome,
including treatment activity, ISI-scores, and depression scores. This algorithm will be further
tested during spring 2013 and its ability to improve treatment outcome for patients at risk will be
presented.

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Is insomnia treatment superior to depression treatment for patients with both


diagnoses? - Results of a randomized controlled trial
Background
Patients with comorbid insomnia and depression are primarily treated for depression. Recent
research indicates that this is not sufficient to cure insomnia and that untreated insomnia
hinders full recovery from depression and increases risk for relapse. This trial compares
treatment effects when patients with both diagnoses receive treatment for either insomnia or
depression.
Methods
Participants (n=43) were recruited via media, and randomized to guided Internet-delivered
cognitive behavior therapy (ICBT) for either insomnia or depression. Primary outcome measures
were symptom self-rating scales (Insomnia Severity Index, ISI, and the Montgomery sberg
Depression Rating Scale, MADRS-S), assessed before and after treatment with follow-up after
6 and 12 months. The participants self-rated need for further treatment after completion of ICBT
was also investigated.
Results
The insomnia treatment was significantly more effective than the depression treatment in
reducing insomnia severity (p<.05), and equally effective in reducing depression severity. The
largest between group effect (Cohens d) was found at 6 months with 0.72 for ISI. Post
treatment, participants receiving treatment for insomnia had significantly less self-rated need for
further insomnia treatment (p<.001) than participants receiving treatment for depression. The
need for further depression treatment was similar in both groups.
Conclusion
This study indicates that for patients with both diagnoses, treatment with cognitive behavior
therapy (CBT) for insomnia may overall be more effective than CBT for depression. Ideally,
efforts to treat both conditions should be made.
Future
A randomized study trying a combined treatment for insomnia and depression starts in the fall of
2012 at the Internet Psychiatry Clinic, Sweden.
A Large Multicenter RCT in a Primary Care Setting Comparing Individualized InternetCBT to Treatment as Usual on Effects on Depression and Self-Rated Work Ability
Martin Kraepelin1, Yvonee Forsell1, Agneta jehagen2, Nils Lindefors1, Kerstin Blom1, Viktor
Kaldo1.
1. Karolinska Institutet, Stockholm, Sweden, 2. Lunds University, Lund, Sweden.
Abstract Central: Introduction Guided Internet-based Cognitive Behavioral Therapy (ICBT) is
an effective and accessible treatment method for a number of our most common psychiatric
disorders. These include disorders like depression, anxiety and stress-related problems which
are frequently diagnosed in primary care patients and are strongly related to lower function,
work-related productivity and sick leave. Although comorbidity is common in mental health
primary care, most CBT and ICBT studies have focused on a single disorder. Effects of both
traditional CBT and ICBT on amount of sick leave and/or work ability need to be investigated
further. Also, although ICBT have been shown effective in numerous controlled trials its use in
more naturalistic settings have so far not been widely explored and a model where a national
ICBT center administer internet treatments for patients assessed and recruited via multiple
primary care settings nationwide has never been evaluated. Method This study presents the
REGASSA-project, a large multicenter RCT evaluating a novel ICBT program that is individually
tailored to each patients problem profile. Separate treatment modules for common psychiatric
and stress-related problems are used. Specific modules directed at work related problems are
added if needed. Participants are recruited from six different counties in Sweden. The primary

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inclusion criteria are (at least) mild depressive symptoms (PHQ-9 10). Participants are
screened with the M.I.N.I. diagnostic psychiatric interview. More than 650 participants are
predicted to be randomized to either ICBT or TAU in total. TAU can include interventions such
as medication or face to face CBT. Current status is 550 participants recruited. The study is an
initial pilot for the possible implementation of ICBT nationwide in Sweden. Results The
treatment phase of the trial ends early in 2013. For this presentation we will have preliminary
results of self-reported work ability (measured with Work Ability Index, WAI), depression
(measured with clinician rated Montgomery sberg Depression Rating Scale, MADRS) and
treatment satisfaction compared to TAU at post treatment and 9 month follow up. A recent
preliminary analyzes with the first 90 ICBT-patients show large within group effect sizes for
ICBT on both MADRS (Cohens D=1.59) and WAI (Cohens D=0.70).
Internet-based CBT for Depression and Anxiety in Parkinson's Disease: A Pilot Study
Martin Kraepelin, Per Svenningsson, Nils Lindefors, Viktor Kaldo.
Karolinska Institutet, Stockholm, Sweden.
Abstract Central: Introduction Parkinson's disease (PD) is a common neurodegenerative
disease with motor and non-motor symptoms. However, PD is also often associated with
depression, anxiety and sleep problems which might further impair the quality of life for PD
sufferers. Main treatments for PD are drugs related to dopamine transmission. Low levels of
motivation, passivity, depression, anxiety and sleep disturbance in patients with PD is probably
to some extent the result of the underlying biological factors causing PD, but there is currently a
lack of knowledge about the optimal treatment(s) of these psychiatric or psychological nonmotor problems. Thus, complementary, non-pharmacological treatments need to be explored
further. Cognitive-behavioral therapy (CBT) is the most widely studied form of psychological
treatment and has recently shown promising effects for PD patients with co-morbid depression,
but previous studies need to be replicated. The lack of CBT-trained therapists is another
problem that needs to be addressed in order to make this new treatment available if confirmed
to be effective. Given in the right way, Internet-based CBT (ICBT) has shown to be as effective
as traditional CBT for a range of both psychiatric disorders and behavioral medical problems
such as insomnia, chronic pain, IBS and tinnitus. However, studies of ICBT for depression and
anxiety in Parkinson's disease are still lacking. Method The main goal of this project is to
develop and evaluate ICBT for PD patients with concurrent depression or anxiety symptoms. All
treatment in this trial is given as an adjunct to Standard Medical Treatment (SMT). Participants
(n=16) are recruited from the Parkinson Clinic in Stockholm, Sweden and fill out a screening
questionnaire via the Internet and meet a neurologist and a psychologist to be assessed on
inclusion and exclusion criteria. This uncontrolled pilot study evaluate the effect on depressive
and anxiety symptoms, sleep problems, everyday level of functioning, cognitive functioning, and
quality of life. Data on patients perception, acceptance and utilization of treatment will also be
collected in order to further refine the intervention. If the pilot study shows promising results a
large randomized controlled trial will be conducted to compare ICBT to a placebo treatment.
Results: Preliminary data from the first four patients shows promising results and the pilot study
is currently recruiting and treating more patients. Final results will be presented.
Eficacia del Tratamiento Cognitivo-Conductual orientado al Dolor y al Sueo en la
Fibromialgia
Maria Lami Hernandez1, M Pilar Martinez1, Elena Miro1, Ana Sanchez1, German Prados2,
Manuel Guzman2.

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1. Universidad de Granada, Granada, Spain, 2. Hospital Universitario Virgen de las Nieves,


Granada, Spain.
La fibromialgia (FM) es un sndrome de etiologa desconocida caracterizado por dolor msculoesqueltico generalizado y crnico. El 96-99% de los pacientes sufre de fatiga y problemas de
sueo, que junto a otros sntomas cognitivos y somticos conforman las variables ms
importantes para su diagnstico. La prevalencia es del 2%-5%, principalmente mujeres de
mediana edad. Cabe destacar la discapacidad asociada a la FM y sus efectos negativos en la
vida personal, laboral y social de las personas y sus elevados costos sanitarios. Actualmente
las guas de prctica clnica de asociaciones como la American Pain Society recomiendan un
abordaje multimodal, incluyendo tratamiento cognitivo-conductual (TCC). Sin embargo, se
desconoce hasta la fecha qu modalidades de TCC pueden ser las ms beneficiosas para la
mejora de la sintomatologa de la FM. El presente estudio examina la eficacia de tres tipos de
TCC, centrado en el dolor (TCC-D), centrado en el insomnio (TCC-I), y centrado en el dolor y el
insomnio (Combinado, TCC-C), frente a un grupo control que slo recibi tratamiento mdico
estndar (TME). Un total de 44 mujeres de 24 a 60 aos de edad con diagnstico de FM segn
los criterios de la American College of Rheumatology, fueron evaluadas con entrevistas
individuales y diversos cuestionarios, y asignadas al azar a las condiciones de tratamiento (11
participantes por grupo). Los grupos estuvieron igualados en diversas variables
sociodemogrficas y clnicas antes del tratamiento. El TCC-D incluy informacin sobre la FM,
relajacin, habilidades de comunicacin, resolucin de problemas, ajuste del nivel de actividaddescanso, y reestructuracin cognitiva sobre el dolor. El TCC-I incluy psicoeducacin, reglas
de higiene de sueo, control de estmulos, restriccin del tiempo en cama y reestructuracin
cognitiva sobre sueo. El TCC-C fue una combinacin de los dos anteriores. El TME consisti
en una pauta farmacolgica habitual. Las pacientes cumplimentaron el Cuestionario de Dolor
de McGill, (Melzack, 1987), el Inventario Multidimensional de Fatiga (Smets, et al., 1995), el
ndice de Calidad de Sueo de Pittsburg (Buysse et al., 1989), la Escala Hospitalaria de
Ansiedad y Depresin (Zigmond y Snaith, 1983), la Escala de 20 Sntomas de Ansiedad ante el
Dolor (McCracken y Dhingra, 2002) y la Escala de Catastrofizacin del dolor (Sullivan, Bishop y
Pivik, 1995). Para el anlisis de datos se recurri a pruebas no paramtricas (Wilcoxon, H de
Kruskal-Wallis y U de Mann-Whitney). Los resultados mostraron cambios significativos entre el
pre y el post-tratamiento del TCC-D en ansiedad y en catastrofizacin del dolor, entre el pre y
post-tratamiento del TCC-I en calidad total de sueo y sus dimensiones, y entre el pre y el posttratamiento del TCC-D y del TCC-C en la ansiedad ante el dolor. Asimismo, en el posttratamiento se observaron diferencias significativas en la intensidad del dolor entre el TCC-D y
el TME, y en la calidad subjetiva y la eficiencia del sueo entre el TCC-I y el TME. En
conclusin, cabe destacar la importancia de incluir en el tratamiento multicomponente de la FM
aspectos psicolgicos referidos al dolor y al sueo con el objetivo de mejorar la sintomatologa
asociada a la enfermedad y contribuir a mejorar calidad de vida de estas pacientes.
A Meta-Analysis of the Effectiveness of Psychological Interventions for Adults with Skin
Conditions
Anastasia Lavda, Thomas Webb, Andrew Thompson.
Clinical Psychology Unit, The University of Sheffield, Sheffield, United Kingdom.
Abstract Central: Skin conditions can be associated with heightened levels of psychological
morbidity, suggesting the need for psychological interventions. The current meta-analytic study
is the first to systematically review a number of specific interventions that have been developed
for use with adults with skin conditions. Our review shows that behavioural interventions such as
habit reversal, and therapies informed by Cognitive Behavioural techniques have the highest

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effect sizes. Psychological interventions for people with skin conditions are designed to improve
the severity of and adjustment to skin conditions. Database, archival and citation searches were
conducted. Studies were included if participants were allocated to either a psychological
intervention (excluding educational interventions and complementary therapies) or a
comparison condition, and if they measured outcomes relevant to the skin condition. Twentytwo studies met these inclusion criteria. Psychological interventions overall were found to have
a medium-sized effect on skin conditions (g = 0.54). Effect sizes for each intervention were
computed and behavioural techniques such as habit reversal were found to have the highest
effectiveness with an effect size of g = 1.05. CBT informed interventions showed a medium-tolarge effect size (g = 0.65). We also coded a number of potential moderators of intervention
efficacy. The present study shows that psychological interventions, and in particular behavioural
and CBT informed approaches, are beneficial for people with skin conditions. The number of
studies that were included in this review is limited however, showcasing the need for more
research to extend the variety and focus of the psychological interventions that are available.
This study was published in the British Journal of Dermatology which is the second highest
ranking medical journal in the field of dermatology. It is however of significance to psychologists
and psychological therapists, as the implications of the findings are widespread. The study
showcases the utility of psychological interventions and particularly behavioural and CBT
informed approaches in health settings, such as dermatology.
Cognitive and Behavioral Therapy of a Post-Surgery Chronic Low-Back Pain: A Clinical
Case Presentation Highlighting the Effects of a Aquatic Psychomotor Relaxation
Therapy
Sylvia Law de Lauriston1, Lizet Jammet2, 3, Colette Aguerre2, Badri Matta1, Franoise Laroche3.
1. Pain Department, Soissons General Hospital Center., SOISSONS, France, 2. 1 EA 2114,
Department of Psychology, Franois Rabelais University, TOURS, France, 3. Pain Department
(Centre d'Evaluation et de Traitement de la Douleur, CETD), AP-HP Saint-Antoine Hospital, 184
rue du faubourg Saint-Antoine, ., PARIS, France.
Abstract Central: Clinical studies have demonstrated the valuable application of CognitiveBehavioral Therapy (CBT) for the treatment of chronic pain. Different study protocols and
guidelines (IASP, 2009) provided evidence for the efficacy of this approach, in particular with
regard to low-back pain. Further meta-analyses have highlighted the importance of
multidisciplinary interventions in order to promote the success of this therapeutic approach
(Lamb & al., 2010). Excellent results concerning the patients presenting pain in lumbar
vertebrae with irradiation in the lower limb confirmed the advantages of this technique with CBT
(Fritz & al., 2010). The aim of this study is to describe the results of a clinical case of a postsurgery low-back pain, handled by CBT based on immersion in water. Method: Patient is a 48year-old woman, on sick leave, with chronic pain in the lumbar vertebra with irradiation in the left
lower limb that had lasted for two years, following two surgical spinal surgeries. Fear of pain
recurrence is the patient's main problem. Secondly, she has non-adapted and passive coping
strategies. The patient was proposed a psychomotor therapy: CBT program combined with
aquatic exercises named: Aquatic Psychomotor Relaxation Therapy (APRT) in order to help
her breaking the vicious circles of pain-inactivity-pain and pain-depression-pain, along with
stress. This program is based on pain exposure by water immersion. It consists in six weekly
individual treatments in the pain relief department (Soissons Hospital), and a six weekly
treatment group at the public swimming pool .In group therapy, patients are encouraged to
share their experience and to discuss their progress and difficulties about pain coping. We also
propose her a combination of pharmacological and non-pharmacological therapies, TENS
(Transcutaneous Electromagnetic Stimulation) and psychological support. Evaluations were

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made at two different periods: before starting treatment, then 10 months later. Results: The
most significant findings when compared evaluations before/after CBT+ APRT are: Pain
decrease (VAS=- 62%), depression (HADS=- 43%) and anxiety (HADs=- 48%). Emotional
distress also decreased (DALLAS=- 30%), as well as kinesiophobia (FABQ=- 95%) and
catastrophizing (CSQ=- 45%). Moreover, we observed a greater ability to entertain attention
from pain (CSQ=+ 20%), reinterpretation of pain sensations (CSQ = 50%), walk (BPI = 60%),
mood (BPI=+ 60%) and general activity (BPI=+ 70%). Conclusions: The patient performed
Cognitive and Behavioral Therapy in a multidisciplinary approach. The Aquatic Psychomotor
Relaxation Therapy contributed to better pain and emotional distress management. It increased
self-efficacy and coping skills in order to promote return to work, and more generally, a better
quality of life.
Calidad de Vida en Pacientes con Enfermedad Cardiovascular: Analisis de Trayectorias
por Sexo y Sintomas Depresivos
Mariantonia Lemos1, Diana Agudelo1, Juan Arango2, Heather Rogers2.
1. Universidad de los Andes, Bogota, Colombia, 2. Universidad de Deusto., Bilbao, Spain.
Abstract Central: Objetivo: evaluar la trayectoria de la Calidad de Vida (CV) en pacientes con
enfermedad cardiovascular (ECV), analizando la influencia que tienen el sexo y la depresin.
Mtodos: Se tom una muestra de 100 pacientes con ECV y se les aplic el SF36 durante su
hospitalizacin y cada seis meses durante dos aos. Mediante anlisis multinivel, se evalu la
trayectoria de la CV de estos pacientes y se analiz la influencia de la depresin, medida con el
Cuestionario de salud del Paciente (PHQ-9) y el sexo, en el componente fsico de la calidad de
vida. Resultados: el componente fsico de la CV tiende a mejorar en los pacientes con ECV a lo
largo del tiempo, donde los hombres presentan mayores niveles que las mujeres. Los sntomas
depresivos se asocian con menores puntuaciones en el momento del evento cardaco, pero
tambin afectan la trayectoria, produciendo un declive significativo en este componente, en
comparacin con los pacientes sin depresin. La CV es un indicador importante en una
enfermedad crnica, ya que da una estimacin subjetiva de la efectividad de los tratamientos
mdicos y quirrgicos (Worcester et al, 2007). Su disminucin se asocia con un mayor riesgo
de mortalidad, especialmente en el componente fsico (Murphy et al., 2008; Schenkeveld et al.,
2010), por lo que es importante establecer programas enfocados a mejorar la CV de los
pacientes, tanto desde el punto de vista mdico como psicolgico (Berbes, Segura & Torres,
2010). Objective: The trajectory of Quality of Life (QOL) in Cardiovascular Disease (CVD)
patients was examined, as was the influence of gender and depression. Method: The SF-36
was administered to 100 inpatients and every 6 months for two years following the clinic visit.
Multilevel analyses were used to analyze the physical component of the SF-36 trajectory and
the influence of depression, as measured by the Patient Health Questionnaire (PHQ-9), and
gender. Results: The physical component sub-scale of the SF-36 tended to improve in these
patients overtime with men showing higher physical QOL sub-totals than women. Higher PHQ-9
scores were associated with lower SF-36 physical component sub-scale scores in the clinic.
Compared to patients without depression, patients with depression were found to be associated
with lower physical component sub-scale scores over time. The QL is an important indicator in a
chronic disease, as it gives a subjective estimate of the effectiveness of medical and surgical
treatments (Worcester et al, 2007). Its decrease is associated with an increased risk of
mortality, especially in the physical component (Murphy et al., 2008; Schenkeveld et al., 2010),
so it is important to establish programs aimed at improving HRQL, both from the standpoint of
medical and psychological (Berbes, Segura & Torres, 2010).

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Stress Control Training in Patients with Metabolic Syndrome


Lucia Novaes Malagris2, Marilda Lipp1.
1. Instituto de Psicologia e Controle do Stress, Campinas, Brazil, 2. Universidade Federal do
Rio de Janeiro UFRJ, Rio de Janeiro - RJ, Brazil.
Between 20% and 25% of the worlds adult population has Metabolic Syndrome (MS) which
represents a significant risk factor for cardiovascular diseases. MS is characterized by a group
of components found simultaneously in one individual: abdominal obesity, glucose
intolerance/insulin resistance, dyslipidemia and high blood pressure. Risk factors associated to
these components are: inadequate diet, sedentariness, tobacco usage, alcoholism and
excessive stress. The aim of this study was to ascertain if stress control training (SCT) can
reduce these risk factors. A total of 32 women with MS were referred by So Francisco de Assis
Teaching Hospital at the Federal University of Rio de Janeiro to participate in the study. The
participants were divided into Control (CG) and Experimental (EG) groups and were evaluated
at the start of the study by means of medical consultation, psychological interview, stress
evaluation (Lipps Adult Stress Symptoms Inventory - ISSL), assessment of the levels of
physical activity (International Physical Activity Questionnaire - IPAQ), nutritional assessment,
as well as laboratory tests of Total Cholesterol, LDL cholesterol, HDL cholesterol and Glucose.
The EG was subjected to SCT and was reevaluated at its end. The CG was evaluated before
and after the period required to carry out the SCT with the EG. The 14-weekly session training
aimed to provide psychoeducation about MS, stress, diet and physical activity, as well as the
teaching of cognitive-behavioral strategies. At the end of the intervention, we found: (1) the age
prevalence was between 50 to 59 years and (2) prior to the SCT, the two groups scored higher
in all components of MS, (3) a significant difference was found post training ( higher rate of
stressed individuals in the CG , p=0.005) and a significant reduction in stress in the EG (p=
0.005), (4) post training, stress level was more severe in the CG, evidenced by the higher
number of individuals in the resistance and near-exhaustion phases, (5) in post raining, there
was a significant difference in the number of stress symptoms found (higher value in the CG ,
p<0.001, and lower in the EG) , (6) significant reduction in stress symptoms (p<0.001) only in
the EG. Higher values were found in the CG (p=0.028) for vigorous physical activity. At the end
of the study, a significant reduction (p=0.012) was found for total Cholesterol and LDL
(p=0.0133), only for the EG. Glucose analysis exhibited a significant increase between pre- and
post- training only for the CG (0.019). Relaxation techniques used on a daily basis were found
to be effective in reducing tension in the EG. There was an increase in Linseed consumption
(p=0.030) and a reduction in Kcal consumption after the training, only in the EG (p=0.028).
There was a significant reduction in sodium consumption for both groups after the Stress
Control Training (p<0.001) and higher values were found for beef consumption in the control
group (p=0.044). Based on the results, it may be concluded that the Stress Control Training is
an effective intervention for the reduction of the main risk factors for M S. It is recommended
that studies be conducted using a larger number of participants to corroborate and expand the
findings of this study.
The Contribution of Cognitive Behavioral Theory to the Treatment of Stress and its
Manifestations
Marilda Lipp1, Lucia Novaes Malagris2, Vivian Mascella3, Valquiria da Cintra Tricoli4, 5, Ana
Paula Justo3, Andressa Becker da Silva3.
1. Instituto de Psicologia e Controle do Stress, Campinas, Brazil, 2. Universidade Federal do
Rio de Janeiro UFRJ, Rio de Janeiro - RJ, Brazil, 3. Pontifcia Universidade Catlica de
Campinas PUCC, Campinas - SP, Brazil, 4. FAAT, Atibaia/SP, Brazil, 5. CETEPEA, Atibaia/SP,
Brazil.

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This round table discussion will bring together the contributions of various authors of a variety of
studies with the aim of clarifying the different aspects of the use of cognitive behavioral
concepts in the reduction of emotional stress and its psychological manifestations, such as
depression, and physical manifestations such as increased cortisol and physical increases, as
with metabolic syndrome. The intention is to focus on the effectiveness of brief focused
treatment specifically aimed at reducing stress in teenagers and adults, by demonstrating its
scope in several areas of activity, including that of social skills in teenagers and lifestyle change
in sufferers of cardiovascular diseases. One of the presentations at this round table will discuss
the significant reduction in levels of depression found following the modality of cognitive
behavioral therapy designed for psychological stress training, conducted over the course of
eight group sessions with adult patients. A review of the literature on the effects of cortisol on
cognitive function will also be presented. This topic is of great importance for the treatment of
stress within the benchmarking of cognitive behavioral therapy as stress in its phases of nearexhaustion and exhaustion triggers adaptive responses in an attempt by the organism to regain
homeostasis, with a simultaneous increase in concentrations of cortisol. Studies showing how
cortisol affects numerous cognitive domains including attention, perception, memory and
emotional processing, will be presented. The aim of the round table is to generate discussion
about the applicability of cognitive-behavioral concepts in the context of a variety of age ranges
and dysfunctions that occur as a result of emotional stress. Focus will also be given to the
applicability of stress control training in the reduction of cardiac risk in particular and how adults
cope with present day stress in general.
Terapia Conductual Cognitiva en los Psico Sndromes Desencadenados por el Efavirenz
Medalit Lucho.
Lima, Ministerio de Salud, Hospital Nacional Dos de Mayo, Lima, Peru.
Abstract Central: Introduccin.- El efavirenz, empleado en la infeccin por el VIH ocasiona
frecuentemente mltiples trastornos neuropsiquitricos, de variable severidad y duracin; los
cuales desencadenan interrupcin o abandono de la terapia, quiebra de la adherencia y
resistencia viral. Mtodo.- En el Hospital Dos de Mayo hemos empleado el efavirenz en 182
pacientes (54 mujeres y 128 varones) desde marzo del 2011 hasta noviembre del 2012. Los
pacientes fueron inicialmente evaluados psicolgicamente, como preparacin para el inicio del
tratamiento, luego se los presentaba al equipo multidisciplinario para que el mdico designara
el tratamiento antirretroviral. Los enfermos que reciban efavirenz fueron tratados
preventivamente mediante relajacin, informacin, correccin de ideas errneas y de mitos y
desensibilizacin sistemtica. Resultados.- Todos los pacientes desarrollaron reacciones
adversas al empleo del efavirenz: leves 21, moderados 62, severos 17. En 20 enfermos se
suspendi temporalmente el tratamiento por efectos txicos. Cada enfermo fue tratado
individualmente con 4 o 5 sesiones de terapia cognitivo conductual. La terapia conductual
cognitiva disminuy los efectos severos a moderados o leves, tolerables para los pacientes, sin
que hubiera necesidad de tratamiento psicofarmacolgico. Conclusin.- La terapia conductual
cognitiva es eficaz para reducir los efectos adversos del efavirenz, evitando el abandono del
tratamiento o el cambio de la terapia antirretroviral.
Impacto Emocional de la Hipoacusia adquirida en la adultez: Implicancias y Abordaje
Viviana Maller1, 2, Berta Cembal3, 4.

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1. Fundacin Aigle, Buenos Aires, Argentina, 2. Asociacin Argentina de Terapia Cognitiva,


Buenos Aires, Argentina, 3. Hospital de Rehabilitacin Manuel Rocca, Buenos Aires, Argentina,
4. Integrante Red de Fonoaudiologa GCBA, Buenos Aires, Argentina.
Introduccin : La prdida de audicin es uno de los problemas ms comunes en la poblacin
adulta. La prevalencia se ha estimado en un 16,5. En Argentina uno de cada tres mayores de
65 aos padece hipoacusia. Si bien la misma aumenta a medida que envejece la poblacin, el
impacto en la calidad de vida resulta ms fuerte entre los ms jvenes. Impacto emocional y
comunicacional: Por s misma, una prdida auditiva disminuye la calidad de vida y acarrea
consecuencias psicolgicas, fsicas y sociales. Conlleva cortes comunicacionales, aumenta el
arousal y el stress . Las respuestas a la continua exposicin a situaciones estresantes y de
frustracin lleva a la aparicin de trastornos psicolgicos o el agravamiento de cuadros
preexistentes. Los pacientes ven afectada su independencia, relaciones sociales y familiares,
integridad psicolgica y autoeficacia percibida. Se ha observado como consecuencia, la
aparicin de sntomas propios de Depresin y Ansiedad. Objetivo: Presentaremos un
tratamiento que se est llevando a cabo con resultados positivos en pacientes de entre 40 y 90
aos. En los encuentros se abordan los diferentes niveles en que se enquistan las dificultades
que causa la Hipoacusia. El tratamiento tiene como objetivos que los pacientes: Reconozcan
las dificultades que genera la Hipoacusia y aumenten el control sobre las mismas,
psicoeducacin, Manejo de estrategias de comunicacin; aumento de la autonoma e
introduccin a Lectura Labial. Adems, incentivar el registro emocional;Brindar y ejercitar
tcnicas para identificar y manejar el estrs; adquirir conocimientos especfico y la exploracin
y expresin emocional. Como resultado se logra disminuir el malestar subjetivo, los sntomas
de ansiedad y depresin y mejora la calidad vincular. Abordaje: Las investigaciones
demuestran la eficacia del tratamiento grupal. Desde el abordaje teraputico, el enfoque es
desde el Modelo Integrativo (Hctor F. Alvarez, 1992). El trabajo es interdisciplinario,
compuesto por una Psicloga y una Fonaudiloga con un programa manualizado compuesto
por seis encuentros: 1. Conociendo y reconociendo la Hipoacusia 2. De la deteccin a la
consulta 3. Comunicacin efectiva 4. Hipoacusia y stress 5. Audfonos y odo: Mitos y verdades
6. Aspectos legales El seguimiento apoya los resultados de las investigaciones internacionales,
demostrando una mejora en los aspectos psicolgicos y comunicacionales. Referencias
Bibliograficas The Hearing Journal,April 2002,Volume55,No.4 Heydebrand G.Mauze, E, TyeMurray, N, Binzer, S, & Skinner M (2005). The efficacy of a structured group therapy
intervention in improving communication and coping skills for adult cochlear implant recipients.
International Journal of Audiology, 44(5) 272-280. Chisolm,T.H.Abrams,H B& McArdle, R
(2004).Short and longterm outcomes of adult audiological rehabilitation. Ear and Hearing, 25,
464-477 Effects of a Cognitive Behavioral Self-help Program on Emotional Problems for People
With Acquired Hearing LossNadia Garnefski*, and Vivian Kraaij (2011)
The Effectiveness of Psychological Stress Control Training on the Reduction of
Biological Risk Factors
Louis Mario Novaes Lipp, Raquel Leite Perini, Greici Maestri Bussoletto, Marilda Lipp.
Instituto de Psicologia e Controle do Stress, Campinas, Brazil.
Abstract Central: Guideline I for the diagnosis and treatment of Metabolic Syndrome defines
Metabolic Syndrome as a complex disturbance represented by a set of cardiovascular risk
factors, usually related to central fat deposits and resistance to insulin. It is recognized as a
complex entity which connects well-established cardiovascular risk factors such as high blood
pressure, hypercholesterolemia and diabetes. The first type of intervention recommended for
these patients is change in lifestyle, prioritizing healthy diet, regular physical activity, as well as

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giving up tobacco usage, abuse of alcohol and stress. Based on this, the study is characterized
by the analysis of laboratory levels of biological indicators associated with Metabolic Syndrome.
The analysis was carried out before and after, in a group of 24 patients - women between the
ages of 45 and 75 - who were subjected to Lipps Stress Control Training. The study was
performed with the aim of carrying out Stress Control Training as a proposal for nonpharmacological treatment based on a change in life habits arising from a dietary reeducation
and adherence to the practice of physical activity and the control of stress and depression. The
results demonstrated that the treatment had a positive influence, prompting the study to
increase the sample size in order to render the data more significant.
Symptoms of Depression in Women Pre and Post Stress Control Training
Vivian Mascella, Marilda Lipp, Ana Paula Justo.
Pontifcia Universidade Catlica de Campinas PUCC, Campinas - SP, Brazil.
Studies have demonstrated the suffering victims of depression experience and which is also
inflicted upon their families. Moreover, the significant damage caused to society as a whole is
proven by virtue of the partial and/or even total dysfunctionality caused by depression. Studies
indicate a link between depression and exposure to stressful life events and there has,
therefore, been a lot of interest shown by researchers in the quest for methods to prevent and
treat emotional stress, including Lipps Stress Control Training. This 8-session long training
includes a set of cognitive-behavioral based procedures, including functional analysis of the
stressors and direct, objective involvement in four pillars of stress control: relaxation, diet,
physical exercise and cognitive restructuring. The main goal of Stress Control Training is to
enable the patient to acquire coping strategies primarily aimed at resolving problems and
eliminating internal sources of stress: dysfunctional cognitions. The effectiveness of this
procedure in reducing pathological levels of stress has been tested on numerous areas, such as
hypertension, coronary disease, psoriasis, vitiligo, unspecific ulcerative colitis, amongst others.
This study aims to evaluate its effectiveness on depression. The sample comprised 29 women
aged between 45 and 74, who were taking part in a larger study in the Psychophysiological
Stress Laboratory at the Pontifical Catholic University of Campinas. All participants signed a
Informed Consent form. The instruments used were Lipps Stress Symptom Inventory (ISSL)
was Becks Depression Inventory (BDI). The BDI was used the week before the Stress Control
Training and one week after its completion. The eight Stress Control Training sessions were
conducted on a weekly basis and lasted two hours. In these sessions, in addition to
psychological guidance, they received instruction from other professionals such as nutritionists,
physical education instructors and nurses. All participants presented with stress at the start of
the treatment. After the Stress Control Training, the sample presented a significantly lower level
of stress (p<0.005). It was found that, before the Stress Control Testing, 21% of the women
presented with minimum levels of depression, 45% light, 24% moderate and 10% severe. After
treatment, these rates changed respectively to: 55% of women with minimum depression, 31%
light, 14% moderate and 0% severe. The results showed a significant difference in levels of
depression at the two points of evaluation (Chi-square=9.091, p=0.0281). It may be concluded
that the Stress Control Training is effective not only in improving levels of stress but also with
the symptoms of depression, which reveals an important link between stress and depression. It
is recommended that studies be conducted with larger samples investigating if stress is a cause
or an effect of depression. Grant from National Council for Scientific and Technological
Development (CNPq) and Coordination for the Improvement of Higher Level Personnel (Capes).
Email: vivian.mascella@hotmail.com

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Treino de Controle do Stress para Mulheres com Migrnea: Uma Proposta de Interveno
Vivian Mascella1, Luiz Gonzaga1, Vanessa Gibran1, Marilda Lipp2.
1. PUC-CAMPINAS, Campinas, Brazil, 2. IPCS- Instituto Psicolgico de Controle do Stress,
Campinas, Brazil.
Abstract Central: Estima-se que mais da metade da populao apresente algum tipo de
cefaleia (dor de cabea) em determinada fase da vida, e em grande parte, de forma crnica. A
maioria das cefaleias de causa primria, ou seja, ela tanto a doena como o prprio
sintoma. Entre elas, as mais frequentes so a Migrnea ou enxaqueca, as Cefaleias do Tipo
Tensional e as demais Cefaleias primrias menos prevalentes. Vrios estudos tm apresentado
que o stress um dos principais fatores desencadeantes da Migrnea como tambm est
relacionado com a durao e piora das crises. O comeo da Migrnea pode ser precipitado por
acontecimentos estressantes de maior intensidade, mas tambm com pequenos
aborrecimentos do dia-dia. Segundo estudos da Organizao Mundial da Sade (OMS)
realizados na Europa e na Amrica do Norte tm revelado que a cada ano, 6% a 8% dos
homens e 15% a 18% das mulheres sofrem com Migrnea. Sua maior frequncia entre as
mulheres, de duas a trs vezes mais do que nos homens se deve a fatores hormonais. O
Treino de Controle do Stress (TCS) um conjunto de procedimentos de base cognitivocomportamental desenvolvido por Lipp, que se desenvolve em aproximadamente 8 sesses, e
que se compe de uma anlise funcional dos estressores e atuao objetiva e direta no que se
designou dos quatro pilares do controle do stress: relaxamento, alimentao, exerccios fsicos
e reestruturao cognitiva. Objetivos geral e especfico: Avaliar a eficcia do TCS no controle
das crises de Migrnea. Em uma anlise intra-sujeitos comparar nveis de stress, qualidade de
vida e a freqncia das crises de Migrnea pr e ps TCS, e em anlise inter-sujeitos comparar
dados dos participantes do grupo que recebeu o TCS com os do grupo controle, que no
participaro do TCS. Objetiva-se tambm verificar se os ganhos obtidos se mantm seis meses
aps o TCS. Mtodos: O estudo ser realizado com 50 mulheres com idade mnima de 18
anos, diagnosticadas com Migrnea de acordo com os critrios diagnsticos da Sociedade
Internacional de Cefaleia, divididas em 2 grupos: 25 que participaro do TCS e 25 do grupo
controle. Sero encaminhadas pelo Departamento de Neurologia do Hospital e Maternidade
Celso Pierro, em Campinas - SP. Sero utilizados o Inventrio de Sintomas de Stress para
Adultos de Lipp, Inventrio de Depresso de Beck, Inventrio de Ansiedade de Beck, Roteiro
de entrevista semiestruturada e o Termo de Consentimento Livre e Esclarecido. Plano para
anlise dos resultados: Intenta-se uma anlise descritiva e estatstica. Para averiguar a relao
de dependncia entre variveis da entrevista e dos testes psicolgicos aplicados ser utilizado
o teste no-paramtrico do Qui-quadrado. Para as variveis categricas, sintomas de
ansiedade, sintomas de depresso e stress, tambm ser utilizado o teste Qui-quadrado para
verificao da significncia entre tais variveis antes e aps as intervenes psicolgicas
(TCS). Discusso: A concluso ser realizada de acordo com a anlise dos resultados. A
finalidade responder os objetivos propostos, tentando-se verificar a eficcia do TCS crises de
Migrnea. Apoio financeiro:*CAPES (bolsa de doutorado); **CNPq (bolsa de produtividade em
pesquisa) Palavras-chave: Migrnea, mulheres, treino de controle do stress.
A Longitudinal Study of the Reality Shock Experienced by First-Year Teachers and Their
Mental Health
Miki Matsunaga1, Yukino Harada2, Nanako Nakamura3.
1. Hijiyama University, Hiroshima, Japan, 2. Koujin Hospital, Tokyo, Japan, 3. Hyogo University
of Teacher education, Kobe, Japan.

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Although the mental health of Japanese teachers has been deteriorating, few studies have
investigated the mental health of first-year teachers. Several studies of first-year teaching
demonstrate that the reality shock of teaching affects beginning teachers in various ways. This
longitudinal research was conducted to examine the relation between the reality shock
experienced by first-year teachers and their mental health. We also explored buffering factors
related to the reality shock experienced by beginning teachers. Sixty-eight first-year teachers
(23 men, 45 women, mean age 25.5 years) answered a questionnaire survey at 4 months (Time
1), 7 months (Time 2), and 11 months (Time 3) after they began to teach. The survey included
the Reality Shock Scale, the Stress Response Scale, the Stress Coping Scale, and the
Perceived Social Support Scale from head-teachers and colleagues. Repeated measures
ANOVAs showed that the reality shock at Time 3 was significantly lower than at Time 1 (p <
.05). The stress response (lack of liveliness and irritation) at Time 2 was significantly higher
than at Time 1 (p < .01).In particular, irritation at Time 2 was also significantly higher than at
Time 3 (p < .001). In addition, a two-way ANOVA (reality shock time) revealed that at Time 2,
the group that experienced high reality shock experienced significantly more stress than the
group that experienced lower reality shock (p < .01). Moreover, multiple regression analysis
indicated that actively seeking solutions to problems ( = -22, p < .05) and seeking social
support from colleagues ( = -.20, p < 10) acted as buffers for reality shock. These findings
suggest that the reality shock experienced by first-year teachers can be reduced gradually.
However, those who changed their viewpoint about their jobs after being employed experienced
mental stress. Therefore, to reduce reality shock, it is important for them to actively seek
solutions to the problems of teaching and seek their colleagues support.
Psicologia do Trnsito: A Mudana de Comportamento de Pedestre Motorista No
Trnsito Brasileiro
Mriam May, Carmen Andrade, Daniel Costa.
unimar Universidade de Marlia, Marlia, Brazil.
COSTA, Daniel Francisco Simes MAY, Miriam Aparecida Moreno ANDRADE, Crmen Valria
A Psicologia do Trnsito o campo da Psicologia que estuda o comportamento dos
participantes do trnsito, incluindo todos que nele atuam, seja sua participao de forma direta
ou indireta. Desta forma, torna-se umas das reas mais extensa e abrangente da psicologia,
porque inclui categoria de indivduos com vrios tipos de personalidades, tais como: agressivo,
apressado, esperto, nervoso, ansioso, estressado, compreensivo, gentil, calmo e muitos outros
comportamentos que se v no dia a dia no trnsito. Este trabalho tem como objetivo investigar,
atravs de uma pesquisa bibliogrfica, como a Psicologia do Trnsito analisa e intervm nos
comportamentos relacionados com trnsito, tendo como principal foco os usurios (pedestres,
ciclistas, motoristas, caronas, motoqueiros entre outros), seguidos dos comportamentos que
integram o sistema estrutural e tecnolgico do trnsito (vias, estradas, veculos) e por ltimo o
sistema legislativo (fiscalizao, Leis e Normas). Para o Cdigo de Trnsito Brasileiro, trnsito
entendido como sendo a movimentao ou imobilizao de veculos, pedestres e animais em
vias terrestres com a finalidade deparada, estacionamento e operaes de carga e descarga,
embarque e desembarque nas vias pblicas, dentro de um sistema convencional de normas,
que tem por fim assegurar a integridade de seus participantes. O comportamento exercido de
duas formas: direto ou indireto. Entende-se por comportamento direto aquele onde h ao
sobre o objeto, isto , o motorista age sobre o carro, da mesma forma o ciclista, motoqueiro, e
no que diz respeito ao pedestre este age sobre a movimentao corporal. O comportamento
indireto o inverso: o veculo no trnsito sofrendo ao direta do motorista. As concluses
parciais que a pesquisa remete atravs dos textos pesquisados at o momento que os

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problemas oriundos do Trnsito podem ser encarados como sendo um problema de sade
pblica por envolver o comportamento humano.
The Role of Pain-related Support and Pain-related Support Preferences in Chronic Pain
Patients Reports of Disability and Relationship Satisfaction
Lachlan McWilliams1, Bruce Dick2, Michelle Verrier2, John Kowal3.
1. University of Saskatchewan, Saskatoon, SK, Canada, 2. University of Alberta, Edmonton, AB,
Canada, 3. The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada.
INTRODUCTION: Research based on the operant conditioning model of chronic pain has
largely assumed that solicitous support is viewed positively by individuals with chronic pain and
that this type of support is likely to reinforce pain behavior and promote disability. Consistent
with this view, many studies have found positive associations between solicitous support and
disability levels. However, several new perspectives on solicitous support have emerged. First,
Newton-John and Williams (2006) found individuals with chronic pain frequently have negative
views of solicitous support and report that it often leads to feelings of guilt and uselessness. In
contrast, support involving active coping, such as encouraging task persistence, received the
most favorable ratings. Second, Cano and Williams (2010) suggested that supportive responses
to those experiencing pain may serve to build intimacy between relationship partners. Thus, it is
possible that solicitous support may both foster disability and promote intimacy. Finally, chronic
pain patients pain-related support preferences have been studied in relation to disability levels.
In general, the desire for solicitous support appears to be positively associated with disability
(McWilliams et al., 2012). The aim of the present study was to investigate whether the
relationships between several forms of pain-related social support and both disability and
relationship satisfaction are moderated by preferences for these forms of pain-related social
support. It was hypothesized that: (a) there would be positive associations between solicitous
support received and both disability and relationship satisfaction, and (b) these associations
would be stronger amongst those with a high level of desire for this form of support than
amongst those with a lower level of desire. METHODS: Chronic pain patients (N = 147) involved
in a romantic relationship were recruited from the University of Alberta Hospitals
Multidisciplinary Pain Centre. They completed measures of pain severity, pain-related disability,
and relationship satisfaction. They also completed the Pain Response Preference Questionnaire
(PRPQ), which asks respondents to report on the type of support desired and the type of
support received. The types of support assessed by the PRPQ were solicitous, encouragement,
and suppression. RESULTS: Multiple regression analyses were used to predict disability and
relationship satisfaction levels. Interaction terms were used to examine whether the
relationships between each type of support received and the dependent variables were
moderated by the degree to which that particular form of support was desired. For disability,
there was a positive main effect of pain severity and a negative main effect of encouragement
desired. The interaction between encouragement desired and encouragement received was
also significant. Follow-up analyses exploring the interaction effect revealed a negative
association between encouragement received and disability that was present amongst those
with average to lower levels of encouragement desired. For relationship satisfaction, there was
a large positive main effect of solicitous support received. DISCUSSION: The findings regarding
the solicitous support received scale are inconsistent with past research indicating solicitous
support is associated with negative pain-related outcomes, but are consistent with the more
recent suggestion that solicitous support may foster intimacy. There is a paucity of research
involving encouragement. The findings indicate that this form of support is likely relevant to
adjustment to chronic pain conditions and warrants additional attention.

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Spirituality and Satisfaction with Healthcare of Portuguese University Students and


Teachers
Rute Meneses1, Cristina Miyazaki2, Jos Pais-Ribeiro3.
1. FCHS, Universidade Fernando Pessoa, Porto, Portugal, 2. Faculdade de Medicina de So
Jos do Rio Preto, So Jos do Rio Preto, Brazil, 3. Universidade do Porto, Porto, Portugal.
Abstract Central: Due to the Positive Psychology Movement, spiritualitys importance for
Psychology has been increasingly recognized, namely in the healthcare field. In this context, the
aim of the present study is to explore the relationship between spirituality of healthy subjects,
namely university students and teachers, and their satisfaction with healthcare. The WHOQOLSRPB and the Satisfaction with Health Care Questionnaire for Outpatients (SHCQ-O; that focus
on the last consultation the respondent had) were administered to 79 Portuguese university
teachers and 251 university students, between 17-82 years of age (M=27.42; SD=10.59),
mostly female (73.3%), single (73.6%) and without health problems (self-report; 74.5%). The
existing health problems had a duration between 0.06 and 35 years (M=10.34; SD=8.60). The
results showed that 3 of the 32 items of the SHCQ-O Importance Subscale had no statistically
significant correlation with at least one of the WHOQOL-SRPB domains. Eleven items of the
SHCQ-O Satisfaction Subscale had no statistically significant correlation with at least one of the
WHOQOL-SRPB domains. These results support an important role for patients spirituality when
considering their satisfaction with the healthcare they receive, which in turns (partly) supports
the systematic implementation of spiritual care as a part of healthcare.
Pain in context: fear, motivational goals, and attention as mediators of pain, disability
and suffering
Ann Meulders1, 9, Judy Veldhuijzen7, Ann Meulders1, 9, Johan Vlaeyen1, 2, Petra Karsdorp3, Rinie
Geenen3, Johan Vlaeyen1, 2, Judy Veldhuijzen7, Tom Snijders7, Joukje Oosterman8, Stphanie
Volders1, Marlies den Hollander2, 4, Jeroen de Jong2, 4, Rob Smeets2, 5, Steven De Peuter6, 1,
Johan Vlaeyen1, 2.
1. Psychology, University of Leuven, Leuven, Belgium, 2. Maastricht University, Maastricht,
Netherlands, 3. Utrecht University, Utrecht, Netherlands, 4. University Hospital Maastricht,
Maastricht, Netherlands, 5. Adelante Centre of Expertise in Rehabilitation and Audiology,
Hoensbroek, Netherlands, 6. BrandNewDay, Herent, Belgium, 7. University Medical Center
Utrecht, Utrecht, Netherlands, 8. Radboud University Nijmegen, Nijmegen, Netherlands, 9.
University of South Australia, Adelaide, SA, Australia.
Chronic pain is fairly common in western societies, yet its treatment remains extremely
challenging and bears a huge health care cost. Because of its complexity, chronic pain is an
intriguing topic for researchers but a frustrating business for clinicians. Nowadays, it is widely
accepted that a pain experience is not merely determined by the strength of the ascending
nociceptive input, but also depends on descending modulation such as the emotional and
motivational state of the organism. Ample evidence suggests that pain-related fear in particular
contributes to the development and maintenance of chronic pain and disability. According to the
fear-avoidance model, the fear that physical activity exacerbates pain or promotes re-injury is
inflated by catastrophic beliefs about pain, instigating a downward cycle of pain, avoidance,
hypervigilance, depression and disuse. Given the immense societal cost of chronic pain,
fundamental research on the psychological factors that mediate the development of chronic pain
condition is highly warranted. Such research might also contribute to the optimization of existing
treatments and the provision of cost-effective health care.
Over the last few decades, several innovative lines of research on basic and clinical processes
have emerged. This symposium aims to bring some of these innovations together, all of which

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contribute in their own special ways to the mounting fundamental knowledge about pain-related
fear and avoidance as well as hypervigilance and dysfunctional attentional processes, as crucial
factors in the disability in chronic pain conditions. Additionally, this symposium seeks to restore
the empirical grounding of our understanding of pain mechanisms in order to optimize treatment
methods and effects.
Four speakers will present their newest research findings. The first speaker, Dr. Ann Meulders,
will present recent experimental evidence showing that the mere intention to perform a painful
movement (i.e., previously associated with a painful stimulus) can come to elicit conditioned fear
responses in itself. These results demonstrate that the involvement of associative learning
processes in the acquisition of fear of movement-related pain are not restricted to actual
movement. Our second speaker, Dr. Petra Karsdorp, will examine the complex relationship
between fear and avoidance and more specifically how conflicting goals (i.e., other than pain
avoidance goals) might affect performance duration in painful tasks. Further, she will discuss
the possibility that inhibitory control (essential for conflict resolution) may moderate the fearavoidance relationship. Our third speaker, Dr. Judy Veldhuijzen will focus on how hypervigilance
and attentional bias might be involved in pain persistence. She will discuss how these
dysfunctional attentional processes can be best targeted in therapy. The final presenter,
Stphanie Volders, will focus on clinical interventions targeting pain-related fear. Using singlecase experimental data she will talk about how safety behaviors can interact with fear reduction
during graded exposure therapy in chronic low back pain patients. She will illustrate the
underlying processes and benefits and/or disadvantages of safety behavior during exposure
treatment
Mere intention to perform painful movements elicits fear of movement-related pain: An
experimental study on fear acquisition beyond actual movements
The fear-avoidance model advances pain-related fear as an important vulnerability factor for the
development of chronic musculoskeletal pain. Recent empirical evidence supports the notion
that healthy individuals can acquire fear of movement-related pain through associative learning,
that is, repeated pairings of a certain movement (conditioned stimulus, CS) and a painful
stimulus (unconditioned stimulus, US). In the context of these findings, two ideas are appealing,
yet uninvestigated. The first idea is that merely the intention to perform a painful movement can
become a covert conditioned stimulus inducing defensive fear responses on its own (i.e. gaining
excitatory properties following Pavlovian acquisition). The second idea is that after extinction
fear of movement-related pain can easily be reinstated after unexpected painful stimuli (i.e.
reinstatement procedure).
To our knowledge, these interesting questions have never been investigated experimentally. In
a voluntary differential conditioning movement paradigm, joystick movements (left/right) served
as CSs and a painful electrocutaneous stimulus was used as pain-US. Participants were
randomly assigned to either the Experimental Group (n = 28), or the Control Group (n = 28).
Verbal fear ratings and fear-potentiated startle were measured throughout the experiment.
During acquisition, one movement (CS+) was consistently followed by the pain-US and another
movement (CS-) was never followed by the pain-US. During extinction, the CS+ movement was
no longer reinforced. During the reinstatement manipulation, participants in the Experimental
Group received two unsignaled pain-USs, whereas the Control Group did not. In line with our
predictions, the CS+, but not the CS- evoked fear of movement-related pain in self-reports and
eye-blink startles. Intriguingly, the mere intention to perform the painful CS+ movement
produced higher eye-blink startle responses than the intention to perform the non-painful CSmovement. We also observed a non-differential reinstatement effect in the verbal ratings, in the
Experimental Group only. The startle modulation did reveal a similar data pattern, yet not
statistically significant. To conclude, this study demonstrates that the mere intention to perform
a painful movement prior to the actual painful movement itself can come to elicit conditioned

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fear responses. These results suggest that actual movement may not be necessary to elicit
pain-related fear responses, maintaining chronic pain-related fear, avoidance and disability.
Pain in a motivational context: the role of inhibitory control in avoidance behaviour
Chronic pain comprises an important problem in health care and society, due to its high impact
and associated disability. Although avoidance behaviour is adaptive in acute pain, avoidance is
shown to be dysfunctional in chronic pain. Prevailing fear-avoidance models have shown that
pain-related fear underlies excessive avoidance. However, there is no one-to-one relationship
between fear and avoidance. We put forward that besides pain-avoidance goals fuelled by painrelated fear; also other goals may motivate performance duration during painful tasks. A conflict
may arise between short-term pain avoidance goals and opposing long-term approach goals.
An intriguing and unresolved issue is how conflicts are solved between opposing short- and
long-term goals. Recently, it has been hypothesized that an inhibitory control system is involved
in the resolution of goal conflicts. We put forward that inhibitory control may moderate the fearavoidance relationship. Reduced inhibitory control may lead to an inability to suppress painavoidance tendencies elicited by pain-related fear.
Pain hypervigilance: the debilitating influence of attentional bias towards pain and the
efficacy of distraction techniques
Dysfunctional attentional processes may be involved in pain persistence. Several studies have
demonstrated that patients with chronic pain display pain hypervigilance - an exaggerated
attentional bias towards pain -, and have difficulty in disengaging from pain. The available
evidence suggests that patients with chronic pain not only have a readily engaged attentional
system reactive to pain, but also to other sensory experiences. These results imply that a
generalized perceptual amplification of sensory experiences is a perpetuating factor in chronic
pain. Of importance, recent evidence indicates that hypervigilance may be an especially
important factor in chronic unexplained pain syndromes such as fibromyalgia, irritable bowel
syndrome and temporomandibular disorder. In addition, it has been shown that an increased
attentional bias towards pain-related information diminishes the efficacy of distraction
techniques. Distraction techniques seem to be beneficial in reducing pain perception in
otherwise healthy subjects but these strategies seem to be less efficient in chronic pain patients.
The current evidence on increased attentional bias to pain and other sensory experiences will
be discussed as well as how these dysfunctional attentional strategies can be best targeted in
therapy.
Pursuing safety: the effect of safety behavior on the reduction of pain-related fear
through exposure in vivo therapy
Catastrophizing about the meaning of pain often results in pain-related fear, which is a
maintaining factor of disability in a-specific chronic musculoskeletal pain, e.g., chronic low back
pain (CLBP). Corrective evidence can be provided upon confrontation with the threatening
stimuli (e.g., activities/situations), while the expected aversive outcome (e.g., physical harm) is
omitted. This is the basic tenet of graded exposure in vivo therapy (GEXP) and has proven to be
successful in reducing pain-related fear and disability. Recently, we found in two experiments
that safety behavior -strategies used to prevent or minimize a feared catastrophe- can interfere
with this disconfirming experience and fear extinction. Others research showed that it does not
necessarily interfere with therapy progress and outcome. Yet, the effect of safety behavior on
fear reduction through GEXP has never been investigated in CLBP patients. The current study
is the first to address this issue. We predicted safety behavior to be beneficial within sessions,
but detrimental between sessions and in the long term. In a replicated single case experimental
design, 12 a-specific CLBP patients with at least moderate pain-related fear and disability are
randomly assigned to one of three GEXP conditions. Patients are instructed to keep on using

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safety behaviors (SB-MAIN), to drop safety behaviors (SB-DECR), or to do nothing at all


regarding safety behavior (SB-NEU). An ABCD design is applied: two no treatment phases
(A/B), separated by an education session, the exposure phase (C) and a follow-up phase (D) at
3 months, 6 months and 12 months post-treatment. Primary outcome measures are pain-related
fear and disability, measured via a diary and 7 assessment sessions (applying questionnaires
and behavioral tasks) before (A/B) , during (C) and at follow-up (D) of the GEXP. Other
measures are: pain intensity, use of safety behavior and activity avoidance. Preliminary results
include two patients (SB-MAIN and SB-NEU). Initial inspection of the diaries shows decreased
disability and fear but more safety behavior in the SB-MAIN patient than in the SB-NEU patient.
Yet, while SB-MAIN seemingly has a superior effect on regaining daily functioning, the data
suggest that the firm dependence on safety behavior also keeps the SB-MAIN patient from
regaining full function and extinguishing what little fear is left.
Nveis de Estresse e Autoconceito em Mes de Filhos Portadores de Deficincia Mental
Ana Paula Montanari, Luciana Bernardes da Rosa.
UNIP, So Jos do Rio Preto, Brazil.
Abstract Central: A proposta deste estudo foi investigar os nveis de estresse e autoconceito
em mes de filhos portadores de deficincia mental. Participaram do estudo vinte mulheres
cujo os filhos receberam diagnstico de deficincias mentais como (Sndrome de Down,
Autismo, Paralisia Cerebral, Sndrome do X-Frgil). Ultilizou-se o Inventrio de Sintomas de
Stress para Adultos de Lipp (ISSL) e a Escala Fatorial de Autoconceito (EFA). Os resultados
mostraram que a maior parte das mes (60%) apresentou estresse. Quanto ao autoconceito, o
resultado se manteve positivo em todas as subescalas. Houve correlao entre estresse e
autoconceito, indicando que o aumento de estresse interfere de forma negativa sobre o
autoconceito podendo colocar essas mulheres em risco de desenvolver problemas emocionais.
Os resultados deste estudo reforam a preocupao de que um diagnstico de deficincia
mental pode causar estresse, ou seja, levar as mes a sofrimento emocional e apontam para a
importncia de intervenes mais adequadas s necessidades das mesmas, assim como a
necessidade de novas pesquisas que investiguem se o status e a interao social podem
influenciar no estresse e no autoconceito de mes de filhos portadores de deficincia mental.
Conceituao Cognitiva e a Reestruturao das Crenas Centrais de um Paciente com
Problemas de Relacionamento Interpessoal
Ana Paula Montanari, Giedre Costa.
UNIP, So Jos do Rio Preto, Brazil.
Abstract Central: Este estudo de caso tem como objetivo apresentar a conceituao cognitiva
e a reestruturao das crenas centrais de um paciente com problemas de relacionamento
interpessoal. Foi sujeito deste estudo uma mulher, 23 anos, solteira, escolaridade nvel superior
completo, assistente social. A queixa inicial apresentada pela paciente foi de ansiedade, senso
de desvalia e dificuldade de relacionamento com a me que, segundo relatos da paciente, no
foi afetiva e apoiadora nos cuidados a ela e aos irmos. Foram realizadas 15 sesses. Foram
utilizados para avaliao inicial Inventrios Beck de Depresso e Ansiedade. Foram utilizados
como recursos teraputicos: educao sobre a Terapia Cognitiva, reestruturao cognitiva,
descoberta guiada, relaxamento, educao da paciente sobre suas crenas, elaborao de
crena mais realista e funcional, registro de evidncias da antiga e nova crena,
questionamento socrtico para modificao de crenas. Durante o processo teraputico foi
possvel levantar atravs dos pensamentos automticos trazidos pela paciente suas crenas
centrais de desamparo: Eu sou incapaz/ Eu sou inferior. Apresentou ainda uma viso

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idealizada da figura materna, que atravs da descoberta guiada tornou-se mais realista. As
crenas centrais foram reestruturadas, possibilitando a percepo de que capaz, entendendo
que os defeitos e as dificuldades so caractersticos de todas pessoas. O processo teraputico
foi caracterizado por resistncia em assumir suas dificuldades como suas, uma vez que adota
como justificativa para suas dificuldades a relao no amorosa e pouco apoiadora vivida com
a me. Ao final do atendimento a paciente mostrou mudanas significativas em seus
esquemas, contudo permanece a dificuldade em lidar com os comportamentos no desejados
apresentados pela me.
Insnia: Proposta de Um Protocolo de Atendimento Clnico em Terapia CognitivoComportamental
Brbara Monteiro.
Psicoclnica Cognitiva do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract Central: A insnia hoje um dos grandes males que afetam a populao mundial,
sendo causa e/ou conseqncia de muitos transtornos psquicos. Este trabalho visa apresentar
um protocolo de atendimento clnico de 9 sesses, tendo cada sesso a durao de 50
minutos, que visam uma mudana de hbitos comportamentais e de padres de pensamentos
disfuncionais relacionados insnia. Na primeira sesso se d a entrevista inicial e a criao
de uma lista de motivao para a terapia. J na segunda sesso aplicado um questionrio
que contm 27 questes que abrangem todos os aspectos necessrios para uma avaliao
inicial da insnia, alm do ndice de Qualidade de Sono de Pittsburg. Na terceira sesso aplicase o questionrio de qualidade de vida, pois estudos mostram que pacientes insones tem uma
reduo na sua qualidade de vida, o Inventrio de Ansiedade de Beck, para que se possa
observar se h a presena de um quadro de ansiedade e um checklist de comportamentos
relacionados higiene do sono para que se possa saber quais so os comportamentos j
realizados pelo indivduo, e para que o terapeuta possa realizar a educao nos
comportamentos que no so realizados por ele no seu dia a dia. Ainda nesta sesso se
orienta o paciente no Registro Dirio de sono, este registro necessrio para que se possa
observar com mais exatido a quantidade e a qualidade do sono apresentado pelo paciente.
Na quarta sesso realizada a psicoeducao em sono, na terapia cognitivo-comportamental e
em insnia, alm da introduo do registro de pensamento disfuncional clssico, para que o
indivduo inicie o processo de reestruturao dos pensamentos disfuncionais relacionados ao
ato de dormir, sendo este registro revisado em todas as sesses seguintes at a sesso de
preveno de recada. Nesta mesma sesso o terapeuta ensina a respirao diafragmtica,
explicando seu objetivo e orientando o sujeito no seu treino dirio. Na quinta sesso o
terapeuta fornece uma lista de instrues para controle de estmulos e uma lista de estratgias
cognitivas a serem realizadas diariamente pelo indivduo, sendo todos os itens das duas listas
trabalhados em sesso. Na sexta sesso realizado o relaxamento muscular progressivo,
alm do treino o terapeuta explicar para o paciente como este relaxamento o ajudar no
combate insnia. Na stima sesso o terapeuta ensina para o indivduo estratgias cognitivas
de manejo da ansiedade no momento de dormir, as principais tcnicas utilizadas so: anotar
em um bloco as preocupaes antes de dormir, imaginar a cabea se esvaziando dos
problemas, imagem mental relaxante e contar 1000 ao contrrio para que ele focalize em uma
atividade montona que o ajudar na induo do sono. Na oitava sesso realizada a
preveno de recada. Na nona sesso o terapeuta reaplica o ndice de Qualidade de sono de
Pittsburg e o Questionrio de Qualidade de Vida para que ele possa observar a efetividade do
processo teraputico para aquele paciente, visualizando se h a necessidade de sesses de
manuteno. Tambm na ltima sesso terapeuta e paciente podem revisar juntos a lista

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motivadora criada na primeira sesso para que possam observar quais itens foram alcanados
no processo teraputico e o que o sujeito pode fazer para alcanar os restantes.
Intervencin Psicoeducativa En Adolescentes Con Sobrepeso Y Obesidad
Ulises Morales, Sergio Galan-Cuevas.
Universidad Autnoma de San Luis Potos, San Luis Potos, Mexico.
La obesidad y sobrepeso infantil se asocian principalmente con enfermedades crnicas a
futuro, por ejemplo; ser obeso en la adultez, desarrollar a temprana edad enfermedades
crnicas, como cncer, hipertensin, diabetes y enfermedades cardiovasculares, padeciendo
discapacidades y enfrentndose a la muerte prematura (Organizacin Mundial de la Salud,
2012). En relacin al aspecto social y psicolgico, los infantes con sobrepeso y obesidad, se
encuentran en un estado de estrs constante, ocasionado por las situaciones sociales a las que
se encuentran expuestos (Korbman de Shein, 2007). En Mxico, el sobrepeso y la obesidad es
un problema importante en todos los grupos de edad, que adems se incrementa a gran
velocidad. La ganancia de peso, ha logrado colocar al pas en el primer lugar de obesidad
infantil a nivel mundial (Secretara de Salud, 2010). En relacin a San Luis Potos, ocupa el
sptimo lugar a nivel nacional (Secretaria de Salud, 2010), pues en 2006, el porcentaje de
nios en etapa adolescente que padecan sobrepeso era equivalente a un 16.9% en hombres y
un 17.7% en mujeres, en tanto, la obesidad indic un 9.2% en los hombres y el grupo de
mujeres un 5.9% (Instituto Nacional de Salud Pblica, 2006). La salud y el bienestar en la
poblacin, se logra a travs de promover la adopcin de estilos de vida saludables, con
especial nfasis en la modificacin de conductas y manejo de las emociones (Guevara -Gasca
& Galn-Cuevas, 2010). Objetivos Objetivo General de Investigacin: Implementar un modelo
de intervencin que permita disminuir, de manera significativa, el sobrepeso y la obesidad en
adolescentes de secundaria. Objetivo General de Intervencin: Implementar un programa de
intervencin psicoeducativa que favorezca el desarrollo de conductas saludables permanentes
en los individuos, con el fin de recuperar y mantener un estado de salud ptimo y evitar el
desarrollo de enfermedades derivadas del sobrepeso y obesidad. Metodologa Diseo
cuasiexperimental con tres grupos control y uno de intervencin por contraste de hiptesis
unilateral. Intervencin cognitivo conductual de 9 meses de duracin. Resultados y discusin
Los resultados esperados son encontrar diferencias estadsticamente significativas entre una
intervencin tradicional y una nueva intervencin psicoeducativa, que permita mostrar los
beneficios de intervenciones centradas en la modificacin de hbitos, de pensamientos y de
creencias. El diseo de intervencin ofrece la posibilidad de trabajar con una muestra
adecuada, aumentando el impacto de los resultados. Con un seguimiento de seis meses
posterior a la intervencin, se analizar el mantenimiento o disminucin de hbitos saludables,
esperando encontrar el mantenimiento de dichos hbitos en el grupo experimental.
Factors Associated with Pain Experiences among Patients with Breast Cancer
Firdaus Mukhtar, Faridah Mohd Said, Siti Noraini Kamarudin.
Universiti Putra Malaysia, Serdang, Malaysia.
Abstract Central: Introduction: Pain can affect psychological and physical functions. The
effects of an inadequate assessment can be a burden on patients. Thus, this study was
conducted to identify the factors associated with pain experiences among breast cancer patients
and to understand them from the perspective of breast cancer patients. Objective: To determine
the factors associated with pain experiences among breast cancer patients at Hospital Melaka.
Method: This research was a cross-sectional study. The duration of the data collection was over

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two months with the aid of a self-administered questionnaire. Data analysis: All the data
collected was analysed using the Statistical Analyses Package for Social Sciences (SPSS
version 17.0) whereby a p value of < 0.05 was considered as statistically significant. The chi
square and correlation test was used to determine the association between the dependent and
independent variables. Results: Pain experiences were found to be high among middle-aged
adults of between 36-55 years old (120, 60%), married (122, 61%), with monthly incomes of
more than RM 1,000 (124, 62%), those who had undergone breast surgery (168, 84%) and
those who had current treatment of chemotherapy (125, 62.5%). In this study, most of the
patients described their pain experiences as moderate pain (115, 57.5%). The mental health
status results in this study showed that patients who had less well-being (111, 55.5%) also had
greater distress (136, 68%), but there was no significant finding between pain experiences and
mental health status (wellbeing, p=0.151, distress, p= 0.755). However, there was an
association between total pain experiences and the spiritual aspect, where there was a negative
significant relationship between meaning (r= -0.156, p <0.028), negative significant relationship
between peace (r= -0.244, p <0.001) and negative significant relationship between faith (r= 0.208, p < 0.003). The results for nurse-spiritual support showed that there was a significant
finding between pain experiences and the nurse-spiritual aspect (p=0.032). Conclusion: This
study has identified that pain experiences are associated with the spiritual aspect and the nursespiritual support. Therefore, educational programming in spiritual care should be included in the
curriculum of the School of Nursing and through Continuous Nursing Education (CNE) among
nurses. Key words: Pain experiences, breast cancer, mental health status, spiritual aspect,
nurse-spiritual aspect.
Psychological Distress, Cognitive Styles and its Relationship to Psychiatric Morbidity
among First Year Medical Students in UPM
Firdaus Mukhtar, Tiong Wen, Noor Aulia Ahmad.
Universiti Putra Malaysia, Serdang, Malaysia.
Abstract Central: Introduction: Psychiatric morbidity among undergraduate students is a global
issue. The objective of this study is to investigate the prevalence of psychiatric morbidity and its
relationship to negative emotions, cognitive styles and quality of life amongst undergraduate
Medical students at UPM. Method: A total of 74 first year undergraduate medical at UPM
completed the Saringan Status Kesihatan Mental (SSKM-20), Depression, Anxiety and Stress
Scale (DASS-21), Automatic Thought Questionnaires-Malay (ATQ-Malay) and Positive
Automatic Thought Questionnaires (ATQ-P). Result: The prevalence of psychiatric morbidity
was 53.6% among medical students. Results also revealed that were significant relationship
between SSKM-20 scores to negative emotions and cognitive styles. Conclusion: The high
prevalence of psychiatric morbidity is found among medical students. This suggests early
screening, prevention program and early intervention are necessary to overcome this issue as
this will give significant impact to their career as future medical doctors
Calidad de Vida y Apoyo Social en Pacientes en Rehabilitacin
Manuela Muoz1, Daniela Bermejo1, Diana Agudelo1, Mariantonia Lemos1, Ana Palacio2.
1. Universidad de los Andes, Bogota, Colombia, 2. Fundacin Santa Fe de Bogot, Bogota,
Colombia.
La enfermedad cardiovascular (ECV) es la principal causa de muerte en Colombia y en el
mundo (DANE, 2008; Smith & Blumenthal, 2011). El apoyo social es un predictor del desarrollo,
el curso y el pronstico de ECV (Cohen, 2004; Shen et al., 2006). En esta lnea, la calidad de

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las relaciones sociales es un predictor de resultados de salud y de calidad de vida (CV) en las
enfermedades crnicas (Bosworth et al., 2000; Cohen, 2004; Molloy et al., 2008). El presente
estudio evalu la relacin entre apoyo social y CV en una muestra de 28 pacientes (42,9%
mujeres; edad promedio: 63 aos) asistentes a un programa de Rehabilitacin Cardaca a
quienes se les aplic el MOS-SSS y el Cuestionario de Salud SF 36. El 63,3% de los pacientes
tenan pareja y el 64,2% perteneca a estrato medio-alto. Se encontraron altas puntuaciones en
apoyo social, sin diferencias por sexo ni grupo de edad. La mayor puntuacin fue en apoyo
instrumental (67,9%) y apoyo afectivo (50%). Esto puede explicarse por las condiciones
socioeconmicas de los pacientes, de tal manera que el tener acceso a mayores recursos
facilita la percepcin de apoyo instrumental. El apoyo afectivo puede relacionarse con el estado
civil de los participantes (la mayora con pareja), lo cual ha sido reportado como mayor apoyo
afectivo. En CV las puntuaciones ms altas se obtuvieron en Rol emocional (60,7%) y
funcionamiento fsico (53,6%). La tendencia general fue a mayores puntuaciones en los
hombres, aunque no hubo diferencias estadsticamente significativas, excepto en la escala de
funcionamiento fsico. Estos datos pueden entenderse en relacin con el apoyo social, ya que,
probablemente, la mayor percepcin de apoyo contribuye a la conservacin del rol emocional.
En conclusin el apoyo social mostr altas puntuaciones en esta muestra, contrario a lo
encontrado en otras culturas. Por su parte, la calidad de vida fue valorada como alta, lo cual
puede explicarse por la asistencia de los participantes al grupo de rehabilitacin.
Emerging contributions of cognitive bias modification (CBM) to health psychology
Lies Notebaert1, Patrick Clarke1, Colin MacLeod1, Bronwyn Milkins1, Patrick Clarke1, Lies
Notebaert1, Colin MacLeod1, Amar Kaur2, Louise Sharpe2, Phyllis Butow2, Eva Kemps3, Marika
Tiggemann3, Jenna Orr3, Justine Grear3, Lies Notebaert1, Bethany Teachman4, Denise Van
Deursen5, Thomas Gladwin5, Elske Salemink5, Gerben Kraaij5, Marthe Ligthart5, Reinout Wiers5.
1. School of Psychology, University of Western Australia, Crawley, WA, Australia, 2. University
of Syndey, Sydney, NSW, Australia, 3. Flinders University, Adelaide, SA, Australia, 4. University
of Virginia, Charlottesville, VA, USA, 5. University of Amsterdam, Amsterdam, Netherlands.
It is now well established that specific patterns of cognitive selectivity favouring the processing
of threatening information are implicated in the development and maintenance of
psychopathology. The majority of this research has focused on patterns of attentional bias and
interpretative bias in people with sub-clinical or clinical levels of anxiety and depression. In
these populations, cognitive bias modification (CBM) techniques have been shown to be
effective in altering these cognitive patterns and producing emotional benefits. Given these
promising findings, researchers in other areas have also started investigating whether such
maladaptive patterns of cognitions are associated with other emotional and behavioural
dysfunctions. Relevant to the area of health psychology, it was found that biased cognitive
processes seem to be associated with a range of health problems, including food consumption
[1], addiction [2], health anxiety [3], and sleep disturbance [4]. It seems likely therefore, that
CBM can also be used to change these maladaptive cognitive patterns in order to attenuate
health problems.
This symposium brings together researchers across a variety of health domains with a shared
interest in utilising CBM to target cognitive processes underlying emotional and behavioural
patterns that are detrimental to ones health. Amar Kaur from the University of Sydney will report
the promising results of a study in which attentional bias modification (ABM) is used to target
health anxiety. Eva Kemps from Flinders University will show that encouraging people to attend
away from unhealthy food (through an ABM procedure) leads to reduced consumption of and
reduced cravings for this food. Lies Notebaert from the University of Western Australia
examines how an interpretation bias training procedure can enhance the effectiveness of a

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melanoma campaign video in increasing sun protection behaviour through the evocation of
domain specific worry. Patrick Clarke, also from the University of Western Australia will present
a study in which people with high levels of sleep-related worry and sleep disturbance were
encouraged to attend a way from sleep-worry related words, with results showing reductions of
worry and improvements in sleep. Finally, Denise van Deursen from the University of
Amsterdam examined the mechanisms underlying a new CBM method in the context of alcohol
addiction, with the aim of increasing its effectiveness. Taken together, this research provides
promising evidence that CBM can be extended into other research areas such as health
psychology to deliver tangible benefits to both non-clinical and clinical populations.
[1] Calitri, Pothos, Tapper, Brunstrom & Rogers (2010). Cognitive Biases to Healthy and
Unhealthy Food Words Predict Change in BMI. Obesity, 18, 2282-2287
[2] McCusker (2001). Cognitive biases and addiction: an evolution in theory and method.
Addiction, 96, 47-56
[3] Lees, Mogg & Bradley (2005). Health anxiety, anxiety sensitivity, and attentional biases for
pictorial and linguistic health-threat cues. Cognition & Emotion, 19, 453-462
[4] Spiegelhalder, Espie, Nissen & Riemann (2008). Sleep-related attentional bias in patients
with primary insomnia compared with sleep experts and healthy controls. Journal of Sleep
Research, 17, 191-196
Anxiety and Physiological Response to Health Threat: The Effects of Attentional Bias
Modification (ABM)
Attention bias modification (ABM) has shown considerable promise as a therapeutic tool across
a range of anxiety disorders, but this study is the first to apply ABM to the context of health
anxiety. Participants were randomised to have their attention trained either towards negative
health-related words (negative training, n = 35), or neutral (health-unrelated) words (neutral
training, n = 40). All participants were exposed to a health stressor, and outcome was assessed
using both physiological (skin conductance response and heart rate) and self-report measures.
Those in the neutral training group displayed an attenuated skin conductance response to
subsequent health stress. No group differences were observed on heart rate, or self-report
measures. Group differences in attention to negative health-related words were not observed,
but there was a significant correlation between change in attention, and increase in state anxiety
following health threat: the more participants attention had shifted away from negative healthrelated words, the lower their increase in anxiety following health stress. These results suggest
that ABM has promise in attenuating individuals response to health-related threats, although
the mechanisms of this effect could not be established. Future research in this area is
warranted.
Attentional Bias Modification Reduces Food Cravings and Consumption
Emerging evidence shows that attentional bias modification can alter consumption behaviour,
such as smoking and alcohol consumption. This study sought to document such beneficial
effects of attentional bias modification in the food and eating domain. Using a modified dot
probe paradigm, participants were trained to direct their attention either towards (attend group),
or away from (avoid group), food cues (i.e., pictures of chocolate). As predicted, attentional
bias for chocolate cues increased in the attend group, and decreased in the avoid group.
Importantly, these training effects generalised to novel, previously unseen, chocolate pictures,
and affected chocolate consumption and craving. Participants in the avoid group ate less
chocolate in a subsequent taste test than did those in the attend group. Additionally, the
attend group reported stronger chocolate cravings following training, whereas the avoid group
reported less intense cravings. Theoretically, the results support predictions of cognitivemotivational models that attentional bias has a causal effect on craving and consumption

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behaviour. At a more practical level, they present a promising avenue for tackling unwanted
food cravings and (over)eating.
Cognitive bias modification targeting behavioural change: can interpretation bias
contribute to adaptive worry to facilitate melanoma prevention behaviour?
Melanoma is one of the most common types of cancers, especially in Australia, with incidence
rates increasing despite there being simple prevention behaviours that substantially reduce the
risk. This is a common problem in many health domains and consequently many public health
campaigns are aimed at encouraging people to adopt more adaptive patterns of prevention
behaviour. Often these campaigns are aimed at increasing perceptions of severity and risk, to
promote threat-related worry and initiate adaptive/protective behaviours (Witte & Allan, 2000).
Indeed, worry, the process of mulling over potential future dangers, has been shown to be a
motivating factor in protective behaviour (McCaul & Mullins, 2003). Research has shown that
one of the cognitive processes underlying worry is the tendency to interpret ambiguous events
in a threatening, rather than benign way. Modification of this interpretation bias through a
procedure known as cognitive bias modification for interpretation (CBM-I) has shown that
facilitating a more benign interpretation bias can result in less intrusive worry (Hirsch et al,
2009). If encouraging a benign interpretive bias can reduce intrusive worry cognitions it is
possible that targeted CBM-I could also potentially increase worry regarding the risk of specific
threats and so promote adaptive behaviour. Thus, the aim of the current study was to
investigate whether the effectiveness of a public health campaign targeting sun protection
behaviour can be increased by training people to adopt a negative interpretation bias.
Participants (N=40) were randomly assigned to two conditions in which ambiguous scenarios
describing physical threats were either always resolved in a threatening way (negative CBM-I
training condition) or in a benign way (positive CBM-I training condition). Participants then
watched a video campaign ad provided by the Cancer Institute NSW. Adaptive sun-protection
behaviour was assessed via a self-report intentions questionnaire and by measuring the amount
of money spent on sun protection during the completion of a game involving the replacement of
luggage items lost on a holiday. Results showed that consistent with previous research,
melanoma worry elicited by the ad was the best predictor of protection behaviour (game
measure). However, contrary to our predictions, the positive CBM-I training condition was more
effective in eliciting worry than the negative CBM-I training condition. Implications for targeting
an increase in adaptive behaviours that are dependent on heightened levels of worry are
discussed.
Altering Sleep-Related Worry and Sleep Disturbance through Targeted Attention Bias
Modification
Attention Bias Modification (ABM) is an emerging psychotherapeutic approach which seeks to
target low level patterns of cognition implicated in the development and maintenance of
psychopathology. Lab-based studies initially demonstrated that the induction of an attentional
bias away from threat serves to acutely attenuate emotional vulnerability in response to a
contrived stressor. Subsequent research has sought to determine the potential clinical benefits
beyond the lab by delivering ABM to patients at pre-determined intervals across a period of
days or weeks in an attemptwith the aim to produce an enduring change in selective attention.
While such studies have delivered promising results, it is possible that the ability of ABM to
produce transient reductions in anxiety vulnerability at targeted points in time may be equally
important in its potential clinical utility. In the present study we sought to examine whether an
internet-delivered attention bias modification (ABM) procedure, completed at a targeted point in
time, could exert a transient impact on worry that would serve to also mitigate sleep difficulties.
Individuals reporting high levels of sleep-related worry and sleep disturbance completed either
an ABM task or a no-ABM control task before sleep on alternating nights across four days (i.e.,

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ABM, no-ABM, ABM, no-ABM) in Study one, and across six days in Study two. Across the two
studies it was found that participants reported shorter sleep-onset latency, less pre-sleep
arousal and better sleep quality on nights when they had completed the ABM task as compared
to nights when they had completed the no-ABM control task. This outcome highlights the
potential benefits of delivering ABM at targeted points in time when biased attention, anxiety,
and worry are likely to be most problematic. Implications will consider whether the optimal
delivery of ABM may involve more discrete targeting of times and situations where attentional
vigilance is most likely to be detrimental to adaptive functioning.
Alcohol-no/go training: the role of response conflict
Recent studies have found that alcohol-no/go training, in which heavy drinkers were trained to
inhibit responses to alcohol cues, resulted in reductions in alcohol use in the week following
training (Houben et al., 2011; Houben et al., 2012). Furthermore, changes in alcohol use were
mediated by changes in automatic attitudes towards alcohol (Houben et al., 2012). One possible
explanation for these findings is that not responding to positive stimuli creates a response
conflict which is solved by devaluating these stimuli (Houben et al., 2012; Veling, Holland, & van
Knippenberg, 2008). In the current study, the response conflict hypothesis was experimentally
tested among heavy drinkers, by manipulating the degree of response conflict and examining
how this affects the effectiveness of alcohol-no/go training. The effects on both implicit attitudes
and drinking behavior will be discussed. A better understanding of the mechanisms though
which alcohol-no/go training affects behavior will allow us to maximize its possible effectiveness
as a form Cognitive Bias Modification for individuals with alcohol use problems.
Stress Control Training in Patients with Metabolic Syndrome
Lucia Novaes Malagris2, Marilda Lipp1.
1. Instituto de Psicologia e Controle do Stress, Campinas, Brazil, 2. Universidade Federal do
Rio de Janeiro UFRJ, Rio de Janeiro - RJ, Brazil.
Between 20% and 25% of the worlds adult population has Metabolic Syndrome (MS) which
represents a significant risk factor for cardiovascular diseases. MS is characterized by a group
of components found simultaneously in one individual: abdominal obesity, glucose
intolerance/insulin resistance, dyslipidemia and high blood pressure. Risk factors associated to
these components are: inadequate diet, sedentariness, tobacco usage, alcoholism and
excessive stress. The aim of this study was to ascertain if stress control training (SCT) can
reduce these risk factors. A total of 32 women with MS were referred by So Francisco de Assis
Teaching Hospital at the Federal University of Rio de Janeiro to participate in the study. The
participants were divided into Control (CG) and Experimental (EG) groups and were evaluated
at the start of the study by means of medical consultation, psychological interview, stress
evaluation (Lipps Adult Stress Symptoms Inventory - ISSL), assessment of the levels of
physical activity (International Physical Activity Questionnaire - IPAQ), nutritional assessment,
as well as laboratory tests of Total Cholesterol, LDL cholesterol, HDL cholesterol and Glucose.
The EG was subjected to SCT and was reevaluated at its end. The CG was evaluated before
and after the period required to carry out the SCT with the EG. The 14-weekly session training
aimed to provide psychoeducation about MS, stress, diet and physical activity, as well as the
teaching of cognitive-behavioral strategies. At the end of the intervention, we found: (1) the age
prevalence was between 50 to 59 years and (2) prior to the SCT, the two groups scored higher
in all components of MS, (3) a significant difference was found post training ( higher rate of
stressed individuals in the CG , p=0.005) and a significant reduction in stress in the EG (p=
0.005), (4) post training, stress level was more severe in the CG, evidenced by the higher
number of individuals in the resistance and near-exhaustion phases, (5) in post raining, there
was a significant difference in the number of stress symptoms found (higher value in the CG ,

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p<0.001, and lower in the EG) , (6) significant reduction in stress symptoms (p<0.001) only in
the EG. Higher values were found in the CG (p=0.028) for vigorous physical activity. At the end
of the study, a significant reduction (p=0.012) was found for total Cholesterol and LDL
(p=0.0133), only for the EG. Glucose analysis exhibited a significant increase between pre- and
post- training only for the CG (0.019). Relaxation techniques used on a daily basis were found
to be effective in reducing tension in the EG. There was an increase in Linseed consumption
(p=0.030) and a reduction in Kcal consumption after the training, only in the EG (p=0.028).
There was a significant reduction in sodium consumption for both groups after the Stress
Control Training (p<0.001) and higher values were found for beef consumption in the control
group (p=0.044). Based on the results, it may be concluded that the Stress Control Training is
an effective intervention for the reduction of the main risk factors for M S. It is recommended
that studies be conducted using a larger number of participants to corroborate and expand the
findings of this study.
Problem-Solving Therapy for Psychological Distress in Japanese Parents of Children
with Cancer: Feasibility and Effectiveness
Akiko Ogata1, Yoshinori Ito2, Toru Okuyama2, Kei Hirai3.
1. Hiroshima University, Hiroshima, Japan, 2. Nagoya City University, Aichi, Japan, 3. Osaka
University, Osaka, Japan.
Background : Parents of children with serious illnesses have lower levels of well-being than
parents in the general population. They must cope with multiple problems and worried about
include those stemming from the uncertainty about the future, management of their own and
their childrens health, carrying out of proper parenting, and surmounting of social problems.
Problem-solving therapy (PST), a cognitive-behavioral intervention has been shown to be
effective for the treatment of common mental disorders, including depression and anxiety, in
primary care and oncology settings. Also in mothers of children with newly diagnosed cancer,
PST has been established as an effective intervention for enhancing problem-solving skills and
decreasing negative affectivity in Western countries. We developed the PST program for
Japanese parents of children with cancer. And we conducted a pilot study to evaluate parents
acceptance and impact of a 5-session program to parents negative affectivity. Methods : The
subjects were 12 parents (all mothers) and they completed the Profile of Mood States (POMS)
and SF-8, pre-, post-treatment, and 1 months after completion of the intervention. The
intervention consisted of five 1-hour individual sessions and one follow-up session (1 month
after) conducted according to the detailed protocol contained in our manual. The PST program
was offered as a generic coping skill applicable to a range of problem-based and emotion-based
stressful situations commonly encountered during treatment of childhood cancer. The specific
problems discussed during the intervention were identified by the individual parent as especially
relevant to him/her and his/her family. Results : 11 mothers completed of the 5 training sessions
and the follow-up session. The mothers decreased negative affectivity (POMS) from preintervention to post-intervention and its effect maintained until 1 month follow-up session(
F(2,20) = 18.542, p<.001, 2 =.65). QOL(SF-8) also improved after PST(F(1.283,20) = 4.78,
p=.04, 2 =.32). Similarly, the mothers rated the overall program high, and reported satisfaction
with this program. Conclusion: The results provide an initial demonstration of the feasibility of
problem-solving program for Japanese mothers of children with cancer. Our findings indicate
that PST program can help reduce maternal emotional distress associated with the diagnosis of
a life-threatening disease in her child. Future studies of such PST program should have a
sufficiently large sample size to evaluate the efficacy of this intervention.

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Promoo da Qualidade de Vida Nos Acufenos: Uso da Biblioterapia


Antnio Oliveira3, 1, Rute Meneses2, Nuno Trigueiros4.
1. Audiology, ESTSP, Vila Nova de Gaia, Portugal, 2. FCHS/CECLICO - Universidade
Fernando Pessoa, Porto, Portugal, 3. Hospital Militar Regional N 1 (D. Pedro V), Porto,
Portugal, 4. Hospital Pedro Hispano (Unidade Local de Sade de Matosinhos, EPE),
Matosinhos, Portugal.
Com o presente estudo pretende-se: (1) Sistematizar as razes para implementar, de forma
sistemtica e rotineira, programas de promoo da qualidade de vida (QDV) para pacientes
com acufenos e (2) apresentar uma proposta para um destes programas baseada na
experincia clnica e na literatura. Os acufenos so uma percepo de som sem estimulao
externa, tornando-se num fenmeno psicosensorial que no ouvido pelos outros. A sua
abordagem difcil, porque ainda no so conhecidos grande parte dos mecanismos
fisiolgicos que os causam, a terapia mdica e medicamentosa est longe de ser eficaz e as
queixas subjectivas no encontram correspondncia nas medies psicoacsticas. Cerca de
4% dos indivduos com mais de 10 anos referem ter acufenos e quase metade de entre eles
apresenta algum tipo de problema na vida quotidiana pela sua presena. Na literatura so
encontradas cinco queixas principais associadas aos acufenos: perturbaes do sono,
problemas auditivos, efeitos negativos na sade geral, problemas emocionais e dificuldades
nas actividades laborais e sociais. Em indivduos portugueses com acufenos, verificaram-se
valores abaixo das normas em todas as dimenses de QDV. Estando os acufenos relacionados
com variveis psicolgicas, torna-se importante conhecer as principais caractersticas
psicolgicas associadas percepo dos acufenos. A literatura e a experincia clnica sugerem
que a ansiedade, a depresso, o coping, a auto-eficcia, o optimismo e o suporte social
devero ser particularmente investigados nos indivduos com acufenos, aos quais se juntam a
componente de espiritualidade. Neste contexto, prope-se e apresenta-se um recurso
teraputico desenvolvido no mbito da biblioterapia com informao relevante e conselhos
prticos (estratgias biopsicossociais), bem como os dados preliminares, da apresentao
deste instrumentos a 16 indivduos, ao qual reagiram de forma positiva, que sugerem que este
pode representar uma forma eficaz e pouco dispendiosa de promover a auto-eficcia,
optimismo, suporte social e o coping dos doentes e de reduzir a sua ansiedade/depresso, i.e.,
promover a sua QDV.
Tabagismo Associado ao Tratamento da Dependncia de Cocana - Uma Reviso
Sistemtica
Lusa Oliveira, Paula Gths, Anelise Coutinho, Irani Argimon.
PUCRS, Porto Alegre, Brazil.
A dependncia de tabaco pode ser um facilitador para o consumo de substncias ilcitas, ainda
assim, poucos estudos verificam a implicao desta comorbidade no resultado do tratamento
para dependncia de cocana. Embora ainda seja controverso, ideal que se oferea o
tratamento de tabagismo, j que se mostra efetivo para dependentes de outras substncias.
Sendo assim, esse estudo objetivou verificar a associao do tabagismo no tratamento de
dependncia de cocana. Para isso, foram utilizados ensaios clnicos e estudos observacionais
com indivduos em tratamento do uso de cocana ou de substncias, que apresentavam
comorbidade com dependncia de tabaco e no recebiam tratamento formal para o tabagismo.
No foram includos artigos experimentais com animais e laboratoriais ou que abordassem
temas relacionados gentica, neuroqumica, gestantes e crianas. Tambm foram excludos
artigos que no estavam no idioma ingls ou portugus e os de reviso de literatura, alm
daqueles com delineamento descritivo, que apenas apresentavam dados de prevalncia da

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comorbidade de ambas as substncias. Para a realizao da busca utilizaram-se os seguintes


descritores: nicotine AND cocaine AND relationship, em todos os campos das bases de
dados e sem restrio de anos. Para esta reviso sistemtica foi realizada uma busca em cinco
bases de dados: BVS (Biblioteca Virtual em Sade), PsycINFO, PubMed, Scopus e Web of
Science, durante o perodo de 29 de agosto at 13 de setembro de 2012. Foi encontrado um
total de 723 e, aps critrios de excluso, apenas 4 preenchiam os critrios de seleo para
esta reviso sistemtica, porm foram revisadas as referncias bibliogrficas dos artigos lidos
na ntegra e outros 5 artigos foram identificados e considerados relevantes sendo tambm
includos. Os estudos foram divididos em subgrupos de acordo com o delineamento e nvel de
evidncia. Na amostra, foram identificados 1433 pacientes e em 4 estudos tambm foi
identificado presena na amostra de uso de crack. Em relao interferncia do tabagismo no
tratamento da dependncia de cocana, identificou-se que o consumo de substncias ilcitas
aumenta proporcionalmente de acordo com a intensidade da dependncia de nicotina. No foi
possvel descrever a prevalncia de tabagismo e comorbidade em virtude dos diferentes
delineamentos e metodologias dos estudos. Para as medidas de avaliao inicial, a
dependncia de cocana foi diagnosticada por uma avaliao clnica baseada no DSM-IV-TR e
o nvel de dependncia do tabaco pelo teste de Fagerstron. Alm disso, em 7 estudos um dos
critrios de mensurao da eficcia do tratamento foi atravs de exames de urina. Em relao
s medidas de avaliao de resultado, foi identificado em 3 estudos uma similaridade de
fatores: nmero de screenings negativos para cocana, dias em tratamento, nmero de
sesses, desistncias. A partir desta reviso, observou-se que o tabagismo prejudica o
resultado do tratamento de cocana a curto, mdio e longo prazo. Tal achado justifica a
necessidade de insero de tratamento de tabagismo concomitante ao tratamento de outras
substncias.
Initial Motivation, Perceived Self-Efficacy and Changes in Intake Habits: A Pilot Study in a
Sample of Obesity Children in Treatment
Elia Oliver1, 3, Patricia Escobar Valero1, Marta Miragall1, Alba Carrillo1, Ausis Cebolla2, 3, Rosa
Baos1, 3.
1. Universidad de Valencia, Valencia, Spain, 2. Universitat Jaume I, Castelln, Spain, 3. Ciber
Fisiopatologa de la Obesidad y la Nutricin, Santiago de Compostela, Spain.
The aim of the cognitive and behavioural treatment (CBT) for childhood obesity is to promote a
healthy lifestyle. The change of the intake habits remains a challenge in CBT programs for
childhood obesity. It is necessary to identify variables that facilitate or prevent this change.
Motivation for change or perceived self-efficacy are two relevant variables that can influence on
the treatment success. The aim of the present study is to analyze the previous level of
motivation for change and the degree of perceived self-efficacy to start a CBT program and their
relations with the modification of intake habits (operativized as an increase of fruits and
vegetables consumption and a decrease of fats consumption). The sample was composed by
17 children (8 boys and 9 girls) from 9 to 13 years old (X=10.4; SD=1.18), recruited from a Child
and Adolescents Cardiovascular Risk Unit from a Paediatric Service. Motivation and selfefficacy before treatment were measured by a specific instrument designed ad-hoc in this study.
During the treatment children filled intake self-registers weekly. Changes in the consumption of
fruits, vegetables and fats were taken into account. Results showed a higher increase of fruits
consumption after the treatment in children with higher scores on motivation and self-efficacy to
carry out the intake objectives. Furthermore, children who had greater consumption of fats after
treatment were those who considered more important to maintain prescriptions and treatment.
This study shows that self-efficacy and change motivation are predictors of intake change in

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obese children, and they are important variables to consider when implementing weight loss
interventions.
Ocorrncia de Transtornos de Eixo I em uma Populao Socioeconomicamente
Vulnervel Atendida em uma ONG na Periferia de Porto Alegre
Kelly Paim, Rossana Andriola, Marcus Barbosa, Ricardo Wainer, Liza Martinato, Caroline Pinto,
Leandro Kuhl, Pedro Moser.
WP, Porto Alegre, Brazil.
O atendimento a uma demanda de pessoas em situao de vulnerabilidade socioeconmica
atravs de servios psicolgicos gratuitos, pode resultar em um papel social de extrema
importncia (HERZBERG, 1996). O objetivo deste artigo caracterizar esta amostra de sujeitos
atendidos em uma ONG na periferia de Porto Alegre. A metodologia utilizada foi a analise de
pronturios de atendimentos psicolgicos realizados nesta ONG. Participaram desta pesquisa
324 sujeitos, de 3 81 anos, sendo 120 do sexo masculino e 204 do sexo feminino. Todos os
participantes assinaram o Consentimento Livre e Esclarecido para Participao em Pesquisa.
Os dados foram analisados como o auxilio da planilha eletrnica SPSS 16.0. As anlises dos
dados colhidos revelam o seguinte: diagnstico de transtornos de ansiedade em 3,1% dos
sujeitos, transtornos do humor em 2,5%, transtornos relacionados substncias em 1,2%,
transtornos de dficit de ateno e disruptivos em 2,8%, transtornos de globais do
desenvolvimento em 0,3%, transtornos de excreo em 0,3% e outros transtornos da infncia e
adolescncia em 1,2% dos sujeitos avaliados. 87% dos sujeitos atendidos no receberam
qualquer diagnstico de Eixo I.
Percepcin del Equipo de Salud Sobre la adherencia Teraputica de los Pacientes
Sometidos a Ciruga de Revascularizacin Miocrdica: Un Estudio Cualitativo
Tania Palacio, Leticia Daguerre, Lorena Estefanell, Estefana Lens.
Universidad Catlica, Montevideo, Uruguay.
El Uruguay provee el acceso a toda su poblacin a los procedimientos de revascularizacin
miocrdica mediante el Fondo Nacional de Recursos (FNR). A partir del 2004 se pone en
funcionamiento dentro del FNR el Programa de Prevencin Secundaria Cardiovascular (PPSC)
con el objetivo de mejorar la asistencia a largo plazo de los pacientes coronarios y optimizar la
inversin de recursos. Esto representa un gran avance en el tratamiento. Sin embargo se
contrapone directamente con el fracaso que todava existe en el manejo a largo plazo de los
factores de riesgo cardiovascular. A partir de esto se decidi explorar la percepcin de los
factores intervinientes en la adherencia teraputica en aquellos pacientes que fueron sometidos
a ciruga de revascularizacin miocrdica y forman parte del PPSC del FNR. Se realiz un
estudio cualitativo que comprende la indagacin de la percepcin de la adherencia teraputica
desde la perspectiva de los actores involucrados en el Programa: equipo de salud y pacientes.
La investigacin sigue en curso, por lo que se presentarn los indicios obtenidos hasta el
momento, centrndose en la mirada del equipo de salud. Se utiliz un diseo transversal de
tipo descriptivo exploratorio con entrevistas semiestructuradas. El marco muestral fue de tipo
intencional, seleccionando a uno de los tres Programas existentes en Montevideo. Se
entrevist a un representante de cada disciplina integrante del equipo de salud (cardilogo,
internista, lic. en nutricin, lic. en enfermera, especialista en tabaquismo) como informantes
calificados. Se cumplieron criterios de calidad de investigacin cualitativa. En cuanto a los
indicios que se presentan hasta el momento, el equipo reafirmara lo planteado en la evidencia
terica que refiere una mejor adherencia en los meses cercanos a la ciruga, debido a la

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repercusin emocional, pudiendo mantenerse la adhesin con el paso del tiempo si es


acompaado con un cambio de creencia en torno a la misma. Como parte de la repercusin
emocional los profesionales mencionan la gran presencia de cuadros depresivos, ansiedad y
angustia, que sin duda afectan la adherencia teraputica. En relacin a las atribuciones
causales que realizan los pacientes sobre su enfermedad los expertos refieren que, existe una
predominancia de atribuciones externas, fundamentalmente vinculadas al azar: porque me
toc, porque me pasan cosas o vinculadas al cigarrillo como un factor causal disociado de su
conducta de fumar. Los entrevistados vinculan esto ltimo a la gran presencia de campaas
realizadas en el pas desde el 2006. Consideramos que la presencia de este estilo atribucional
en el origen de la enfermedad facilita la adquisicin de conductas tambin externas para el
tratamiento de la misma. Perciben que existe una mejor adherencia a las indicaciones
farmacolgicas que a aquellas que implican cambios en el estilo de vida: ejercicio fsico y
alimentacin, vivindolo con un sentido de prdida. Esto podra deberse a que los pacientes
subestiman su incidencia en el origen de la enfermedad as como en su tratamiento. Estos
indicios forman parte de la primera fase de la investigacin y sern complementados con los
aportes de las percepciones de los propios pacientes sobre su adherencia.
La Experiencia Uruguaya en el Tratamiento de la Dependencia al Tabaco
Tania Palacio, Elba Esteves, Gambogi Rosana, Gustavo Saona, Ana Cenndez.
Fondo Nacional de Recursos, Montevideo, Uruguay.
Abstract Central: En el ao 2003 el Fondo Nacional de Recursos (FNR) decidi implementar
un programa de prevencin secundaria de enfermedades cardiovasculares como forma de
optimizar la asistencia y los recursos destinados al abordaje de dichas patologas, por lo que
inicia el Programa de Tratamiento de la Dependencia al Consumo de Tabaco. El objetivo del
programa es disminuir la prevalencia de consumo de tabaco en la poblacin. Incluye lograr el
abandono del consumo de tabaco en los pacientes que solicitan ayuda, tratar la dependencia al
tabaco y disminuir el nmero de pacientes tratados que recaen en el consumo. La propuesta
est integrada por: 1. Charla introductoria grupal, con objetivo informativo y motivacional. 2.
Tratamiento grupal con coordinacin tcnica. Se hace nfasis en el uso de herramientas
cognitivo-conductuales con el objetivo de lograr el control gradual del consumo, restructuracin
cognitiva, logro de la abstinencia y mantenimiento de la misma a largo plazo. 3. Tratamiento
farmacolgico con sustituto nicotnico en forma de goma de mascar y Bupropin Los pacientes
que se han asistido a los programas con convenio con el FNR entre el 1 de enero de 2004 y el
31 de diciembre de 2011 sumaron 24735. La ltima evaluacin se realiz en 4279 pacientes
ingresados entre julio de 2007 y junio de 2008. Para evaluar la abstinencia luego de un ao del
tratamiento se realiz en agosto del 2010 un contacto telefnico a una muestra aleatoria,
estratificada, constituida por 578 pacientes. La poblacin estaba integrada en su mayora por
mujeres (57.8%), la edad promedio fue 45.6 aos (mnimo 14 - mximo 85) y el 48.4% vivan
en Montevideo. La totalidad de los pacientes recibieron indicaciones dirigidas a modificar
pautas conductuales, mientras que un 71.1% recibi adems tratamiento farmacolgico durante
un tiempo promedio prximo a 100 das. El 52.9% de la poblacin recibi tratamiento
combinado con chicles de nicotina y bupropin. Segn los datos obtenidos con el control
telefnico mencionado, representativa del total de la poblacin, el porcentaje de abstinencia
puntual (ltimos 7 das) al momento del llamado fue 46.2% y el 13.8% logr abstinencia
mantenida por un ao o ms. Considerando los pacientes que efectivamente recibieron
tratamiento, definido por un mnimo de 4 controles en el programa, el porcentaje de abstinencia
mantenida por un ao asciende a 22.4%. Mediante un modelo de regresin lineal se estudiaron
las variables relacionadas con el xito del tratamiento, es decir con el logro de abstinencia
mantenida por ms de un ao. Las variables que tuvieron clara vinculacin al xito fueron el

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sexo femenino, el mayor nmero de controles y el uso de frmacos especficos para el


tratamiento del tabaquismo. Conclusiones El programa de tratamiento en el lapso de 7 aos ha
estimulado el tratamiento del tabaquismo en el sistema sanitario, ejerciendo un rol destacado
en la capacitacin de profesionales de la salud en el tema y en la asistencia de los pacientes
fumadores. La acciones implementadas han facilitando la accesibilidad al tratamiento mediante
convenios con instituciones del mbito pblico y privado, contribuyendo a dar respuesta a las
recomendaciones del Convenio Marco de la OMS para el Control del Tabaco.
The Applicability of Cognitive-Behavioral Therapy in Promoting Life Skills in Teenagers
Ana Paula Justo2, Marilda Lipp1.
1. Instituto de Psicologia e Controle do Stress, Campinas, Brazil, 2. Pontifcia Universidade
Catlica de Campinas PUCC, Campinas - SP, Brazil.
The promotion of health in young people has become a focus of interest in recent years and
concomitantly, the need for preventive action. In view of the vulnerability of teens and the fact
that much of the behavior acquired in this phase will be maintained for the rest of their lives, the
promotion of skills represents the best strategy for preventing problems, whether they be
physical, emotional or behavioral, during the teenage years, which will consequently contribute
to a less stressful adulthood. The aim of this work is to present an analysis of the applicability of
cognitive-behavioral therapy (CBT) in health promotion programs, focusing on the development
of life skills and the reduction of stress. Life skills are a set of psychosocial and interpersonal
skills that help people to cope with adversity in a healthy and positive fashion. This set of skills
includes decision-taking, problem resolution, critical thinking, creative thinking, effective
communication, interpersonal relationships, self-awareness, empathy, managing emotions and
stress. The main theoretical principles that underpin CBT state that emotional and behavioral
complaints are the result of excessively dysfunctional (or irrational), rigid and distorted thinking
which, when active, would have the capacity to influence an individuals mood and behavior.
The identification of these thoughts and their subsequent modification are the core elements of
cognitive-behavioral treatment. CBT also assumes that any development (cognitive, emotional
or behavioral) takes place in a social context, it being impossible in practice to conceptualize,
treat clinical problems or even promote health without being concerned with the family
environment or with the group of people of the same age. In practice, CBT is active, structured,
problem-oriented, collaborative and strategic, founded on the cognitive-behavioral formulation of
the maintaining factors of an individuals difficulties and can be applied on an individual or group
basis. For younger people, the intervention requires the content and techniques applied to be
adapted, and requires creativity and flexibility. The use of examples, analogy, (material) objects,
dynamics and games, enables the young person to remain attentive and involved. CBT
interventions involve a series of strategies that combine cognitive and behavioral techniques,
such as psycho-education, affective education, relaxation training, observational modeling,
exposure, social skills training, assertiveness training and cognitive restructuring, amongst
others. Its targets are the three core domains (cognitive, emotional and behavioral) and it
shares the common objective of helping the young individual to develop a view of the world
characterized by a constructive approach to the resolution of his problems that, by way of
carefully planned exercises, helps the young person and their families to build an adaptive
perspective focusing on the resolution of their problems. Having at its base the skills required for
a healthier and more adaptive stance, it is understood that CBT provides all the elements
required for preventive interventions in the area of health and in the development of life skills.
Email: paulajusto@yahoo.com.br

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Avaliao da Eficcia de um Grupo Psicoeducativo Sobre Ansiedade, Depresso e


Qualidade de Vida de Pacientes com Psorase
Caroline Pavan-Cndido1, 2, Ricardo Gorayeb2.
1. Universidade do Oeste Paulista, Presidente Prudente - SP, Brazil, 2. Hospital das Clnicas da
Faculdade de Medicina de Ribeiro Preto da Universidade de So Paulo, Ribeiro Preto - SP,
Brazil.
A psorase uma dermatose crnica que produz diversos e amplos impactos na qualidade de
vida dos pacientes e est intimamente relacionada a aspectos psicolgicos. No Brasil, pouco se
tem estudado sobre o assunto e so raros os relatos de interveno psicolgica com estes
pacientes. O objetivo deste estudo foi avaliar os efeitos de um grupo psicoeducativo aberto
sobre ansiedade, depresso e qualidade de vida de pacientes com psorase, atendidos em um
hospital pblico de uma cidade do interior do estado de So Paulo, Brasil. Setenta pacientes
participaram do estudo. Os materiais utilizados foram dois roteiros de entrevista
semiestrutarada (primeira e segunda avaliaes), o Inventrio Beck de Ansiedade (BAI), o
Inventrio Beck de Depresso (BDI), e os instrumentos ndice de Qualidade de Vida em
Dermatologia (DLQI) e ndice de Incapacidade Provocada pela Psorase (PDI). Os pacientes
foram avaliados em dois momentos: quando iniciavam sua participao no grupo
psicoeducativo e entre 12 e 14 meses aps a primeira avaliao. Foram realizados testes para
verificar se houve mudana nos nveis de ansiedade, depresso e qualidade de vida e se a
mudana foi produto da participao do paciente no grupo. Alm disso, foram realizados testes
para verificar se o comparecimento em um maior nmero de sesses do grupo produziu uma
reduo maior na ansiedade e depresso e um aumento maior dos ndices de qualidade de
vida. Os resultados dos testes evidenciaram que mudanas no conhecimento sobre a
dermatose, nos nveis de depresso (BDI e BDI-13) e no impacto na qualidade de vida (PDI)
foram produtos de interveno, possivelmente a participao dos pacientes no grupo. Os testes
tambm mostraram que no houve efeito do nmero de sesses na melhora das medidas
psicolgicas, mas sim efeito da varivel conhecimento sobre a psorase sobre as medidas de
ansiedade, depresso (BDI e BDI-13) e qualidade de vida (DLQI), ou seja, quando maior o
conhecimento sobre a dermatose, maior a melhora em relao s medidas de ansiedade,
depresso e qualidade de vida. Conclui-se que importante realizar avaliaes de ansiedade,
depresso e qualidade de vida dos pacientes com psorase e fornecer ateno especializada,
incluindo acompanhamento psicolgico juntamente com o tratamento mdico, a fim de garantir
no somente a melhora clnica do quadro, mas tambm a melhora da qualidade de vida.
Relacin Depresin y Estrategias de Afrontamiento de Mujeres con Riesgo Gestacional
Asistidas en el Hospital San Pedro de Pasto
Adriana Perugache, Claudia Lara Villareal, Yanneth Ardila Villareal.
Psicologa, Universidad de Nario, San Juan de Pasto, Colombia.
Abstract Central: Descripcin El objetivo de la investigacin fue determinar la relacin entre
los niveles de la variable depresin y cada una de las estrategias de afrontamiento utilizadas
por mujeres con alto riesgo gestacional asistidas en el hospital San Pedro de Pasto.
Metodologa La investigacin se realiz desde el enfoque cuantitativo, fue de tipo correlacional
y de corte transversal. Los instrumentos utilizados para la recoleccin de informacin fueron: el
inventario de estrategias de afrontamiento (CSI) en la versin espaola de Cano, Rodrguez y
Garca (2007), la Escala de depresin del centro de estudios epidemiolgicos (CES-D) y el
cuestionario sociodemogrfico y datos clnicos. La muestra se obtuvo a partir de muestreo por
conveniencia, se utiliz un anlisis de compontes principales, un anlisis de regresin mltiple
un anlisis de correlacin entre las variables de estudio y una prueba de Chi- cuadrado.

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Resultados En cuanto a las variables de estudio se encontr que la mayor parte de la muestra
se encuentra en el nivel alto y muy alto de depresin. Las estrategias de afrontamiento ms
utilizadas por las mujeres de la muestra fueron: autocritica, evitacin y pensamiento
desiderativo. Se encontr una relacin inversa altamente significativa entre la variable
depresin y las estrategias: resolucin de problemas y apoyo social, representada en
coeficientes de -.488 y -.372 respectivamente y una relacin directa altamente significativa
entre depresin y las estrategias autocritica, evitacin y retirada social con coeficientes de .443,
.300, .452, respectivamente. En cuanto a las variables sociodemogrficas y clnicas se
encontr que la edad gestacional present una relacin directa con la variable depresin y que
la actividad laboral se relacion significativamente con la estrategia apoyo social. Conclusiones
La depresin durante el embarazo de riesgo presenta niveles altos y muy altos, lo que indica
que en la muestra existe sintomatologa depresiva. La presencia de sntomas de depresin
durante el embarazo de riesgo tiene una relacin directa con las estrategias de afrontamiento
autocritica, evitacin, retirada social y pensamiento desiderativo. La presencia de sntomas de
depresin durante el embarazo de riesgo tiene una relacin inversa con las estrategias de
afrontamiento resolucin de problemas y apoyo social. Los niveles de depresin de la gestante
de riesgo varan en funcin del periodo de gestacin. Bibliografa Cano, J., Rodrguez, L. &
Garca, J. (2007). Adaptacin espaola del Inventario de Estrategias de Afrontamiento. Actas
EspPsiquiatr, 35 (1), 29 -39 Davinson, G. (2005). Psicologa de la conducta anormal. Mxico:
Ediciones Limusa. Gomez, M. (2007).Guia de intervencin para pacientes con embarazo de
alto riesgo. Perinatolreprudhum, 21,111-12. Instituto Departamental de Salud de Nario (2007).
Manual de atencin de salud sexual y reproductiva para el departamento de Nario. Colombia:
IDSN. Tobon, S., Vinacia, S. &Sandin, B. (2003). Modelo procesual del estrs en la dispepsia
functional: Implicaciones para la evaluacin y el tratamiento. Revista de Psicopatologa y
psicologa Clnica, 9, 81-98.
Estresse em Professor do Ensino Superior
Camila Pinto1, Janana Barletta2.
1. Instituto Minerva de Educao IMEA, Aracaju, Brazil, 2. Universidade Federal de Sergipe
UFS, Aracaju, Brazil.
Pesquisas tm evidenciado que o estresse uma das doenas que mais aparecem nos
estudos sobre a sade do professor de ensino universitrio. Alm da sade, a presso do dia a
dia tem refletido em outros aspectos como na qualidade de ensino. No Brasil, diversos fatores
podem estar influenciando como a carga horria intensa, a demanda de trabalho excessiva, a
grande quantidade de alunos em sala de aula, a baixa remunerao e a falta de incentivo
docncia pelas instituies superiores. Dessa forma, compreender a dinmica de trabalho dos
professores permite a possibilidade de buscar alternativas para diminuir o estresse ocupacional
e suas consequncias nesse contexto. O objetivo deste trabalho exploratrio foi identificar a
presena de sintomas de estresse em professores de uma universidade privada no estado de
Sergipe e descrever o ambiente de trabalho. Participaram do estudo, voluntariamente, 10
professores que lecionavam no curso de Servio Social presencial na capital, mas que tambm
tinham que viajar para lecionar nos campi localizados nas cidades do interior do estado. Aps a
assinatura do Termo de Consentimento Livre e Esclarecido, foram aplicados dois instrumentos
de maneira individual: um questionrio desenvolvido para este estudo, contendo questes
sobre idade, nvel de formao e caractersticas do trabalho, e o Inventrio de Sintomas de
Stress para Adultos (LIPP, 2004). Todos os participantes eram do sexo feminino com idade
mdia de 39,6 anos (28-52 anos), sendo que trs eram solteiras, duas divorciadas e cinco
casadas. A maior parte (6) tinha mais de 10 anos de experincia em docncia universitria e
uma carga horria mdia em sala de aula de 27 horas semanais (20h-38h; DP=5,87). Duas

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professoras eram doutoras, cinco mestres e trs especialistas, sendo nove contratadas como
horistas e uma em tempo integral. Alm das atividades em sala de aula, sete professoras
orientavam trabalhos de concluso de curso, uma exercia funo administrativa e trs tinham
outras atividades empregatcias fora da universidade. O menor tempo de deslocamento da
capital para as cidades do interior era de uma hora e o maior de duas horas. Sobre o nvel de
estresse, apenas uma professora no apresentou alterao. Uma delas estava na fase de
alerta (17%) e oitos estavam na fase de resistncia (33% - 42%). Outro dado relevante foi a
predominncia dos sintomas psicolgicos (70% dos sintomas), sendo que os principais foram
irritabilidade e sensibilidade emotiva excessivas, pensamento fixo em um nico assunto e
diminuio da libido. Acredita-se que a incorporao de um programa de manejo de estresse
poderia favorecer esse quadro, aumentando estratgias de enfrentamento do professor,
melhora da sade psquica do profissional e, consequentemente, maior motivao do professor
ao trabalho docente.
Efectos de una Intervencin Cognitivoconductual Sobre la Adhesin Teraputica y
Regulacin Emocional en Pacientes con Enfermedades Gastrointestinales
Ivonne Prez Snchez, Nancy Caballero Surez.
UNAM, Mxico, Mexico.
Abstract Central: Las enfermedades gastrointestinales tienen alta prevalencia e implican un
alto costo econmico,social y personal, Se sabe que las emociones negativas desencadenan o
exacerban los sntomas. Las Enfermedades gastrointestinales son se caracterizan por su
cronicidad pueden tener consecuencias graves por la erosin progresiva de la mucosa
intestinal; si no se tratan adecuadamente, lo ms frecuente es que ocurran hemorragias
internas o la perforacin de alguna parte del intestino o del estmago, lo que puede llevar a la
muerte. Tales padecimientos representan, adems, un factor de riesgo para el desarrollo de
tumores malignos. Los pacientes con enfermedades gastrointestinales muestran escasa
adhesin al tratamiento mdico, y a pesar de los resultados favorables de las intervenciones
psicolgicas para coadyuvar el tratamiento mdico de estos problemas, los avances
farmacolgicos han hecho de lado tales intervenciones; sin embargo, la respuesta al
tratamiento mdico es incompleta porque se excluyen variables conductuales y emocionales
Que influyen en dichas enfermedades. Respecto a las intervenciones psicolgicas probadas
con estos padecimientos, a pesar de los resultados favorables informados en cuanto a la
reduccin de la sintomatologa, la mayora de los estudios no son recientes y han descuidado
las variables de adhesin a la toma de medicamentos y la modificacin de estilos de vida tales
como un rgimen alimenticio inadecuado, el sedentarismo y las conductas de riesgo (fumar y
beber alcohol y caf), que representan elementos importantes para el tratamiento integral de
los trastornos gastrointestinales y que ayudaran a reducir an ms o ms rpidamente la
frecuencia, duracin e intensidad de los sntomas. Por ende, el objetivo de este estudio fue
evaluar el efecto de una intervencin cognitivo-conductual sobre la adhesin teraputica y la
regulacin emocional de pacientes con enfermedades gastrointestinales. Participaron tres
mujeres, una con gastritis, otra con reflujo gastroesofgico y una con ambos padecimientos. Se
utiliz un diseo de sujeto nico para estudio de casos. Se emple un autorregistro conductual
para recolectar datos de adhesin, frecuencia e intensidad de emociones y sntomas, adems
del Inventario de Ansiedad de Beck y el Inventario Estado-Rasgo de la Expresin del Enojo. Se
obtuvieron adems indicadores fisiolgicos durante sesiones que incluyeron protocolos de
relajacin. Las pacientes mostraron cambios favorables en las conductas de adhesin y
regulacin emocional, lo que se tradujo en la disminucin de sus sntomas.

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Adaptacin, Aplicacin y Evaluacin de la Eficacia de Un Programa para la Prevencin


de ITS/VIH en Mujeres Adolescentes (DIVINE IV): Desigualdad de Gnero y Abuso de
Poder
Maria Teresa Ramiro1, Nickia D. Braxton2, Deja L. Er2, Aaron T. Vissman2, Gualberto BuelaCasal1, Mari Paz Bermdez1, Ralph J. DiClemente2.
1. Universidad de Granada, Granada, Spain, 2. Emory University, Atlanta, Georgia.
Los adolescentes y las mujeres se encuentran en mayor situacin de riesgo de enfermedades
de transmisin sexual ITS/VIH (ONUSIDA, 2007; UNESCO, 2010). Cabe pensar en la
existencia de una serie de factores relacionados con el gnero y el aumento en la
vulnerabilidad frente a la infeccin por el VIH y otras ITS (Falde, Lameiras y Bimbela, 2008).
En lo referente a diversos constructos psicolgicos, cabe subrayar la influencia entre otros, de
la Asertividad Sexual (Santos-Iglesias y Sierra, 2010), la Ideologa de Gnero (Santana, Raj,
Decker, La Marche y Silverman, 2006) y el Reparto del Poder dentro de las Relaciones de
Pareja (Amaro, 2005), sobre las conductas sexuales de riesgo. Por ello, el objetivo de este
estudio es la aplicacin y evaluacin de eficacia de una serie de estrategias preventivas para el
riesgo de ITS/VIH, basadas en la Teora de gnero y poder, concretamente relacionadas la
desigualdad de gnero y el abuso de poder. Segn la Teora de Genero y poder, aplicada a la
reduccin de la conducta de riesgo para ITS/VIH, la desigualdad de gnero influye en la
capacidad de la mujer para negociar y poner en prctica las estrategias de reduccin de riesgo
de VIH con sus parejas sexuales masculinas. De acuerdo con esta adaptacin de la teora, las
mujeres adolescentes pueden tener dificultades para llevar a cabo prcticas sexuales seguras
cuando existen desigualdades de gnero en el reparto de poder, que otorgan a los hombres
mayor control sobre la relacin y la toma de decisiones. Asi, se llev a cabo la adaptacin
(Braxton, Bermdez, Er, Ramiro y DiClemente, 2009) de una serie de estrategias incluidas en
un programa de intervencin de probada eficacia en los Estados Unidos (DiClemente, et al.,
2004) a travs del modelo ADAPT-ITT (Wingood y DiClemente, 2008). Dichas estrategias,
estn destinadas a mejorar las habilidades de las mujeres para distinguir las relaciones
saludables de las no saludables, reconociendo la diferencia entre el abuso de poder y el
respeto, e incrementar las habilidades de las mujeres para hacer frente a una pareja agresiva,
evitando el riesgo. La muestra estuvo formada por 190 mujeres espaolas de edades
comprendidas entre los 15 y 18 aos, que fueron aleatorizadas al grupo experimental, formado
por 112 mujeres (M=15,59; DT= 0,82), y al grupo control, formado por 88 mujeres (M=15,90;
DT =1,08). La aplicacin de las estrategias preventivas se realiz sobre las mujeres
pertenecientes al grupo experimental, que se dividieron en 12 grupos, en un taller de 4 horas
de duracin. Por el contrario las mujeres pertenecientes al grupo control recibieron un dossier
informativo con prcticas y hbitos saludables. Para determinar la eficacia de las estrategias
preventivas, se realiz una evaluacin en diferentes momentos; pre-intervencin, postintervencin, y seguimiento a los 3 y 6 meses. La evaluacin se realiz tanto al grupo control,
como al grupo experimental, y estaba formada por los siguientes cuestionarios: (1) Miedo a la
negociacin sobre el uso de preservativo (Wingood y DiClemente, 1998); (2) Autoeficacia para
rechazar mantener sexo (Zimmerman, 2000); y (3) Evitacin de riesgo (Wingood y DiClemente,
1998). Posteriormente, se realizaron los anlisis estadsticos pertinentes, y se exponen los
resultados estadsticamente significativos.
Adaptacin, Aplicacin y Evaluacin de la Eficacia de Un Programa para la Prevencin
de ITS/VIH en Mujeres Adolescentes (DIVINE III): Habilidades Sociales y Comunicacin
Asertiva
Maria Teresa Ramiro1, Deja L. Er2, Nickia D. Braxton2, Aaron T. Vissman2, Gualberto BuelaCasal1, Mari Paz Bermdez1, Ralph J. DiClemente2.

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1. Universidad de Granada, Granada, Spain, 2. Emory University, Atlanta, Georgia.


La tasa de nuevos casos de infeccin por VIH ocasionados por relaciones sexuales han
aumentado en Espaa (rea de Vigilancia de VIH y Conductas de Riesgo, 2011; European
Centre for Disease Prevention and Control, 2010). Algunos informes relacionan el aumento en
la tasa de nuevos casos de VIH y otras Infecciones de Transmisin Sexual -ITS- (Centro
Nacional de Epidemiologa, 2011) con un incremento en las prcticas sexuales de riesgo (rea
de Vigilancia de VIH y Conductas de Riesgo, 2011; ONUSIDA, 2011). Cabe destacar que
durante la adolescencia tienen lugar las primeras relaciones sexuales existiendo una mayor
probabilidad de implicarse en conductas de riesgo para la salud en esta etapa (Dick et al.,
2006), entre ellas, las de ndole sexual. Por ello, el objetivo de este estudio es la aplicacin y
evaluacin de eficacia de una serie de estrategias preventivas para el riesgo de ETS/VIH,
basadas en la Teora cognitiva social, concretamente relacionadas con las habilidades sociales
y la comunicacin asertiva. Segn la teora cognitiva social, uno de los principales aspectos
sobre los que hay que trabajar para la modificacin de conducta son las habilidades sociales,
as como fomentar la creencia de que dichas habilidades pueden ser ejecutadas (autoeficacia).
Para ello se llev a cabo la adaptacin (Braxton, Bermdez, Er, Ramiro y DiClemente, 2009) de
una serie de estrategias incluidas en un programa de intervencin de probada eficacia en los
Estados Unidos (DiClemente, et al., 2004) a travs del modelo ADAPT-ITT (Wingood y
DiClemente, 2008). Dichas estrategias, pretenden promover la prctica de las habilidades de
comunicacin asertiva y segura para fomentar la confianza de los participantes en su
capacidad para negociar y poner en prctica la reduccin de riesgos en situaciones de ndole
sexual, de la vida real. La muestra estuvo formada por 190 mujeres espaolas de edades
comprendidas entre los 15 y 18 aos, que fueron aleatorizadas al grupo experimental, formado
por 112 mujeres (M=15,59; DT= 0,82), y al grupo control, formado por 88 mujeres (M=15,90;
DT =1,08). La aplicacin de las estrategias preventivas se realiz sobre las mujeres
pertenecientes al grupo experimental, que se dividieron en 12 grupos, en un taller de 4 horas
de duracin. Por el contrario las mujeres pertenecientes al grupo control recibieron un dossier
informativo con prcticas y hbitos saludables. Para determinar la eficacia de las estrategias
preventivas, se realiz una evaluacin en diferentes momentos; pre-intervencin, postintervencin, y seguimiento a los 3 y 6 meses. La evaluacin se realiz tanto al grupo control,
como al grupo experimental, y estaba formada por los siguientes cuestionarios: (1) Frecuencia
de comunicacin parental sobre sexo, sida/ITS y embarazo (Wingood y DiClemente, 1998); (2)
Frecuencia y autoeficacia en la comunicacin con pareja estable y ocasional (Wingood y
DiClemente, 1998); y, (3) Frecuencia de comunicacin con parejas sexuales en los ltimos 6
meses (Wingood y DiClemente, 1998). Posteriormente, se realizaron los anlisis estadsticos
pertinentes, y se exponen los resultados estadsticamente significativos.
Protocolo Vencendo o Pnico e o Tratamento do Transtorno de Pnico e da Agorafobia
Bernard Range.
Programa de Pos-Graduacao em Psicologia, Universidade Federal do Rio de Janeiro, Rio de
Janeiro, Brazil.
Abstract Central: Desde 1997 vem sendo desenvolvidas pesquisas sobre tratamentos
cognitivo-comportamentais, inicialmente individuais e depois em grupo, para o transtorno de
pnico e da agorafobia, na Diviso de Psicologia Aplicada do Instituto de Psicologia da UFRJ.
Os resultados exitosos tm sido atribudos a quatro grandes momentos da interveno: (1)
psicoeducao; (2) aquisio e fortalecimento de estratgias de manejo da ansiedade; (3)
mudana de crenas irracionais e (4) e a aliana teraputica que se constri nos grupos
teraputicos. A psicoeducao, que contem informaes sobre a fisiologia e a psicologia do

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medo e da ansiedade, permite que os pacientes possam compreender o processo do que se


passa com eles de forma diferente, isto , entender que as sensaes que sentem no so
perigosas, a curto prazo, apesar de serem muito desagradveis. Isto permite que seja
introduzida a segunda fase do tratamento incluindo estratgia A.C.A.L.M.E-S.E., que se
caracteriza por uma postura de aceitao das sensaes, oposta ao movimento inicial dos
pacientes com transtorno de pnico que o de rejeitar as sensaes pela convico delas
serem sinais de perigo iminente. Outro passo o do treino respiratrio, em que os clientes so
solicitados a respirarem de forma ofegante por um minuto, produzindo as sensaes similares
s que ocorrem quanto tm ataques de pnico, seguidas por uma respirao diafragmtica.
Alm disso, a reestruturao cognitiva permite uma reflexo das interpretaes distorcidas.
Estes trs passos fazem os pacientes recuperarem um senso de autoeficcia. Exerccios
voltados para uma habituao interoceptiva so tambm fundamentais para a reduo da
oposio s sensaes. Numa terceira fase, como estratgia de preveno de recadas, so
iniciados os questionamentos a crenas disfuncionais relacionadas aprovao de outros, ao
perfeccionismo e intolerncia a sensaes corporais enquanto so iniciadas as exposies
graduais, progressivas e de longa durao para os pacientes agorafbicos. Como os resultados
vieram sendo consistentes, este protocolo tambm foi utilizado em treinamentos distncia de
terapeutas de diversas regies do Brasil, havendo replicaes em outros servios clnicos do
Brasil.
Elaboracin de una Gua de Solucin de Problemas para Cuidadores de Pacientes con
Cncer
Nancy Rangel - Domnguez.
1. Universidad Nacional Autnoma de Mxico, Distrito Federal, Mexico, 2. Instituto Nacional de
Cancerologa, Distrito Federal, Mexico.
Abstract Central: El cncer y sus tratamientos modifican gravemente las vidas de las
personas que lo padecen as como la de sus familias, en particular la del cuidador primario
quien experimenta una serie de situaciones problemticas en diversas reas: familiar, social,
laboral, salud fsica y psicolgica. Esto hace necesario el diseo e implementacin de
intervenciones que permitan que los cuidadores desarrollen habilidades de afrontamiento activo
tal como la solucin de problemas. Sin embargo por mltiples situaciones propias del rol de
cuidador esta poblacin tiene poco acceso a programas psicosociales, es por ello que se
requiere de materiales que puedan consultar en diferentes momentos, de fcil manejo y que
reflejen los problemas que experimentan al cuidar de un familiar enfermo, al tiempo que modela
estilos de afrontamiento positivos. Atendiendo a esta necesidad se dise una gua de solucin
de problemas. Inicialmente se entrevist a un grupo de cuidadores para conocer los principales
problemas que enfrentan, posteriormente con la informacin recabada se escribi una serie de
historias que fueron sometidas a una evaluacin por parte de un grupo de expertos en la
atencin de pacientes con cncer y sus familias (mdicos, psiclogos, trabajadores sociales y
enfermeras) a quienes se pidi que calificaran el porcentaje en qu las historias reflejaban las
situaciones cotidianas de los cuidadores. El mismo ejercicio se realiz con un grupo de
cuidadoras primarias. Las historias con un mayor porcentaje de cercana con la realidad fueron
elegidas para realizar un ejercicio basado en la Terapia de Solucin de problemas respecto a
las problemticas presentadas. Las historias y las posibles soluciones propuestas fueron
presentadas a un grupo de psiclogos cognitivo-conductuales y se les pidi que calificaran el
porcentaje en que las historias se acercaban a un proceso teraputico habitual basado en la
solucin de problemas. Posteriormente se entregaron las historias y sus posibles soluciones a
un grupo de cuidadoras para que evaluaran el lenguaje empleado e hicieran observaciones
respecto a la presentacin de las problemticas. La versin final de la gua presenta la

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siguiente estructura: 1. Exposicin de la relacin existente entre el bienestar emocional y las


habilidades de solucin de problemas 2. Conceptos bsicos de la solucin de problemas 3.
Descripcin general de la tcnica de solucin de problemas 4. Ejercicios de solucin de
problemas I. Incluye las historias con ejercicios ya resueltos: "Los problemas de Mari" y "Los
problemas de Vctor" 5. Ejercicios de solucin de problemas II. Incluye las historias con
ejercicios para resolver: " Los problemas de Mara Elena" y "Los problemas de Miguel"
Actualmente se realiza la ltima fase del proyecto en la que se tiene por objetivo evaluar el
impacto del material de apoyo sobre variables psicolgicas como sintomatologa ansiosa y
depresiva, sensacin de control y sobrecarga del cuidador primario.
Do Patients Generalize Their Exposure Experiences to Situations Outside the Context of
Therapy? An Experimental Study with Chronic Pain Patients in a Context of an RCT
Jenny Riecke, Sebastian Holzapfel, Winfried Rief, Julia Glombiewski.
Department for Clinical Psychology and Psychotherapy, University of Marburg, Marburg,
Germany.
Exposure is known as one of the most effective interventions in cognitive behavioral therapy
essentially for anxiety disorders and phobias. Several studies have also evaluated the
effectiveness of in vivo exposure in chronic low back pain (CLBP) (Bailey et al., 2011). Yet, little
is known about the long-term maintenance and generalization of the effects of exposure. To
date, there are three experimental studies that addressed this question (Crombez et al., 2002;
Goubert et al., 2002; Trost et al., 2008). Only one of them showed successful generalization,
while the others concluded that participants learned more an exception than a rule. The present
study is the first to perform a test of generalization in a clinical setting including a sample that
actually underwent an exposure treatment for CLBP. Purpose. The current study investigated
generalization of pain and harm expectancies of movements in CLBP after completion of
exposure in vivo (EXP) or a cognitive behavioral pain treatment (CBT-P). We investigated
whether there are group differences in 1) ratings of perceived harm, 2) overpredictions of pain
and harm, 3) correction of these overpredictions when the same movement is repeated, 4) the
generalization of the correction of overprediction to another dissimilar movement. Method. 30
CLBP patients participated in a performance test after completion of a psychological pain
treatment (EXP or CBT-P). Participants rated the shortened version of the Photo Series of Daily
Activities (PHODA) measuring perceived harmfulness of physical activities (Leeuw et al., 2008).
The performance test consisted of two back stressing movements (rated as substantially
harmful) selected from a PHODA-Rating before the beginning of treatment. The patient was
requested to perform each movement twice resulting in four performances. Before and after
performing the movements, patients gave pain and harm ratings (expected vs. experienced) on
an 11-point numerical rating scale. Results. A 2 (time: Phoda_pre treatment vs. Phoda_post
treatment) X 2 (group: EXP vs. CBT-P) analysis of variance was performed on perceived harm
reports. There was a significant main effect of time showing lower harm ratings after treatment
F(1,28) =16.33, p=0.01, 2=.77. We also found a significant group X time interaction effect with
a higher decrease of perceived harm reports for the EXP group in comparison to the CBT-P
group F(1,28)=8.61, p=0.03, 2=.76. This indicates possible effects of generalization in the EXP
group. Further, participants of the EXP group showed no overprediction of pain (t=1.35, p=0.23)
or harm (t=1.58, p=.17), in fact, they accurately predicted pain and harm. In contrast,
participants of the CBT-P group expected more pain and harm than they actually experienced.
These results can be interpreted in terms of successful generalization. Conclusions. CLBP
participants undergoing exposure treatment showed successful generalization in comparison to
participants of a more general psychological pain treatment. Patients were able to transfer their
exposure experiences to a completely new situation outside the context of therapy. This

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supports the idea that exposure treatment in general offers more than learning an exception to a
rule.
Comunicao de ms noticias na formao mdica: o Roll play na propedutica mdica
Carlos Ritter.
Medicina, Universidade de Caxias do Sul, Caxias do Sul, Brazil.
A maioria dos cursos de Medicina tem valorizado aspectos humanistas da formao mdica. O
desenvolvimento humano dos futuros mdicos pode ser abordado na disciplina de
Propedutica Mdica utilizando a tcnica de Role Play no treinamento da relao mdico
paciente especialmente no que se refere a Comunicao de ms noticias, raramente abordado
nos cursos. Atravs do Protocolo Spyke e tcnicas cognitivo-comportamentais possvel
monitorar e desenvolver processos empticos do aluno e possibilitar a integrao com equipe
multidisciplinar e reconhecimento de vulnerabilidades que podero ser abordados pelo corpo
docente durante o curso.
El Papel del Bienestar de los Profesores en la Interaccin y Percepcin de los
Estudiantes en el Aula. El Caso de las Profesiones de Ocupacin Temprana
Angelica Riveros, Rosa Barona Pea, Karina Leon.
National University of Mexico, Mexico D.F., Mexico.
Abstract Central: En el caso de las profesiones econmico-administrativas, es frecuente que
el desarrollo profesional represente una forma de movilidad social real hacia la mejora de las
condiciones de la familia de origen. Hay en los estudiantes una expectativa de rpida insercin
laboral, que en muchos casos, se deriva de una situacin social que lo requiere. Estas
condiciones favorecen el desarrollo y mantenimiento de creencias de responsabilidad, auto
exigencia y previsin de amenazas y dao que, al depender de las condiciones de crianza y
experiencias profesionales, pueden adoptar patrones generacionales cambiantes y rgidos,
sobre la visin o percepcin de cualidades y los criterios de xito o fracaso profesional. Las
carreras como contadura y administracin suelen ser preferidas por personas con una alta
necesidad de control, orden y estructura por lo que se han identificado problemticas
relacionadas con rigidez por creencias en responsabilidad exacerbada, rasgos del trastorno
obsesivo compulsivo y sus consecuencias en bienestar. Los profesores que son poco
apreciados por sus alumnos tienden a notar comportamientos que pasaran desapercibidos por
otros profesores, a interpretarlos con mayor facilidad como agresiones hacia ellos y a explicar
la necesidad de dureza y rigidez como una conviccin importante y necesaria para la formacin
de los alumnos. Las reacciones de desagrado y castigo de los profesores se explican por
caractersticas personales de los alumnos que frecuentemente se acompaan de estigmas
como flojos, groseros e irresponsables. Bajo estas condiciones se favorecen problemticas de
interaccin al interior del aula que pueden ayudar a comprender el proceso del cinismo
paulatino caracterstico del agotamiento laboral en docentes. En contraparte, se ha identificado
que bajo estas condiciones la capacidad de recuperacin explica las diferencias en bienestar e
interaccin con los alumnos que caracteriza a los profesores que son preferidos por sus
alumnos. El propsito del presente trabajo es identificar las variables que fungen como factores
protectores y vulnerantes del funcionamiento y bienestar del docente. Participaron 125
profesores de materias relativas a contadura y administracin a quienes se les aplic un
instrumento sobre funcionamiento grupal sobre los alumnos con quienes trabajaron al final del
semestre diseada ex profeso para el estudio. Se aplic el instrumento de creencias en
responsabilidad de Salkovskis, Shafran, Rachman & Freeston (1999). La escala de

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Recuperacin personal (Wagnild, 2009), la escala de Eficacia interpersonal del profesor de


Brower y Tomics (2001) y la escala de estrs percibido de Cohen y Kamarck y Mermelstein
(1983). Los resultados arrojaron que no hubo diferencias por turno o materia, sin embargo el
anlisis de funcin discriminante por el funcionamiento grupal alto, medio y bajo mostr que las
diferencias ms importantes recayeron en la capacidad de autorregulacin, rigidez de reglas en
la infancia y responsabilidad excesiva. Los resultados se discuten en funcin de las
implicaciones en bienestar de los profesores y las relaciones que establecen con los
estudiantes.
Psicoterapia de Previsin Reproductiva: Una Psicoterapia Socialmente Responsable en
el Per
Ysis Roa.
Instituto de Investigacin, Universidad de San Martin de Porres, Lima, Peru.
Abstract Central: Concebir la psicoterapia como una relacin interpersonal y voluntaria entre
terapeuta y paciente cuyo objetivo es la aplicacin de tcnicas o principios para tratar
problemas psquicos y comportamentales es, pese a la diversidad de definiciones, la forma ms
comnmente aceptada por la mayor parte de profesionales en el campo de la salud mental. Sin
embargo, la definicin que maneja la APA (2012) es ms amplia dado que seala que
psicoterapia es: Cualquiera de un grupo de terapias, que se utiliza para el tratamiento de
trastornos psicolgicos, que se centran en la modificacin de comportamientos errneos,
pensamientos, percepciones y emociones que pueden estar asociados con trastornos
especficos. Con lo cual nos deja 2 opciones, podramos utilizar a la psicoterapia en su funcin
de rehabilitacin, dado que seala que se utiliza para el tratamiento de trastornos psicolgicos
y podramos utilizarla en su funcin de prevencin dado que seala que la psicoterapia se
centra en la modificacin de comportamientos errneos, pensamientos, percepciones y
emociones que pueden estar asociados con trastornos especficos, con lo cual nos deja claro
que podemos utilizarla sin mediar trastorno alguno especfico. Los comportamientos sexuales
de riesgo son los causantes de una amplia gama de problemas de salud pblica en el Per
tales como el SIDA y las infecciones de transmisin sexual, pero son los causantes tambin de
una de las enfermedades crnicas ms importantes y cuya tendencia creciente es una realidad
no solo en pases desarrollados, sino tambin en pases en vas de desarrollo como el Per,
me refiero a la infertilidad. La infertilidad es una enfermedad cuyas repercusiones negativas a
corto, mediano o largo plazo en la salud mental de los individuos es evidenciada por
numerosos estudios, a pesar de ello los estudios sealan que los jvenes no asocian los
comportamientos sexuales de riesgo y la infertilidad. Por tanto desde un enfoque preventivo, el
objetivo del presente trabajo es proponer la fundamentacin de una psicoterapia denominada
de previsin reproductiva que busca la modificacin de comportamientos errneos,
pensamientos, percepciones y emociones asociadas con el cuidado de la salud sexual y
reproductiva de los jvenes y contribuir as con la sociedad a travs de la atenuacin de
problemas de salud pblica en el Per.
Efecto de Tcnicas de Autocontrol y Solucin de Problemas en la Alteracin de la
Importancia Atribuida a Factores Disposicionales en la Adherencia a la Dieta en Adultos
con Diabetes Mellitus Tipo II
Ma. de Lourdes Rodrguez-Campuzano, Antonia Rentera-Rodrguez, Karla Soto-Aguirre,
Carlos Nava-Quiroz.
Universidad Nacional Autnoma de Mxico, Mxico, Mexico.

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La diabetes mellitus tipo II est cobrando cada vez ms vidas en el mundo. La psicologa ha
estudiado diversas variables relacionadas con ella, una de ellas es la adherencia a la dieta que
resulta central para su tratamiento. Con base en el Modelo Psicolgico de la Salud Biolgica
(Ribes, 1990) se dise un taller para mejorar la adherencia a la dieta en pacientes diabticos.
El trabajo que aqu se presenta forma parte de una lnea de investigacin y tuvo como objetivo
evaluar el efecto de las tcnicas de autocontrol y solucin de problemas para alterar la
importancia atribuida a diversos factores disposicionales situacionales que interfieren con el
rompimiento de la dieta (circunstancia social, lugares, objetos, inclinaciones, propensiones,
tendencias). El estudio fue pre-test post-test y cont con una muestra intencional voluntaria de
42 participantes diabticos captados de centros de salud del Distrito Federal y rea
metropolitana. En la primera fase se aplic un instrumento expresamente desarrollado para
evaluar la importancia atribuida a diversos factores disposicionales, despus, en la modalidad
de club de diabetes, se entrenaron habilidades de autocontrol y solucin de problemas para
que los pacientes lograran modificar el papel disposicional de algunas variables del contexto de
su conducta de comer. En el post-test se volvi a aplicar el instrumento. El programa se aplic
durante 12 sesiones semanales de dos horas cada una. Se encontr una diferencia
estadsticamente significativa entre las medidas pre y post que sugieren que las tcnicas son
efectivas para la alteracin de factores contextuales que dificultan la adherencia.
Influencia del Tipo de Diabetes, Estrategias de Afrontamiento, Sexo, Optimismo y
Pesimismo Sobre el Apoyo Social
Jose Rondon1, Zoraide Lugli2.
1. Instituto de Psicologa, universidad Central de Venezuela, Caracas, Venezuela, 2.
Universidad Simn Bolvar, Caracas, Venezuela.
Abstract Central: La presente investigacin tiene como finalidad conocer el efecto del tipo de
diabetes, las estrategias de afrontamiento, el sexo, el optimismo y el pesimismo sobre las redes
sociales y el apoyo social percibido por los sujetos con diabetes y cmo se relacionan entre s
estas variables; ya que autores como Castro y cols. (1997) plantean la necesidad de estudiar
qu variables determinan el apoyo social recibido por una persona, y Trento et al. (2007)
afirman que el tipo de diabetes incide de forma diferencial en el comportamiento del sujeto.
Para tal fin se validaron y aplicaron los Cuestionario MOS de Apoyo Social de Sherbourner y
Stewart (1991) para medir apoyo social percibido; la Escala de Social Network and Support de
Unden & Orth-Gomer (1989) adaptada por Feldman (2002) para medir redes sociales y The
Life Orientation Test (LOT-R) de Scheier, y Carver (1994) adaptado por Otero y cols. (1998)
para medir optimismo y pesimismo. Tambin se aplic el cuestionario de Estrategias de
Afrontamiento de Rodrguez-Marn y cols (1992) adaptado por Zaragoza (2006). Se emplearon
300 diabticos (81 tipo I y 219 tipo II) entre hombres y mujeres con edades comprendidas entre
17 y 70 aos de edad que asistan a los diferentes centros de salud de la ciudad de Caracas,
en un diseo transeccional-causal de campo. Para analizar los resultados se emplearon
estadsticos descriptivos y un anlisis de ruta para verificar las relaciones planteadas. Derivado
de los hallazgos encontrados se establece que el tipo de diabetes per se no afecta el apoyo
social que tenga una persona con esta condicin de vida. Tampoco la variable sexo influir
directamente sobre el apoyo social, pero si a travs de relaciones mediadas por el optimismo y
las estrategias de afrontamiento tanto de evitacin como de aproximacin al problema;
destacando que son las estrategias de afrontamiento lo que en ltima instancia determinar el
apoyo social de los sujetos con diabetes, por lo que se recomienda construir y aplicar
programas de intervencin clnica para ensear a la persona con diabetes a afrontar su
enfermedad mediante estrategias de aproximacin al problema

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Investigacin de las Particularidades de Atencin Psicolgica en Jvenes Mexicanos de


Educacin Media Superior con Ideacin Suicida
Jose Rosales, Martha Crdova.
Psicologa, Facultad de Estudios Superiores Izcala,Universidad Nacional Autnoma de Mxico,
Cuautitlan Izcalli, Mexico.
En Mxico, de acuerdo con los datos del INEGI (2008), el porcentaje de muertes por suicidio
con respecto a muertes violentas, increment de un promedio de 4.4 % durante el quinquenio
de 1990 a 1994, a un promedio del 11 % durante el quinquenio de 2002 al 2006. Donde el
incremento ms alto se observ en las edades entre los 15 y los 19 aos. Por lo que el
reconocimiento de las particularidades de atencin psicolgica de este grupo de jvenes, es
relevante para el diseo de programas de prevencin del suicidio. Materiales: Instrumento para
la Deteccin de Ideacin Suicida en jvenes del proyecto de Evaluacin de Ideacin Suicida en
jvenes de la FES Iztacala. Integrado por: escala de Ideacin Suicida Roberts-CES-D; escala
de Actitudes disfuncionales (DAS-A) de Weissman y Beck, (1978) ; escala de Desesperanza de
Beck, Weissman, Lester y Trexler (1974); escala de Locus de Control, adaptada y validada
para adolescentes mexicanos por Gonzlez-Forteza (1992); escala Multidimensional de Apoyo
Social Percibido (Zimet, Dahlem y Farley, 1988); y escala de Trastornos Emocionales de
Berwick et al. (1991). Objetivo: Delimitar los requerimientos de atencin psicolgica de jvenes
de Educacin Media Superior, identificados con manifestacin de ideacin suicida. Mtodo: 1.
Seleccin de una muestra no aleatoria de 2050 jvenes estudiantes de 10 escuelas
preparatorias del Estado de Mxico. 2. Segmentacin de la muestra en dos grupos: grupo con
ideacin suicida y grupo sin ideacin suicida. Con criterio de una puntacin a 2 DE arriba de
la media con la escala de Roberts-CES-D, para la localizacin de presencia de ideacin
suicida. 3. Reconocimiento de la condicin descriptiva de la presencia de ideacin suicida, con
base en un anlisis de regresin logstica binaria. 4. Ubicacin de las particularidades de
atencin psicolgica de los jvenes con ideacin suicida. Resultados: Porcentaje de jvenes
con ideacin suicida del 6.7 % en mujeres, y del 4.6 % en hombres. En mujeres se asoci
trastorno emocional, desesperanza, percepcin de ausencia de apoyo familiar y antecedente
de intento suicida. Y en hombres, trastorno emocional, desesperanza y antecedente de intento
suicida. Conclusiones: Las particularidades de atencin psicolgica reconocidas en los jvenes
con ideacin suicida, de ambos gneros, fueron: 1. Riesgo suicida, derivado del grado de
planeacin suicida y su vinculacin con el grado de desesperanza y malestar emocional. 2.
Vulnerabilidad ante las condiciones estresantes, derivada de la cronicidad del comportamiento
suicida. 3. Distorsin cognitiva del futuro y pensamientos asociados a la generacin,
mantenimiento e incremento de emociones negativas. Con delimitacin de dos escenarios
probables; jvenes con necesidad de atencin para restringir una crisis suicida. Y jvenes con
requerimiento de atencin para enfrentar la baja tolerancia a la frustracin, la forma negativa de
percibir el futuro y las cogniciones que inciden en la manifestacin e incremento de emociones
negativas.
Descriptive Study: Burnout in Workers of Oncology Units
Graciela Rozas Caamao1, Fernando Urra Silva2, 3.
1. Universidad Santo Tomas, Santiago de Chile, Chile, 2. Universidad Central de Chile,
Santiago de Chile, Chile, 3. Universidad de los Andes, Santiago de Chile, Chile.
Abstract Central: This present investigation has been planned as a descriptive study that
allows us to identify and describe protective factors that favor absence of Burnout in workers of
Oncology units of Dr. Exequiel Gonzlez Corts Hospital and Dr. Stero del Rio. The
methodology combined was used to contemplate a quantitative and a qualitative phase. In the

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quantitative phase was applied a questionnaire of attitude towards work that evaluate that
evaluates Burnout syndrome in health professionals, allowing to know the existing relationship
between Burnout and its sub variables; with the independent variables: age, sex, year career,
age in the institution, marital status, working hours and laboral situation. As analysis techniques
were used information nonparametric statistical: Spearman correlation coefficient, U test of
Mann-Whitney, and statistical Kruskall - Wallis. The results indicated that the variable Hospital
showed significant differences in relation to the voltage source and the associated physical
Burnout disorders. Similarly, it was found that there were significant differences in the "marital
status" variable of the sample, in relation to levels of behavioral disorders. The second phase of
qualitative methodology allowed identifying and describing protective factors that influence the
absence of Burnout in oncology professional teams of hospitals considered in this investigation.
As the data collection method was used the semi-structured interviews in depths, framing its
analysis on the Grounded Theory. There are three groups of protective factors, personal
factors, psychosocial and socio-cultural. Within personal protective factors, were observed
affective and cognitive factors, personality characteristics, the development of alternatives and
disconnection acquired skills. Psychosocial factors that were found in the accounts of the
respondents were: the influence of family of origin of the professional, social support intimate
environment, the positive perception of the work on the unit, the perception of work as appealing
theme institutional reality and possibility of change. Finally, sociocultural factors, evidenced in
the analysis had valoric reference to changes in attitude and professional training. The analysis
also looked at the interaction of these factors, describing the protective mechanisms that
influence the absence of Burnout in oncology teams considered in this investigation.
Behavioral Medicine in Latin America: Recent Developments, Challenges, and
Perspective
Juan Jose Sanchez-Sosa, Angelica Riveros.
National University of Mexico, Mexico City, D.F., Mexico.
Abstract Central: En pases industrializados y en desarrollo, sigue una transicin
epidemiolgica que genera preocupacin tanto en las instituciones pblicas de salud como en
organismos internacionales y la sociedad en general. En principio sera de esperarse que las
condiciones socio demogrficas que acompaan al desarrollo propiciaran aumento en la
incidencia de padecimientos crnicos como enfermedades del corazn, diabetes, cncer,
hipertensin, etc.; pero que esta tendencia se compensara con una disminucin en los males
infecciosos, ya que suelen asociarse con la pobreza y una educacin deficiente. Esta especie
de compensacin ocurre en pases desarrollados pero en muchos pases de Amrica Latina, el
Caribe, Asia y frica, continan altas las prevalencias de las infecciones mientras que muestran
crecimiento alarmante las enfermedades crnicas. La investigacin en Psicologa de la Salud
en general, y medicina conductual en particular, en Amrica Latina, ha mostrado que el
comportamiento humano es un ingrediente clave del compromiso y prdida de la salud. Sin
embargo la investigacin tambin muestra que el comportamiento es ingrediente medular de la
conservacin de la salud y de su recuperacin. En virtud de que los beneficios de las
intervenciones psicolgicas tambin dependen de las condiciones socio-demogrficas y
culturales de los usuarios, las estrategias derivadas de los principios bsicos que regulan el
comportamiento requieren adaptaciones sistemticas para fortalecer el auto cuidado y reducir
el sufrimiento. En el trabajo se abordan estos aspectos claves y se muestran efectos clnicos
derivados de la instrumentacin de estrategias cognitivo conductuales en diversos
padecimientos crnicos. Varios estudios examinan los efectos de intervenciones de esta
naturaleza sobre la Calidad de Vida de pacientes con hipertensin esencial y reactiva, diabetes,
cncer de mama y problemas gastrointestinales, entre otros. Los pacientes de todos estos

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padecimientos experimentan, no slo sufrimiento por su condicin mdica y por los efectos
colaterales de medicamentos y procedimientos mdicos; sino que se agudiza el estrs derivado
de condiciones econmicas comprometidas y grados intolerables de incertidumbre. Las
principales medidas incluyen escalas sobre: preocupaciones, desempeo fsico, aislamiento,
percepcin corporal, funciones cognitivas, actitud ante el tratamiento, tiempo libre, vida
cotidiana, familia, redes sociales, dependencia y relacin con el mdico. Otras medidas
incluyen registros de sintomatologa ansiosa y depresiva y el registro de comportamientos de
adhesin teraputica. Despus de cumplir con los requisitos ticos, se expone a los pacientes a
procedimientos que van desde la psico-educacin hasta procedimientos para: establecer
habilidades, identificar y modificar cogniciones disfuncionales y mejorar la autorregulacin
emocional. Los resultados revelan mejora clnica y estadsticamente significativa en
prcticamente todas las reas. Se discuten las implicaciones del avance de la especialidad en
la formacin de expertos en medicina conductual en Amrica Latina como parte del crecimiento
de la psicologa de la salud. Palabras clave: epidemiologa, crnico, conducta, creencias,
emocin, disfuncin, psicosomtica
Atividades Ldicas como Estratgia de Humanizao na Hospitalizao do Cncer
Infantil: Um Estudo Bibliogrfico
Marina Santiago de Oliveira.
UNIP, So Jose do Rio Preto, Brazil.
Abstract Central: O cncer uma doena gentica rara na idade infantil atingindo cerca de 10
em cada 100.000 crianas a cada ano no Brasil. O tratamento vai depender do tipo de cncer,
localizao, estagio e evoluo exigindo frequentes hospitalizaes. Neste ambiente
desconhecido a criana encontra-se frgil pela doena e o estigma que esta trs, perde sua
autonomia, sofre com os estressores e com a despersonalizao decorrente da prpria
instituio que prioriza o mecanismo do modelo biomdico. As atividades ldicas neste
contexto so entendidas como instrumento teraputico a servio do bem estar biopsicossocial
da criana e estratgia eficaz de humanizao. O estudo presente teve como objetivo explorar
a bibliogrfica produzida no Brasil de 2005 a 2010. Aps a reviso bibliogrfica realizada no
desenvolvimento deste trabalho encontramos contribuies significativas ressaltando a
importncia de intervenes psicossociais que vo de encontro com um tratamento
humanizado do cncer infantil.
Envelhecimento Populacional: O Impacto Social e Psicolgico na Capacidade Funcional
e Autonomia na Longevidade no Sculo XXI
Ellen Santos, Caroline Nicolini.
Unimar, Marlia, Brazil.
Neste trabalho buscamos investigar e discutir a acelerao do envelhecimento populacional e a
marginalizao da imagem do velho e de sua capacidade funcional e autonomia, bem como
as conseqncias sociais e psicolgicas para o idoso frente ao estigma e as representaes
sociais negativas sobre a velhice. Para tanto, utilizou-se do mtodo de pesquisa bibliogrfica, a
partir dos textos e autores de maior relevncia dentro da temtica abordada. O texto elaborado
de carter descritivo e hipottico-dedutivo. Onde buscou-se analisar a forma como o
fenmeno do envelhecimento ocorre em nossa sociedade e como ele afeta e afetado por ela,
levando assim, em considerao, os valores e comportamentos da sociedade. Observamos
que historicamente o idoso vem sendo abandonado, estigmatizado e esquecido. O velho no
visto ou aceito pela sociedade como algum producente. A famlia muitas vezes o rejeita ou lhe

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suprime a autonomia. Em geral, os mais jovens tm preconceito, lhe faltam com respeito, no
lhes do ateno, pois se cansam de sua nostalgia. O envelhecer e o estado-de-ser-velho at
hoje um tema difcil de ser encarado. possvel observar a percepo negativa quanto ao
idoso refletida nas oportunidades a eles oferecidas. O investimento no idoso ou para o idoso
subestimado, uma vez que no se acredita na possibilidade de retorno. Assim, por exemplo,
seu bem-estar posto em detrimento com a reduo de oportunidades no mercado de
trabalho, e investimentos para a sua reciclagem e atualizao escassos ou inexistentes. O
estigma e a representao negativa feita pela sociedade quanto velhice limita as suas
oportunidades de opo e deciso por uma atividade, como tambm a sua autonomia, por ser
encarado como incapaz de responder e cuidar de si.
Trabalho, Sade e Qualidade de Vida
Adriana Souza, Carmen Andrade, Halley Matias.
Universidade de Marlia, Quintana, Brazil.
MATIAS, Halley de Oliveira LOPES, Adriana de Souza ANDRADE, Crmen Valria dos Santos
Este trabalho, realizado atravs de atravs de uma pesquisa bibliogrfica, tem por objetivo
discutir alguns aspectos referentes ao trabalho, os riscos ocupacionais e a sade e como deve
ser esse trabalhador para esse novo tempo. Vivemos numa sociedade em mudanas e num
momento excitante para as organizaes. Trabalhar significa realizar uma obra que expresse
resultados, que traga reconhecimento social e permanea alm da vida, como tambm
sinnimo de esforo rotineiro e repetitivo, muitas vezes sem liberdade; de resultado consumvel
e incmodo inevitvel. Mas, em contrapartida, o trabalho no contexto social atual, passa a
representar um elemento essencial para o indivduo, pois lhe confere dignidade e insero
social, e assim, se confunde com a prpria vida, j que pode ser comparado como instrumento
utilizado para satisfazer as necessidades primrias das pessoas, ou seja, prover a saciedade
corporal e, portanto, a sobrevivncia. Percebe-se claramente indcios a uma dicotomia
ideolgica na mente humana, relegando ao trabalho um carter de mal necessrio. . Os
profissionais da sade, principalmente os que atuam no ambiente ocupacional, enfatizam o
ambiente laboral, preocupando-se com as novas formas de produzir, de organizar, com os
mtodos inovadores da tecnologia, com o ritmo acelerado do trabalho, responsabilidades e
complexidade de tarefas. Esses fatores dentre outros, destacam a relao entre a sade e o
trabalho. Atravs rea de RH, as organizaes buscam, com o emprego de novas formas de
gesto, como programas de relaes humanas, sade e qualidade devida, intensificar o
trabalho e aumentar a produtividade de uma maneira mais humana. Apesar da pesquisa ainda
no estar concluda, os resultados parciais demonstram que as organizaes so lugares
atravs da qual o sujeito pode satisfazer algumas de suas necessidades e desejos: financeiras,
de prazer, de realizao, de reconhecimento, entre outros, mas, ao mesmo tempo, so lugares
onde vivencia conflitos, angstias e mantm-se submetido aos objetivos e ao controle
organizacionais j que as organizaes oferecem um sistema pronto de recompensas e
satisfaes no qual o sujeito deve adaptar-se enquanto o vnculo for mantido.
Os desafios de um trabalho interdisciplinar: como motivar os pacientes para a mudana
de comportamento
Karen Szupszynski1, Viviane Rodrigues3, 1, Martha Ludwig2, 1, Fernanda Souza2, 1, Margareth
Oliveira1, Raquel Boff1, Nathlia Susin1.
1. Psychology, PUCRS, PortoAlegre, Brazil, 2. Psychology, ULBRA, Canoas, Brazil, 3.
Psychology, UNIVATES, Lajeado, Brazil.

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O Modelo Transterico de Mudana de Comportamento (MTT) est fundamentado na premissa


de que a mudana comportamental acontece ao longo de um processo, no qual as pessoas
passam por diferentes nveis de motivao para mudana. Estudos mais atuais mostram que
alm da presena dos estgios motivacionais, o processo de mudana composto por
mecanismos de mudana como: a Auto-eficcia para abstinncia, a Tentao para o uso e os
Processos de mudana. Este Modelo tem sido utilizado no tratamento para diferentes
comportamentos-problema tais como dependncia qumica, transtornos alimentares e
sndrome metablica. Para que o terapeuta possa avaliar melhor esses construtos em cada
paciente, diferentes instrumentos vm sendo criados. Diante disso, a primeira palestra da
Mesa, intitulada Modelo Transterico de Mudana: teoria e prtica ser uma introduo
terica sobre o Modelo Transterico de Mudana, mostrando publicaes atuais, estudos
randomizados e a validao de escalas. A segunda palestra tratar sobre a aplicao do
Modelo Transterico no tratamento da Sndrome Metablica e ter como ttulo Protocolo de
tratamento para pacientes com sndrome metablica. O objetivo deste trabalho ser de
apresentar o desenvolvimento de uma interveno com base neste modelo e direcionada para
pacientes com risco cardiovascular (mais especificamente com sndrome metablica). Este
tratamento vem sendo realizado no contexto de uma pesquisa interdisciplinar e tem se
mostrado uma interveno efetiva no que tange a mudana de comportamento. J a terceira
apresentao ser focada na aplicao do Modelo em usurios de drogas, intitulada
Efetividade do MTT para usurios de crack. O objetivo deste trabalho foi desenvolver um
programa de avaliao e tratamento psicoterpico baseado no Modelo Transterico de
Mudana para usurios de crack. De acordo com os resultados, 45% dos pacientes que
receberam a interveno do MTT estavam em abstinncia aps 3 meses, e no grupo controle
apenas 20%; e 22% do grupo experimental relatou estar muito bem, enquanto nenhum no
grupo controle se descreveu nessa condio. Atravs de resultados finais, pretende-se publicar
e divulgar a adaptao do trabalho do Modelo Transterico em usurios de crack. A quarta e
ltima apresentao, intitulada Capacitao profissional em entrevista motivacional, estar
direcionada para treinamento da Entrevista Motivacional em profissionais da sade, objetivando
complementar os conhecimentos do Modelo Transterico de Mudana. Este estudo piloto teve
como objetivo explorar a viabilidade, aceitabilidade e eficcia de um treinamento em EM para
profissionais da rea da sade. Um total de 40 participantes: estagirios e profissionais da rea
da sade, receberam um treinamento intensivo de oito horas sobre EM. O treinamento foi
didtico e os componentes do treinamento consistiram de teoria e atividades vivenciais tais
como debates, prtica e roleplay. Cem por cento dos participantes apresentaram um aumento
positivo relacionado Importncia e Confiana. Observou-se aumento na proficincia na
capacidade de identificar habilidades bsicas da EM.
Theoretical, Clinical, and Empirical Use of Mindfulness: A Strategy for Overcoming
Adversity
Filiberto Toledano-Toledano1, 2, Ajandra Mrquez Caldern2, Luis Incln Reyes3.
1. Hospital Infantil de Mxico Federico Gmez, Instituto Nacional de Salud., Ciudad de Mxico,
Mexico, 2. Universidad Nacional Autnoma de Mxico, Ciudad de Mxico, Mexico, 3. Instituto
Nacional para el Desarrollo Humano y Social, AC, Ciudad de Mxico, Mexico.
Abstract Central: Introduction: As observed on the first decade of XXI century, nontransmissible diseases became up to 60% of worldwide morbidity and mortality, this is
increasing as chronic diseases do since. predictions indicate that by 2030 HIV-AIDS,
depression and ischemic heart disease will be the leading causes of death and investment to
human health care (World Health Organization, 2009), these conditions respond to a multiple
causes context and demand viable answers from a multifactorial approach. Method: In order to

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find sustenance and scientific evidence on the theoretical, clinic y empiric usefulness of
mindfulness and its use for health intervention, we conducted a review of the international
literature, search of references was conducted by identifying items in the following electronic
databases, on the OVID platform: PsycINFO, Medline, PubMed, Ebsco, ProQuest and the
Cochrane Collaboration. For search strategy we used the following key words in English and
Spanish in combination with atencin plena or mindfulness: health intervention, therapy,
mindfulness, stress, mind, body, anxiety, excitement, stress reduction, randomized design,
cognitive behavioral intervention, meditation or vipassana, meta analyzes, systematic reviews,
controlled and correlational studies. Results: Findings encompass researches from 2000 to
October 2012, from which we obtained and reviewed 91 full-text articles and 10 abstracts in
Cochrane Collaboration. A total of 82 articles were considered for analysis, which were
recovered to be read at length. After review, we selected 7 meta-analysis, 5 systematic reviews
and 26 quasi-experimental studies, which met the methodological criteria specified in the
method section and were included for final analysis. Results suggest several empirical studies
that show evidence for use of mindfulness-based interventions (McCoon, 2012; Davidson, 2010;
Jacobs et al., 2010; Wallace, 2006, Kabat-Zinn, 1994, 2003;), and may be effective for stress
reduction, pain and chronic diseases (Merkes, 2010; Ledesma y Kumano, 2009; Grossman,
Niemann, Schmidt & Walach, 2004), for the treatment of mood disorders (Franco, Fuente,
Salvador, 2011; Hofmann, Sawyer & Witt, 2010), and for emotional regulation promoting
(Papies, Barsalou & Custers, 2011). Discussion: Findings are consistent with research literature
on healthy behavior (Jacobs et al., 2010; Shapiro, Oman, Thoresen, Plante, Flinders, 2008;
Dekker, 2008), cognitive behavioral intervention processes (Hayes, 2004) and its implications
for practice from the behavioral medicine approach (Klainin-Yobas, 2012; Chiesa & Seretty,
2010, 2011).
Pilot of a Reduction Weight Program for Patients with Obesity Class 1
Cristina Torres, Claudia Gutierrez, Leonidas Castro Camacho, Gloria Delgado.
Departamento de Psicologa, Universidad de los Andes, Bogot, Colombia.
Abstract Central: The obesity is one of the most important risk factor for different conditions of
health and recuperation of medical treatments like transplant. Currently, many nutritional,
pharmacologist and surgical treatments directed to weight loss has been developed, however
the maintenance of result after completing treatment is the most difficult goal. Many studies
have evidence that the change of eating habits should be a decisive factor that contributes of
the maintenance of results after the weight control program. The aim of this design was
development and evaluates an integral protocol of psychosocial intervention for transplant
patients with obesity. In order to evaluate this protocol, patients with liver transplantation were
evaluated previously and select based in the weight criteria. Finally to this previous examination,
three patients were selected for participate in the protocol. All patients accepted voluntarily
participated in this design. Before to starting the protocol, the patients were evaluated with
anthropometric and psychological scales for subsequent comparison with the same measures
after complete the protocol. The sessions of 120 minutes, were directed for the interdisciplinary
group of health psychology and nutrition according to the appropriate topic and consisted in (1)
take measurements of patient progress, (2) task review and exercises of the previously session,
(3) presentation by the specialist of work domain during session (4) practice demonstrations, (5)
patients participation, (6) instructions of tacks for make during the week. The topics of each
sessions are: (1) Introduction and psycho-education about the possible causes of obesity,
reasons and motivations for the change and detailed description of the program and the relation
with the possible causes of obesity, (2) information and instructions about characteristic of food
types, criteria selection and distribution of food in daily diet by the nutrition team, (3) training in

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eating habits, (4) training in regulation emotional methods as alternatives to food intake, (5)
training in focus attention and mindfulness during eating activity, (6) Practice in dining room
about skill learned (7) training in routines programming, activities and instructions about physical
exercise and (8) training in relapse prevention and procedure for long term maintenance. The
results indicate reduction of weight over time in patients where the weight gain is a secondary
effect of pharmacological treatment for medical condition. The patient No 1 kept the weight
during all program (61 kilos), patient No 2 loss 4 kilos (98 to 94) and patient No 3 loss 6 kilos
(66 to 60). These results are maintained 3 months after protocol. This program show promising
results in eating habits of patients with obesity. Its important remembers that these results are
preliminary and should be taken with caution. However this program can emerge as a viable
and effective option for weight reduction maintained in the time.
La Investigacin Cualitativa en Psicologa
Rebeca Trevio Montemayor, Angelica Lechuga Quiones, Yolanda Martinez Lpez.
psicologia, universidad juarez del estado de durango, Durango, Mexico.
Abstract Central: Introduccin Es bien sabido que la idea de salud, por lo menos desde hace
tres dcadas, est estrechamente vinculada con aspectos que van ms all de los puramente
biolgicos; la tradicin epidemiolgica en nuestro mbito regional ha empezado apenas a
reconocer que los mtodos de investigacin arraigados en el positivismo han significado aislar
el fenmeno de salud y enfermedad de contextos sociales y psicolgicos. Este reconocimiento
de la salud y enfermedad como fenmenos complejos definido como bio-psico-social, ha
implicado, un incipiente desplazamiento desde el paradigma investigativo con el que se
construy la propia epidemiologa como ciencia; la cuantificacin de las determinantes
conceptuales que van del objeto concreto al objeto de conocimiento. Pregunta de investigacin.
Una buena pregunta sera empezar a explorar en qu medida la metodologa epidemiolgica,
anclada en el positivismo, revitalizado a partir del racionalismo crtico, ha sido responsable de
llevar a la investigacin en salud hacia una visn unidimensional, lo biolgico. Premisas. El
presente trabajo parte de dos premisas bsicas: i) la visin epidemiolgica segn la cual la
enfermedad es analizada a partir de una poblacin homogenizada en relacin con el evento
posible de riesgo; significa la prdida de sus particularidades y con ello ciertos trazos de su
referente concreto al referente emprico; y, ii) la inclusin del componente psicolgico en la
investigacin en salud, qued aislado, a partir de la inclusin del llamado racionalismo crtico
popperiano, al aproximarse a entender un problema complejo de manera unidimensional.
Objetivos. Reconocer la importancia del racionalismo crtico en la consolidacin de la
epidemiologa como ciencia, pero tambin de la biologizacin en la investigacin en nuestro
mbito y la exclusin de la problemtica psicolgica como componente bsico para explicar
problemas de salud. Revisar el trayecto que han debido recorrer los mtodos cualitativos y en
qu medida las estrategias por ellos propuestas resultan ser ms adecuadas para incorporar
una visin multidimensional al problema de salud. Mtodo. Se trata de un anlisis sobre la
construccin del conocimiento en salud, una revisin histrica y una reflexin epistemolgica
sobre la pertinencia y los alcances de la investigacin cualitativa para incorporar la cuestin
psicolgica como parte sustantiva en la investigacin epidemiolgica. Resultados. Un trabajo
reflexivo y analtico sobre el estado del arte de la investigacin en salud en nuestro mbito
regional y la urgencia de incluir mtodos e interpretaciones de carcter psicolgicos para la
cabal comprensin de nuestros problemas en salud.
Pediatric Diseases, Positive Psychology, and Cognitive Behavioral Therapy: Case Study

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Andromeda Valencia, Ximena Ruiz, Lucia Torres, Jatziri Jove, Lucero Valencia, Anagabriela
Bonilla.
Centro de Servicios Psicolgicos, UNAM, Mexico, City, Mexico.
Abstract Central: Chronic diseases in childhood affect not only the diagnosed child, because
the health situation also changes the primary caregivers and other members of the immediate
environment, specially their siblings. However, psychological treatments often focus only to
follow medical recommendations or emotional effects associated with the disease in the sick
child. Many children with chronic and hereditary diseases face changes in their health condition
as they grow, and also while experiencing novel family situations. That is why is relevant for the
families with a sick child to acquire different skills that will help them not only to manage the
disease, but to prevent situations that may be related to risk factors (such as hereditary aspects,
stress, parenting, etc.) and also to increase protective factors (good family relationship, good
communication, well-being strategies, strengths, etc.). We use as intervention program The
Optimistic Game (Valencia, 2007), that is a program that rest on the hypothesis that the
reduction of the negative symptoms is important but is also necessary to build positive
emotions, character strengths and well-being components as goals of a psychological
intervention program for children with chronic diseases and their families. This study include six
participants all members of two nuclear families. The mothers are sisters, married to brothers
who are also the children parents. Both families are composed of father, mother and two
children, being the firstborn of each family the one with a disease. In the first case the oldest
child has Cleft hard palate and the soft palate with bilateral cleft lip and in the second case the
first daughter suffers from Type 1 diabetes. Minor children of both families are healthy, but have
behavioral problems. In the paternal line there is a significant history of diabetes type I and type
II present in many family members. Moreover, in the maternal family, grandpa and grandma's
cousin had cleft lip. Also there is a history of hypertension and anxiety in the mother's family.
The Intervention was an experimental design of single case type AB, and we used the
Therapeutic Contract, Adherence Carnet, Behavioral Interview, Family Environment Scale
(FES-Moos, 1980; adapted by Ayala), Children`s Depression Inventory (CDI- Kovacs, 1992),
Children Attributional Style Questionnaire and the CAVE Technique (Seligman, 1986), Parental
Stress Index (Abidin, 1979,1990; adapted by Ayala) and the Social Satisfaction Questionnaire
(Valencia, 2002). The Optimistic Game gives cognitive and behavioral skills to the children and
their families to improve their quality of life and the adherence to medical treatment. The
intervention was divided into evaluation and social validity and treatment (7 modules for parents
and 6 for children-siblings).
Intervencin Cognitivo Conductal para Onicofagia en Universitarios
Yelitza Vallejo Marn, Monica Fulgencio Jurez, Roberto Oropeza Tena.
Facultad de Psicologa, Universidad Michoacana de San Nicols de Hidalgo, Morelia, Mexico.
Abstract Central: La onicofagia es definida como un hbito parafuncional que consiste en
morder y cortar las uas con los dientes, provocando heridas en los dedos, labios y encas, as
como el desarrollo de diversas infecciones bucales. ste hbito puede constituir una va de
escape para la tensin y ansiedad en quien lo padece (Castillo, Reyes, Gonzlez y Machado,
2001). Encuestas realizadas muestran que alrededor del 25% de los estudiantes y
aproximadamente el 10% de los adultos mayores de 35 aos, se muerden las uas en forma
compulsiva. La terapia cognitivo-conductual ha sido ampliamente utilizada en el tratamiento de
hbitos parafuncionales como la onicofagia, considerndose la tcnica ms exitosa hasta el
momento (Adonegui, 2006). El objetivo de esta investigacin fue eliminar la onicofagia en seis
universitarios, a travs de una intervencin cognitivo-conductual. Los instrumentos aplicados

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fueron: Entrevista Inicial (EI), Inventario de Ansiedad de Beck (IAB), Cuestionario de Confianza
Situacional (CCS), Autorregistro de onicofagia y el Cuestionario de Satisfaccin con el
Tratamiento (CST), diseado especficamente para esta investigacin. La aplicacin de estos
instrumentos fue de manera individual y dentro de las sesiones de la intervencin cognitivoconductual. Los resultados obtenidos muestran que, efectivamente las situaciones causantes
de ansiedad en los participantes fueron un factor precipitante para la ocurrencia de la
onicofagia, y a medida que estas situaciones se vieron menos ansigenas, la onicofagia
disminuy significativamente en todos ellos. Con estos resultados se observa la importancia de
desarrollar y ampliar programas cognitivo-conductuales para el tratamiento de la onicofagia y
de los hbitos parafuncionales en general.
Exploring the Use of Behavioural Therapy for Insomnia in Shift Workers
Annie Vallieres1, 2, Emmanuelle Bastille-Denis1, 2, Monica Roy1, 2, Tarek Simon1, 2.
1. cole de psychologie, Universit Laval, Qubec, QC, Canada, 2. Institut universitaire en
sant mental du Qubec, CRCHUQ, Qubec, QC, Canada.
Introduction: About 30% of the Canadian workers population works on shift. It has been
reported that 14 to 32% of night shift workers and 8 to 26% of rotating shift workers suffer from
Shift Work Sleep Disorder (SWSD). Insomnia is a main symptom of SWSD. Current
interventions to treat SWSD consist of pharmacological and light therapies. Only a few
behavioural treatments, such as naps, exist to treat this population. This study explores the
feasibility and clinical utility of sleep restriction therapy for insomnia in a group of night shift
workers. Method: Six participants meeting SWSD criteria according to ICSD-II were recruited
(mean age = 45.7 years old SD = 8,2; 3 women). A multiple baseline design was used. After
baseline, each participant received six to eight weekly treatment sessions. Treatment sessions
include basic knowledge about sleep and sleep restriction therapy for insomnia. Sleep
restriction therapy is applied first to nocturnal sleep, then to diurnal sleep, and finally to naps.
Participants wore an actigraph and completed a daily sleep diary throughout the
experimentation. They also completed self-reported questionnaires before and after treatment.
For each sleep period (diurnal sleep, nocturnal sleep, and naps), total sleep time (TST), total
wake time (TWT), wake after sleep onset (WASO), sleep onset latency (SOL), and sleep
efficiency (SE) were calculated from both devices. Results: Times series analyses of sleep
diaries data showed that SE increased from baseline to post-treatment for all participants for
both diurnal and nocturnal sleep periods. Diurnal sleep SE increased by an average of 10.1%
while nocturnal sleep SE increased by 22.1%. TST increased by 25.4 minutes during diurnal
sleep for 3 participants while it increased by 57.5 minutes during nocturnal sleep for 5
participants. SOL decreased by 10 minutes in nocturnal sleep while WASO decreased for
diurnal and nocturnal sleep by 15.0 and 51.0 minutes respectively. Finally, self-reported
questionnaires suggested a decreased in depressive symptoms and in general fatigue for four
participants from baseline to post-treatment. Conclusion: Our study suggests that sleep
restriction therapy is feasible, well accepted, and could improve sleep in night shift workers
suffering from SWSD. More studies are warranted to understand and treat insomnia with
behavioural interventions in the context of shift work.
Estrategias de Afrontamiento y Calidad de Vida en un Grupo de Pacientes con Cncer de
Mama
Martha Juliana Villegas Moreno, Lucy Nieto.
Universidad Catlica de Pereira, Pereira, Colombia.

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La calidad de vida se ha convertido en un concepto importante en las ciencias de la salud y en


las ciencias sociales, alrededor de ella se han realizado diferentes estudios que han sido
agrupados por Schwartzmann, 2003, y ms recientemente por Urza, Caqueo- Urzar 2012; en
donde se exponen no slo las diferentes nociones de calidad de vida, sino las diversas
alternativas de medicin tanto objetivas como subjetivas que permitan hacer una lectura de
este fenmeno subjetivo ante todo en pacientes con algn tipo de condicin crnica. La
perspectiva de las estrategias de afrontamiento, que permite acercarse a las valoraciones que
realizan los pacientes sobre las situacin estresantes, desarrollada por Lazarus y Folkman,
1987; Lazarus, 2000 recientemente se ha asociado a la calidad de vida; en Colombia se ha
validado un instrumento que permite observar el uso que de estas estrategias hacen los
pacientes Londoo, Henao, Puerta, Arango y Aguirre (2006). Estudios como el de RiveraLedesma, Montero-Lpez y Sandoval-vila (2012) muestran la importancia de la relacin entre
estas dos variables, calidad de vida y afrontamiento y sealan la pertinencia de orientar los
estudios en torno a la calidad de vida y relacionndola especficamente con las estrategias de
afrontamiento religioso como un modo de entender el ajuste psicolgico de los pacientes a una
condicin crnica. El propsito del presente estudio consiste en observar la medida de calidad
de vida, en un grupo de pacientes diagnosticadas con cncer de mama, y las estrategias de
afrontamiento que stas utilizan con ms frecuencia. De un marco muestral de 297 pacientes
atendidas en la ciudad de Pereira por cncer mama durante 2011, en una IPS que alberga
cerca del 95% de pacientes de la ciudad, se realiza una seleccin aleatoria y finalmente se
toma una muestra de 40 mujeres, de las cuales en el anlisis exploratorio de datos, se
descartan 11 por fallos en el levantamiento de la informacin; se analizan slo 29 casos que
cumplen con todos los criterios. Hacindose tratamiento estadstico sobre stos. Se utiliza el
software estadstico para ciencias sociales SSPSS para Windows versin 20. Las variables a
analizar fueron: la calidad de vida, y las estrategias de afrontamiento, los Instrumentos
utilizados: WHOQOL 100, desarrollado por La Organizacin Mundial de la salud, (OMS) y la
EECP (Escala de Estrategias de Coping Modificada), validado por Londoo y cols. en el ao
2006 que indica en total un alpha de cronbach total de 0,847. El grupo de pacientes evaluadas
comprendi edades entre los 26 y los 81 aos. La media de edad fue de 58 aos, con una DS
de 12,40. Los resultados indican unos niveles de calidad de vida que no se asocian con
condiciones sociodemogrficas, pero s con estrategias de afrontamiento frente al padecimiento
del cncer de mama.
Cognitive Behaviour Therapy to Deal with HIV and Stigma
Maretha Visser.
Psychology, University of Pretoria, Pretoria, South Africa.
Abstract Central: A model of cognitive behaviour therapy (CBT) was developed, implemented
and assessed in order to assist HIV-positive women in South Africa to deal with HIV and
internalised stigma. Interviews with HIV-positive women revealed five common themes in the
experience of HIV: feelings of powerlessness, anger and guilt, destructive behaviour,
experience of stigma and uncertainty about the future. These themes were used in the
development of a CBT intervention. The intervention was implemented and evaluated. Twenty
HIV-positive women were randomly assigned to an experimental group who received eight
sessions of individual therapy, and a control group who were placed on a waiting list. Pre- and
post assessments of the two groups were compared using five quantitative scales measuring
coping skills, internalised stigma, enacted stigma, self-esteem and depression. Non-parametric
Mann-Whitney tests show that after therapy the experimental group experienced lower levels of
depression, internalised stigma and negative coping, and higher levels of self-esteem and
positive coping, compared to the control group. Additionally, a qualitative analysis was made of

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transcripts of the therapy sessions to explore the effect of various therapeutic techniques.
Positive cognitive reframing and decatastrophising as well as training in coping and
assertiveness skills were effective in facilitating change. Complex cognitive techniques such as
identifying underlying automatic thoughts and Socratic questioning were not effective and
needed more time to teach. It is recommended that practising psychologists explore and
develop this CBT model with their HIV-positive clients.
The Influence of Motivational Set on the Effects of Safety Behavior During Extinction of
Fear of Movement-Related Pain
Stphanie Volders1, Elien Lenaerts1, Steven De Peuter1, Johan Vlaeyen1, 2.
1. University of Leuven, Leuven, Belgium, 2. Maastricht University, Maastricht, Netherlands.
Background. Pain-related fear, like fear of movement-related pain (FMRP), is known as a
significant maintaining factor of aspecific, chronic musculoskeletal pain. Therapy based on
Pavlovian extinction seems to be successful in decreasing fear and improving daily function.
Yet, patients tend to frequently engage in subtle, within-situation avoidance responses or safety
behavior, which could maintain FMRP in the long run. Previous experiments indeed show that
the presence of safety behavior during extinction enhances extinction at the moment, but
promotes a return of fear when it is omitted afterwards, also known as protection from
extinction. Interestingly, cognitive theories suggest that the motivation to avoid an expected
catastrophe behind the behavior can matter in determining this effect. In the current study, we
further compared the effects of safety behavior on the extinction and return of FMRP, while
manipulating the motivation behind it (to avoid pain vs. to double a monetary reward). We
expected enhanced extinction but a return of FMRP when safety behavior during extinction is
performed to avoid pain, as opposed to enhanced extinction but no return of FMRP when the
same behavior is performed to attain a reward. Method. We employed the voluntary joystick
movement paradigm, using three joystick arm movements as conditioned stimuli (CS). These
were either always followed by the US (a painful electrocutaneous stimulus; CS+), never
followed by the US (CS-) or served as the CS that was extinguished (CSp+/-). A betweensubject design with 3 conditions was applied: 1) the control group (CG, n=30), using no safety
behavior during extinction, 2) the safety group (SG, n=30), using safety behavior during
extinction while being told this could avert the US 3), the reward group (RG, n=30), using safety
behavior during extinction while being told this could improve task performance and double the
monetary reward. CS-US contingencies were identical in the SG and RG and in the subsequent
test phase, safety behavior was omitted in both groups. Safety behavior was operationalized as
pushing the joystick shooting button. Retrospective ratings of the US-expectancy and selfreported FMRP served as dependent measures as well as eye blink startle modulation.
Results. Preliminary repeated measures ANOVA of the US expectancy and FMRP ratings
show appropriately acquired CS-(no)US contingencies and proper discriminative fearful
responding to the different CSs for all groups. When testing for return of FMRP in the second
extinction block vs. the first test block, we found a significant CS x Group x Block interaction
(F(4, 174) = 9.37, p < .0001). In the SG, safety behavior enhanced extinction, but its omission in
the test phase promoted a return of FMRP. In the RG, there was no return of fear, but also no
enhancement of extinction, compared to the other groups. Conclusion. The present results
corroborate the results of previous experiments about protection from extinction by safety
behavior. Yet, this effect seems to be overruled by a positive motivational set. Further research
is needed to explore motivational influences of safety behavior on extinction itself and before
making clinical recommendations.

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Investigaes Brasileiras sobre Habilidades Sociais em Diferentes Quadros Psicolgicos


/ Brazilian Research Studies on Social Skills in Different Psychological Contexts
Marcia Wagner1, Leda Rbia Maurina1, 2, Ilana Andretta2, Jaqueline Garcia3, Margareth
Oliveira2, Mirna Brillmann2, Raquel Boff2, Margareth Oliveira2, Martha Ludwig2, Nathlia Susin2,
Fernanda Souza2, Lauren Terroso2, Marcia Wagner1, Ilana Andretta2.
1. Escola de Psicologia, Faculdade Meridional - IMED, Passo Fundo, Brazil, 2. Pontifcia
Universidade Catlica do Rio Grande do Sul, Porto Alegre, Brazil, 3. Universidad de Granada,
Granada, Spain.
Investigaes brasileiras envolvendo habilidades sociais (HS) vm sendo conduzidas com
elevada frequncia, visto a constatao dos prejuzos que os dficits nas HS desencadeiam
nos indivduos. O presente simpsio tem por objetivo apresentar pesquisas sobre o tema em
diferentes quadros psicolgicos. Uma das pesquisas descreve a avaliao e interveno breve
grupal com universitrios com Transtorno de Ansiedade Social (TAS) com utilizao do
Questionrio de Ansiedade Social para Adultos (CASO-A30). Tambm apresentado um
programa de avaliao e treinamento em HS aplicado em grupo de dependentes qumicos
internados em uma comunidade teraputica. Outro estudo avalia as habilidades sociais e
descreve o perfil dos pacientes com Sndrome Metablica (SM), que a combinao de
obesidade, dislipidemia, resistncia insulina e hipertenso. O prximo estudo apresenta uma
investigao de avaliao das HS e Qualidade de Vida Relacionada Sade (QVRS) para
perceber os obstculos e benefcios da adeso ao tratamento em pacientes com obesidade
mrbida em quatro hospitais do sul do Brasil. Alm disso, so descritos dados preliminares de
uma pesquisa em andamento que visa constatar a relao entre a dependncia de Internet e
as habilidades sociais de uma populao de escolares a partir da aplicao do Inventrio de
Habilidades Sociais para Adolescentes. Os estudos concluram que indivduos com distintos
problemas clnicos e psicolgicos apresentam mais dificuldades nas habilidades sociais quando
comparados populao geral.
Desenvolvimento de Habilidades Interpessoais no Transtorno de Ansiedade Social
Habilidades Sociais podem ser definidas como um conjunto de comportamentos emitidos por
um indivduo de modo adequado situao em um contexto interpessoal, respeitando esses
comportamentos nos demais, resolvendo os problemas imediatos da situao e minimizando
futuros problemas Esse trabalho apresenta os resultados de uma interveno breve grupal com
universitrios com Transtorno de Ansiedade Social (TAS) denominada Programa de
Desenvolvimento de Habilidades Interpessoais, visando a melhora da competncia
interpessoal e individual por meio do ensino de estratgias para o aperfeioamento de suas
habilidades de relacionamento social. Atravs da aplicao do Questionrio de Ansiedade
Social para Adultos/ CASO-A30, antes e depois da interveno, verificou-se se o instrumento
consegue monitorar mudanas de comportamento e avaliar os efeitos do programa de
Desenvolvimento de Habilidades Interpessoais na conduta dos indivduos. A amostra foi
composta de 32 estudantes de instituies de ensino superior do estado do Rio Grande do Sul,
Brasil, que apresentavam TAS. Da amostra total, 71,9% (n=23) sujeitos eram do sexo feminino
e 28,1% (n=9) do sexo masculino, com mdia de idade 25,75 anos (DP= 8,05). O programa foi
realizado em formato grupal, variando entre cinco a oito participantes, com dez encontros
semanais de durao de duas horas cada. Foram desenvolvidos os seguintes contedos:
autoconhecimento e habilidades de apresentao, relacionamento interpessoal e habilidades
de conversao, habilidades de expresso de afeto e empatia, habilidades de assertividade,
habilidades de conflito, lidar com o estresse, pensamento crtico e criativo, tomada de deciso e
resoluo de problemas. Os resultados do Programa de Desenvolvimento de Habilidades
Interpessoais sugerem que os participantes apresentaram melhoras em seu repertrio de
habilidades sociais, na interao grupal, alm de aumento da assertividade em situaes

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difceis, o que foi evidenciado pela melhora no escore total do CASO-A30 ps-interveno.
Destacam-se as diferenas encontradas no F1 (Falar em pblico), Fator 2 (Interao com o
sexo oposto), Fator 4 (Expresso assertiva de incmodo, desagrado ou tdio) e Fator 5 (Estar
em evidncia e fazer papel de ridculo). Esses achados evidenciam a capacidade do
instrumento em monitorar as mudanas de comportamento relacionadas ansiedade social
nessas dimenses, bem como a eficcia da interveno baseada no desenvolvimento das
habilidades interpessoais.
Treinamento de Habilidades Sociais em Dependentes Qumicos/ Social skills training in
Chemical Dependents
A dependncia qumica (DQ) um problema de sade publica que traz inmeros prejuzos
sociedade. A literatura descreve que em usurios de drogas h uma relao direta com dficits
em Habilidades Sociais (HS) como baixa habilidade de enfrentamento, baixa auto-estima e
pouca capacidade de resoluo de problemas. Desenvolver habilidades de enfrentamento e
habilidades sociais pode ser um fator de preveno primrio e tercirio. Alem da relao com a
dependncia qumica, baixos ndices de HS tambm esto relacionados comorbidades
altamente prevalentes em DQ como depresso e fobia social. Este estudo clnico trata de um
programa de treinamento em HS aplicado em grupo de 24 dependentes qumicos internados
em uma comunidade teraputica. Fez-se uma avaliao antes e uma depois da interveno
com os seguintes instrumentos: ficha para identificao de dados scio-demograficos, escalas
Beck para avaliao de intensidade de sintomas de depresso e ansiedade (BAI e BDI), Drug
Use Screening Inventory (DUSI) para avaliao da idenficao de problemas em relao ao
uso de drogas e o Questionrio de Ansiedade Social (CASO A-30). Iniciaram o processo de
avaliao 24 participantes e, aps a avaliao, finalizaram o processo 6 sujeitos com
problemas com lcool, cocana e crack que apresentaram ansiedade social. Os sujeitos
participaram de 10 sesses estruturadas de treinamento em HS com durao de 90 minutos
em cada sesso. Na avaliao, houve ansiedade em relao a falar em pblico, na interao
com sexo oposto e estar em evidncia, pontuaram intensidade de sintomas de ansiedade e
depresso mnimos e no houve identificao de alta intensidade de problemas em relao ao
uso de drogas. Aps o treinamento, houve melhora nos sintomas de ansiedade social e nos
sintomas depressivos e ansiosos. A partir deste estudo, conclu-se que o treinamento em
habilidades sociais mostrou resultados vlidos para este grupo, mas sugere-se estudos mais
robustos incluindo outros instrumentos, visando controle maior de variveis, e com reavaliao
no ps alta dos sujeitos.
Avaliao de habilidades sociais em pacientes com sndrome metablica
A Sndrome Metablica (SM) um quadro clnico caracterizado pela combinao de obesidade,
dislipidemia, resistncia insulina e hipertenso. O objetivo foi avaliar as habilidades sociais
(HS) e descrever o perfil dos pacientes com SM submetidos a um programa de interveno.
Trata-se de um estudo quantitativo, descritivo e de coorte prospectiva. A amostra foi composta
por 65 sujeitos, destes, 37 concluram o programa. Os participantes foram 63,1% (n=41) do
sexo feminino e 36,9% (n=24) do sexo masculino, com escolaridade mnima de quinta srie do
ensino fundamental, com idade entre 30 e 60 anos e mdia de peso 91,54 (DP=12,11). Os
instrumentos utilizados foram: questionrio de dados scio demogrficos; perfil antropomtrico;
Adult Self Report/ASR; Inventrio de Habilidades Sociais/IHS; Cuestionrio de Ansiedad Social
para Adultos/CASO A-30; marcadores bioqumicos sanguneos e verificao da presso
arterial. Os resultados na avaliao antropomtrica, nas variveis, peso, IMC, circunferncia
abdominal e colesterol foram estatisticamente significativos na avaliao ps-interveno
(p<0,005). As HS quando avaliadas antes e depois no mostraram diferenas estatisticamente
significativas na maioria dos fatores, exceto no fator 3 do CASO A-30 (Conversao e
desenvoltura social), no qual as mulheres pontuaram acima da mdia. J a anlise dos itens do

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IHS mostrou pontuaes abaixo da mdia, sendo itens referentes a pedir mudana de conduta,
discordar do grupo, pedir ajuda de amigos e favores a colegas. Sendo assim, a modificao de
estilo de vida, oportunizando adeso a uma alimentao saudvel e a pratica regular de
exerccio fsico pode beneficiar distintas faixas etrias, sendo fundamental o foco em
estratgias que propiciem maior adeso dos pacientes com SM aos programas de interveno.
Obesidade : Perder para Ganhar ?
A prevalncia mundial da populao adulta portadora de obesidade, com ndice de Massa
Corporal (IMC 30 kg/m2), j sobrepujou a cifra de 400 milhes de indivduos. Essas
estimativas so preocupantes devido carga de doenas associadas obesidade e ao maior
risco de morte sendo a obesidade mrbida uma condio refratria aos tratamentos clnicos
convencionais, com uma taxa de recidiva ao redor de 98%. Seu tratamento vem constituindo
um desafio para diversas reas que cuidam da sade, devido os constantes fracassos em
alcanar a perda de peso necessria, de forma duradoura. As pesquisas voltadas aos
tratamentos da obesidade mrbida tm se ocupado prioritariamente em alcanar a perda
ponderal, dando menor nfase ao estudo dos demais fatores como a Qualidade de Vida
Relacionada Sade (QVRS), j que os tratamentos clnicos, apesar de no oferecerem
riscos, produzem perdas ponderais clinicamente pouco relevantes, envolvendo custos e
frustraes. O objetivo deste estudo avaliar a QVRS e as habilidades sociais dos pacientes
para perceber os obstculos e benefcios da adeso aos tratamentos indicados, antes e aps o
BPGYR. Este estudo foi realizado em quatro hospitais do sul do Brasil credenciados para
cirurgia baritrica e contou com 401 pacientes, adultos, de ambos os sexos, que aguardavam
atendimento clnico de acompanhamento para o By PassGstrico em Y de Roux (BPGYR) nos
ambulatrios das respectivas instituies. As avaliaes ocorreram antes e seis meses aps a
realizao da cirurgia, no perodo entre junho de 2008 a dezembro de 2011.
Habilidades Sociais e Dependncia de Internet em Adolescentes
Estudos a apontam que o dficit em habilidades sociais contribui significativamente para a
dependncia de Internet em adolescentes uma vez que os indivduos com dificuldades na
interao social optam por interagir online, fazendo com que permaneam frente ao
computador por muitas horas diariamente. Estes geralmente consideram as relaes virtuais
menos ameaadoras, e por usarem demasiadamente a Internet para alcanar suas
necessidades de socializao tendem a possuir menos amigos e relaes amorosas reais, o
que acaba por torn-los mais solitrios. O presente estudo tem como objetivo apresentar dados
preliminares de uma pesquisa em andamento que visa constatar a relao entre a dependncia
de Internet e as habilidades sociais de uma populao de escolares. Os participantes (n=482)
sero requisitados a preencher o Inventrio de Habilidades Sociais para Adolescentes (IHSA)
instrumento que possibilita mensurar o desempenho em habilidades sociais de adolescentes
atravs de seis subescalas: empatia; autocontrole; civilidade; assertividade; abordagem afetiva
e desenvoltura social. Para verificar a dependncia de Internet ser usado o Internet Addiction
Test (IAT).
Avaliao da Presena de Sintomas Depressivos e de Ansiedade no Contexto
Universitrio
Marcia Wagner, Carlisa Peccin, Franciele Batistella, Priscila Cerutti, Deomar Bordignon.
IMED, Passo Fundo, Brazil.
O presente trabalho tem o objetivo de avaliar a presena de sintomas depressivos e de
ansiedade em universitrios, visto o prejuzo que tais sintomas desencadeiam na vida
acadmica. Est vinculado pesquisa Avaliao e Promoo de Habilidades Sociais no
Transtorno de Ansiedade Social da Escola de Psicologia da Faculdade Meridional/IMED -

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Passo Fundo, RS, Brasil. O estudo proposto de cunho quantitativo e observacional. Foi
avaliado e autorizado pelo Comit de tica em Pesquisa da IMED. Os instrumentos utilizados
foram: ficha de dados sociodemogrficos, Inventrio de Depresso de Beck e Inventrio de
Ansiedade de Beck. A amostra foi composta de 24 sujeitos, 25% (n= 06) eram do sexo
masculino e 75% (n=18) do sexo feminino, com mdia de idade 24 anos. Em relao ao estado
civil, a maioria da amostra solteira 79,2% (n=19), 16,6% (n=4) so casados ou com unio
estvel e 4,2% (n=1) divorciado. Quanto avaliao da presena de sintomas depressivos,
62,5% (n=15) da amostra apresentaram sintomas mnimos, enquanto 25% (n=6) em grau leve
e 12,5% (n=3) moderado. Quanto presena de sintomas de ansiedade, 33,3% (n=8)
mostraram sintomas em grau mnimo, 33,3% (n=8) moderado, 20,8% (n=5) grave e 12,5%
(n=3) leve. Os resultados revelam a presena de sintomas depressivos e de ansiedade na
populao acadmica, com um ndice mais elevado de ansiedade, o que demonstra a
importncia do desenvolvimento de intervenes grupais, que auxiliam os indivduos na
diminuio dos prejuzos decorrentes destes transtornos, proporcionando uma melhor
qualidade de vida.
The Development of a Cognitive-Behavior Group Intervention Program to Reduce the
Hostility Levels of Coronary Heart Disease Patients and Its Effect on
Psychophysiological Reaction
Chia-Ying Weng1, Chin-Lon Lin2, 3, Tin-Kwang Lin4, 3, Chiu-Tien Hsu1.
1. Department of psychology, National Chung Cheng University,Taiwan, Taiwan, Taiwan, 2.
Division of Cardiology, Department of Internal Medicine, The Buddhist Hualien Tzu Chi General
Hospital, Taiwan, Taiwan, 3. School of Medicine, Tzu Chi University, Hualien, Taiwan, Taiwan,
Taiwan, 4. Division of Cardiology, Department of Internal Medicine, The Buddhist Dalin Tzu Chi
General Hospital, Taiwan, Taiwan.
The purpose of study:To develop a cognitive-behavior group intervention program to reduce the
hostility levels of coronary heart disease (CHD) patients and examine its effect on blood
coagulation function. Method:A case control study with matched age, sex and education, based
on a two group pre- and post-test design was adopted. Experimental group included 9 CHD
patients (mean age = 56.33 10.45, male 66.7%) who attended a weekly two-and-a-half hour
session of cognitive-behavior group intervention program with psycho-education and
biofeedback-assistant relaxation training for two months. Control group included 16 CHD
patients (mean age = 59.256.44, male 68.8%) who did not receive any psychological treatment
until they finished the three-month waiting status. Results:After intervention, there were
significant reductions in hostility level ( t = -3.562, p < .05), respiration rate ( t = -2.542, p < .05),
EMG level ( t = -2.362, p = .05), and SC level ( t = -3.184, p < .05) for participants of
experimental group. The repeated measure of ANCOVA showed significant interaction effects
and indicated that there was a significantly higher reduction of respiration rate (F = 4.94, p <
.05) in experimental group than those of waiting-controlled group by controlling the covariate
variables as age and sex. Conclusion:The eight-session cognitive-behavior group intervention
program not only has an effect to reduce psychological distress, but also has an effect to involve
the psychophysiological reactions of CHD patients, decreasing the respiration rate, which may
reduce the stress responses of CHD patients.
Cognitive Behavioral Therapy applied in the prevention and control of Childrens
Emotional Stress in the school
Valquiria da Cintra Tricoli.
1. FAAT, Atibaia/SP, Brazil, 2. CETEPEA, Atibaia/SP, Brazil.

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Surveys show that the number of children with symptoms of stress is increasing significantly. It
can be caused by internal sources (created by the child according to the way he/she faces the
daily situations, thoughts, personality type and attitudes) and externally (with colleagues,
teachers, activities, tests, separation of parents, the birth of a little brother, increased
requirements, amongst others). The child's enrollment in school is occurring earlier and earlier.
School is a place where the child is exposed a variety of stressors. The child needs to be seen
as a whole, considering the biopsychosocial development stage. Educational institutions that do
not respect individual differences of students, disregarding their expectations, their concerns
and fears, will be a source of stress. Immature child and/or with learning problems, suffering
deficiencies of stimulation at home, at school, and under exaggerated pressure, may develop
anxiety and negative self-esteem. The school currently has in addition to the function of
teaching, greater responsibility with regard to education and training of their clientele. For each
age-specific needs. Therefore, the children's educational process, need to stimulate the
emotional, psychomotor and social development, problem solving, self-esteem, and facts of
everyday life, which are essential to stimulate the cognitive process, besides enabling the
development of strategies for the management and control of stress for this population.
Stressed children tend to fail in school performance, because excessive stress hinders
attention, concentration, memory, organization, etc. The contact of students and teachers and
the exchanges between the family and the school, enable teachers to better understand each
child. Cognitive behavioral therapy has tools that will enable prevention and the acquisition of
stress management techniques based on a realistic view of the facts, facilitating social
practices, such as social skills training, solve problems, self-esteem, relaxation, physical activity,
as well as the control and prevention of stress of faculty and staff, who are in daily contact with
the students.In a private school, in the city of Sao Paulo , cognitive behavioral techniques were
applied in a group of 30 children in the second grade of elementary school, of both sexes aged
seven and 8 years. It was noted a reduction of stress in 60% of the children, based on the
children's Stress Scale (ESI), which was applied before and after the 16 intervention sessions.
There was also improvement in grades and in student behavior in the classroom, in the
organization of personal belongings, social interactions between the group and the teacher.
Furthermore, it was noticed more effectiveness for troubleshooting, when compared with the
other class with students of the same age group and series. What was the importance of
carrying out a preventive and intervention work in the area of emotional stress in educational
institutions. The findings show the importance of preventive works in stress management for
children within school settings. E-mail: valtricoli@uol.com.br
Intellectual & Developmental Disorders/ Discapacidad Intelectual y Trastornos del
Desarrollo/ Deficincia Intelectual e Perturbaes do Desenvolvimento
Personality Disorders or Intellectual Disability? Diagnostic Dilemma Regarding a Case
Study
Maria Barba, Romina Cortizo, Maria Cruz, Belen Daz, Ana Cascales, Maria Mas, Angela
Navarro, Juan Ramn Castao.
Hospital del Mar, Barcelona, Barcelona, Spain.
INTRODUCTION Many instruments have been designed for the assessment of maladaptive
personality traits and personality disorders in diferent populations. But in the context of clinical
practice, the clinician faces the complexity of diferent comorbidities that increase the difficulty of
this particular diagnosis. We report the case of a 40-year-old woman with a childhood history of
orphanage, institutionalitzation and learning difficulties. As an adult she had a history of

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conflictive relationships, mood disregulation, unspecific fears, limited planification skills and poor
parenting that led to the removal of her childrens custody. On the interview, she displayed a
puerile attitude and behaviour alterations that arouse a diagnostic dilemma. METHOD We
performed a clinical interview with both the patient and her elder daughters separately. The
neuropsychological assessment consisted on an intellectual evaluation featuring the Weschler
Adult Intelligence Scale (WAIS-III) and the Weschler Memory Scale (WMS-III). And the
personality evaluation was complemented with the Structural Clinical Interview for DSM-IV.
Complementory mesures were also aplied to rule out factitious components. RESULTS Global
interpretation suggested the intellectual limitations of the patient were not enough to account for
the symptoms, and maladaptive traits were found to be a relevant factor. Indication of a
symptoms magnifications were found. CONCLUSION More research should be conducted in
the field of personality disorders in patients with intellectual disabilities, considering there is no
instrument with proved validity in this population. Validity scales should also be included to
assess in cases were factitious symptoms are suspected.
Calidad de Vida y Formacin Laboral de Jvenes con Discapacidad Intelectual
Lilian Castro Durn.
Universidad de Concepcin, Concepcin, Chile.
Abstract Central: En la esfera del desarrollo humano, una de las facetas principales la
constituye la calidad de vida, es decir, la expresin multidimensional de diversas reas del
bienestar. Este concepto fue acuado originalmente por Schalock (1996b), quien lo define
como un concepto que refleja los deseos de una persona sobre su calidad de vida respecto a
ocho dimensiones centrales de su vida: Bienestar Emocional, Relaciones Interpersonales,
Bienestar Material, Desarrollo Personal, Bienestar Fsico, Autodeterminacin, Inclusin Social y
Derechos. Las personas con discapacidad no se encuentran ajenas a estos mbitos de
bienestar, sin embargo, la consecucin de stos se vuelve ms compleja, dada la naturaleza
misma de su discapacidad, no slo en lo que comporta a su propia ndole individual sino
tambin a su relacin e incorporacin en el plano social. Es probable, que en el mbito
educativo los principales propsitos para con los estudiantes con necesidades educativas
especiales, estn orientados al desarrollo de competencias de carcter bsico que les permitan
algn grado de autonoma y de habilitacin laboral para acceder e insertarse en la sociedad.
Existen diversos factores que inciden en el nivel de calidad de vida, uno de ellos, que en
diversas investigaciones se ha constatado y resulta importante, es la insercin laboral, puesto
que sta influye significativamente, ya sea de manera directa o indirecta, en el desarrollo de las
dimensiones ya nombradas. Ahora bien, en el caso de las personas con discapacidad
intelectual, la necesidad de estar insertos laboralmente cobra aun mayor relevancia ya que
mediante sta pueden aspirar a mejorar diversos mbitos de su vida, ya sea Bienestar material,
Autodeterminacin, Desarrollo personal, entre otras. Por tanto, el objetivo de esta investigacin
es determinar la relacin entre la formacin laboral que se les brinda a jvenes con
Discapacidad Intelectual insertos en Escuelas Especiales y la Calidad de Vida que ellos
presentan. Se utilizar un diseo de investigacin no experimental transaccional de tipo
correlacional. La investigacin har uso de la Escala Integral: Evaluacin Objetiva y Subjetiva
de la calidad de vida de personas con discapacidad intelectual (Verdugo, et al., 2009).Por tanto,
teniendo como base investigaciones anteriores relacionadas con el tema calidad de vida, es
esperable encontrar que aquellos jvenes con discapacidad intelectual insertos en talleres
laborales guiados bajo un paradigma clnico, tienen una autopercepcin disminuida respecto a
su calidad de vida, especialmente en las dimensiones Autodeterminacin e Inclusin Social
(Cerda et al, 2007), en relacin a los jvenes que se encuentran en talleres guiados por un
paradigma social; asimismo, las puntuaciones promedio de la Escala Subjetiva sern

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superiores a las alcanzadas en la escala objetiva, independientes del factor de comparacin,


finalmente, al comparar las puntuaciones medias de las escalas subjetiva y objetiva, las
autopercepciones de las mujeres o de sus profesores en el caso de la escala objetiva son
superiores a las puntuaciones promedio de las autopercepciones de los hombres o de sus
profesores en la escala objetiva.
Social Skills Group Training, KONTAKT for Children and Adolescents with HighFunctioning Autism: A Pilot Evaluation
Nora Choque Olsson1, 2, Sven Blte1, 2.
1. Center for Neurodevelopmental disorders (KIND) Karolinska Institutet, Stockholm, Sweden,
2. Division of Child and Adolescent Psychiatry, Stockholm, Sweden.
Access to evidence based treatment for children and adolescents with high-functioning autism
(HFA) with psychiatric comorbidity are very limited.There has been conducted a pilot study in
order to improve access to evidence-based practices in the HFA. The pilot project aims to
evaluate the social skills group training for children and adolescents with high functioning autism
(HFA) according to the Frankfurt model, KONTAKT. The pilot project was conducted in
Childrens and adolescents psychiatric clinic in Sdertlje, outside Stockholm. The method is
manual based and focusess on children and adolescents with ASD. The objective of the
program is to improve their communication and social skills. The program is based on the
principles of cognitive-behavioral training in cooperation with parents and teachers. The focus of
program is on children with behavior problems. The treatment program includes exercises for
the development of social skills, as well as discussion of the problems of social cognition, social
interaction, self-reflection and describing themselves aswell as others. The program includes 12
sessions (brief intervention within 3 months) and 24 sessions (long intervention for 6 months), in
addition to between 3 and 6 meetings with parents. Each session includes a 1 to 1 hours.
Parents received oral and written information about the pilot project and they are provided their
consent to their child's participation in this project. Each group consists of 8 participaants and
two groupleaders. This method has been widely developed in Germany (Herbrecht et al, 2009)
and has a documented good effect. Method The participants were 4 teens with high-functioning
autism (HFA) with psychiatric comorbidity such as ADHD, anxiety and depression, between 13 17 years old. All participants have an intelligence rate > 85 and comorbidities such as ADHD,
anxiety and depression. Measuring The following instruments were used before and after group
therapy: Social Responsiveness Scale; Adaptive Behavior Assessment System - second
edition; The Autism Spectrum Quotient; Clinical Global Impression-Improvement/Severity;
Developmental Disabilities Modification of the Children's Global Assessment Scale DD-CGAS.
Results According to the results of SRS childrens and adolescent with HFA the individuals have
increased their capacity for social interaction comparing before and after the treatment was
carried out. According to AQ results which shows that teenagers were estimated higher than
before the treatment. One explanation may be that teenagers have becomed more aware of
their difficulties. The result is also difficult to interpret when people with AST in general,
difficulties to fill out the questionnaires, which may indicate that therapists need to be more
aware of the child /adolescents has understood the questions and / or found the answer.
Another explanation could be that teenagers have better insight into their difficulties.DD CGAS
results show some improvement. CGI, which is also an estimate therapists do before and after
group therapy. The result shows better performance. The results can be used as a preliminary
measure that shows trends and direction of using KONTAKT, which may be useful in work with
children and adolescents with ASD.

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Aspectos emocionais interferindo no processo de aprendizagem


Rosane Costa2, 1, Acio Gama1, 2.
1. Universidade Estcio de S, Nova Friburgo, Brazil, 2. UNESA, Nova Friburgo, Brazil.
O presente resumo fruto da experincia vivida na Cidade de Cordeiro - RJ (Brasil), em
associao com Secretaria de Educao de Cordeiro e o Laboratrio de Prticas Sociais /
UNESA, que teve como objetivo investigar o fracasso escolar, bem como verificar se h
deficincia intelectual ou perturbao do desenvolvimento, para que eles pudessem alcanar
seu potencial de aprendizagem. Frente a estes problemas de baixo desempenho escolar que
aparecia frequentemente associado a problemas scio emocionais, constituindo problemas
para o educando que apresentava dficits nas habilidades de soluo, problemas e
comportamentais, manifestando simultneas dificuldades escolares, problemas nos contextos
social e acadmico e ainda criando problemas nos relacionamentos interpessoais. Foi possvel
perceber notadamente que a afetividade, assim como a inteligncia, mantinha uma relao
constante e recproca no processo de constituio do psiquismo do educando, influenciando de
maneira preponderante o desenvolvimento de sua aprendizagem e de sua personalidade. O
Psiclogo poder propiciar ao professor ferramentas para que desempenhe o papel de
mediador no processo educativo e na aquisio de conhecimento pelo educando. Isso significa
que a ao precisa ser pautada no conhecimento acerca do desenvolvimento psicolgico,
consequentemente, das suas necessidades. Acredito que, dessa forma, o professor ter
condies de tomar as decises importantes para o desenvolvimento de habilidades e
potencialidades, que faam desse educando uma pessoa plenamente realizada em suas
aprendizagens. Finalizo enfatizando que, para o educando, a relao com os outros, bem como
o desenvolvimento de vnculos afetivos e ateno aos seus aspectos emocionais, so
necessrios e fundamentais para o aprendizado e ampliao de sua capacidade cognitiva.
Autores: Acio Acioli Cintia Werneck Mrcia Farssura Raquel Bolais Rosane Costa
Psicoterapia Cognitivo-Comportamental para Pacientes com Autismo de Alto
Funcionamento ou Sndrome de Asperger
Lidia Cruz.
prtica privada, Belo Horizonte, Brazil.
Abstract Central: O autismo infantil uma sndrome comportamental que pode ser identificada
em qualquer faixa etria. Porm, as alteraes nucleares encontram-se presentes desde antes
de os trs anos de idade. Assim como na sndrome de Asperger, os sintomas so: alteraes
na comunicao, na interao social e no comportamento. Tanto no autismo de alto
funcionamento como na sndrome de Asperger, a inteligncia encontra-se preservada. Desta
forma, muitos destes indivduos estabelecem-se na vida afetiva ou profissional. Porm, devido
a sua maneira peculiar de viver a vida, sofrem rejeio por seus pares. A abordagem cognitivocomportamental a mais indicada para auxiliar este grupo de pessoas. Porm, para que seja
realmente eficaz, necessrio que os indivduos que so submetidos a ela tenham
desenvolvido previamente algumas habilidades sociocognitivas, como capacidade de tomada
de perspectiva e auto-regulao verbal, o que no o caso dos pacientes do espectro do
autismo. Desta forma, faz-se necessrio incluir o desenvolvimento destas habilidades no
protocolo de atendimentos. Os pressupostos bsicos da psicoterapia cognitiva assumem que o
que traz sofrimento para as pessoas no so os acontecimentos em si, mas a maneira que
cada um percebe a situao. Os pacientes com autismo e sndrome de Asperger
constantemente se sentem rejeitados devido ao dficit de habilidades sociais. Porm, devido
extrema rigidez de pensamento, as tcnicas tradicionais de reestruturao cognitiva no so
to eficazes com este grupo de pacientes. Estas pessoas sofreram rejeio social durante toda

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a vida e no adiantaria trabalhar esta percepo como se fossem distores cognitivas. As


pessoas que no so do espectro do autismo possuem uma habilidade natural e espontnea
de elaborarem hipteses sobre os estados mentais de si mesmas e de outras pessoas,
processo nomeado Teoria da Mente. As pessoas que so do espectro possuem dficit nesta
habilidade e percebem o mundo de forma diferente, mais egocntrica e mais rgida. A Teoria da
Mente serve como um norteador para o comportamento social e um dficit nesta habilidade
cognitiva certamente acarretar grandes prejuzos na interao social e na comunicao. A
psicoterapia com este indivduos deve incluir o desenvolvimento da Teoria da Mente e o treino
de habilidades sociais, entre outras tcnicas. Para tanto, sugere-se o seguinte protocolo de
atendimentos: a)Reconhecer emoes em mim; b)Reconhecer emoes no outro; c)Inferir
pensamentos no outro; d)Reconhecer os pensamentos automticos; e)Aprender sobre o
impacto que emoes, pensamentos e comportamentos exercem entre si; f)Desenvolver a
habilidade de antecipar a reao das pessoas; g)Treino de habilidades sociais; h)Treino de
resoluo de problemas. Este protocolo foi elaborado a partir de outros protocolos de
atendimento a este grupo de pacientes. Sem o desenvolvimento da Teoria da Mente muito
difcil para um indivduo ter relacionamentos sociais satisfatrios e no adiantaria o esforo do
terapeuta em alterar as crenas de rejeio em uma pessoa que se comporta de forma a
causar forte rejeio em seus pares.
Verbal Ability and Disorder Specific Cognitions and Symptoms: An Empirical
Investigation at the Neglected End of the Range
Stephen Edwards, Henry Jackson.
University of Melbourne, Melbourne, VIC, Australia.
Abstract Central: The specificity of cognitive content for accompanying symptoms of anxiety
and depression has been well established amongst a range of adult groups in the general
population. This is particularly so where diagnostic differentiation between anxiety and
depression is clear and symptoms are at case level. The impact of verbal ability on cognitions,
symptoms and the relationship between them has received little attention though especially
amongst groups with low intellectual ability. In fact, potential participants with an intellectual
disability are often excluded from research. For this study, a group of 69 adults with a mean
receptive language standard score of 63 who used community support services were recruited
and screened for emotional recognition and scoring ability then read the Cognitions Checklist
(CCL-A & CCL-D), the Beck Anxiety (BAI) and the Beck Depression (BDI-II) Inventories. Eight
indicated they were receiving treatment for depression at the time and six for anxiety. Scoring
was by response to a visual analogue scale specific to the instrument and the interviewer paid
careful attention to the validity of responses. A total of 58 participants gave valid completions on
the four instruments and mean total scores of 12 (CCL-A), 13 (CCL-D), 16 (BAI) and 15 (BDI-II)
were found with alpha coefficients on each one suggesting robust internal consistency with this
group. Analysis of scores on the BAI and BDI-II showed a significant positive correlation
between the two symptom measures. Further analysis with hierarchical multiple regression
showed that CCL-D cognitions do predict the BDI-II symptoms, consistent with the cognitive
content specificity hypothesis, but that CCL-A cognitions do not predict symptoms on the BAI or
the BDI. Similar findings have been reported for some studies of non-clinical adult groups as
well as some children and adolescents suggesting the need for results to be considered in the
context of developmentally determined emotional processing capacity
Estrategias y Entrenamiento en Habilidades Desde la Terapia de Aceptacin y
Compromiso para Padres de Nios con Problemas del Desarrollo

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Sandra Fagua1, 2, Rochy Vargas2.


1. Clinica Neurorehabilitar, Bogot, Colombia, 2. Universidad Javeriana, Bogot, Colombia.
Ser padre o madre de un hijo en condicin de discapacidad es un reto que desde el principio
implica enfrentarse a obstculos sociales, culturales, familiares y de la salud. Los padres y
madres, deben buscar estrategias para manejar el sufrimiento y la incertidumbre a las que se
ven expuestos durante largos periodos de tiempo (Drotar, Baskiewicz, Irvin, Kennell y Klaus,
1975, 1975; McAndrew, 1976; Erickson y Upshur, 1989; Yetter, 1992; Noojin y Walander, 1996;
Weigner y Donders, 2000), "la necesidad de adaptacin puede llegar a sobrepasar a las
personas y convertirse en una fuente de estrs importante" (Kazdin, 1994), que lleva a los
padres y madres a desarrollar conductas problemticas, que los alejan cada vez ms de sus
metas y valores como padres, y que son coherentes con el Trastorno de Evitacin Experiencial
(TEE). Esta investigacin busc incrementar conductas de cuidado parental y la adherencia a
tratamientos de rehabilitacin en los padres de nios con problemas del desarrollo a travs de
la intervencin en la interaccin padres-hijos usando entrenamiento en habilidades entre otras
estrategias de modificacin de conducta enmarcadas en la Terapia de Aceptacin y
Compromiso (ACT). Con ese propsito se organizaron dos grupos con las familias de los nios
en condicin de discapacidad. Se maneja un diseo de lnea de base mltiple entre
condiciones y entre sujetos, esperando demostrar que la Terapia de Aceptacin y Compromiso
(ACT) es efectiva para incrementar las conductas de cuidado parental, la adherencia a
tratamientos de rehabilitacin y mejorar la calidad de vida de padres e hijos.
Attention to Word Stress at 12-months in Infants Later Diagnosed with Autism Spectrum
Disorder: A Prospective, Longitudinal Study of High-Risk Infants
Jennifer Ference, Suzanne Curtin.
Psychology, University of Calgary, Calgary, AB, Canada.
Background: Typically-developing infants are highly sensitive to the rhythmic patterns of their
language (Mehler, et al., 1988). This sensitivity may be directly linked to the ability to detect
words in long speech streams and learn new words (Christophe, et al., 2001; Curtin, et al.,
2005). Indeed English-learning 12-month-olds can map trisyllabic word-object pairings with
labels that differ solely in stress (STRONG-weak-weak vs. weak-STRONG-weak; Curtin, 2009).
Less is known, however, about the atypical processing of word-stress and how this could affect
early word learning. For children with Autism Spectrum Disorder (ASD), the most commonly
affected aspect of speech is the production of stress, rhythm, and intonation (McCann & Peppe,
2003). To explore whether atypical processing of word stress is present in infancy in this
population, we tested infant siblings of children with ASD (SIBS-A). Given that about 19% of
infant siblings of children with ASD will also be diagnosed (Ozonoff et al., 2011), and that an
additional 15-20% will develop language impairments (Constantino, et al., 2010), this population
offers a unique opportunity to study possible atypical processing of word stress and its impact
on developmental outcomes. Objectives: We examined whether 12-month old SIBS-A (n=15)
learn labels for objects when those labels differ solely in word-stress, as is found in typical
development (see Curtin, 2009). We also examined whether this early ability was related to
developmental outcome at 24-months. Methods: Infants were tested at 12-months using the
Switch task (see Werker, et al., 1998) where they were habituated to the trisyllabic word forms
BEdoka and beDOka (STRONG-stress denoted by capital letters) paired with novel objects
that were presented on a central monitor. At test, one of the word-object pairings was
mismatched. Longer looking times to this switch indicated successful mapping of the labels to
objects and the ability to discern minimally different word-forms. A clinical best estimate of the
developmental outcome of these infants was assessed at 24-months by a registered

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psychologist using the Autism Diagnostic Observation Scale (ADOS; Lord, et al., 1989).
Results: Based on the results of the ADOS at 24 months, infants were divided into three groups:
Typically Developing (TD; n=4), Language Delayed (LD; n=5), and Autism Spectrum Disorder
(ASD; n=6). Preliminary results indicated that TD infants looked significantly longer to the
switch (p<.05), LD infants looked longer to the same test trial (p<.05), and ASD infants did not
differentially attend to either test trial (p=.21). Conclusions: While only preliminary conclusions
may be drawn from this study, important points for future research emerge from these findings.
First, while not all infant siblings of children with ASD will go on to receive a diagnosis of ASD or
be LD, those who do may be less likely to have perceived speech in the same way as typically
developing one-year-olds. This could in turn be indicative of deleterious developmental
outcomes. Overall, these findings suggest the need for further research on the early
development of infants at risk for ASD, particularly given the fact that this disorder tends not to
be diagnosed until 3 to 4 years of age.
The Effectiveness of Attribution Retraining on Health Anxiety of Parents of Children with
Visual Impairment in Iran
Amir Ghamarani, Mahnaz Shirani.
Univerdity of Isfahan, Isfahan, Islamic Republic of Iran.
This study investigated the effectiveness of attribution retraining on health anxiety of parents of
children with visual impairment. The research design was Quasi-experimental research
methods with pretest-postest control group.Sample included 50 parents of children with visual
impairment(25 subject in experimental group and 25 subjects in control group).Questionnaires
was the Meta worry questionnaire(Wells,2009).mulitivariate analysis of covariance showed that
in experimental groups, attribution retraining intervention had significant effect on health anxiety
(p=0/0001).Take together the result of this study demonstrated the effectiveness of changing
interpretations and perceotions of parents of children with visual disabilities toward their health
anxiety.
The Comparative Study of Quality of Life in Disabled Persons and Veterans in Iran
Amir Ghamarani1, Elham Nabatian2.
1. Univerdity of Isfahan, Isfahan, Islamic Republic of Iran, 2. Islamic Azad Univerdity of Birjand,
Birjand, Islamic Republic of Iran.
Objective: This study was done to compare the quality of life of veterans and the disabled
persons in Iran. Method: 60 people (30 disabled and 30 veterans) randomly selected by random
sampling. The groups who responded to the World Health Organization Quality of Life
Questionnaire Short Form. Results: The results showed that there is no significant difference
between veterans and disabled persons in quality of life .Discussion: Quality of life for disabled
persons and veterans are at the same level.
The Effectiveness of Attribution Retraining on Hope and Mental Welfare of Parents of
Children with Visual Impairment in Iran
Amir Ghamarani, Mahnaz Shirani.
Univerdity of Isfahan, Isfahan, Islamic Republic of Iran.
This study investigated the effectiveness of attribution retraining on Hope and Mental Welfare of
parents of children with visual impairment. The research design was Quasi-experimental

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research methods with pretest-postest control group.Sample included 50 parents of children


with visual impairment(25 subject in experimental group and 25 subjects in control
group).Questionnaires was the Hope questionnaire(Snyder et al, 1991) and Mental
Welfare(Cummins,2006) .mulitivariate analysis of covariance showed that in experimental
groups, attribution retraining intervention had significant effect on Hope (p=0/02) and Mental
Welfare (p=0/0001).Take together the result of this study demonstrated the effectiveness of
changing interpretations and perceotions of parents of children with visual disabilities toward
their Hope and Mental Welfare.
Programa de Habilidades Sociales para el Control de la Ira en Nios con TEA de C.I.
Promedio
Lizbeth Gladys.
1. Lima, Centro de Educacion Caminito, Lima, Peru, 2. ALAMOC, Lima, Peru.
El presente estudio se llev a cabo con 10 nios con TEA (DSM V), de C.I. Normal de 9 y 10
aos a quienes se les aplic un Programa de Habilidades Sociales para controlar la ira. El
programa inclua incrementar el contacto ocular, atencin y referencia conjunta, el
comportamiento interactivo, solicitar ayuda, esperar turnos, iniciar, mantener y finalizar una
conversacin, actividades de inters con otros nios con o sin TEA. Previamente se observ la
dinmica de la conducta de los nios en una situacin social espontanea no dirigida para
determinar las conductas a trabajar, las mismas que posteriormente fueron registradas en tres
sesiones de lnea base, observndose un dficit en dichas habilidades sociales. El tiempo de
aplicacin del programa fue de tres meses con una frecuencia de tres veces a la semana en
sesiones de 45 minutos, todas las sesiones fueron trabajadas en grupo. Luego se pas a la
fase de intervencin, para ello se les mostr su video a los nios de las conductas mostradas
en sus actividades realizadas en la primera sesin, el objetivo era que reconozcan las
conductas positivas y negativas que cada uno mostr al interactuar con su compaeros, por
ejemplo algunos identificaron y refirieron estar furiosos porque no le prestaron el DVD u otros
prestaban su material a peticin de manera inadecuada. En la intervencin se uso 3 niveles del
software My Community, Social Skill Builder (2004) traducido al castellano. El nivel uno permita
que los nios se familiaricen con elementos especficos de la interaccin social y las relaciones
entre iguales. El modulo dos aade opciones mltiples para que el nio elija la conducta social
adecuada, por ejemplo si el nio mir a los ojos de la otra persona, si utiliz un tono adecuado
de voz, si esper su turno, etc. Ambos niveles se trabajaron en la casa de un amigo, la tienda,
cine y restaurante. Si marcaba la alternativa correcta, el nio era reforzado socialmente, sino se
volva a ver el video y la terapeuta guiaba a un anlisis para discriminar la conducta adecuada.
El modulo 3, presentaba cuatro imgenes fijas y se peda que tenga en cuenta las claves de
contexto relevantes para buscar la imagen indicada. Esto se alternaba con juego de roles entre,
agregando actividades con dilogos que ellos tenan que completar en las imgenes
proporcionadas, por ejemplo una situacin de salida al cine. La ltima fase del programa se
realiz en contextos reales. Los resultados reflejan que los nios aprendieron a controlar su ira,
que presentaban previamente como tirar las cosas al suelo, llorar, gritar o pegar al compaero
cuando no obtena lo que requeran, siendo reemplazas por conductas pro sociales lo cual
demuestra que el dficit de estas conductas hacen que los nios presenten conductas
relacionadas con la ira.
Case Report: Diphenhydramin Hydrochloridum (Benocten) for Sleep Disorders in Autism
Spectrum Disorders

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Ana Jeanmonod-Tirado, Emilie Erard, Markus Kosel, Evangelos Manolis, Giuliana Galli
Carminati.
Mental Disability Psychiatric Department (UPDM) - Departement of adult psychiatric
specialties,Geneva University Hospitals, Geneva, Switzerland.
Introduction Very little literature about sleep disorders exists in the population with mental
retardation, despite the fact that it is a frequent cause of decompensation. With this case-report
we would like to present a patient who responded, after many trials with various hypnotic-like
drugs, to diphenhydramine. This patient was diagnosed with autistic spectrum disorder and
important mental retardation, presenting a behavioral disorder needing medication or watchful
waiting. This patient was sleeping very little or not at all since 200. He was sleeping an average
of 2-3 hours/night and presented nocturnal and early awakenings; this exacerbated his
psychomotor restlessness and his behavioral disorder during the day, creating a vicious circle.
M. JJ took many different medications during the last 10 years to induce sleep (Zolpidem 10mg
at bedtime, Lorazpam 1mg), all of which had a weak beneficial effect for a short period of time
without a good quality of sleep. This type of drug had a paradoxal effect, exacerbating his
agitation and his behavioral disorder. M. JJ also showed a poor response to a treatment with
Circadin Retard (melatonin). Method Participant: 29 year old male, origin: Switzerland. Personal
and familial history, clinical somatic status and psychiatric status: - M. JJ is a tall young man,
with important psychomotor restlessness consisting of constant strolling and verbal stereotypy,
frustration intolerance, who can become self- and/or hetero-aggressive (slaps himself, pulls
hair). At the moment of the study, he's in somatic good health. He doesnt have any sleep
pathology, but a constant anxiety linked to his autistic spectrum disorder. We treated M. JJs
sleep disorder since July 2012 with Diphenhydramine (Benocten) 50mg at 9pm. Pharmacological and therapeutic use: The diphenhydramine used with M. JJ has an
antihistaminic effect, its primary action being to block the receptor for histamine. Results Increase in sleep quantity and quality: Its the first time that diphenhydramine has been used in
the population of mental development as a sleep inductor. Since the introduction of
diphenhydramine 50mg, M. JJ has been falling asleep 30 minutes after ingestion. We observed
a profound sleep for an average of 6-7 hours per night. - Improvement of behavioral disorder
and psychomotor agitation due to a better quality of sleep and an increase in sleep duration. No adverse reactions noticed since the introduction of diphenhydramine. Conclusion Its the first
time that diphenhydramine has been used in the population of mental development as a sleep
inductor. M. JJ, was sleeping only a few hours (2-3hrs) every night, even with medication
(hypnotic-like, melatonin). Since the introduction of diphenhydramine, he sleeps 6-7 hours per
night and has a better quality of sleep (neither early nor night awakening). Thanks to the more
profound sleep induced and maintained by the diphenhydramine, M. JJ has improved his
physical and mental performances. The patient is more concentrated on his tasks and more
present in the therapeutic relationship. He also presents less aggressivity. All of these
improvements were clinically observed. It should also be noted that the diphenhydramine may
be associated with melatonin as an adjuvant. Even if for our patient the melatonin alone wasnt
effective, the adjuvant is effective at a dosage of 4mg of melatonin administered concurrently
with diphenhydramine. We noticed a striking improvement of M. JJs behaviour after 6 weeks of
treatment.
An adult Patient with Deletion 22q13.3 (Phelan-McDermid Syndrome): Clinical Findings,
Genetic Testing and Psychiatric Issues
Ana Jeanmonod-Tirado1, Douibi Abdelhalim1, Bottani Armand2, Galli-Carminati Giuliana1.

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1. Psychiatric Unit of Mental Development, Dept of Psychiatry, Geneva University Hospitals,


Geneva, Switzerland, 2. Service of Genetic Medicine, Geneva University Hospitals, Geneva,
Switzerland.
22q13.3 deletion, also known as Phelan-McDermid syndrome, is a genetic disorder caused by
the heterozygous loss of the distal long arm of chromosome 22. The size of the deletion can be
variable and leads to the loss of many genes, among which SHANK3 plays a critical role. This
syndrome is characterized by moderate to severe intellectual impairment, absent or severely
delayed speech, autistic-like behavior and very often auto-/heteroaggressiveness. Seizures
might also occur.Atypical for a chromosome aberration is height growth which is normal or even
accelerated. It is hard to suspect the diagnosis on physical traits (long narrow head, prominent
ears, pointed chin, droopy eyelids, deep-set eyes, 2-3 toe syndactyly, dysplastic toe nails) alone
as they are not that specific. Chewing on non-food items (clothes,toys,) is frequent as well as
bruxism, hair pulling and aversion toclothes. As the chromosome imbalance is usually too small
to be seen on a conventional karyotype, the diagnosis is made by specific techniques such as
FISH (Fluorescent In Situ Hybridization), MLPA (Multiplex Ligation Probe Analysis) or array
CGH (Comparative Genomic Hybridization). We report the physical and genetic findings, as well
as the various challenging psychiatric issues (aggressive behavior, intolerance to frustrations,
severe agitation) and treatment modalities of a 26-year-old female patient first diagnosed in
early childhood with autism of unknown origin and later found to carry the deletion in question.
Ref.: Phelan K., McDermid HE. The 22q13.3 deletion syndrome (Phelan-McDermid syndrome).
Mol Syndromol 2011; 2:186-201
Cognitive Behavioral Therapy in Medicated and Non-Medicated Adults with Attention
Deficit Hyperactivity Disorder. A Systematic Review and Meta-Analysis
Pablo Lpez1, 2, Dolores Alvarez Prado1, 2, Andrea Viggiano1, 2, Rafael Kichic1, 2, Alicia
Lischinsky1, 2, Fernando Torrente1, 2, Agustn Ciapponi1, 2.
1. INECO (Institute of Cognitive Neurology), Buenos Aires, Argentina, 2. Institute of
Neurosciences, Universidad Favaloro, Buenos Aires, Argentina.
In this study we present a systematic review about the efficacy of Cognitive Behavioral Therapy
(CBT) in medicated and non-medicated adult patients with Attention deficit hyperactivity
disorder (ADHD). Epidemiological studies estimate that the prevalence of ADHD is around 5%
in childhood and approximately 2.5% in adulthood. Since ADHD has been shown to persist in
adulthood with serious health and occupational consequences, diverse psychological
treatments have been developed for this population, most of which are inspired by CBT. The
studies about the efficacy of CBT for adults ADHD are growing, but evidence is still limited and
heterogeneous. Some of the trials compare CBT plus pharmacological treatment vs.
pharmacological treatment alone, because this last modality is considered the treatment-asusual. However there are also studies that compare CBT alone vs. different types of control
groups that include patients with and without medication. Accordingly, our aim is to review the
existing evidence and in particular to compare if there are significant differences in the effect
sizes of the studies that employed CBT alone versus CBT plus medication, to differentially
evaluate the efficacy of CBT for this population. For this purpose, we consider individual and
group treatments of CBT in any of its variants. The electronic search included the following
databases: Cochrane Central Register of Controlled Studies (CENTRAL), part of The Cochrane
Library, MEDLINE, EMBASE, LILACS, CINAHL, PsycINFO, BIOSIS Previews, Cochrane
Library of Systematic Reviews, and Database of Abstracts of Reviews of Effects (DARE).
Additionally we included dissertations and abstracts from the Association for Behavioral and
Cognitive Therapies Convention, World Congress on ADHD (organized by the World Federation

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of ADHD), and the Annual Meeting of the American Psychiatric Association. Finally, we
consulted experts and researchers in the field, including investigators from all review articles
and primary studies identified through searches, about ongoing and/or unpublished trials.
Practical Parent Training Program for Parents of Adolescents with Developmental
Disorders
Risa Matsuo1, Masahiko Inoue2.
1. Tottori University Graduate School of Medical Sciences, Yonago, Japan, 2. Tottori University
Graduate School of Medical Sciences, Yonago, Japan.
The present study reports on a group parent training program for parents of children with
developmental disorders in early adolescence. Over the past three years, this program has
been practiced five groups seven-teen parents of children with developmental disorders in early
adolescence. Parents acquired positive interactions with their child, problem-solving
communication training, behavior contract, and cognitive restructuring. This program consisted
of 6 sessions of 120 minutes each, which were held once every 2 weeks, and a structured
lecture and work. The Child Behavior Checklist(CBCL), Strengths and Difficulties
Questionnaire(SDQ), Beck Depression Inventory(BDI), Conflict Behavior Questionnaire for
Parents(CBQ) were used as an index before and after the intervention. The CBCL total T-score,
Internalizing Problems T-score, Externalizing Problems T-score, CBQ score, both significantly
decreased. BDI and SDQ were not significantly improved with this program. However, the
absolute score decreased in 10 of 17 Parents. These results suggest that this program was in
reducing negative parent-child interactions and child behavior problems. Participants in this
program indicated high satisfaction with the parent training program for parents of children with
developmental disorders in early adolescence. The present study will indicate that a parent
training program for parents of children with developmental disorders in early adolescence is an
effective intervention for reducing anxiety of the parents. The program participants interactions
with their child has improved, so their childs behavior, parent-child relations has improved.
Additional research is necessary to a randomized controlled trial and of preserve the
effectiveness. We will be delivering detailed results of the program, on the day.
Efectos de un Tratamiento Conductual en el Habla Espontanea de Preescolares con
Trastornos Fonolgicos Alveolares
Liliana Mejia Mendoza, Blanca Graciela Arredondo Martnez, Adriana Patricia Gonzlez
Zepeda, Monica Fulgencio Jurez, Roberto Oropeza Tena.
Facultad de Psicologa, Universidad Michoacana de San Nicols de Hidalgo, Morelia, Mexico.
Abstract Central: Se presenta un estudio sistemtico sobre un tratamiento conductual para la
correccin los trastornos fonolgicos alveolares en el habla infantil. Se experiment con cuatro
participantes mediante la aplicacin de un tratamiento conductual basado en ensayos de
ecoicas, tactos y tactos-intraverbales. Participaron 2 nios y 2 nias con la edad comprendida 5
aos, con errores alveolares. Se utiliz un diseo reversible con diferentes respuestas verbales
(ecoicas, tactos, y tactos-intraverbales; adems de la aplicacin de los instrumentos IEA y CEFI
para la obtencin de Lnea Base y Seguimiento), con evaluaciones pre-test y post-test para la
generalizacin del habla espontnea del nio. El P1 pronunci correctamente entre un 42% a
63% de palabras que implicaban fonemas alveolares previa a la intervencin, y post-test entre
73% a 97%, mostrando el porcentaje ms bajo cuando interactu con su tutor, y el ms alto
cuando lo hizo con el experimentador. El P2 en el pre-test obtuvo 43% a 62% y en el post-test
entre un 76% a 99%, presentando el porcentaje ms bajo cuando interactu con otro nio, y el

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ms alto cuando lo hizo con el experimentador. El P3 en el pre-test alcanz 48% a 55% y en el


post-test entre un 63% a 88%; la mejor pronunciacin la hizo cuando interactu con otro nio, y
la menos adecuada cuando estuvo con su tutor. El P4 fue el que no mostr grandes cambios,
pues en el pre-test obtuvo un 30% a 35% y en el post-test un 40% a 46%, teniendo la ms alta
puntuacin con el experimentador y las ms baja al interactuar con otro nio Estos resultados
llevan a concluir la necesidad de intercalar diferentes tipos de ensayos (ecoicos, tactos e
intraverbales) y adems de entrenar a las diadas participantes a relacionarse funcionalmente
para provocar una mayor generalizacin desde el entrenamiento verbal en las sesiones hacia el
habla espontnea del nio.
Psychological Treatment for Adults with ADHD - Results and Evaluation of a New
Treatment Manual Based on Cognitive- and Dialectical Behavioral Techniques
Berkeh Nasri, Nils Lindefors, Ylva Ginsberg, Viktor Kaldo.
Karolinska Institutet, Stockholm, Sweden.
Abstract Central: Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common,
inherited and disabling developmental disorder with early onset. Most often ADHD persists
across the life span, affecting 2-4% of adults. Despite ADHD adults seeking help for
assessment and/or treatment in increasing numbers, literature regarding psychological
treatment is relatively limited. However, studies of cognitive behavioral therapy (CBT) and
dialectical behavior therapy (DBT) show that structured short-term therapies are promising in
reducing ADHD related symptoms and increasing life quality. No treatment study has, up until
now, evaluated the effects of a treatment manual that combines techniques from both of these
therapeutic treatments. Method: This pilot study aims to evaluate a new CBT and DBT based
treatment manual for adults with ADHD in a group setting in an open study. 16 adults with a
confirmed diagnoses of ADHD will be recruited from different psychiatric outpatient clinics in
Stockholm, Sweden. Also participants with comorbid problems will be included. During the 14
week course of treatment, the patients go through 10 treatment modules designed to enhance
executive and organizational skills, behavioral analysis, impulse control and emotion regulation
as well as specifically tailored interventions based on the needs of the particular patient group.
In order to enhance and evaluate the components of the treatment manual, the patients fill out
weekly assessment questionnaires, designed to measure their level of understanding, usage,
and perceived benefit of the various treatment interventions. Every week (two days after each
group session) the patients receive a 20 minute telephone call. The purpose of these calls is to
support them in their homework assignments. The primary outcome measure of the study is
Adult ADHD Rating Scale (ASRS v-1.1) which is filled out before and after treatment, along with
a range of secondary measures of depression, function and emotional regulation. Results: The
first patients have been included and the study will be completed in spring 2013. Initial results
are promising, final results will be reported. A future RCT where the treatment is delivered
through the Internet is scheduled for autumn 2013. This study will be based on the treatment
manual of the present pilot study and preliminary results will be presented if available.
Enseanza Universitaria en el Manejo de Tcnicas Conductuales para Intervencin en
Educacin Especial
Patricia Plancarte, Hugo Romano.
PSICOLOGA, FES-IZTACALA-UNAM, Tlalnepantla, estado de Mrxico, Mexico.
Objetivo: exponer la metodologa de enseanza para capacitar estudiantes universitarios de
pregrado en el tratamiento acadmico de nios con Necesidades Educativas Especiales (NEE)

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y mostrar los resultados de la intervencin en 3 estudios de casos. Mtodo: Participantes:


alumnos del 6 semestre de la carrera de Psicologa que prestan su servicio social y 12 nios
con NEE (sin discapacidad ostensible) remitidos para evaluacin y tratamiento por dificultades
de aprendizaje y problemas conductuales asociados. Escenario: Aulas y cubculos de la Clnica
Universitaria de la salud Integral (CUSI) FES-Iztacala. Materiales: 1) Diagnstico Conductual
Acadmico (DCA) (para evaluar el manejo de aritmtica, lectura y escritura); 2) cuestionarios
de padres, maestros y nios; 3) audiograbadora; 4) contadores;5) cronmetros; 6) materiales
instruccionales diversos. Procedimientos generales: Los estudiantes reciben un curso-taller
propedutico como preparacin a la aplicacin del modelo de enseanza correctiva, que
pondera la atencin personalizada (1 a 1) para el desarrollo de diversas actividades de
planeacin, evaluacin e intervencin, mismas que se resumen en un expediente integrativo
para comunicacin interdisciplinaria y de seguimiento del caso. Se entrena a los estudiantes en
los siguientes apartados: Identificacin, ambientacin, diagnstico funcional, deteccin de
errores, colocacin, programacin, diseos instruccionales, establecimiento de objetivos,
seleccin de estrategias de intervencin. La secuencia de intervencin y supervisin de los
estudiantes se realiza a cargo de dos profesores quienes capacitan, evalan, asesoran y
retroalimentan a los estudiantes universitarios. Procedimientos especficos: Con base en
deteccin de errores, identificacin del nivel de aprendizaje de la conducta, y los patrones de
aprendizaje en la ejecucin de los nios con NEE, se elaboran paquetes de intervencin
integrados por tcnicas presentadas como eventos antecedentes y consecuentes, para su
aplicacin y evaluacin diaria en las 3 reas acadmicas y categoras y conductas deficitarias.
Se capacita al alumno en manejo de decisiones educativas a partir de la evaluacin e
intervencin diaria y directa. Resultados: los datos que se obtiene semestralmente se analizan
a partir de ganancias y prdidas totales y diarias, para conocer global y especficamente el
efecto de las diversas intervenciones en la consecucin de los objetivos generales. En este
reporte se presentan los resultados, por medio de tablas y grficas, obtenidos de 3 casos
tratados por ms de 1 tutor y ms de un ao de intervencin considerando: 1) Ganancias y
prdidas totales pretest-postest obtenidas en la evaluacin inicial y final con el DCA. 2)
Eliminacin, mantenimiento o aparicin de errores por categora acadmica. 3) Efectividad de
paquetes de tcnicas de intervencin conductual. Discusin: Se analiza el cumplimiento de los
objetivos de docencia en el entrenamiento universitario y el objetivo de servicio a partir de
resultados generales y la presentacin de casos; la efectividad de las tcnicas conductuales y
criterios de aplicacin; procedimientos de enseanza y retroalimentacin; y el valor para la
prctica profesional.
Adapting Cognitive Behavioural Therapy for Youth with a Diagnosis of ASD and an
Obsessive Interest in Others
Karen Ramsay, Rosalind Turner.
Child & Family Mental Health, Southern District Health Board, Dunedin, New Zealand.
Abstract Central: It is common for individuals who present with ASD to struggle with the
development of social and romantic functioning during adolescence. Young people with an ASD
desire intimate relationships and friendships yet they lack the skills and knowledge to initiate
such relationships successfully. Their attempts at developing such relationships appear to be
clumsy and inappropriate and could be perceived by others as odd. Due to their lack of social
awareness some young people with an ASD may persist in their pursuit of others to the point
where they are seen as a nuisance. There is however a smaller sub-group whose behaviour is
more extreme and they are highly at risk of being perceived as stalkers or obsessional
followers unless intervention occurs. This paper will review several treatment case studies in
which Cognitive Behavioural Therapy (CBT) was adapted to address the inappropriate

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obsessional focus towards peers of the young people with ASD and reduce risk of stalking
behaviour, as well as addressing other ASD related symptoms,. e.g. co-morbid anxiety. A range
of CBT strategies as described by Stallard (2002) and McClure & Friedberg (2004) and others
were utilized. These included identifying obsessive, intrusive thoughts and developing strategies
in relation to these. Mindfulness techniques and behavioral contracts were incorporated to help
manage and reduce obsessions. There was also particular focus in treatment on the young
persons specific difficulties with understanding social situations and making adaptations to CBT
that encouraged him or her to developing more age appropriate social skills, albeit in a rulebound and task-oriented way. Donoghue et al (2011) noted that there is still limited research in
to the efficacy of CBT in treating the mental health problems of young people with a diagnosis of
ASD. Our paper provides further suggestion that CBT is indeed effective with this population,
along with the importance of addressing any obsessional interest in others/peers in order to preempt the young person moving toward law-breaking and being viewed as a stalker.
Enseanza Universitaria en el Manejo de Tcnicas Conductuales para Intervencin en
Educacin Especial
Patricia Plancarte, Hugo Romano.
PSICOLOGA, FES-IZTACALA-UNAM, Tlalnepantla, estado de Mrxico, Mexico.
Objetivo: exponer la metodologa de enseanza para capacitar estudiantes universitarios de
pregrado en el tratamiento acadmico de nios con Necesidades Educativas Especiales (NEE)
y mostrar los resultados de la intervencin en 3 estudios de casos. Mtodo: Participantes:
alumnos del 6 semestre de la carrera de Psicologa que prestan su servicio social y 12 nios
con NEE (sin discapacidad ostensible) remitidos para evaluacin y tratamiento por dificultades
de aprendizaje y problemas conductuales asociados. Escenario: Aulas y cubculos de la Clnica
Universitaria de la salud Integral (CUSI) FES-Iztacala. Materiales: 1) Diagnstico Conductual
Acadmico (DCA) (para evaluar el manejo de aritmtica, lectura y escritura); 2) cuestionarios
de padres, maestros y nios; 3) audiograbadora; 4) contadores;5) cronmetros; 6) materiales
instruccionales diversos. Procedimientos generales: Los estudiantes reciben un curso-taller
propedutico como preparacin a la aplicacin del modelo de enseanza correctiva, que
pondera la atencin personalizada (1 a 1) para el desarrollo de diversas actividades de
planeacin, evaluacin e intervencin, mismas que se resumen en un expediente integrativo
para comunicacin interdisciplinaria y de seguimiento del caso. Se entrena a los estudiantes en
los siguientes apartados: Identificacin, ambientacin, diagnstico funcional, deteccin de
errores, colocacin, programacin, diseos instruccionales, establecimiento de objetivos,
seleccin de estrategias de intervencin. La secuencia de intervencin y supervisin de los
estudiantes se realiza a cargo de dos profesores quienes capacitan, evalan, asesoran y
retroalimentan a los estudiantes universitarios. Procedimientos especficos: Con base en
deteccin de errores, identificacin del nivel de aprendizaje de la conducta, y los patrones de
aprendizaje en la ejecucin de los nios con NEE, se elaboran paquetes de intervencin
integrados por tcnicas presentadas como eventos antecedentes y consecuentes, para su
aplicacin y evaluacin diaria en las 3 reas acadmicas y categoras y conductas deficitarias.
Se capacita al alumno en manejo de decisiones educativas a partir de la evaluacin e
intervencin diaria y directa. Resultados: los datos que se obtiene semestralmente se analizan
a partir de ganancias y prdidas totales y diarias, para conocer global y especficamente el
efecto de las diversas intervenciones en la consecucin de los objetivos generales. En este
reporte se presentan los resultados, por medio de tablas y grficas, obtenidos de 3 casos
tratados por ms de 1 tutor y ms de un ao de intervencin considerando: 1) Ganancias y
prdidas totales pretest-postest obtenidas en la evaluacin inicial y final con el DCA. 2)
Eliminacin, mantenimiento o aparicin de errores por categora acadmica. 3) Efectividad de

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paquetes de tcnicas de intervencin conductual. Discusin: Se analiza el cumplimiento de los


objetivos de docencia en el entrenamiento universitario y el objetivo de servicio a partir de
resultados generales y la presentacin de casos; la efectividad de las tcnicas conductuales y
criterios de aplicacin; procedimientos de enseanza y retroalimentacin; y el valor para la
prctica profesional.
Terapia de Aceptacin y Compromiso: Un Recurso para la Atencin en Educacin
Especial
Alejandro Rtali, Kysbel Tovar.
Universidad Pedaggica Experimental Libertador-Instituto Pedaggico de Caracas, Caracas,
Venezuela.
Abstract Central: La educacin especial se orienta bsicamente a la atencin de personas con
discapacidad. En el caso especfico de la discapacidad intelectual y los trastornos del
desarrollo, se consideran los aspectos biolgicos, psicolgicos y sociales para el abordaje
integral, con apoyo de equipos multiprofesionales. En el presente trabajo se analiza el caso de
una joven con Sndrome de Down (B.), cuya relacin con su madre ha interferido en su
desempeo laboral debido a los pensamientos y acciones de la madre que considera que su
hija no es capaz de realizar sus actividades de manera ptima. Desde la perspectiva contextual
y considerando los componentes de la Terapia de Aceptacin y Compromiso, se ha observado
que tanto el diagnstico de la discapacidad intelectual como las estrategias de tratamiento
generan en la persona y su familia, patrones caractersticos del Trastorno de Evitacin
Experiencial que se constituyen en factores que interfieren en la apreciacin de lo que se
considera valioso para ellas. Por otra parte, los patrones de comportamiento de los padres en
relacin con la presencia de un hijo con discapacidad intelectual se relacionan con contenidos
privados perturbadores que controlan sus acciones, las cuales influyen en la atencin que
pueden ofrecer a su hijo y que por lo general no es favorable para l. La evaluacin psicolgica
y pedaggica permiti conocer el tipo de eventos y/o pensamientos privados perturbadores de
B. y de su madre, as como sus valores en diversos dominios (relaciones familiares, formacin,
trabajo, ocio) y las competencias para el trabajo de B. La intervencin en varias sesiones
incluy la clarificacin de los valores y la aceptacin psicolgica de madre e hija; igualmente se
reforzaron las actividades laborales de B., que le permitan aproximarse a sus valores. Los
resultados muestran que la TAC constituye un recurso valioso para la atencin de personas
con discapacidad intelectual, como parte del abordaje integral que propone la educacin
especial.
Experiencia Colombiana del Impacto del Mtodo Integrativo en Procesos de
Rehabilitacin Cognitivo Conductual en Poblacin con Dficit Cognitivo
Angela Sanchez, Jose Hernandez, Leslie Pena.
Clinica Neurorehabilitar, Bogota, Colombia.
En respuesta a la necesidad de brindar apoyo efectivo a personas con dficit cognitivo y sus
familias , la Clnica Neurorehabilitar cre el Mtodo Integrativo, el cual fue estructurado en
circuitos teraputicos que unificaron otras metodologas teraputicas facilitando la rehabilitacin
e integracin a la sociedad de las personas con dficit cognitivo. El Mtodo Integrativo involucra
un plan de trabajo con un equipo interdisciplinario de profesionales de diferentes reas de la
salud, segn las necesidades particulares de cada caso, y busca obtener una mirada integral
de la situacin de los participantes. As mismo, para este estudio tuvo en cuenta cuatro (4)
esferas de ajuste: a) Familiar, con relevancia en la aceptacin, el compromiso, la confianza

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tanto en el equipo teraputico como en el mtodo, y el conocimiento a fondo de la intervencin


y la forma apoyo al proceso, como base fundamental para la obtencin y sostenimiento de los
logros a travs del tiempo; b) Diseo Teraputico, con enfoque integral mediante circuitos
teraputicos de Fonoaudiologa (terapia del lenguaje), Terapia Ocupacional, Fisioterapia,
musicoterapia y otras terapias complementarias, donde estuvieron inmersos todos los objetivos
de intervencin, el diagnstico y las metas teraputicas por niveles; c) Educacin y
Socializacin, implementada con una interaccin bidireccional continua del equipo teraputico
con profesionales en educacin y un entrenamiento previo a dichos educadores, una
adaptacin curricular y una sensibilizacin a los compaeros de los participantes, obteniendo
retroalimentacin de los logros obtenidos por los participantes durante el curso teraputico; y d)
Esquema de Nutricin, por parte de un especialista en el manejo de factores bioqumicos y
metablicos, involucrando una dieta especial libre de gluten y casena que ayud a los
participantes a tener una estabilidad orgnica traducida en mejoras en el rea cognitivoconductual. OBJETIVO: Describir el impacto del Mtodo Integrativo como estrategia de
intervencin en procesos de rehabilitacin cognitivo-conductual en poblacin Colombiana con
dficit cognitivo. PARTICIPANTES: La muestra fue conformada por 43 usuarios entre los 3 y 32
aos de edad, las cuales hacen parte de la poblacin de la Clnica Neurorehabilitar en Bogot,
Colombia y fueron diagnosticadas previamente con algn tipo de Dficit Cognitivo. MTODO:
Para verificar el impacto del Mtodo Integrativo en la muestra de personas con Dficit
Cognitivo, se realiz un estudio con diseo descriptivo de corte transversal. Instrumento:
Encuesta dirigida a los familiares de los usuarios para identificar los aspectos de mejora
respecto a la sintomatologa inicialmente en cuanto a: mejora a cognitivo-conductual global y
por intervencin nutricional, mejora en educacin y socializacin, mejora en el lenguaje,
mejora en procesos atencionales, mejora en procesos de memoria, y mejora en calidad de
vida familiar. RESULTADOS: El 91% de los padres encuestados reportaron estar de acuerdo
con la efectividad del Mtodo Integrativo, con un 70%de acuerdo con la mejora a nivel
conductual global y un 54% a travs de la intervencin nutricional, un 79% de acuerdo con la
mejora en educacin y socializacin, un 57% de acuerdo con la mejora en el lenguaje, un 72%
de acuerdo con la mejora en procesos atencionales, un 72% de acuerdo con la mejora en
procesos de memoria, y un 76% de acuerdo con la mejora en la calidad de vida familiar.
CONCLUSIONES: De acuerdo con el reporte de los familiares el Mtodo Integrativo podra
considerarse como una estrategia de intervencin efectiva en los procesos de rehabilitacin
cognitivo-conductual en poblacin Colombiana con dficit cognitivo. Palabras Clave: Dficit
Cognitivo, Intervencin, Mtodo Integrativo, Rehabilitacin
The Cognitive Behavioral Psychotherapy intervention on child with phobia and profound
bilateral hearing loss with cochlear implant indication: a report case
Rachel Schlindwein-Zanini, Cludio Ikino.
Hospital Universitrio, Universidade Federal de Santa Catarina - UFSC, Florianpolis, Brazil.
Hearing Loss-HL reflects on the childs development.This reported clinic case that occurred at
University Hospital-UFSC,Otorhinolaryngology/Psychology Service.The patient AM,2 years
old.She had profound bilateral HL(confirmed by EAEP and OAE)perceived 1 year ago,not use
AASI, her communication was gestural and a delay on the language development was
perceived.The doctor requested the adaptation of Individual Sound Amplification ApparatusAASI("hearing aid), heading her to Cochlear Implant(CI).She flatly refused to wear the
device,crying and moving herself,fact that prevented the Speech Therapists contact.Rendered
impossible the CI,since that this is a prerequisite to the use of AASI to the CI for around 6
months,she sent to the teams Psychologist. For the CIs performance to take place, it is
required that the patient has a profound bilateral sensorineuraldysacousis HL,without the benefit

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of a AASI,and favorable psychological assessment about the motivation, expectations and


psychological conditions so he or she will be able to use the CI. The family is also
evaluated.METHODOLOGY:The Psychologist diagnosed a phobia and anxiety condition,
compatible with ICD-10:F40.2,considering specifics phobias,and initialized a psychological
intervention focused on Cognitive Behavioral Psychotherapy(CBP),because of the phobic
behavior towards members of hospital team and the strong refusal of an AASIs approach.On
this first psychological attention step, a rapport and therapeutic bond was established, which
aimed at obtaining tolerance and acceptation from the patient to a teams member and to the
AASI.It was carried out a brief neuropsychological assessment and systematic desensitization
techniques towards the process related to AASI.It was, too,use a doll designed by the
Psychologist,which simulated the uses of an AASI by the child, allowing,through projective and
recreational psychological techniques, the emotional and behavioral expression of the patient
faced with the situation.On this occasion,the parents also received psychological orientation and
signed a psychotherapeutic contract. In the same month, a new psychological consultation took
place in which it was observed an improvement of the psychological condition, decreasing in the
phobic symptoms and acceptance,maintaining the systematic desensitization procedures, with
progressive and positive results.Afterwards, bilateral earmold was placed.The psychological
interventions included the patients parentsparticipation. She showed herself receptive to the
procedures and professionals upon receiving the AASI.After 15 days, parents witnessed great
improvement behavioral, adaptive and hearing.After 3 months her adaptation was confirmed
and it was daily observed that the girl spontaneously used the AASI and done Speech
Therapy.In the next year,AM was submitted to CI surgery.Nowadays,she is developing speech,
improvement of the on her Neuropsychomotor Development-NPMD and quality of lifeQL.CONCLUSION:The integrated psychological intervention(CBP) was essential for the
accomplishment and the success of the treatment,the patients fitting with the prosthesis and the
benefits stemming from it,with quick and consistent results,like the resolution of the phobic
symptoms and improvement of NPMD and QL.
The Cognitive Behavioural Psychotherapy on Cases of Brain Malformation of Breast-Fed
New-Born Baby on Death Situation
Rachel Schlindwein-Zanini, Micheli Sotili, Lecila Oliveira, Rafael Ferreira.
Psychology - Hospital Universitrio, Universidade Federal de Santa Catarina - UFSC,
Florianpolis, Brazil.
The discussions about anencephalic children/others brain malformations considering
clinical/ethics and human issues, reflecting on mother-childs relationship. Objective:To report
the psychological cares experience of a mother whose child is schizencephalic at the hospitals
pediatric infirmary. Clinical History:A breast-fed new-born of 34 days old that presented, on
Computed Tomography of the Skull, images compatibles with schizencephaly of bilaterally
open-lips, communicating itself with relevant CSF Concentration and brain tissue loss; bilaterally
cortical-cerebral dysplasia, suggesting Diffused Pachygyria; corpus callosum not formed, small
periventricular calcifications. The schizencephaly is characterized by unilateral/bilateral
interhemispheric fissure up to the periventricular region, frequently accompanied by spastic
para/quadriplegia or hypotony with pyramidal disclosure, mental retardation and epilepsy signs.
At the clinic it was observed the maintenance of breathing functions, body temperature
regulation and suction inability. The mother has Panic Syndrome, Bipolar Mood Disorder-BMD,
prior use of psychotropic drugs, without any adherence currently; resistance to the Staff
interventions and fanciful notions on her daughters prognostic (Buying house with bigger yard
so she can run). Rubi is this housewifes fourth child and the firstborn of the couple (father
staying illegally in Brazil). Methodology:The mother was attended during the childs

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hospitalization for presenting a psychologically perturbed reaction to the neuroradiology


diagnosis and the imminent death of her daughter. During the psychological care, her feelings
were heard and an neuropsychological orientation took place observing the patient`s situation
and her neuropsychological prognosis. It was analyzed, (Psychological approach) her
expectations, her ideas of persecution and guilt, issues about her grief and the good-bye ritual
of the child, by using Cognitive Behavioural Therapy (CBT), like Problem Solving
(maximization of functional abilities), Guided Discovery (the discovery of each situation
significations, linked with the own patients provided information), Feedback and
Strengthening(which permits the acquisition and development of adaptive behaviors), besides
of the psychiatric treatments acceptation. Results and discussion:The way of seeing the
malformation diagnosis of the child, to understand and accept that, and the possibility of a
neuropsychological prognosis varies, because it promotes a feeling of grief/death of the
imaginary babe, with probability of the mother developing puerperal depression, between other
manifestations on comorbidity with BMD, worsening the situation. At the hospital, it was carried
out the baptism and the good-bye ritual between daughter and mother, followed by the last
ones discharge. Days after, Rubi died. The psychological care using CBT techniques treats the
psychological disorganization, helps the therapeutic adherence and the creation of a new reality
interpreting situations of fetus malformation, and improves the cooperation of the individual and
the family that was handled by the staff. Conclusion: Psychological intervention on mothers of
malformed brain children associated with the neuropsychological orientation and tests with
neuroimaging are important. The impact of the brain malformations diagnosis, the wide
neuropsychological damage and the imminence of death is a distress moment that needs
mental health care. In this case, the CBT shows itself effective and workable. It is necessary the
Psychologists comprehension/action about the psychotherapeutic and neuropsychological
context for better definition of the clinical conduct. It is evident, the importance of discussing
clear guidelines about psychological procedures on cases of anencephaly and schizencephaly.
Cognitive-Behavioral Intervention to Develop Socio-Emotional Adaptive Behaviors in 4-7
Year Old Children with Sensory Integrative Dysfunction
Rosa Taramona Aparcana.
Dejalo Ser, Lima, Peru.
Abstract Central: The professional work in a private therapy center in Lima can observe
children 5-7 years enrolled II and III level of Basic Education, corresponding respectively to
initial, first grade and second grade, with a clinical diagnosis sensory integrative dysfunction.
According to the results obtained in evaluating these children have occupational mobility
impairment (dynamic coordination, postural control, balance, segmental dissociation, fine motor
coordination) behavioral difficulties (aggression, hyperactivity, sensation seeking, outsourcing);
difficulties cognitive processes (attention, concentration, study skills and learning) and emotional
difficulties (adaptation, anxiety, depression and social skills). Within the therapeutic functions of
the institution is to develop programs that allow recuperative enable these areas and provide the
child with necessary conditions for the acquisition of motor skills, social, behavioral and
emotional suitable adaptive. From there, the idea of developing a program of cognitive
behavioral intervention where parents and children involved with sensory integrative dysfunction
diagnostic question considering as What effect does a program of cognitive behavioral
intervention where parents and children involved, for achieve the development of adaptive
processes of behavior in children with sensory integrative dysfunction enrolled in preschool, first
and second grade? The objective of the research is to describe the effect of cognitive behavioral
intervention program in the areas of aggression, hyperactivity, conduct problems, attention
problems, social adaptability, leadership, anxiety, social skills, depression, and atypical, in

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children who have been diagnosed with sensory integrative dysfunction. The program aims to
provide children with behavioral strategies to meet the socio-emotional situations in their
environment. This research is a qualitative approach of comparative descriptive level. The
sample consists of families with children aged 5-7 years diagnosed with sensory integrative
dysfunction attending our institution. The instruments used were the EPS Questionnaire
(Evaluation of sensory processing) developed and published by Parham and Ecker in your
research Evaluation of Sensory Processing in 2002. The translation is handled in Peru is
produced by Erna Imperatore Blanche and BASC, system behavioral assessment of children
and adolescents developed by Cecil R. Reynolds and Randy W. Kamphaus. For purposes of
research has developed an intervention program for children and parents in obtaining significant
results adaptive behaviors of children
Treino de Habilidades Sociais e Acadmicas : Um Estudo de Caso de um Adolescente
Autista
Aline Valentim, Bruno Andrade, Yara Carobrez, Maria Ribeiro, Ludmila Ueda, Ana Vieira.
DPI, UEM, Maring, Brazil.
O DSM-IV classifica o autismo como um Transtorno Global do Desenvolvimento que
caracteriza-se principalmente pela dificuldades em interao social e comunicao alm de
comportamentos repetitivos. A interveno analtico comportamental em casos de autismo
denominada ABA (Applied Behaviour Analysis) que consiste na aplicao dos princpios
analticos comportamentais a problemas especficos. O tratamento analtico comportamental do
autismo tem como objetivos a aquisio de comportamentos que se apresentam deficitrios ou
inexistentes em diversas reas e diminuio dos comportamentos estereotipados ou em
excesso. Neste trabalho sero apresentados os resultados parciais do treino de habilidades
sociais e acadmicas realizado com um adolescente de 16 anos, do sexo masculino,
diagnosticado com autismo. As sesses ocorrem semanalmente no PROPAE - Programa
Interdisciplinar de Pesquisa e Apoio a Excepcionalidade - e so realizadas por quatro
estagirios de Psicologia da Universidade Estadual de Maring. Dois estagirios realizaram
treze sesses referentes s habilidades acadmicas com uma segunda lngua : o ingls. Os
assuntos abordados foram: comparativo; superlativo; futuro simples; artigo indefinido e artigo
definido. Focando habilidades sociais e autonomia foram realizadas 7 sesses. At momento,
verificou-se uma melhora no desempenho do adolescente na resoluo de exerccios bem
como na interao social.
Proposta de um Programa Baseado em Realidade Virtual para Desenvolvimento de
Habilidades Bsicas para Interveno em Casos de Autismo
Aline Valentim, Maria Ribeiro, Vnia Sant'Ana.
DPI, UEM, Maring, Brazil.
Abstract Central: A palavra autista vem do grego auts, que significa por si mesmo e foi
utilizada para caracterizar comportamentos voltados para o prprio sujeito. Segundo CID-10, o
Autismo Infantil (F 84.0), um Transtorno Global do Desenvolvimento caracterizado por:
Desenvolvimento anormal ou alterado com presena de uma perturbao caracterstica do
funcionamento em cada um dos trs domnios: interao social, comunicao, comportamento
focalizado e repetitivo, e ainda com presena de manifestaes inespecficas, como fobias,
transtornos do apetite e do sono e comportamentos agressivos. Para a Anlise do
Comportamento (A.C.), uma sndrome de dficits e excessos que pode ter uma base
neurolgica, mas que est, todavia, sujeita a mudana, a partir de interaes cuidadosamente

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organizadas. A linha de atuao que se prope a colocar conceitos tericos e filosficos da


A.C. a servio das necessidades e problemas especficos, que incluem o autismo conhecido
pela sigla ABA e utiliza-se de mtodos baseados em princpios cientficos do comportamento
para construir repertrios socialmente relevantes e reduzir repertrios problemticos. A
principal caracterstica do trabalho realizado pelo analista do comportamento o
comprometimento com a premissa de que TODO comportamento possui uma funo (causa) e
por isso, oferece ferramentas valiosas. Nos casos de autismo, geralmente a interveno visa
(1) ampliao e a aquisio de comportamentos que se apresentam deficitrios ou inexistentes
no repertrio (em diferentes reas: verbal, acadmica e pr-acadmica, social, de brincar,
profissional, de atividade fsica, artstica e (2) a diminuio de comportamentos em excesso e
que so inadaptativos (restrio de interesses e de motivao, comportamentos
autoestimulatrios, como birras comportamentos agressivos em relao a si mesmo e aos
outros. Dadas as especificidades da condio autista e das necessidades de interveno,
algumas habilidades bsicas so fundamentais para o sucesso na utilizao da tecnologia
comportamental por familiares e profissionais. Acreditando que a A.C. pode contribuir no s
com interveno direta, mas que seus princpios podem tambm contribuir para o
desenvolvimento daquelas habilidades de familiares e profissionais, aprimorando assim,
indiretamente, os prprios programas de preveno para que possam minimizar a gravidade
dos efeitos comportamentais e educacionais dessa condio e, talvez, evitar o prprio
desenvolvimento de um repertrio autista. O presente trabalho se prope a apresentar uma
reviso terica sobre os principais programas dirigidos ao atendimento de autistas com enfoque
sobre as habilidades necessrias para implementao daqueles. Tambm sero discutidos
resultados de procedimentos utilizando realidade virtual e apresentada uma proposta de
elaborao de um programa utilizando o recurso de realidade virtual para treinamento de
familiares e profissionais envolvidos no atendimento de clientes autistas com objetivo de tornar
o processo mais eficiente e favorecer a manuteno dessas novas habilidades. Desse modo, a
A.C. atenderia simultaneamente tanto aos clientes autistas quanto aos familiares e profissionais
envolvidos com os casos.
Intercultural Psychology/ Psicologa Intercultural/ Psicologia intercultural
Projeto Algo Por Algum - Pessoas em Situao de Rua em Santarm - Par - Brasil
Izaura A. cardoso, Lucivnia Incia de Souza.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Constantemente nos deparamos com pessoas em situao de rua e quase
sempre estabelecemos algum tipo de troca; por vezes um olhar estereotipado de vagabundo,
drogado, coitado, ou mesmo perigoso. E essa interao se apresenta muitas vezes dotada
de sentimentos como medo, constrangimento, pena, nojo. Porm, muito pouco com verdadeiro
reconhecimento de humanidade. A sociedade habituada com aquela figura grotesca das ruas
deixa de enxerg-lo, pois sua condio sub-humana no lhes causa mais impacto. O espao
social ocupado pelo morador de rua um espao subordinado, pois no possui o que lhe de
direito natural. Baseado nesse fato, este projeto tem como objetivo fortalecer aes de
promoo de sade e qualidade de vida para as pessoas em situao de Rua de Santarm Pa - Brasil. Pblico alvo: 25 pessoas em situao de rua. Inicialmente foi realizado uma
pesquisa sobre os relatos de experincias de 15 pessoas em situao de Rua de Santarm
que ficam localizados no mercado 2000. Atravs destes relatos de experincias foram
detectados muitos problemas que afetam suas vidas como: o frio, as doenas adquiridas nas
ruas, a dificuldade no acesso hospitais pblicos, fome, uso abusivo de lcool e outras drogas,
excluso social e ausncia de oportunidades para os que anseiam sair das ruas. realizado

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mensalmente rodas de conversas sobre direitos e cidadania, cuidado pessoal, escuta, oficinas
de artesanatos e orientao sobre os prejuzos do consumo de substancias psicoativos.
Tentou-se estabelecer no s um cenrio de investigao, mas um olhar para uma populao
que provoca, instiga e se movimenta.
Aplicaciones Clnicas y de la Salud en la Praxis Paraguaya de las Terapias del
Comportamiento
Maria Celeste Airaldi, Norma Coppari, Jos Britos.
Sensorium Centro Especializado en Psicologa, Ciudad del Este, Paraguay.
La siguiente mesa clnica presenta tres experiencias de evaluacin e intervencin
comportamental con muestras de nios y jvenes de Paraguay. La primera investigacin tuvo
el objetivo de identificar la incidencia del bullying en colegios privados de Ciudad del Este, la
cual surgi como necesidad de identificar las modalidades de acoso escolar en la zona. La
muestra se compuso de alumnos y docentes. Const de 170 alumnos de de 5to. a 9no. grados
y 19 docentes . Se emple el Cuestionario de Evaluacin del Bullying para el Alumnado
(PRECONCIMEI), la checklist Mi Vida en la Escuela y el PRECONCIMEI para profesorado. Los
resultados demostraron que, en el caso de los varones, la modalidad ms frecuente de bullying
es la denominacin al compaero con apodos denigrantes e insultos, mientras que las nias
tienden al aislamiento social y a crear rumores. 20% de los alumnos mencion ser vctima de
maltrato e intimidaciones todos los das, y en varios casos, por de parte de los profesores. En
base a los resultados se realizaron talleres de concienciacin con los alumnos, con un enfoque
de prevencin y psicoeducacin. El segundo estudio describe las habilidades de interaccin
social en un contexto cultural paraguayo, con una iniciativa que apunta al aumento de la
produccin de tesinas de licenciatura en la carrera de Psicologa de la Facultad de Filosofa de
la Universidad Nacional de Asuncin. En cuanto a objetivos cientficos pretende construir
conocimientos sobre las competencias para la interaccin social desarrollados por
adolescentes de dos ciudades de Paraguay, haciendo diferencias entre los castellano y guaran
hablantes. Contempla entre sus acciones la convocatoria de estudiantes de Psicologa con el
requisito de tesis o tesina pendiente, interesados en aportar al tema, proporcionndoles
cooperacin que coadyuve la produccin cientfica y el egreso de sus estudiantes. Finalmente,
la tercera presentacin conjuga deteccin-intervencin comportamental en una muestra de
jvenes afectados por el incendio del supermercado Ykua Bolaos en Asuncin, conocido
como 1A. Se aplic Informacin Biogrfica e Historia de Vida, Sucesos de Vida del Adolescente
e Inventario de Riesgo Suicida (IRIS). Los resultados acumulados entre los aos 2000 y 2012,
privilegian a la muestra "destinataria" del 1A (N=122), en comparacin con la muestra control
(N=670). Se registran diferencias en la presencia de comportamientos disfuncionales en la
muestra afectada, con mayor intensidad y frecuencia para el sexo masculino. Las medias ms
elevadas, para varones y mujeres, registran tenencia uniforme de mayor a menor puntaje (1A,
pblica y privada) en las reas familiar, sexual y personal. Contingencias disfuncionales tienen
que ver con familias desmembradas, maltrato intrafamiliar, desocupacin, alcoholismo,
drogadiccin, embarazos precoces, desercin escolar, entre otros La estrategia comunitaria
aplica tcnicas operantes, de autorregulacin, de habilidades sociales, de solucin de
problemas, etc. Los resultados demuestran incrementos de patrones de comportamiento
saludables y decremento de los disfuncionales. Esto implica que la propuesta de seguimiento y
aplicacin de medidas preventivas en intervenciones de promocin de la salud psicolgica es
eficaz.
Cognitive Therapy with International Students

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Nancy Arthur.
Ed Studies Counselling Psychology, Uni versity of Calgary, Calgary, AB, Canada.
Abstract Central: There has been substantial growth in the number of students who leave
home to study in another country. It is estimated that the number of international students
worldwide has increased from 0.8 million in 1975 to 3.7 million in 2009, which represents a more
than four-fold increase. International students have in common the experience of cross-cultural
transition between countries and cultures. Living in a new cultural context provides international
students with profound opportunities for learning. The degree to which students navigate new
understandings about self, about other people, and the world around them is influential for
students adjustment, their academic success, and for the construction of their cultural identities.
Although most international students manage their transition experiences with few difficulties,
other students experience major difficulties of adjustment which manifest in serious mental
health issues. It is important to distinguish between symptoms of culture shock and more
serious symptoms of distress that may manifest in anxiety or depression. Cognitive therapy is
proposed as an intervention that can be used to help international students to explore their
cultural beliefs and integrate new cultural understandings. This presentation will highlight the
ways that cognitive therapy can be used to help students to explore their cultural identities and
beliefs while experiencing serious symptoms of distress during cross-cultural transitions. A key
for applying cognitive therapy with international students is the therapists capacity for honoring
cultural beliefs in both home and host cultures. This capacity requires therapists to be grounded
in their own belief system and to be able to work with students whose worldview and belief
system may sharply contrast their own. Considerations for applying cognitive therapy across
cultural contexts will be highlighted, with considerations for working with diverse international
student populations.
Why Choose Internet-Delivered CBT? Differences in Help-Seeking Characteristics
Between Chinese and Matched Non-Chinese Internet-Delivered CBT Participants in
Australia
Isabella Choi, Caroline Hunt.
School of Psychology, The University of Sydney, Camperdown, NSW, Australia.
BACKGROUND: Delivering Cognitive Behavioural Therapy (CBT) over the Internet is one
strategy to overcome treatment barriers and increase the capacity of mental health services.
People from culturally or linguistically diverse groups often face additional cultural and practical
barriers to treatment and have lower mental health service utilisation than the general
population. Internet-delivered CBT (iCBT) may provide several advantages over face-to-face
treatment in overcoming treatment barriers and reducing unmet need for people from cultural
backgrounds. In a recent randomised controlled trial, a culturally adapted iCBT program was
shown to be efficacious for Chinese Australians with depression. This study explores the appeal
of iCBT to Chinese Australians who applied to the online depression program, and whether their
motivations for participating in iCBT were different to that of people from Western backgrounds.
AIMS: To compare the help-seeking characteristics and motivations of Chinese and nonChinese Australian people applying to iCBT depression programs. METHOD: Fifty-five Chinese
Australian participants in a Chinese language iCBT depression program were compared to a
non-Chinese Australian iCBT depression program sample matched on age and gender (n=55).
Groups were compared on demographics, help-seeking characteristics, and motivations for
choosing to participate in the iCBT program. RESULTS: No significant differences were found
between groups on demographic factors. The non-Chinese sample had more severe symptom
scores and earlier depression onset and a longer period of depression compared to the Chinese

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sample. The Chinese iCBT participants were significantly less likely to have sought prior
treatment, receive medication and help from a psychologist or psychiatrist compared to nonChinese participants. The main reasons for Chinese participants to choose iCBT over face-toface treatment was because of convenience in time (71%), costs involved (58%), convenience
in transportation (50%), privacy and anonymity (35%), thinking that their symptoms were not
severe enough for face-to-face treatment (21%), and not being aware of any face-to-face
treatment (19%). Non-Chinese participants chose iCBT because of convenience in
transportation (66%), convenience in time (49%), costs involved (45%), and face-to-face
treatment did not help (23%). Chinese participants were significantly more likely to report
convenience in time and not being aware of any face-to-face treatment as reasons for seeking
iCBT treatment compared to non-Chinese participants. Other analyses of subcategories of
Chinese and non-Chinese applicants to the iCBT program will be presented. CONCLUSIONS:
The significant differences between groups suggest that Chinese and non-Chinese Australians
sought iCBT treatment for different reasons. iCBT treatment appealed to non-Chinese
Australians with more severe symptoms and those who have not responded to previous face-toface treatment. In contrast, Chinese iCBT participants were less likely to have sought previous
face-to-face treatment and reported more reasons for participating in iCBT, suggesting that
iCBT provides additional advantages than face-to-face treatment in reducing treatment barriers
and unmet need in Chinese people.
Los Celos se Relaciona al Amor? Comparacin entre Respuestas de Estudiantes
Brasileos y de Norte-Americanos
Nazar Costa, Calope Costa, Holga Cristina Gomes, Juliana Lobato, Ludmilla Lima Gondim,
Mayra Pereira da Silva, Renata Pinheiro, Thas Almeida, Valentina Almada Lima.
Universidade Federal do Maranho, So Luis, Brazil.
La literatura sobre los celos tiene centrado en estudios sobre lo que se conoce como celos
romntico. A partir de esto se puede suponer una relacin entre los celos y el amor. A lo largo
de la historia de la humanidad y, mismo hoy da, la cultura espera celos en las relaciones de
pareja. En esta investigacin se compar datos de un estudio llevado a cabo, con estudiantes
norte americanos, sobre la relacin entre celos y amor y, especficamente, se verific si las
personas relacionan estos eventos y se busc identificar si hombres y mujeres presentaban
respuestas distintas. Participaron del estudio, 200 estudiantes universitarios, 100 hombres y
100 mujeres, con ms de 18 aos. El instrumento consisti en un cuestionario constituido de
preguntas generales acerca de los participantes y de 22 tems en una escala lykert de 1 a 5
puntos. Para empezar, la investigadora informaba que en un estudio ya hecho fue constatado
que hombres muestran reacciones distintas cuando imaginan su esposa interactuando con otro
hombre. Enseguida, fue pedido a los participantes dar su opinin sobre las respuestas dadas
por estos hombres, analizando tres condiciones: inocua, fuerte coqueto y traicin. Para
cada situacin, los participantes deberan contestar tomando como base la reaccin del marido
celoso y del marido no celoso. Entre las situaciones estaban en lo mucho que cada marido
amaba, deseaba cuidar, respetaba y deseaba quedarse con su esposa, adems en lo mucho
que consideraban la reaccin del marido como adecuada, aceptable y racional, entre otras.
Hemos tratado de comparar, para cada tem, las respuestas con respecto a la reaccin del
marido celoso y con respecto a la reaccin del marido no celoso, basado en la suposicin de
que cuanto ms el comportamiento de la mujer se hizo menos inocente, los participantes vern
la reaccin del marido celoso como ms amable y ms favorable en comparacin con la
reaccin del marido no celoso. Los datos apoyan la hiptesis y son consistentes con los
obtenidos con los estudiantes norte americanos, pues cuanto ms la situacin era provocativa,
en la condicin celos, la mayora de los participantes respondi que el marido amaba, quera

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estar y cuidar a su esposa. Del mismo modo, en la condicin celos, en las situaciones ms
provocativas, ms participantes calificaron la respuesta del marido como adecuada, aceptable y
razonable. En cuanto al sexo fue encontrado poca diferencia, ya que las diferencias
significativas (mayor o igual a 10%) se encontraron slo para tres variables: lo mucho que el
marido deseaba cuidar y quera estar con su esposa y la medida en que la reaccin fue
racional (en la condicin inocua en la cual el marido senta celos). Las mujeres mostraron un
mayor nivel de aceptacin al marido que senta celos en la condicin inocua como una
demostracin de lo mucho que el quera cuidar y estar con su esposa, mientras que los
hombres calificaron como ms racionales que las mujeres, la reaccin del marido celoso en
esta misma condicin. Llegamos a la conclusin de que los celos y el amor estn relacionados
tanto en la cultura americana y en Brasil, por lo que es importante identificar las variables en
estas culturas que favorecen la construccin de esta relacin.
Why is Self-talk a Useful Psychological Tool?
Maria Damianova.
Monash South Africa, Johannesburg, South Africa.
Abstract Central: Founded in Vygotskys seminal work on language and thought, the
contemporary explorations of self-directed talk have offered substantial empirical support to its
role as a cognitive and self-regulatory tool. The continual presence of self-talk in individuals
psychological repertoire during adulthood has by now been widely acknowledged and validated.
However, the scope of psychological functions facilitated by this tool and the cultural variations
in its use remain open to further conceptual refinements. The aim of the present study was to
explore whether self-talk is used extensively by young adults across various functional domains
and to determine whether it plays a role in facilitating individuals psychological wellbeing. The
study further explored whether there are cross-cultural differences between South African and
international students in their use of self-talk. The participants of the study, who were students
completing their undergraduate degrees were invited to complete the Self-talk scale (STS), the
Self-verbalisation Questionnaire (SVQ) and Psychological General Wellbeing Index (PGWB).
The results revealed that the South African and international students did not differ in their use
of self-talk. In a Multiple Regression Model, it was indicated that unlike the facets of SVQ, the
facets of STS predicted significantly individuals level of psychological wellbeing and the
predictive value of self-criticism was specifically highlighted. The findings confirm that self-talk is
used extensively by young adults from various cultural and linguistic backgrounds for cognitive,
self-regulatory and therapeutic purposes, and serves as an instrument facilitating their
psychological wellbeing.
Te Cuento un Cuento: Estrategias de Liberacin Tensiva en Los Andes
Venancio Dominguez Condezo.
Universidad de Hunuco, Huanuco, Peru.
Abstract Central: Introduccin La comunicacin humana siempre fue oral y narrativa, la
escritura se invent tardamente. \...es uno de los temas emergentes ms fascinantes de la
psicologa contempornea\...\ la construccin del significado surge de la narrativa,...actividad
humana fundamental\" (Alfredo Ruiz, 2010). Nuestra proposicin: la narrativa recrea
\competencias emotivo-relacionales, cognitivas y culturales\ permitiendo superar estados de
estrs e inadaptacin educativo social en nios y sociedades emergentes, afectados por crisis
econmico- culturales. Objetivo: Proponer la aplicacin de la narrativa (literatura oral) como
estrategia de liberacin psicolgica y favorecer procesos de clima institucional ptimo.

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Metodologa: Cualitativa, descriptivo explicativa; ni\el monogrfico, Muestra: Cinco leyendas de


pampa y puna, jirkas deidades de los Andes Peruanos; una experiencia de relatos amenos
como estrategia de aprendizaje. Diseo: Descripcin narrativa, consejos y orientaciones
comparativos, tareas, compromisos y evaluacin. Esquema: narracin emotiva (x) estimula
reflexiones razonadas (y). Resultados: Los andinos construyeron en la cima de los cerros
piramidales plataformas circulares, con muros de contencin superpuestos; para la observacin
y captacin de energas csmicas, comunicacin entre pueblos, meditacin y liberacin
psicofsica y purificacin espiritual. Experiencias teraputicas: a. Nios deprimidos escuchando
cuentos de condenados, diablos, leyendas y fbulas, se muestran atentos, razonan
positivamente y superan estados emocionales negativos. Somos protagonistas de estrategias,
as atesoramos en la memoria cientos de cuentos orales de la literatura popular; aprendimos a
ser ms atentos y adquirir una personalidad equilibrada. Razn de la educacin emocional y
literatura infantil, b. En clases de Gramtica aun motivando los alumnos se dorman; "...de
sbito quebr la clase contndoles un cuento \colorado\ , se rieron a mandbula estirada,
pidieron ms relatos; tuvieron como tarea recoger ms relatos cmicos y escribir. Leyeron en
voz alta... el ambiente se llen de carcajadas; los textos fueron excelentes materiales
didcticos, partiendo de la \"mente narrativa\ como estrategia de aprendizaje", c. Actualmente,
los mitos, leyendas, paradojas, chistes y hasta chismes, son elementos fundamentales de la
risoterapia recomendadas por la psicologa positiva. Recomendacin: Es urgente la
institucionalizacin de la etno-psicologa basada en la mente narrativa de los pueblos andinos,
la cotidianidad para la liberacin psicofsica y prevenir a las colectividades de los grandes
problemas psicolgicos que se avecinan. Co-autora: Amarilis Domnguez Palpa (Psicologa y
Doctora en Educacin)
Anlisis pluridimiesional del comportamiento social en Venezuela para el
establecimiento de lneas de intervencin cognoscitiva conductual para polticas
pblicas
Hector Dunn1, Migne Muoz2, Laura Palacios3, 1, Evart Gurley Valls4, Josmar Torres2.
1. CliniPser: Clinica Integral de Psicologia, Ergonomia y Rehabilitacion, Ciudad Guayana,
Venezuela, 2. Ministerio de Educacion: Centro de Atencion Integral para Personas con
Autismo, Ciudad Guayana, Venezuela, 3. Ministerio de Educacion: Centro Comunitario de
Proteccion al Estudiante, Casacoima, Venezuela, 4. Ministerio de Educacion: Centro de
Diagnostico, Orientacion, Formacion y Seguimiento para la Diversidad Funcional, Ciudad
Guayana, Venezuela.
Al reflexionar sobre el comportamiento social en Venezuela, se plantea un estado de
perplejidad fenomenolgica al percibir la discrepancia entre las oportunidades que presenta
este pas dado su potencial natural, geogrfico y humano, en contraste con problemas que se
han tornado estructurales, entendidos como comportamientos conducentes a pobreza,
corrupcin y violencia (Garrido, 2006; Ugalde, 1994). Son innumerables las manifestaciones de
este aserto, evidenciadas a diario tanto en los medios de comunicacin de masas como en los
testimonios de las personas allegadas, quienes se quejan de homicidios, robos, engaos,
ineficacia de servicios, entre otros. Un pas donde la gente parece estar acostumbrndose a la
hostilidad en las relaciones interpersonales, a la carencia de pensamiento comunitario, a la
transgresin de la ley y de las buenas costumbres, incluso por parte de personas que jams
seran consideradas ni se declararan a s mismas como delincuentes o antisociales.
Clsicamente, se propone que los determinantes de la conducta pueden ser biolgicos o
ambientales; es decir, si lo que hacemos es producto de la herencia gentica o del aprendizaje
(Vygotsky, 1927; Bronfenbrenner y Ceci, 1993; Len, 2011). Hoy en da se incluye un tercer
elemento, constituido por las decisiones personales (Len, 2011), fortalecidas por una familia

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estructurada que provea nutricin afectiva y disciplina firme y, por la otra parte, la identificacin
consciente de una vocacin ligada a un proyecto de vida. Combinados configuran una base de
desarrollo que expone a los individuos a factores protectores y de riesgo que los hacen
vulnerables en mayor o menor grado al desarrollo de ciertos comportamientos (Colombo,
1992). Sobre esta base, el presente panel hipotetiza que si una poblacin de individuos,
representada en este anlisis por la poblacin de Venezuela, comparte experiencias y
condiciones de vida comunes, desarrolla creencias, valores, actitudes y conductas que
conforman sus estilos de actuacin cultural. Por lo tanto, la problemtica asociada a pobreza,
corrupcin, indefensin y violencia, que se han tornado parte estructural de la sociedad
venezolana, tendran su raz en creencias irracionales (Ellis, 1975) y distorsiones cognoscitivas
(Beck, 1995) que se han venido formando a lo largo de la historia y hacen que hoy en da se
perciban como habituales el poco valor por la vida, el poco respeto por las autoridades y las
leyes, la dificultad para cumplir con reglas sociales bsicas como normas de cortesa e
irrespeto por el derecho cvico del conciudadano. La posibilidad para contrarrestar estas
caractersticas inapropiadas se plantean, en primer lugar, desde un anlisis que permite
comprender el fenmeno desde las siguientes dimensiones: (a) clnica, (b) cognoscitivo-social y
conductual y (c) histrica y antropolgica; y luego desprender propuestas para un abordaje
teraputico apoyado en polticas pblicas, compuestas principalmente por estrategias
psicosociales que deben integrarse en la infaestructura educativa, tanto magisterial como de
comunicacin de masas, con el fin de propulsar el cambio de los esquemas de pensamiento
que sostienen los valores y actitudes que conducen a los comportamientos de pobreza,
corrupcin y violencia.
Algunas Reflexiones Sobre una Terapia Cognitiva-Conductual Latinoamericana y
Argentina
Alicia Facio1, 2, Adelia Caneo1.
1. Asociacion de Terapia Cognitva y Conductual del Litoral, Parana, Argentina, 2. Universidad
Nacional de Entre Rios, Parana, Argentina.
Abstract Central: Al convertirse la Terapia Cognitiva-conductual (TCC) en un fenmeno
mundial, se hace necesario aplicarla teniendo en cuenta las caractersticas culturales y socioeconmico-polticas de las distintas regiones del planeta. Este trabajo aportaremos algunas
reflexiones sobre cmo debera ser una TCC latinoamericana o, al menos, argentina. Haremos,
primero, una breve descripcin de algunos rasgos comunes y distintivos de la Argentina dentro
de la regin. Analizaremos, luego, algunas diferencias interculturales basndonos en a) las
respuestas al test NEO-PI-R de una muestra comunitaria y una clnica estudiadas por Facio y
otros y el baremo argentino del test MMPI-2 de Casullo y otros. Ambos Indican que las medias
argentinas son ms altas en emocionalidad, sensibilidad y desconfianza y ms bajas en el
factor conciencia que las muestras normativas estadounidenses b) Los estudios longitudinales
de Facio y otros sobre el desarrollo socioemocional de jvenes argentinos desde los 13 hasta
los 27 aos: -Los metaanlisis de Oyserman muestran que la mayora de los pases
latinoamericanos puntan ms alto en individualismo y colectivismo que los norteamericanos
de origen europeo. El familismo -definido como un fuerte apego hacia la familia y la bsqueda
de armona, apoyo y consejo familiar- es la forma de colectivismo que caracteriza a los pases
latinoamericanos. La investigacin argentina de Facio y otros demuestra que el familismo es
alto y que quienes son ms congruentes con los valores predominantes (al mismo tiempo
individualistas y familistas) presentan una serie de ventajas en su desarrollo psicosocial. - Por
otra parte, la teora de la autodeterminacin de Deci y Ryan postula que autonoma no es
sinnimo de independencia, como se considera en los pases altamente industrializados de
occidente. Los jvenes argentinos, mientras respetaran su autonoma aceptaban la

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participacin de los padres en sus asuntos personales sin interpretarla como intromisin, sino
como inters y amor. Lo mismo suceda con otros vnculos ntimos. Por ltimo, contestar la
pregunta de cmo debera ser una TCC latinoamericana o argentina requiere desarrollar un
programa de investigacin clnica en el cual se prueben las intervenciones que resultaron
exitosas en el primer mundo y se evale qu aspectos deberan modificarse y en qu sentido.
Basndonos en los hechos arriba expuestos y en nuestra larga experiencia como terapeutas y
formadores de terapeutas cognitivos analizaremos slo tres de los tpicos que consideramos
importantes para dicho programa de investigacin: 1) Dada la alta emocionalidad y la
expectativa de una menor distancia interpersonal, habra que dedicar mayor tiempo y energa
que la habitual en el primer mundo a construir una relacin teraputica clida y estrecha para
luego introducir gradual y cautelosamente la construccin de habilidades? 2) Dada la alta
valoracin de la emocin por sobre la racionalidad sera ms eficiente recurrir a argumentos
tales como te conviene pensar/hacer as, qu efectos tendra esto sobre tus seres queridos
o cmo hara una persona viva que a la bsqueda de evidencia racional? 3) Recurrir
asiduamente a las imgenes y a las metforas -ms conectadas a la emocin- producira
mejores resultados teraputicos?
De la Investigacin Clnica a la Realidad Hispanoamricana From Clinical Research to
Social Reality in Hispano-America
Antonella Galli, Vicente Caballo, Mariela Goldberg, Marcia Wagner, Fabin Olaz, Arturo
Heman.
Asociacin Psicolgica Iberoamericana de Clnica y Salud, Granada, Spain.
Hispanoamrica refleja una realidad social, vinculada a la ansiedad y a la violencia de genero.
Nos encontramos con ansiedad social en nios, muchas veces vctimas del acoso escolar, por
lo que necesitamos una deteccin precoz como una escala transcultural que presentamos. As
poder prevenir lo que hallamos en alumnos peruanos de psicologa, una elevada ansiedad
generalizada y ansiedad social, o en el alumnado universitario argentino, una pasividad de las
mujeres hacia la agresividad sexual. Tambin es importante tomar en cuenta las evaluaciones
de las creencias en las mujeres mexicanas que nos ayuda a entender a la mujer hispana y
seguir el modelo de intervencin del programa de habilidades sociales que se muestra en los
universitarios brasileros. Presentamos varios trabajos de investigacin en Hispanoamrica que
abre las puertas al panorama actual de los principales problemas que ocurren en nuestro
medio.
Desarrollo de una Nueva Medida de Autoinforme para la evaluacin transcultural de la
ansiedad social en nios
Development of a new self-report measure for assessing transcultural social anxiety in
children
La evaluacin de la ansiedad social es un campo que est precisando de una mayor
clarificacin y concrecin actualmente. Existen diversos cuestionarios utilizados
internacionalmente para la evaluacin de la ansiedad social en adultos y en
nios/adolescentes, pero la mayora de ellos plantea una serie de problemas, en especial los
relativos a esta ltima poblacin. El presente trabajo culmina varios aos de investigacin
dirigidos al desarrollo de un nueva medida de autoinforme para la evaluacin de la ansiedad
social en nios de 9 a 15 aos, el Cuestionario de ansiedad social para nios (CASO-N24),
compuesto por 24 tems y 6 factores (Caballo et al., 2012). Han participado en esta
investigacin 12 pases latinoamericanos y Espaa, con una muestra de 12.801 sujetos con
edades comprendidas entre 9 y 15 aos y distribuidos aproximadamente al 50% para cada
sexo. El anlisis factorial confirma la estructura de seis factores del cuestionario, que explican

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el 60,63% de la varianza y que se concretan en los siguientes: 1) Interaccin con el sexo


opuesto, 2) Hablar en pblico/Interaccin con profesores, 3) Quedar en evidencia/Hacer el
ridculo, 4) Interaccin con desconocidos, 5) Expresin de molestia, desagrado o enfado y 6)
Actuar en pblico. La correlacin entre los distintos factores va de 0,20 a 0,48, lo que seala
que hay muy poco solapamiento entre las reas que est evaluando. El alfa de Cronbach es de
0,89, indicando una elevada consistencia interna del cuestionario. Se presentan igualmente
otras propiedades psicomtricas de esta medida de autoinforme, que muestran la solidez del
CASO-N24 y que respaldan la multidimensionalidad de la ansiedad/fobia social en nios.
Esperamos que con este nuevo instrumento de evaluacin se minimicen los problemas que
encontramos en los cuestionarios sobre ansiedad social ms utilizados a nivel internacional.
Evaluacin Psicopatolgica en Alumnos Peruanos de Psicologa de una Universidad
Privada con seguimiento a cuatro aos
Psychopathological assessment in Peruvian Psychology Students from a private
university and a four year follow-up
En una investiga de Galli, E. et al. (2002) en 225 estudiantes de medicina identific que 46,6%
de los estudiantes sufran alguna psicopatologa. En esta investigacin se aplic la adaptacin
Mini Entrevista Neuropsiquitrico MINI International (CIE-10 version) y un formulario de
recoleccin de informacin en 71 estudiantes de psicologa de una universidad privada de
Lima. El propsito de esta investigacin fue conocer los diferentes trastornos psicopatolgicos
en todos los aos de estudios y la autopercepcin de la enfermedad, la demanda sentida (si
sienten que necesitan ayuda), y la demanda expresada (si estn recibiendo atencin). Se
encontr una alta prevalencia de los trastornos psicopatolgicos en el primer ao de estudios
predominando la ansiedad generalizada (70%), en comparacin con el ltimo ao de estudios,
la prevalencia fue menor. Como un trastorno aislado, la prevalencia fue el trastorno de
ansiedad generalizada predominando con un 25 %. La auto percepcin de la enfermedad fue
de 7%, la demanda sentida (creer que necesitan ayuda) de 7% y la demanda expresada (que
estn recibiendo intervencin) de 4%. Frente a esta preocupacin al hacer seguimiento del
primer ao de estudios, cuatro ao despus, se encontr que del 70% el trastorno de ansiedad
generalizada se haba reducido en un 30%, y del 50% que saban a donde acudir en caso de
recibir ayuda haba aumentado en un 100%. El 100% que ahora cursaban su ltimo ao de
carera haban aplicado durante esos aos las tcnicas psicolgicas cognitivos conductuales
aprendidas en la carrera, siendo las ms empleadas la solucin de problemas, la relajacin
muscular, el autocontrol y las habilidades sociales.
Competencia Interpersonal y Actitudes hacia la violacin en estudiantes universitarios.
Lneas de investigacin y desarrollo de programas
Interpersonal Competence and Attitudes toward rape in college students. Lines of
research and program development
En los ltimos aos, la violencia de gnero en general y la violencia sexual en particular, se han
constituido como una problemtica de urgencia a nivel nacional e internacional. Segn cifras
del fondo de desarrollo de las Naciones Unidas para la Mujer (Unifem), se calcula que en
Amrica Latina, en promedio, la mitad de las mujeres sufri alguna vez violencia psicolgica de
parte de sus parejas, de ellas, el 30% fue vctima de violencia fsica y el 10% de violencia
sexual. En un estudio realizado en 31 universidades de 16 pases diferentes, se puso de
manifiesto que el 29% de los estudiantes haba asaltado a un compaero en los 12 meses
anteriores a la entrevista (Straus, 2004). Por su parte, Warkentin y Gidycz (2007) informan que
el 21,2% de los hombres universitarios encuestados haban cometido algn tipo de agresin
sexual, mientras que un 1,7% haba llevado a cabo un acto de violacin
En este sentido, podra pensarse que la actitud de hostilidad a las mujeres puede ser el
resultado de estereotipos sexuales machistas relacionados con la necesidad de sumisin de la

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vctima, entre los que destacan las actitudes favorables o justificadoras de la violencia sexual
(Heise 1998) tanto de vctimas como de victimarios. Sumado a esto, se ha puesto de manifiesto
que las creencias y las actitudes tolerantes con la violencia contra las mujeres constituyen un
factor de riesgo para su ocurrencia (Sanmartn, Farnos, Capel & Molina 2000). En la actualidad
el estudio de las actitudes favorables hacia la violacin se ha constituido como un rea de
investigacin de inters a nivel internacional. Entre los instrumentos elaborados en los ltimos
aos para la evaluacin de este tipo de actitudes justificadoras de los actos de violacin de los
que son vctimas las mujeres, se destaca la Escala de Actitud Favorable hacia la Violacin
(EAFV) de Lottes (1991). En el presente trabajo se presentan los resultados de una serie de
estudios realizados en el marco del Laboratorio de Comportamiento Interpersonal (LACI) de la
Facultad de Psicologa, Universidad Nacional de Crdoba acerca dos modelos predictivos de
las actitudes hacia la violacin en estudiantes universitarios de psicologa utilizando esta escala
e incluyendo a la Autoeficacia Social y las Habilidades sociales como variables predictivas y se
discuten algunas lneas de trabajo para el diseo de programas preventivos con base en el
entrenamiento en Habilidades Sociales de pareja y en Terapia Integral de Pareja (IBCT)
diseados por nuestro grupo de trabajo.
Estructura Factorial Preliminar de la Escala de Creencias de Mujeres de OKelly en
Poblacin Mexicana
Preliminary Factorial Structure of the OKelly Women Belief Scale in the Mexican
Population
La versin Mexicana del OKelly Women Belief Scales (OKelly, in press) Australiana fue
administrada a una muestra de 363 mujeres nacidas y residentes en Mxico. Al adaptar un
instrumento a un pas con un idioma distinto al del pas donde fue inicialmente diseado, Brislin
(1976) sugiere el uso del mtodo de traduccin inversa o back-tranlation method, donde una
persona bilinge traduce el original del Ingls al Castellano y otra persona bilinge traduce esta
versin castellana de nuevo al Ingles. A continuacin se comparan ambas versiones inglesas
para resolver discrepancias en el significado. El anlisis factorial con rotacin varimax y con
autovalor de 3 mostraron 36 reactivos de los 92 originales en el estudio de Australia, y con el
40.138% de la varianza total explicada. Al agrupar los reactivos en dos factores: uno de
Racionalidad, con 14 reactivos y uno de Irracionalidad, con 22 reactivos se obtuvo una
correlacin baja (r = .119) entre ellos. Estos resultados confirman la equivalencia de la versin
Mexicana al instrumento original para identificar la presencia de creencias absolutistas y rgidas
en las mujeres (TREC) sobre el rol femenino tradicional.
Interveno Grupal em Universitrios Brasileiros com Transtorno de Ansiedade Social
Group Intervention for Brazilian University Students with Social Anxiety Disorder
Este estudo teve por objetivo realizar a avaliao e a promoo das habilidades sociais no
Transtorno de Ansiedade Social (TAS) em estudantes do ensino superior, a fim de propiciar
aos indivduos uma melhor qualidade de vida e verificar mudanas comportamentais ocorridas
aps o Treinamento de Habilidades Sociais (THS). Tem cunho quantitativo e uma pesquisa
de interveno caracterizada como pr e ps-teste. Os instrumentos utilizados foram: Ficha de
Dados Pessoais e Sociodemogrficos, Questionrio de Ansiedade Social para Adultos (CASOA30), Inventrios Beck de Depresso (BDI) e Ansiedade (BAI). A amostra foi composta por 19
estudantes da Faculdade Meridional (IMED), Rio Grande do Sul, Brasil, com critrios
diagnsticos de TAS. Aps autorizao do Comit de tica em Pesquisa da IMED, os sujeitos
foram convidados a participar do estudo. Resultados: da amostra de 19 universitrios, 26,32%
(n=5) eram do sexo masculino e 73,68% (n=14) feminino. Destes, 10 sujeitos (52,63%)
desistiram no decorrer do tratamento, enquanto 09 (47,37%) participaram de toda a
interveno, sendo 77,80% (n=7) do sexo feminino e 22,20% (n=2) masculino, com idade
mdia de 28 anos. Na avaliao inicial, 55,6% (n=05) sujeitos apresentaram TAS No

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Generalizado e 44,4% (n=04) TAS Generalizado; j na reavaliao ps THS houve melhora


dos sintomas, sendo que 77,8% (n=07) sujeitos apresentaram diminuio das pontuaes nos
fatores, no apresentando mais escore para caracterizar TAS, enquanto 22,2% (n=02) sujeitos
continuaram apresentando sintomas de TAS No Generalizado. Quanto aplicao das
Escalas Beck, os resultados do BDI evidenciaram 44,4% (n=04) sujeitos com sintomas
mnimos de depresso, 33,3% (n=03) sintomas leves e 22,2% (n=02) sintomas moderados,
enquanto o BAI evidenciou 33,3% (n=03) sujeitos com sintomas graves de ansiedade, 22,2%
(n=02) sintomas moderados, 22,2% (n= 02) sintomas leves e 22,2% (n=02) sintomas mnimos.
Na reaplicao do BDI, 77,8% (n=07) sujeitos apresentaram sintomas mnimos de depresso e
22,2% (n=02) sintomas leves, enquanto no BAI 44,4% (n=04) sujeitos evidenciaram sintomas
mnimos de ansiedade, 33,3% (n=03) sintomas leves e 22,2% (n=02) sintomas graves. Os
achados do estudo apontam que o THS uma boa escolha na reduo dos sintomas de
ansiedade e o CASO-A30 mostrou-se um instrumento eficaz na identificao do TAS, bem
como na melhora dos comportamentos ps interveno. Tal resultado corrobora a literatura que
refere que programas de interveno voltados ao desenvolvimento das habilidades sociais e
tratamento da ansiedade social apresentam importante papel, estimulando a competncia
individual e interpessoal dos sujeitos com transtornos de ansiedade.
Investigaciones Iberoamericanas sobre ansiedad social y tratamiento cognitivo
conductual, la relacin conyugal, el estrs ocupacional y la respuesta del amor en la
mujer / Latin American research studies on social anxiety and cognitive behavioral
therapy, the marital relationship and the ocupacional stress and love response in women
Antonella Galli, Mariela Goldberg, Arturo Heman, Larissa Nobre, Sandra Anguiano Serrano,
Arturo Prieto.
Asociacin Iberoamericana Psicologa Clnica y de la Salud, Granada, Spain.
Se ha querido mostrar algunas investigaciones en Iberoamrica como es la evaluacin de la
ansiedad social en alumnos mexicanos de psicologa, y el tratamiento cognitivo conductual
desde el contexto uruguayo. Tambin hemos querido presentar los hallazgos de la calidad de
relaciones conyugales en Brasil y Espaa y la respuesta del amor desde un contexto peruano.
Adems como el coflicto ocupacional afecta la salud en las mujeres de Chile, as como la
respuesta del amor . La variedad de investigaciones promete un encuentro multicultural de las
problemticas de Iberoamrica.
Caracterizacin de la ansiedad social en una muestra de estudiantes mexicanos de la
carrera de psicologa: Resultados preliminares
Characterization of social anxiety in a sample of Mexican students in the psychology
program: Preliminary results
El objetivo de este trabajo fue el de analizar las caractersticas clnicas de la ansiedad social en
estudiantes mexicanos de la carrera de psicologa, utilizando el Cuestionario de Ansiedad
Social para Adultos- CASO-A30 (Caballo, et. al. , 2010) y la Escala de ansiedad social de
Liebowitz, versin autoinforme (LSAS-SR, 1987). Participaron 350 estudiantes de la carrera de
psicologa de la Universidad Nacional Autnoma de Mxico, FES Iztacala. Este estudio es la
continuacin de una investigacin previa realizada con 250 estudiantes, en donde se pretende
obtener una muestra estadsticamente significativa para identificar las caractersticas de la
ansiedad social en este tipo de poblacin, ya que de manera cotidiana se han identificado
casos de ansiedad social, que repercute en el funcionamiento adecuado y en los objetivos que
se esperan de quienes estudian esta carrera. En los estudios anteriores (Anguiano, Vega, Nava
y Olvera, 2012), se encontr un porcentaje significativo de estudiantes con fobia social
especfica y generalizada. Sin embargo, fue una muestra pequea (210 estudiantes), pero el
objetivo final es obtener una muestra significativa.

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En esta ocasin la muestra aument a 350 estudiantes, y se consideran preliminares. En este


estudio al igual que el de Caballo, Salazar, Irurtia, Arias y Equipo de Investigacin CISO-A
(2010) se obtuvieron resultados similares entre la correlacin obtenida entre los cinco factores
del CASO-A30 y las subescalas de ansiedad y evitacin de LSAS-SR (p=0,01), por lo que se
concluye que ambos instrumentos son tiles para identificar la ansiedad social. Se discuten las
implicaciones clnicas y profesionales de los resultados obtenidos, ya que en mayor o menos
grado se detect que los estudiantes de esta carrera presentan algn tipo de fobia social o
especfica.
Bajo un criterio clnico se estara observando que varios estudiantes de psicologa padecen o
pueden desarrollar algn tipo de fobia social generalizada o especfica si no tienen una
atencin psicolgica adecuada y oportuna. Cuando este tipo de trastorno no recibe una terapia
psicolgica a tiempo, puede convertirse en otro factor de riesgo que podra hacer que
emergieran otros trastornos psicolgicos, como las adicciones, los trastornos depresivos y los
trastornos de pnico, entre otros.
A qualidade da relao conjugal: um estudo com brasileiros e espanhis.
The quality of the marital relationship: a study with Brazilians and Spaniards
O conceito da qualidade conjugal (QC) controverso na literatura cientfica, muitas vezes
utilizada como sinnimo da satisfao ou do ajuste conjugal. Para este estudo foram
estabelecidas algumas propriedades (critrios) que permitiram julgar o valor da relao. Assim,
para que uma relao tenha reconhecida sua qualidade deve: satisfazer a seus membros
quanto sua percepo de relao ideal, oferecer segurana, permitir que seus membros
exeram seus direitos interpessoais e sintam reciprocidade de sentimentos como o amor,
respeito e o compromisso. Este estudo props um modelo matemtico para valorar a QC em
casais brasileiros e espanhis. Participaram 364 brasileiros, 61,3% mulheres (idade M=36,04
DP=11,82) e 38,7% homens (idade M=38,80 DP=12,26). E 458 espanhis, 55% mulheres
(idade M=35,50 DP=12,94) e 45% homens (idade M=37,98 DP=13,68). Os participantes viviam
relaes heterossexuais, com um mnimo de um ano de relacionamento, sendo possvel a
participao de um ou ambos os membros do casal. A base terica deste modelo considera
que aspectos individuais, relacionais e contextuais afetam a qualidade das relaes, e sua
variao est vinculada tambm aos processos adaptativos dos membros do casal em
situaes de dificuldade (como proposto por Karney e Bradburry, 1995). Assim sendo, as
variveis moduladoras do modelo avaliadas como favorecedoras a qualidade das relaes
foram: (a) maleabilidade/recuperao (resilincia), (b) necessidades bsicas cobertas, (c)
conformidade com as crenas e expectativas sociais, (d) entorno social favorvel e (e)
concordncia entre o casal. Por outro lado as debilitadoras de QC foram: (f) necessidade de
mudana por parte do/a parceiro/a e (g) estresse percebido. Foram realizadas diferentes
anlises de regresses lineares e o modelo encontrado explica um 62,50% do critrio QC na
populao brasileira (R2=0,625; p=0,000), e um 58,70% na populao espanhola (R2=0,587;
p=0,000). A pontuao de QC medida pelo modelo matemtico poderia oscilar entre 1 e 25. O
total de participantes brasileiros obteve um QC de tipo mdio igual a 11,12, assim como o total
de espanhis, que obteve uma pontuao igual a 11,71. A varivel de maior capacidade
explicativa neste modelo foi a maleabilidade/recuperao medida neste estudo a partir da
capacidade de tolerncia a frustrao, autoeficcia percebida, percepo do apoio social e
estado de sade. Foram analisadas as diferenas das variveis do modelo em relao
nacionalidade e encontramos diferenas estatisticamente significativas apenas nas variveis
maleabilidade/recuperao (F (1,820)= 7,333, p=0,05; d=0,18) onde espanhis pontuaram
mais alto que brasileiros, e na conformidade com as crenas e expectativas sociais
(F(1,819)=13,785; p=0,000; d=0,26) em que a mostra brasileira apresentou pontuaes
superiores. Acreditamos na necessidade de continuar desenvolvendo o modelo a partir do

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aprimoramento das medidas de cada modulador e da incluso de novas variveis. A espera


que este modelo contribua na fundamentao de uma soluo
Ansiedad Social, rumiaciones y abordaje cognitivo-conductual
Social Anxiety, ruminations and the cognitive-behavioral approach
.
La ansiedad social es un trastorno que produce consecuencias en el mbito
emocional,social,laboral,educativo,que tiene alta comorbilidad con depresin y consumo de
sustancias, y que puede ser tratado en forma temprana.Una de las formas que recientemente
se est reconociendo que incide en el mantenimiento de este trastorno es la rumiacin La
rumiacin se diferencia de la reflexin, en que la persona evala los acontecimientos pasados
como una experiencia de aprendizaje, lo que no ocurre con la rumiacin que se asocia al afecto
negativo y la inaccin. Es muy importante que el profesional clnico lo pueda detectarlo y
tratarlo para reestructurar los contenidos irracionales que mantiene sobre su actuacin pasada
y que influyen en su actuacin social futura dando de esta forma una oportunidad para el
cambio. : Temor a la Incertidumbre: Debemos sentirnos ansiosos o temerosos ante cualquier
cosa que sea incierta o potencialmente peligrosa. Se trabaja junto con el paciente ansioso
social sobre el manejo de la incertidumbre como algo cotidiano as como la invalidez de la
creencia de que por esta razn ser peligroso.Por lo tanto ,el objetivo apuntar a que reevale
el contenido de su creencia, sabiendo que no por incierto ser seguramente peligroso:
Perfeccionismo: Debemos ser eficientes y casi perfectos en todo lo que nos propongamos. Se
trabaja junto con el paciente ansioso social en el error de que hay un modo estndar correcto
perfecto de funcionamiento social ,al cual las personas debemos ajustarnos. Esta idea solo
nos hace sentir mal y con la decepcin de que muy poco probablemente consigamos este
objetivo; La idea del Control: Es horrible y catastrfico cuando las cosas no son de la manera
que deberan. Se trata y se valoriza en forma positiva, la capacidad de improvisacin y la no
necesidad de tener todo bajo control para manejarse con eficacia ante otras personas. Se
desarrolla la capacidad de valorar positivamente los cambios y las cosas que la vida nos pone
en el camino como oportunidades de aprendizaje y mejora personal; La necesidad de
Aprobacin: Necesitamos la aprobacin incondicional de todas las personas significativas en
nuestra vida. Se trabaja junto con el paciente ansioso social sobre el error de crearse una
necesidad (si no lo tengo no lo puedo soportar) a diferencia del gusto o preferencia en agradar
a otras personas.
El estrs en la mujer y la respuesta del amor
Stress in women and the love response
El estrs se ha caracterizado, como una respuesta de lucha o huida, tanto fisiolgica y de
comportamiento. Pero las respuestas en las mujeres estn mas relacionadas al cuidado de los
dems, en la relacin con el estrs. Experimentan diferentes eventos psicosociales que los
hombres, como el ser madre, tendiendo a desarrollar una respuesta de amor. EL amor es la
respuesta coordinada de una fusin de variadas emociones, pensamientos, vas neuronales
positivas, y los mecanismos de recompensa que finalmente permiten que el cuerpo, la mente y
el espritu para mantener el equilibrio incluso cuando se enfrentan el estrs. Los pptidos y
hormonas que se liberan con amor, incluyendo las endorfinas, la oxitocina, dopamina,
vasopresina y el xido ntrico, que ayuda a apagar la respuesta al miedo, evocar la respuesta
de relajacin y crear una fisiologa positiva.
Conflictos laborales que afectan la salud de la mujer / Labor conflicts that affect
womans health
La aplicacin de la Escala de Conflictos Ocupacionales en la Salud revela los efectos de ocho
ejes de dicotomas laborales que influyen en la salud fsica, mental y social de mujeres

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trabajadoras. Se examinan las influencias en la Salud de la mujer asociadas a conflicto en el


trabajo en cuanto a: 1. INTERS: agrado - desagrado; 2. APTITUD: habilidad - inhabilidad, 3.
AUTORREALIZACIN: expande - limita el desarrollo personal; 4. TIEMPO LIBRE: libertad obligacin; 5. INGRESOS ECONMICOS: riqueza - subsistencia; 6. RELACIN CON JEFE:
colaboracin - explotacin; 7. RELACIN CON IGUALES: compaerismo - rivalidad; y, 8.
MANEJO DE PODER: dominar - someter a otros.
Los efectos de estos ejes de conflictos asociados al trabajo sobre la salud fsica, mental y
social de la mujer trabajadora son considerablemente mayores a los efectos en la salud
atribuidos a los conflictos intrapsquicos postulados desde otras epistemologas psicolgicas.
CBT Training in the Ugandan and Zimbabwean Public Health Services
Elaine Hunter1, 5, Dave Baillie2, 3, Harriet Birabwa-Oketcho3, Dixon Chibanda4, Melanie Abas5, 4,
Patricia D'Ardenne2.
1. South London & Maudsley NHS Foundation Trust, London, United Kingdom, 2. East London
NHS Foundation Trust, London, United Kingdom, 3. Butabika National Referral Hospital,
Kampala, Uganda, 4. Psychiatry Department, University of Zimbabwe, Harare, Zimbabwe, 5.
Institute of Psychiatry, London, United Kingdom.
Abstract Central: Background Evidenced based research has shown the efficacy of cognitive
behavioural therapy (CBT) across a range of psychiatric disorders in a wide variety of countries.
However, there has been very little research and training on the potential use of CBT
approaches in the public sector in Uganda or Zimbabwe. Aims The aims of the study were to
support the development of CBT knowledge and skills in the public health workforce in these
sub-Saharan countries. Methods The study aimed to increase CBT skills in local mental health
clinicians in two ways: 1) by delivering an intensive programme of skills-based, experiential,
workshops alongside supervision to a small group of the psychological leads in both countries;
2) by offering a series of 2 day introductory CBT workshops to a wider audience of locally based
clinicians. The training was conducted by two volunteers (a clinical psychologist and
psychiatrist) from the UK with extensive CBT experience. Results The findings from both the
intensive and introductory trainings showed significant improvements on self rated CBT
knowledge and skills. Qualitative data showed that CBT was viewed as a positive approach to
working with patients in Uganda and Zimbabwe. Discussion We have shown that it is possible to
introduce a supervision based form of CBT that results in an increase in self rating of skills and
competencies. Feedback from those trained indicates that CBT can be a culturally acceptable
treatment in both Zimbabwe and Uganda. Potential challenges and future directions are
discussed.
Projeto Algo Por Algum - Pessoas em Situao de Rua em Santarm - Par - Brasil
Izaura A. cardoso, Lucivnia Incia de Souza.
IESPES - Isntituto Esperana de Ensino Superior, Santarm - Par, Brazil.
Abstract Central: Constantemente nos deparamos com pessoas em situao de rua e quase
sempre estabelecemos algum tipo de troca; por vezes um olhar estereotipado de vagabundo,
drogado, coitado, ou mesmo perigoso. E essa interao se apresenta muitas vezes dotada
de sentimentos como medo, constrangimento, pena, nojo. Porm, muito pouco com verdadeiro
reconhecimento de humanidade. A sociedade habituada com aquela figura grotesca das ruas
deixa de enxerg-lo, pois sua condio sub-humana no lhes causa mais impacto. O espao
social ocupado pelo morador de rua um espao subordinado, pois no possui o que lhe de
direito natural. Baseado nesse fato, este projeto tem como objetivo fortalecer aes de
promoo de sade e qualidade de vida para as pessoas em situao de Rua de Santarm -

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Pa - Brasil. Pblico alvo: 25 pessoas em situao de rua. Inicialmente foi realizado uma
pesquisa sobre os relatos de experincias de 15 pessoas em situao de Rua de Santarm
que ficam localizados no mercado 2000. Atravs destes relatos de experincias foram
detectados muitos problemas que afetam suas vidas como: o frio, as doenas adquiridas nas
ruas, a dificuldade no acesso hospitais pblicos, fome, uso abusivo de lcool e outras drogas,
excluso social e ausncia de oportunidades para os que anseiam sair das ruas. realizado
mensalmente rodas de conversas sobre direitos e cidadania, cuidado pessoal, escuta, oficinas
de artesanatos e orientao sobre os prejuzos do consumo de substancias psicoativos.
Tentou-se estabelecer no s um cenrio de investigao, mas um olhar para uma populao
que provoca, instiga e se movimenta.
Developing and Evaluating the STAR: An Intervention to Enhance the Coping and
Acculturation of International Students
Nigar Khawaja.
School of Psychology & Counselling, Queensland University of Technology, Brisbane, QLD,
Australia.
Abstract Central: One quarter of students in the Western universities are from overseas.
Studying in a foreign environment can be challenging and international students often report
adaptation and acculturation stress. However, there is a noticeable shortage of psychological
interventions to aid the acculturation and adjustment of international students in a culturally
appropriate and sensitive manner. The present study addressed this issue through the
development and pilot evaluation of a brief psychological intervention labelled the STAR:
Strengths, Transitions, Adjustments, and Resilience. The STAR program was developed using
suggestions from international students and university professional and academic staff. It
comprises of four weekly two-hour sessions, and is experiential and cognitive-behavioural in
nature. The STAR program aims to enhance coping and thereby psychological adaptation and
acculturation. The program is trialled in group and individual format. Sixteen international
students participated in the group format while four participated in the individual format. The
participants completed measures of coping self-efficacy, social self-efficacy, psychological
adaptation, and psychological distress at pre, post, and one-month follow-up. Results showed
that participants psychological adaptation and coping self-efficacy increased significantly
between pre and post, with the treatment gain maintained at the one-month follow-up for
psychological adaptation. The STAR program did not have an impact on psychological distress;
however, participants were only minimally distressed at the commencement of the program.
Qualitative feedback collected from the participants highlighted their perspective of the
intervention. The advantages and the disadvantages of the two formats as well as the practical
issues are discussed. The new intervention is promising and requires further evaluations.
Las innovaciones en los modelos cognitivo conductuales y sus aplicaciones en
contextos multiculturales
Guido Pablo Korman2, 4, Eduardo Keegan4, Cristian Javier Garay4, Guillermo Lencioni1, 4,
Guadalupe Rosales4, Florencia Pahl3.
1. Beam Up, Ciudad Autnoma de Buenos Aires, Argentina, 2. Consejo Nacional de
Investigaciones Cientficas y Tcnicas, Ciudad Autnoma de Buenos Aires, Argentina, 3. La
Salle University, Philadelphia, PA, USA, 4. Universidad de Buenos Aires, Facultad de
Psicologa, Ciudad Autnoma de Buenos Aires, Argentina.

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El modelo cognitivo conductual es difcil de ser descripto como un modelo uniforme. Hay una
serie de abordajes muy distintos que podran ser incluidos dentro de las terapias cognitivas
conductuales. Desde un comienzo, estos desarrollos adquirieron un fuerte compromiso con la
investigacin emprica, en aras de validar dichos conocimientos, tanto en lo que hace a las
terapias como a las teoras que las sustentaban. Con el correr de los aos, las terapias
cognitivas se multiplicaron y diversificaron, aplicndose a distintos trastornos y problemas en
gran parte del mundo. Se generaron nuevos interrogantes y nuevos desafos que dieron lugar a
distintos modelos cognitivos, en muchas ocasiones centrados en problemas nuevos y en otras
desde posiciones epistemolgicas distintas. La terapia cognitiva presenta un eclecticismo
tcnico, lo que permite una gran variabilidad en las tcnicas de intervencin. Este hecho se
encuentra respaldado por la gran cantidad de enfoques cognitivos que presentan diversas
tcnicas de intervencin en funcin no solo del trastorno especfico, sino del contexto cultural o
religioso en que se lleve a cabo el tratamiento. Dentro de la terapia cognitiva existe una vasta
literatura que da cuenta de los intentos de incorporar herramientas de otras disciplinas a la
prctica psicoteraputica. Dichos modelos en muchas ocasiones implican la utilizacin de
elementos de otros sistemas de creencias. Sirva de ejemplo el nmero importante de clnicos y
tericos que han escrito extensamente acerca de la integracin de tcnicas provenientes del
sistema panindio como son las tcnicas de conciencia plena utilizadas en muchos modelos
psicoteraputicos cognitivos. El foco de estas nuevas formas de tratamiento est dado por la
utilizacin de una serie de recursos que implican estrategias de aceptacin, tcnicas
metacognitivas por sobre estrategias de cambio cognitivo. Estos temas han generado intensas
polmicas en el seno de las terapias cognitivas. En esta mesa redonda discutiremos respecto
de los avances en terapia cognitiva y su utilizacin en contextos diversos. Los presentadores
de esta mesa se desempean como terapeutas o investigadores en Latinoamrica o trabajan
con poblacin latina en los Estados Unidos. Es nuestro objetivo discutir estos nuevos
desarrollos a la hora de pensar en nuevos campos de aplicaciones y las particularidades que
presenta la aplicacin de la terapia cognitiva en estos distintos contextos.
Introduction of CBT Training Programs Held in Beijing, China
Xianyun Li.
Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China.
Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy for most types of
mental disorders. Given that Chinese language and background are totally different from those
in English-language countries and a fewer of Chinese professionals are qualified CBT therapists
in mainland of China, providing CBT training among mental health professionals are quite
important and necessary for improving mental health services in China. We started to invite
CBT trainers from USA, Canada, and Hong Kong to provide a continuous CBT training in
Beijing for the 18 psychiatrists who were from different regions of China from 2007 to 2011 as
our first five-year CBT supervisors training program, under the support of Doctor Lisa
Napolitano and Professor Keith Dobson, International Association for Cognitive Psychotherapy,
and the fund support of Columbia University. During the first training project, we held a seven
days or longer training courses each time and twice a year. We developed and carried out the
training modules and the trainees were quite motivated to practice their CBT skills in their
clinical settings under the irregular group supervision (we lack of supervisors because of the
obstacle of language). After finishing the first training project, we started the second continuous
CBT training program for the 20 enrolled mental health professionals including psychiatrists and
psychologists in 2012 under the support of Doctor Lisa Napolitano and Professor Keith Dobson.
It is a two-year training program and we hold the training twice a year. Based on the past sevenyear CBT training experiences in Beijing, we definitely can say CBT is suitable for Chinese

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people and culture. But in China psychoanalysis is quite popular nowadays, so we need to
socialize CBT widely to make it accepted by the professionals and the public.
Interculturalidad en el Proceso Psicoteraputico: La Visin Cognitivo Comportamental
Edgard Pacheco Luza.
1. ALAMOC, Cusco, Peru, 2. Universidad Andina del Cusco, Cusco, Peru.
Abstract Central: En la aplicacin del modelo teraputico cognitivo conductual se hace
necesario considerar las variables socio culturales, tanto en la formulacin de caso y el diseo
de tratamiento. En la prctica clnica, nos encontramos con un conjunto de particularidades con
respecto a problemas complejos de la vida cotidiana de los pacientes, quienes tienen su propia
percepcin propia de su cultura, por esto es de particular inters en las aplicaciones de la
terapia cognitivo conductual la prctica y el fundamento terico en las zonas andinas de
Latinoamrica. Interesan los modelos explicativos de la creencia como aplicacin ideogrfica
de la prctica clnica, que debe estar fundamentada en un conjunto de informaciones
nomotticas que responden a una propia identidad socio cultural, la elaboracin de sus
esquemas cognitivos son sustentados en la asimilacin de estos en su ambiente y su cultura.
Las intervenciones clnicas con base emprica exigen generar protocolos de intervencin que
sean eficaces, que respondan a su propia realidad orientados hacia un modelo de calidad de
vida y satisfaccin productiva hacia su desarrollo. Los problemas psicolgicos responden a
mltiples variables, dentro de estas, los componentes psicosociales son determinantes en el
resultado que permita el xito de tratamiento. El poblador latinoamericano con races andinas
desde edades tempranas, se ha visto orientado a la integridad de la vida en funcin de la
naturaleza. La creencia y la fe es el eje fundamental de esta integridad trascendental, forma
particular de percibir el mundo por medio de los cuales establece sus esquemas cognitivos.
Otorga a la naturaleza una capacidad de visin y direccionamiento de la existencia en el
pasado, presente y futuro. A partir de esta percepcin surge la necesidad de adaptar las
creencias irracionales en funcin de sus propias creencias que les otorgan equilibrio entre las
necesidades, su vida y la naturaleza, en funcin de la existencia el logos y el mito. En esa
imagen hay componentes de sacralizacin de la naturaleza y productos rituales mgico utilitarios que vienen a ser smbolos y prcticas para sus propias alternativas de intervencin
ante sus problemas cotidianos. En el plano mgico -utilitario estn las creencias en las
"huacas" y la bsqueda de seres sobrenaturales para que cumplan un beneficio. Se describe la
conceptualizacin psicolgica de la salud, la enfermedad o el dao, asociado al procesamiento
de informacin meta cognitiva, saber cmo enfrenta estas experiencias a nivel individual como
representacin mental, los aspectos culturales asociados a ella, los significados del concepto
enfermedad, la construccin y representacin social y los aspectos simblicos tienen que ir
directamente asociados a la conducta y la salud. La aplicacin teraputica desde la
interculturalidad establece un vnculo unitario entre el cuerpo y la mente asociado a la
naturaleza y su idealizacin.
Cultural Differences in Coping and Cognitive Styles in Response to a Negative Mood: A
Comparison of Asian-Canadian and European-Canadian Undergraduate Students
Jennifer Prentice, Amanda Epp, Keith Dobson.
Psychology, University of Calgary, Calgary, AB, Canada.
Our current understanding of depression is primarily based on research conducted with Western
samples. Exclusive reliance on Western samples for the development of cognitive models of
depression may not account for the potential variability in depression in non-western cultures.

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The purpose of the present study was to investigate the applicability of cognitive models of
depression and coping strategies across cultures. Thirty-four Asian-Canadian and 46 EuroCanadian students were recruited to determine if cognitive processes related to depression
differentially occur in each culture. Participants completed a mood scale, a demographic
questionnaire, and participated in a Structured Clinical Interview to determine their eligibility to
participate. Participants completed measures assessing self-construals and degree of
acculturation to Canadian society. A negative mood induction was then performed; participants
who successfully mood-induced participated in a talk-aloud procedure, and completed
measures of rumination and avoidance. Specifically, the Response Styles Questionnaire and
the Cross-Cultural Coping Scale were administered. In line with the hypotheses, the AsianCanadian sample was found to endorse greater levels of avoidance coping, relative to the EuroCanadian sample. In addition, rumination was found to significantly predict dysphoria for the
Euro-Canadian sample only. These results contribute to the current literature as they suggest
that cognitive factors representative of a vulnerability to depression in Western cultures may not
operate equivalently in Asian cultures. Moreover, the results of this study will help to inform the
development of more culture-sensitive models of depression, which will in turn contribute to the
development of more culturally appropriate care for Canadas multicultural society.
La Aproximacin Conductual en Chile en Tiempos de Dictadura: Una Perspectiva Desde
la Vida y Obra de Sergio Yulis
Vanetza Quezada1, 2, Mario Laborda1, lvaro Vergs3.
1. Psicologa, Universidad de Chile, Santiago, Chile, 2. Pontificia Universidad Catlica de Chile,
Santiago, Chile, 3. University of Missouri-Columbia, Santiago, Chile.
Abstract Central: El 11 Septiembre de 1973 en Chile, el Comandante en Jefe de las Fuerzas
Armadas General Augusto Pinochet dio un Golpe de Estado al Gobierno Socialista de Salvador
Allende, iniciando una Dictadura que dur 17 aos. En los primeros aos de este perodo las
Universidades fueron intervenidas y oficiales leales al Dictador tomaron el lugar de Rectores,
Decanos y Directores. Sergio Yulis, quien obtuvo el Ttulo Profesional de Psiclogo en la
Universidad de Chile (1962) y el Grado Doctor en Psicologa Clnica en la Universidad Iowa en
1968, en su rol de Director de la Escuela de Psicologa de la Universidad Catlica se le solicito
desvincular a aquellos profesores que tenan vnculos con el socialismo. Ante su negativa,
Sergio Yulis fue presionado a renunciar razn por la que comienza a buscar un lugar para
trasladarse junto a su familia. Luego de pasar un tiempo en Costa Rica, Venezuela y Colombia,
Sergio Yulis y familia, vivieron su exilio en Canad, pas donde trabaj como Director del
Servicio Psicolgico del Hospital Royal Victoria del Allan Memorial Institute, y como Profesor
Asociado de McGill University. Los aos que Sergio Yulis estuvo en Chile (1969-1973) fueron
sin duda los ms fructferos y promisorios para la Aproximacin Conductual en el Pas. Yulis
introdujo la psicologa conductual en Chile incluyendo la terapia conductual en los cursos de
psicoterapia de las nicas dos Escuelas de Psicologa existentes en ese tiempo en el pas,
facilitando el desarrollo de dicha aproximacin al fortalecer el desarrollo de la psicologa
cientfica en un contexto en el cual prevaleca una visin psicoanalista y fenomenolgica del
estudio de la conducta humana. Desafortunadamente, la salida forzada de Sergio Yulis y el
silenciamiento de sus principales seguidores interrumpi abruptamente el desarrollo de la
Aproximacin Conductual en Chile. El objetivo del presente trabajo es examinar la vida y obra
de Sergio Yulis (1936 - 1980), pionero de la aproximacin conductual en Chile, enfatizando el
impacto de la dictadura sobre esta.

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Culture-Specific Illness-Beliefs and Motivation for Psychotherapy in Migrant Inpatients:


Use it or Loose it
Hanna Reich, Winfried Rief, Ricarda Mewes.
Department of Psychology, Division of Clinical Psychology and Psychotherapy, Marburg,
Germany.
Background: Non-western migrant populations in western societies often suffer from poor
mental health. Moreover, little success of psychotherapeutic treatments has been reported for
these populations. Given that psychotherapy motivation is crucial for a successful treatment, a
low psychotherapy motivation may be one cause for poor outcome of mental health
interventions in migrant patients. Until today, there are only sparse endeavors towards an
indigenization of mental health treatments, i.e. migrants culture-specific explanatory myths or
illness-beliefs often are not considered adequately. Objectives: We assume that the
psychotherapy motivation is lower in non-western migrants than in natives, and that this is
mainly explained by culture-specific illness-beliefs (e.g. belief in fatalistic or supernatural illness
causes). In study 1 we therefore compare the psychotherapy motivation of Turkish migrants,
which are typical for immigrants to western societies (collectivist culture, often lower education
and higher affinity towards religion) with native Germans (individualist, western culture), and
evaluate possible explanations for reduced psychotherapy motivation. Furthermore, we
hypothesize that motivation for psychotherapy in migrants can be improved by a short
intervention addressing illness perception, culture-specific illness beliefs, and the improvement
of outcome expectations. Therefore, in study 2 we investigate the efficacy of a low intensity
intervention to enhance psychotherapy motivation in Turkish migrants using an experimental
design with follow-up. Methods: Subjects in both studies are inpatients in mental health units,
with an ICD-10 F3- or F4-main diagnosis (i.e. depressive, somatoform, anxiety, and/or
adjustment disorder). In study 1, subjects (n=50 natives and n=50 migrants) complete self-rating
questionnaires assessing motivation for psychotherapy, depressive and somatoform symptoms,
illness perception, illness-related locus of control, and causal illness attributions. In study 2, we
are investigating a sample of n=68 Turkish migrant patients randomized to either a computerbased intervention with the aim of enhancing psychotherapy motivation (experimental group), or
a control condition. They complete self-rating questionnaires before and after intervention, as
well as a two-weeks follow-up. Results: In study 1, we found that motivation for psychotherapy
was lower in Turkish migrant than in native inpatients (p<.01), even though symptom burden
was higher in migrant patients (p<.001). The association between cultural background and
motivation for psychotherapy was fully mediated by stronger beliefs in supernatural illness
causes in the migrant sample (p<.01), and also by lower internal and higher external-fatalistic
illness-related locus of control in this sample (p<.10). For study 2, the intervention protocol and
first results will be presented. Conclusions: Culture-specific illness-beliefs and the causality
beliefs of migrant patients should be integrated in a culturally sensitive manner into
psychotherapeutic treatment in order to improve motivation for psychotherapy. Culturally
adapted treatment programs should be designed and evaluated in order to provide better
mental health care to migrant populations.
Viudez, Afrontamiento y Gnero en la Adultez Mayor: Un Estudio Mixto en Poblacin
Mayor Colombiana
Maria Reyes, Daniela Cano, Maria-Camila Diaz, Sonia Orozco, Angela Pereira.
Universidad El Bosque, Bogot, Colombia.
Abstract Central: Experimentar la prdida de la pareja en la adultez mayor es un evento de
alta probabilidad, lo que es considerado uno de los principales sucesos de vida estresantes que

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genera desequilibrio psicolgico (Bennett, Hughes y Smith, 2004). El presente estudio tuvo
como fin comprender la forma en que las personas mayores viven y afrontan la viudez. As
mismo, se plante como objetivo identificar similitudes y diferencias entre un grupo de personas
mayores colombianas y los resultados en un grupo de mayores britnicos encontrados por
Bennett, Hughes y Smith (2005). Se realiz un estudio de metodologa mixta, basado en el
estudio de Bennett, Hughes y Smith (2005) Psychological response to later life widowhood:
coping and the effects on gender. Primero se llevo a cabo una fase cualitativa a travs de
entrevistas a profundidad, usando como anlisis teora fundamentada en donde se
entrevistaron a 29 personas entre los 55 y 90 aos residentes de la ciudad de Bogot. En la
fase cuantitativa se realiz un anlisis de regresin loglineal, con el fin de identificar interaccin
entre sexo, afrontamiento y respuesta psicolgica. Los resultados de la fase cualitativa
indicaron que el afrontamiento a la viudez se enmarca en siete factores psico-socio-culturales,
encontrando dos factores de mayor jerarqua: (a) apoyo social; y, (b) sentido de la vida; seguido
de seis factores: (a) Relacin previa, (b) Participacin en actividades, (c) Fortalezas personales,
(d) percepcin de vitalidad; y, (e) Consecuencias generadas por la prdida. El anlisis
cuantitativo a travs de regresin loglineal evidenci una interaccin significativa tan solo entre
afrontamiento y tipo de respuesta psicolgica, pero no se encontr una interaccin significativa
entre afrontamiento y sexo, ni respuesta psicolgica y sexo. Las respuestas asociadas al
afrontamiento exitoso fueron participacin en actividades y seguir adelante; mientras que, el no
afrontamiento se caracteriz por respuestas como aislamiento y soledad. En cuanto a la
comparacin con la poblacin britnica, se encontraron como diferencias que en Colombia la
viudez genera dificultades de tipo El apoyo social y la religin como fuente de apoyo se
encontr como un factor que facilita el afrontamiento en los mayores colombianos, situacin
que no ha sido evidente en los ingleses estudiados por Bennett, Hughes y Smith (2005).
Conductas Mentirosas: Perspectivas Conductistas Cruzadas y Anlisis de una Prctica
Social en el Contexto Colombiano
Anne-Rachel Schehr Buchs.
Pontificia Universidad Javeriana, Bogot, Colombia.
Abstract Central: La mentira, o mejor dicho la conducta mentirosa, hace parte de nuestra vida.
Se encuentra en todas partes del mundo, en todos los estratos. Se estima que una de cada 5
interacciones sociales es mentirosa (Ford, 1999). Aunque esta practica es muy comn y se
encuentra en todas partes del planeta, parece existir modos de mentir muy diferentes segn el
contexto socio-cultural. Friedl (1962, citada por Barnes, 1994) reporta as que en los campos de
Grecia, los padres mienten a sus hijos de manera deliberada y esto para educar y ensearles a
discriminar los actos y palabras de los dems. En la cultura china existe tambin pautas de
crianza bien especificas en cuanto al manejo de las mentiras, y los paps ensean a sus hijos a
discriminar los contextos donde se requiere o se puede usar la mentira (Wang, Bernas,
Eberherd, 2011). En Madagascar, se transmite deliberadamente informacin falsa a los que
nos pertenecen a la comunidad para preservarla (Ford, 1999). Como psicloga europea
viviendo en un pas latino-americano me he encontrado en varias situaciones en las cuales
observ gentes, sean nios o adultos, mintiendo en modos muy diferentes de lo que haba
experimentado en otros contextos culturales tales como los de Estados Unidos o Suiza. El
propsito de esta presentacin es entonces de desarrollar un anlisis de las conductas
mentirosas como practica cultural en el contexto colombiano partir de varias perspectivas
desarrolladas dentro del conductismo: Teora de los Marcos Relacionales (Hayes et al. 2001;
McHugh et al, 2006), interconductismo (Ribes, 1985; Ortega, 2005), estudios de diseo cultural
realizados por Glenn (1989, 2004) y Mattaini (1996, 2010). Deception is part of our life.
Although this practice is very common and is found in all parts of the world, there seems to be

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as many different ways of lying as socio-cultural contexts. Friedl (1962, cited by Barnes, 1994)
for example reported in the countryside of Greece, parents lie deliberately to their children so as
to educate and teach them to discriminate the actions and words of others. In the Chinese
culture, there are also very specific educational patterns in the management of lies, and the
parents teach their children to discriminate contexts that require using lies (Wang, Bernas,
Eberherd, 2011). In Madagascar, false information is deliberately spread to people who dont
belong to the community so as to preserve its integrity (Ford, 1999). As a European
psychologist living in a Latin American country I've experimented several situations in which I
watched people lying , and this in modes very different from what I had experienced in other
cultural contexts such as the U.S. or Switzerland. So the purpose of this presentation is to
develop an analysis of deception as a cultural practice in the Colombian context based on
various perspectives developed within behaviorism: Relational Frame Theory (Hayes et al.
2001; McHugh et al, 2006), interbehaviorism (Ribes, 1985; Ortega, 2005), cultural design
studies conducted by Glenn (1989, 2004) and Mattaini (1996, 2010).
Perfil, Principais Queixas e Encaminhamentos dos Acadmicos Atendidos no Servio de
Psicologia da Universidade Federal da Integrao Latino-Americana
Leticia Scheidt, Vanessa Silvestro.
Pr-Reitoria de Assuntos Estudantis e Comunitrios, Universidade Federal da Integrao
Latino-Americana, Foz do Iguau, Brazil.
A Universidade Federal da Integrao Latino-Americana (Unila) tem como misso institucional
formar recursos humanos aptos a contribuir com a integrao latino-americana, com o
desenvolvimento regional e com o intercmbio cultural, cientfico e educacional da Amrica
Latina. Oferece 16 cursos de graduao e possui hoje aproximadamente 1000 alunos de 10
pases da Amrica Latina. O Servio de Psicologia da Pr-Reitoria de Assuntos Estudantis e
Comunitrios tem por objetivo atender o estudante em sofrimento psquico, atravs de
estratgias de preveno, promoo e restaurao da sade, a partir da articulao com
demais setores da universidade. O objetivo do servio instrumentalizar os acadmicos
atravs de tcnicas psicolgicas, para promover a resoluo de problemas e o
desenvolvimento individual e social que auxilie a sua permanncia na universidade com
qualidade. O presente estudo se trata de um levantamento de dados dos pronturios de todos
os acadmicos da Unila atendidos pelo servio de Psicologia, desde a sua estruturao, em
maro de 2012, at o presente momento, novembro de 2012. No total, foram atendidos 100
alunos, representando cerca de 10% dos estudantes. Desses, 15 estiveram em modalidade
grupo e 85 em atendimento individual. Quanto varivel sexo, observou-se um predomnio de
um sobre o outro, pois 59% eram do sexo masculino e 41% do sexo feminino. A faixa etria
dos alunos atendidos de 18 a 38 anos, sendo que a mdia da idade de 21,83 anos. A
grande concentrao se d entre 18 e 20 anos, com 51%. Entre 21 e 25 anos, h 37%. E, por
fim, 7% tem entre 26 e 30 e 5% tem entre 31 e 38 anos. Estudantes de todos os cursos da
universidade procuraram o servio. O curso com maior procura foi Antropologia (12%). Em
Cincias Biolgicas foram 10%. No curso de Cincia Poltica e Sociologia houve 9%. Tanto
Letras quanto Desenvolvimento Rural e Segurana Alimentar somaram 8% cada. Em Histria
da Amrica Latina so 7%. Relaes Internacionais e Engenharia de Energias Renovveis
correspondem a 6% cada. Engenharia Civil de Infraestrutura, Cincias Econmicas e
Arquitetura e Urbanismo tratam de 5% cada. Sade Coletiva, Msica, Geografia e Cinema e
Audiovisual apresentam 4% cada. Por fim, 3 acadmicos (3%) so do curso de Cincias da
Natureza. Em relao nacionalidade, houve distribuio entre brasileiros (48%) e estrangeiros
(52%), com ligeiro predomnio de estrangeiros. Desses, o maior nmero foi de equatorianos
(11%), seguido de uruguaios (10%), paraguaios (9%), peruanos (8%), chilenos (6%), bolivianos

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(4%), colombianos (3%) e argentinos (1%). As nacionalidades que no demandaram o servio


de psicologia foram os salvadorenhos e venezuelanos. As principais queixas, sintomas e
demandas apresentadas envolveram: ansiedade, dificuldade de concentrao e ateno,
estresse ps-traumtico, ataque de pnico, dificuldade de relacionamento, surto psictico,
solido, dficit de habilidades sociais, insatisfao com o curso e/ou com a universidade,
apatia, insegurana, luto, gravidez indesejada, oscilaes de humor, abuso de substncias,
dificuldade de aprendizagem, dificuldade de adaptao, transtorno alimentar, agressividade,
ideao suicida, busca de auto-conhecimento. Dentre as aes do servio de Psicologia esto
o acolhimento, a orientao e o encaminhamento. Algumas das estratgias utilizadas foram:
orientaes nos mbitos acadmico, relacional, de organizao pessoal; orientaes famlia;
reestruturao cognitiva; psicoeducao sobre transtornos e sintomas; tcnicas de respirao
diafragmtica e relaxamento; dessensibilizao sistemtica; balana decisional; avaliao
psicolgica; psicoeducao sobre distores cognitivas; encaminhamento para sistemas de
monitoria e tutoria da universidade; encaminhamento para rede de sade do municpio; e
encaminhamento para clnicas-escola da cidade.
THE IMPORTANCE OF MULTIPLE INFORMANTS ASSESSMENT IN THE
PSYCHOLOGICAL EVALUATION Edwiges Ferreira de Mattos Silvares
Edwiges Silvares1, Margareth Oliveira2, Andressa Avila2, Maria Lucia Tiellet2, Marina Rocha1,
Ana Claudia Peixoto3, Bernard Rang4, Paula Braga-Porto1, Deisy Emerich1, Cacilda de S5,
Edwiges Silvares1.
1. Clinical Psychology, University of So Paulo, So Paulo, Brazil, 2. Pontifical Catholic
University of Rio Grande do Sul, Porto Alegre, Brazil, 3. Universidade Federal Rural do Rio
Janeiro, Nova Iguau, Brazil, 4. Universidade Federal do Rio Janeiro, Rio de Janeiro, Brazil, 5.
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
THEME: Multiple Informant Assessment & Transcultural Psychology ABSTRACT:There is no
consensus about the right route to be followed in order to reach the best evaluation or
intervention strategies for clinical cases that come to a psychological consultation. This fact is
understandable considering the diversified nature of human problems as well as their intensity
and the time they started. These points bring another question concerning the measurement of
psychological devices: there are not tools to measure human psychological difficulties with high
validity and reliability level. On the other side it is also well known the harsh to clinical decisions
and applied research brought by these facts. These points are associated to the scientific
knowledge about the way the environmental factors influence behaviors which vary as well as in
function of established patterns developed along the whole life of everyone. All these points
lead to the conclusion that a comprehensive psychological evaluation implies the necessity to
access several sources of information about persons who go to psychological consultation. One
recent way to overcome some of these difficulties in relation to a reliable psychological
assessment is the empirically based assessment (EBA) with multiple informants. There are
several EBA psychological systems around the world and ASEBA is one of them, developed
over several years of research and designed to assess individual skills, adaptive functioning,
emotional and social, as well as behavior problems. The ASEBA instruments enable the
evaluation of people of all ages from the perception of oneself and/or guardian, educator or
someone close. The informant must answer the questions, considering the last six months.
However data on multiple informant assessment have brought attention to researchers: the level
of agreement among different informants when two different people describe one same specific
person and how their answers vary depending of informant age, gender or ethnic factors. Trying
to understand better these questions this symposium is proposed with various Brazilian
researchers, affiliated to five educational institutions, from different regions of the country. Prof.

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Edwiges Silvares (PhD) - the chair of the this symposium- had previously been invited by the
present congress organization comittee to present one workshop in Transcultural Psycholoy
and later on to present different categories of work in WCBTC013 - So, considering the huge
size of the country and the expected cultural diversity within its different regions , Brazilians
researchers were invited , by Dr Silvares, to participate and present data from their regional
studies in which ASEBA tools were used with people of various stages of development focusing
specially to the importance of multiple informants in the psychological evaluation, when using
ASEBA instruments. Yet, four studies will be presented in the symposium in the following order:
the first two discuss non-referred population data of different age and the two last ones referred
data of children and adolescents respectively with selective mutism and enuresis . The
presentation titles and presenters are : 1) The importance of evaluating multiple informants with
adult normal population (use of ASR and ABCL), presented by Prof. Margareth Oliveira (PhD),
2) The importance of multiple informants on the psychological assessment of adolescents (use
of YSR ), presented by Prof. Marina Monzani da Rocha (PhD), 3) Multiple informant profile of
children with Selective mutism, presented by Prof. Ana Claudia Peixoto (PhD) e 4) Multiple
Informant Evaluation of children with Enuresis, presented by Paula Braga Porto (MS). CNPq
Funds
THE IMPORTANCE OF EVALUATING MULTIPLE INFORMANTS WITH ADULT NORMAL
POPULATION (USE OF ASR AND ABCL)
Margareth da Silva Oliveira, Andressa Celente de vila & Maria Lcia Tiellet Nunes
ASEBA scales were developed over several years of research and are designed to assess
individual skills, adaptive functioning, emotional and social, as well as behavior problems. The
ASEBA instruments enable the evaluation of people of all ages from the perception of oneself
and/or guardian, educator or someone close. The informant must answer the questions,
considering the last six months. The present study aimed to compare the information provided
by adults with their informants, verifying this information by comparing two groups of informants.
Method: quantitative design, cross-sectional. The sample consisted of 660 participants from the
general population, with 330 adults who responded (ASR Adult Self-Report) and 330 informants
who answered the ABCL (Adult Behavior Checklist) about the adults respondents. Results: For
the ASR respondents, the mean age was 31.57 years (SD=12.38; Min 18 and Max 59 years)
and 57.9% (n=191) of them were female. Regarding education of the respondents, 5.5% (n =
18) were without schooling, 7% (n=23) in the range of elementary school, 18.1% (n=60) in high
school, 57% (n=188) in Higher Education, 7.2% (n=24) in the Graduate and 5.1% (n=17) of
respondents did not complete this item. With regard to the socioeconomic status of these
respondents (according to the Brazil Economic Classification Criteria), 17.2% belonged to Class
A, 35.2%, 25.55% Class B, Class C and D without information 22.1%. In the sample of
informants in relation to the respondents, 27.6 (n = 91) were friend (a), 18.2% (n=60) was
stepfather/stepmother, 13.6% (n=45) were mother/father, 11.3% (n=37) were brother (a) and
son (a), 11.2% (n=37) were husband (a), 6.1% (n=20) were other respondents, 8 8% (n=29)
were companion (a) and boyfriend (a), 3.3% (n=11) did not provide this information. As for the
answers to the items of the instruments, there was no statistically significant difference between
the groups of respondents and informants regarding withdrawn subscales (p=0.378), RuleBreaking Behavior (p=0.802), Intrusive behavior (p=0.857) Externalizing problems (p=0.51),
total problems (p=0.90), according to the results of the paired t test. The other subscales Anxious /depressed, Somatic Complaints, Thought problems and Attention problems - the
differences were significant (p <0.001) between the two groups: respondents and informants.
Conclusion: No significant difference, from the statistical point of view, were found for
externalizing problems, in both groups - respondents and informants agree in their perceptions
to items the instruments evaluate. The disagreement between these groups are in regard to
their perceptions of adaptive functioning and psychopathology, that is: respondents and

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informants have different perceptions. One hypothesis to be investigated to better understand


the results would be to separate the informants who could judged closest to the respondents
(friend, stepfather / stepmother, father / mother) from others because of social desirability. The
fact that respondents and informants perceive the behavior of the respondent differently on
some items may be of help, for example, for clinical psychologists to organize a battery of
instruments for psychological evaluation in order to better understand the respondent and the
demand for evaluation and/or treatment. Similarly psychologists who work in other fields of
psychology can understand better the respondent, in the case of referring him to functions or
positions in organizations, as a second example. The fact of having multiple informants qualifies
the use of the ASR. CNPq Funds
THE IMPORTANCE OF MULTIPLE INFORMANTS ON THE PSYCHOLOGICAL
ASSESSMENT OF ADOLESCENTS (USE OF YSR)
Marina Monzani da Rocha
Assessment of behavioral problems of adolescents is usually based on interviews with parents
and with the referred youth. Different factors can influence how parents perceive their children
behavior, such as the presence or history of parental psychopathologies, the type of problem
presented by the youth, and the time exposure to youths behavioral problems. These
restrictions, together with the well known fact that behaviors vary across context on which they
are presented, leads to assuming that to make a comprehensive assessment it is important to
obtain information form multiples informants. This recommendation applies especially when it is
considered that each informant can offer a unique perspective on the behaviors under analysis,
which certainly enriches the overall view of the case and assists the professional to make
decisions. In this study, two approaches were chosen to demonstrate the importance of
including multiples informants on the psychological assessment process. Initially, it will be
presented a study on the agreement patterns between parents and youths on the assessment
of behavioral problems using standardized forms: the Youth Self-Report (YSR) and the Child
Behavior Checklist (CBCL/6-18), on which 66 cases of adolescents referred for psychological
treatment were included. Clinical implications of the similarities and differences on the
assessment will be discussed. Following, a case study of a 12 year old girl, referred for mental
health services, will be presented. In this case, the inclusion of the mothers assessment, using
the CBCL, the inclusion of the adolescent herself, using the YSR, and some teachers
perspectives using the Teacher Report Form (TRF), in the evaluation process allowed the
practitioner to identify how the adolescent behaved in each environments/interactions. These
data obtained with multiple informants have enabled a broader understanding of the case, which
helped the responsible practitioner to design the most appropriated intervention plan. In
conclusion, both studies indicate that the use of multiple informants on the assessment process
is important, regardless of the divergences, because knowing behaviors in different contexts is
crucial to elaborate complete diagnostics and adequate interventions. FAPESP&CNPq
MULTIPLE INFORMANT PROFILE OF CHILDREN WITH SELECTIVE MUTISM THROUGH
BEHAVIORAL QUESTIONNAIRES: CBCL / TRF
Ana Claudia Azevedo Peixoto & Bernard Rang
This work aims to show profile results for a group of children that have a psychological disturb
called Selective Mutism (SM). Many authors argue that SM is considered a subtype of social
phobia in children, and relate the SM to a learned behavior. It has also been observed that the
feeling of being ashamed is a definitive factor to keep the problem. Twenty-four children (15
girls and 9 boys between four and fourteen years old, with an average of 7,9 years old at the
moment of the analysis) participated of this study. The children were currently studying in public
and private schools in Rio de Janeiro, Brazil. The SM was noticed in the former years of 37.5%
children through characteristics such as communication delay along with trouble in relationships

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and starting dialogues. In other 37.5% of the cases, parents only realized the mute behavior
when the child started attending school. The SM occurred basically at school, since 100% of the
children used to speak at home. 59.09% of them would not speak at school and 54.55% would
rarely speak in public places. Concerning the habitation 91.67% of the children used to live with
their traditional families; 4.17% lived only with their mothers and 4.17% lived with their fathers.
Studies suggested that most of the children showed prolonged mutism and not transitory one.
Among the instruments used to characterize this group we highlight the behavior
questionnaires: Child Behavior Checklist (CBCL) andTeachers Report Forms (TRF), using
multiple informants. As a result, we were able to notice that there were significant differences in
internalizing(ID), externalizing(ED) and totalizing scales (TD)according to parents
perception.Teachers and parents have different perceptions on the issues. The first group
considered that the ID was in the clinic area, while the second one believed it was in the
limtrophe (bordering) area. The three externalizing items that characterize the group the most
were: moody or irritated, screams too much, easily jealous. Concerning the troubles of
attention scale, the three most signalized items were: kids that have an immature behavior for
their age, kids who are nervous or tense, kids that keep thinking for a long time and cant
keeping themselves concentrated. The mind problems were: kids who seemed to be looking at
nowhere, kids with certain obsessive thought and strange behavior. In this study five winner
items or more emphasized by the result two (frequently true) in the TRF were: doesnt speak,
shy, timid, shamefaced and uncomfortable. The first four items are from the
retraction/depression scale and the last one is from the anxiety/depression scale. Concerning
the whole CBCL, the most emphasized ones were: shy, jealous, doesnt speak,
suspicious and concentration problems. Conclusion: Comparisons between CBCLs and
TRFs provide objectively the SM behavioral profile that is helpful for whoever interacts with
them and wants to see them growing out of it.
MULTIPLE INFORMANT EVALUATION OF CHILDREN WITH ENURESIS
Paula Braga- Porto, Deisy Ribas Emerich, Edwiges Ferreira de Mattos Silvares & Cacilda
S
According to the International Children Continence Society, nocturnal enuresis is defined as
discrete incontinence episodes while an individual is asleep. Enuresis is one of the most
prevalent problems in childhood, affecting up to 15% of children from 5 to 7 years of age and 1
to 2% of young adults. Enuresis may be primary, when the child has not obtained previous
bladder control, or secondary, when such control was achieved for at least six months. It is also
classified as monosymptomatic, when it is not associated with other lower urinary tract
symptoms, or non-monosymptomatic, when these symptoms, such as urgency, are present.
Enuresis etiology has unclear hereditary aspects. Its physiology is based on a combination of at
least two of these malfunctioning systems: incapacity to wake in response to full bladder signals
plus nocturnal polyuria or detrusor hyperactivity. In general, bedwetting is a problem that affects
the lives of children and their families. Parents may show intolerance to enuresis and blame the
child for it and may even physically punish their children. These reactions do not help and can
contribute to increasing the impact of the problem in the child's life. Regarding overall behavioral
problems, according to an evaluation through CBCL, children with enuresis tend to be present
more behavioral problems than children at the same age, but less clinical than referred children.
Moreover, children with enuresis may have low self-esteem and others problems related to the
social impact of bedwetting since the child with this problem feels different from others. Once
the parental reaction to the disorder may influence how child sees the problem, it is important to
consider this variable in the assessment process, either by clinical interview or by instruments
designed for this purpose and its also important include the child in this process to identify how
she/he sees the problem. The perception of multiple informants allows a comprehensive

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assessment and then selects the most appropriate intervention. Acknowledging the importance
of including multiple informants, this study aims to compare the report of sixty parents and
children about the attitudes towards enuresis.FAPESP - Funds
Culture-shock and Hypochondriasis
Kinga Williams.
MENSANA, Goring, United Kingdom.
In an attempt to cross-fertilise Cross-Cultural and Clinical Psychology, the poster seeks to
explain why Health Anxiety (Hypochondriasis) appears to be the "chosen psychopathology" of
immigrants when compared to natives. This robust finding of increased incidence (Still 1961;
Ward et al 2001) is as yet to be satisfactorily accounted for. As an advance on the Terror
Management Theory (i.e. culture buffers against mortality-awareness, e.g. Greenberg et al
1997) and the Mortality Salience Hypothesis (i.e. mortality salience increases other-culture
intolerance, e.g. Rosenblatt et al 1989), a new hypothesis is put forward, named the Reverse
Mortality Salience Hypothesis (i.e. other-culture intolerance increases mortality salience,
Williams 2004). Added to the combination of the above, Health Anxiety is proposed to be
construable as a possible dysfunctional coping mechanism used to counter the effect of Cultureshock - whick, in turn, is regarded as a potential outcome of Culture Distance. Mindfulness of
this process-pattern aids the attribution of treatment of Culture-shock-induced somatization, by
orienting patients and professionals towards Culture Learning.
Mood Disorders/ Trastornos del Humor/ Transtornos do Humor
A Comparison of Cognitive Vulnerability Factors in Patients with Persistent and
Remitting Lifetime Symptom Course of Depression
Thorsten Barnhofer1, Kate Brennan2, Catherine Crane2, J. Mark Williams2.
1. King's College, London, United Kingdom, 2. University of Oxford, Oxford, United Kingdom.
Abstract Central: This talk will present a study that investigated differences in early risk and
cognitive vulnerability factors between patients with relatively more persistent or remitting
course of depression. Patients with at least three previous episodes who were currently in
remission were categorized based on visual timelines of their lifetime symptom course. Of the N
= 127 patients, n = 47 showed a persistent course of the disorder with unstable remissions and
symptoms most of the time, and n = 59 showed a course with more stable, lasting remissions.
Group comparisons indicated that patients with a more persistent course were significantly more
likely to have suffered from childhood emotional abuse, and reported higher levels of
experiential avoidance and related core beliefs. Experiential avoidance partially mediated the
effect of childhood emotional abuse on persistence of symptoms. The results suggest that
experiential avoidance represents an important target for treatments of chronic depression.
Potentials and Perils of Using Mindfulness-Based Cognitive Therapy (MBCT) for Patients
with Acute Depression
Thorsten Barnhofer1, Jennifer Wild2, Willem Kuyken3, Thorsten Barnhofer1.
1. King's College, London, United Kingdom, 2. University of Oxford, Oxford, United Kingdom, 3.
University of Exeter, Exeter, United Kingdom.
There is a high risk for relapse and recurrence in patients who suffer from depression.
Mindfulness-Based Cognitive Therapy (MBCT) combines intensive training in mindfulness

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meditation with cognitive interventions in order to help patients become better able at
recognizing and disengaging from maladaptive patterns of negative thinking that are at the core
of vulnerability to relapse. A number of clinical trials have demonstrated that MBCT significantly
reduces relapse rates in patients with more than three previous episodes who are currently in
recovery, and it is recommended for relapse prevention by national guidelines for clinical
excellence in the UK. Despite having been specifically developed for relapse prevention, the
treatment is now increasingly being offered to patients who are not in full recovery, partly due to
the fact that those with highest risk of relapse often continue to suffer from residual symptoms
following episodes. Recent evidence suggests that the treatment may be particularly effective in
patients with unstable remissions. Furthermore, a number of preliminary studies have explored
the use of MBCT for chronic and treatment-resistant depression, all with promising results. This
panel discussion will explore the potentials and perils of the use of MBCT for patients with
current depression. Based on a review of latest findings from trials of MBCT in acutely
depressed patients, it will address questions concerning the feasibility and acceptance in acute
depression, the rationale for its use in chronically depressed patients, limitations of its
application, particularly with regard to trauma and early adversity, the need for modification, and
the case for its use in the wider context of interventions for chronic depression.
Comparing CBASP to CBT in Depression: Results of a pilot RCT
Gaby Bleichhardt, Katrin Wambach, Nikola Stenzel, Winfried Rief.
Department of Psychology, University of Marburg, Marburg, Germany.
Abstract Central: Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is a
specific treatment for the chronically depressed. It has been tested in a large psychotherapy and
medication clinical trial, and it was found to be as effective as medication. When combined with
medicine, it surprisingly produced huge effects (average HRSD score reduction of >17 points;
Keller et al., 2000). CBASP has never been directly compared to cognitive-behavioral therapy
(CBT). Furthermore, there are no results for CBASP in non-chronic patients. In this pilot,
common CBASP was therefore applied to patients with acute major depression, and it was
compared to CBT. A randomized-controlled trial with two active treatment arms (CBASP vs.
CBT with emphasis on behavioral activation) and a waiting list control group was designed.
Patient with current Major Depression and BDI-II > 17 are included. Scheduled sample sizes are
N=50 per condition. Changes in the BDI-II were defined as primary outcome. It is hypothesized
that results for CBASP are at least comparable to those of CBT and that is more effective than
waiting list. At the time of presentation, 25 patients per condition will be completely assessed.
Current preliminary results are in line with the hypotheses: Significant time effects (p<.001), no
interaction (CBASP vs. CBT) and high longitudinal effect sizes (d > 1 SD) for both active
conditions were found already. The presentation will additionally report on our clinical
experience with this treatment. It is concluded that CBASP can work for non-chronic patients as
well.
ICTs Tools for the Prevention of Depression: Clinical Characteristics of a Risk Population
of Unemployed Men
Cristina Botella1, 3, Adriana Mira1, Azucena Garca Palacios1, 3, Soledad Quero1, 3, Antonio Riera
Lpez del Amo1, Guadalupe Molinari1, Diana Castilla1, 3, Ins Moragrega1, 3, Carla Soler1, Rosa
Baos2, 3.
1. Universitat Jaume I, Castelln, Spain, 2. Universidad de Valencia, Valencia, Spain, 3. Ciber
de Fisiopatologa de la Obesidad y Nutricin (CIBEROBN), Castelln, Spain.

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Introduction Emotional disorders (ED) are one of the most common health problems worldwide.
According to the World Health Organization depression will become the second most important
cause of disability in 2020. For this reason prevention of depression is one of the 5 central focus
points in the European Pact for Mental Health and Well Being. It is know that there is a
significant relationship between depression, stress and coping. Also, people suffering from
emotional disorders often use maladaptive emotion regulation strategies and have low coping
behaviour that contributes to the presence of clinical symptoms. So, it is important to develop
strategies for monitoring coping and promote emotion regulation in people exposed to high
levels of stress Information and Communication Technologies (ICT) can help us in this task and
in to identify people at risk. Within the framework of the European OPTIMI project, we have
designed ICTs based tools for the prevention and treatment of depression. Purpose The aim of
this work is to present the clinical characteristics of the participants (risk population: unemployed
men), who are in a difficult situation and have shown interest in benefiting from our program for
the prevention of depression. Method Some cognitive, behavioural, and physiological sensors
have been developed (EEG, ECG and accelerometer). Also we had developed an intervention
program ICT based: Coping with Stress and Emotion Regulation Program (Smiling is Fun). It is
a self-applied program via the Internet for the prevention of depression. It includes a CBT
protocol with the possibility of using the physiological sensors. 69 healthy high risk participants
met the inclusion criteria and were randomly assigned to three experimental conditions: 1)
Intervention program plus sensors (N=20), 2) Intervention program (N=25), 3) Waiting list
(N=24). All participants were unemployed men suffering stress related to financial concerns and
lack of employment. The clinical measures used were: Beck Depression Inventory II (BDI-II),
Overall Depression Severity and Impairment Scale (ODSIS), Overall Anxiety Severity and
Impairment Scale (OASIS), Positive and Negative Affect Scale (PANAS), Brief Cope,
Multicultural Quality of Life Index (QLI) and Perceived Stress Scale (PSS). Results The men
age of the participants was 31.25 (SD= 9.55) and the mean duration of unemployment was
18.84 months (SD=12.40). The clinical characteristics of the sample shown that the participants
had a good psychological health as had low level of depressive and anxiety symptomatology
at baseline. The means in BDI, OASIS, ODSIS and PSS were very low. Conclusion The results
show that the participants at this moment, despite confronting a stressful life situation, have a
high capacity to cope with it. Remains to be seen whether, as time passes, this coping capacity
decreases and if the program Smiling is Fun can protect this population at risk and prove to be
useful for preventing prevention.
La Relacin de la Rumiacin y Variables Metacognitivas entre Adolescentes de Costa
Rica
David Campos1, Esteban Montenegro1, 2.
1. Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica, 2. Instituto de
Investigaciones Psicolgicas, San Pedro de Montes de Oca, Costa Rica.
Abstract Central: La rumiacin, entendida como un proceso de pensamiento depresivo
repetitivo y persistente referente a los sntomas de la depresin y sus posibles causas y
consecuencias (Nolen-Hoeksema, 1991) actualmente representa un constructo central en la
investigacin de la depresin (Papageorgiou & Siegle, 2003). Ahora bien, a pesar del creciente
inters que se ha gestado en torno a su estudio, son escasas las investigaciones dirigidas a
dilucidar los posibles factores relacionados con su desencadenamiento y diferencias
individuales, especialmente en el caso de adolescentes. El estudio tuvo como objetivo
investigar la asociacin de las creencias metacognitivas con la tendencia de rumiacin entre
adolescentes, con base en el modelo metacognitivo de la rumiacin y la depresin
(Papageorgiou & Wells, 2003). La muestra estuvo integrada por 212 jvenes estudiantes de

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secundaria, con una media de 15,9 aos (DE= 1,4 aos), quienes completaron una batera de
instrumentos que incluan el Inventario de Depresin para Nios de Kovacs, la Escala de
Rumiacin del Cuestionario de estilos de respuesta para nios, la Escala de Creencias
Positivas sobre la Rumiacin, la Escala de Creencias Negativas sobre la Rumiacin, las
Escalas de Depresin Ansiedad Estrs y Cuestionario de Preocupacin de Pensilvania para
Nios. Entre los resultados obtenidos cabe desatacar que se hall una diferencia significativa
entre altos y bajos rumiadores en el reporte de sntomas depresivos, t(205)=6.86, p < .001,
siendo mayor la puntuacin de los adolescentes con alta tendencia de rumiacin (M=13.22,
DE=6.38) en comparacin con los bajos rumiadores (M=7.77, DE=5.00). Tras realizar un
ANOVA se encontr un efecto significativo del sexo en la puntuacin de rumiacin F (1, 210) =
4.43, p =.04, 2 = 0. 021. Al realizar un ANCOVA el gener perdi el efecto significativo sobre
la depresin (F (1, 207) = 3.08, p = .08, 2 = .01) al introducir como covariable la tendencia de
rumiacin (F (1, 206) = 98.65, p < .001, 2 = .32). Igualmente, se realiz un ANCOVA que
demostr un efecto significativo de las creencias metacognitivas positivas al co-variar con
rumiacin (F (1, 207) = 84.25, p < .001, 2 = .29). El factor sexo no present un efecto
significativo F (1, 207) = .78, p = .37, 2 = .004. Finalmente, con el fin de determinar el grado de
asociacin de una serie de variables relevantes sobre la tendencia de rumiacin de la muestra
de adolescentes empleada, se emple una regresin multiple, utilizando la puntuacin de la
medida de rumiacin como variable dependiente. El modelo final fue estadsticamente
significativo, F(8, 172)=21.53 p<.001, R2 corregida = .48. Siendo la edad exacta en aos y
meses, la sintomatologa depresiva, la tendencia de preocupacin, las creencias
metacognitivas positivas y las metacognitivas negativas sobre incontrolabilidad y dao,
predictores significativos de la rumiacin (p<.05). En conclusin, los resultados de este estudio
dan soporte a los postulados de la teora de estilos de respuesta y del modelo metacognitivo de
la rumiacin y la depresin, en una muestra de adolescentes costarricenses. De igual forma da
lugar a considerar que ambas teoras son complementarias.
Anlise Comparativa de Distores de Pensamentos em Grupos de Depressivos e No
Depressivos
Adriana Carneiro, Makilim Baptista.
Laboratrio de Aval. Psi. em Sade Mental, Universidade So Francisco, Itatiba, Brazil.
O estudo de padres negativistas relacionados depresso so classificados pela Terapia
Cognitiva como base para ser possvel um tratamento adequado e eficaz da depresso. Isso
porque so encontrados maiores nmeros de recorrncia em casos que no so submetidos a
sesses psicoteraputicas pareadas com tratamentos farmacolgicos. Desse modo, investigar
quais so os padres de pensamentos mais frequentes em sujeitos depressivos, utilizando
medidas sistematizadas, como um teste psicolgico, facilita o acompanhamento do tratamento,
permitindo ao psicoterapeuta avaliar e monitorar tais distores. O presente trabalho teve como
objetivo buscar evidncias de validade de critrio para a Escala de Pensamentos Depressivos
EPD, comparando padres de pensamentos entre depressivos (G1; n=37) e no depressivos
(G2; n=583). No G1, os participantes foram diagnosticados com Depresso por meio da
Structured Clinical Interview for DSM Disorders- SCID, ao passo que o G2 indicava no
questionrio de identificao no possuir diagnstico de transtorno mental prvio e ter entre 18
e 59 anos. Os resultados confirmaram os pressupostos tericos, indicando que o G1
apresentou maiores distores de pensamentos em relao ao G2, sendo estas diferenas
estatisticamente significativas. Nesse sentido, o presente estudo fornece uma evidncia de
validade para o instrumento, indicando que este pode ser promissor ao propsito elencado.

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Escala de Pensamentos Depressivos: Estudos Iniciais de Uma Escala Baseada na Trade


Cognitiva de A. T. Beck
Adriana Carneiro.
Laboratrio de Aval. Psi. em Sade Mental, Universidade So Francisco, Itatiba, Brazil.
A Terapia Cognitiva tem como um dos pressupostos bsicos a considerao de que a
negatividade no um sintoma, mas sim, parte de uma funo central na instalao e
manuteno da depresso, uma vez que existe a tendncia distoro da realidade e
aplicao de um vis negativo nas interpretaes sobre si, o futuro e o mundo. Por esta razo,
pode-se considerar que as crenas disfuncionais sejam a chave para o entendimento da
depresso, e tambm, para seu tratamento de forma eficaz, ponderando que a severidade dos
sintomas podem tambm ser avaliados indiretamente pelo nmero e intensidade de crenas
disfuncionais. Atrelado a esta problemtica, observa-se que as estatsticas atuais demonstram
que a depresso afeta milhes de pessoas, independente da idade, sexo, estado civil,
escolaridade ou status social. Considerando a importncia que os testes possuem dentro de
um processo de avaliao psicolgica, o objetivo principal deste trabalho apresentar e discutir
resultados referentes a construo, validao e padronizao de um instrumento para avaliar
pensamentos depressivos em adultos, denominado atualmente de Escala de Pensamentos
Depressivos- EPD. Sero apresentados os passos da construo dos itens e as anlises sobre
diferenas de pensamentos depressivos por sexo. Ademais, ser discutido brevemente sobre
os resultados obtidos por meio de anlise fatorial, tal como os principais desafios inerentes a
esse trabalho.
O tratamento do paciente com Transtorno Bipolar em TCC: trs intervenes
simultneas. Treating patient with Bipolar Disorder with CBT: three simultaneous
interventions
Marcelo Carvalho1, Bruno Colho1, 2, Marcela Braz1, Gildo Angelotti1.
1. Psychiatry Institute, Universidade de So Paulo, Sao Paulo, Brazil, 2. Psychiatry Insitute,
Universidade do ABC, Santo Andr, Brazil.
O tratamento do paciente com Transtorno Bipolar exige uma rpida aderncia ao tratamento
medicamentoso e a terapia individual para controle das crises, principalmente em fases no
depressivas. O uso de tcnicas em Terapia Racional Emotiva Comportamental podem
rapidamente estimular a participao na terapia e modelar para tarefas futuras de maior
complexidade, bem como, colaborar na aderncia medicao. A modificao do discurso
atravs da TREC nos primeiros atendimentos pode garantir a rapidez de intervenes sobre o
pensamento de forma segura, principalmente num momento de euforia e pouca crtica do
paciente, de forma diretiva. O acompanhamento pelo mdico psiquiatra em colaborao com
as descries do terapeuta sobre o paciente garantem tambm um ajuste rpido e adequado
contingente as variaes de humor. A integrao da famlia deve ocorrer tambm reduzir riscos
da desistncia, diminuio do estresse e controle de danos frente as futuras oscilaes de
humor, naturais a doena e ao ajuste medicamentoso. Nosso trabalho descreve, o tratamento
na prtica clnica sobre o mesmo paciente com trs intervenes paralelas e simultneas: 1.
Atendimento individual e o engajamento ao tratamento atravs da TREC; 2. Tratamento
Psicofarmacolgico e adequao a psicoterapia; 3. Terapia Familiar e suporte ao paciente.
Behavioral Activation Treatment for Depression: Historical Background, Efficacy, and
Future Directions in Dissemination
Anahi Collado-Rodriguez, Soraida Castillo, Laura MacPherson, Carl Lejuez.

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University of Maryland - College Park, College Park, MD, USA.


Background: The current poster will offer a historical background and general overview of
contemporary Behavioral Activation therapies, for which there has been emerging interest as
efficacious and cost-beneficial treatment for depression. The poster will discuss results of a
behavioral activation treatment (BATD; Lejuez et al., 2001; 2011) delivered to monolingual
Spanish-Speaking Latinos in the United States. Generally, disparities in mental health treatment
have prevented this group from accessing effective interventions. Reasons cited for these
disparities include language barriers, high cost of services, lack of culturally sensitive
treatments, and stigma toward mental health treatment. BATD may be well-equipped to address
the existing barriers through its focus on individuals personal values, which contribute to
cultural-sensitivity, its efficiency and cost-effectiveness, straightforward rationale, and
explanation of depression as a cause of clients environments and not of their internal
processes, which may serve to decrease stigma. Method: The current study sought to establish
preliminary efficacy of the 10-session BATD in a group of monolingual Spanish-speaking
Latinos (N=10) who had elevated depressive symptomatology. Participants were assessed at
baseline for DSM-IV Axis I psychiatric diagnoses, and at each session for depressive
symptomatology and for the proposed BATD mechanisms: activity engagement and
environmental reinforcement. An additional aim of the study was to evaluate the need for
making cultural modifications to the treatment through in-depth participant interviews. Our final
sample consisted of seven females and three males. Participants had a mean age of 38 (SD=
5.34 years). Results: Hierarchical Linear Model analyses indicated that over the BATD course
there was a significant decrease in depressive symptomatology (p < .001) and significant
increases in activation (p = .04) and environmental reinforcement (p = .02). Further, increases in
activation corresponded concurrently with decreases in depression (p = .01) while a
bidirectional prospective relationship between increases in environmental reinforcement and
decreases in depression was observed (all ps < .04). Sustained clinical gains in depression and
activation, and an increase in environmental reinforcement were observed through the followup. The in-depth interview results suggested high treatment acceptability. Discussion: This
study provides preliminary support for BATD as an efficacious and acceptable treatment for
depression in this group. Results provided evidence of correspondence between depression
and BATDs proposed mechanisms of change; Treatment adherence rates were higher relative
to those that have been reported in samples with similar characteristics. Research extensions
including a treatment control group and a larger sample size are encouraged. Future directions
in and benefits of disseminating Behavioral Activation therapies in Latin America are proposed.
The Earlier the Better: Use of Cognitive Behavioural Therapy (CBT) based Interventions
by Midwives for Antenatal Mothers at Risk of Depression and Anxiety Disorders
Agatha Conrad1, Anthony O'Brien1, 2, Tanya Connell1.
1. Hunter New England Mental Health, Newcastle, NSW, Australia, 2. University of Newcastle,
Newcastle, NSW, Australia.
Abstract Central: Perinatal mood disorders are becoming increasingly prevalent in Australia
with antenatal depression or depressed mood effecting 25% of women and postpartum
depression 16%. Depression and related disorders affect the wellbeing of the woman, her infant
and her family, as well as having an impact on family relationships that may impact upon the
future health and well-being of children It is therefore essential to identify women at risk of
developing anxiety and depression perinatally to ensure that they have appropriate care during
the pregnancy CBT has been found to be effective in treating major depressive and anxiety
disorders. Traditionally midwives have been involved in screening and educating women about

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pregnancy. They have however limited scope of practice regarding the impact of mental health,
particularly depression on the wellbeing of the pregnant woman. This project offers a unique
opportunity for the midwives to enhance their skills in delivering a clinical intervention to
antenatal mothers. The project aim is to develop a group based CBT intervention for midwives
working with antenatal mothers at risk of anxiety and depression disorders. Results of the
randomised controlled trial will be presented and implications for clinical practice promulgated.
Adjustment Disorder and Personality Traits: A Descriptive Study
Mara frica Cruz, Salvador Sibina, Maria Barba, Romina Cortizo, Mireia Forns, Patricia
Carolina Garnier, Mara Rosa Mas, Rebeca Santonja, Adelina Abellanas, Angela Navarro, Juan
Ramon Castao, Belen Diaz, Luis Miguel Martn, Antoni Bulbena.
CSMA Sant Mart Sud, INAD- Parc de Salut Mar, Barcelona, Spain.
Introduction: Adjustment disorders (ADs) present important diagnostic dilemmas in that they are
often poorly defined and overlap with other diagnostic groupings. The objective of this study is
to describe the traits of personality in an adult sample of outpatients with AD diagnose.
Methods: To analyze the characteristics of personality with the Revised NEO Personality
Inventory (NEO-PI-R) in a sample of 52 subjects with AD diagnosis in accordance with DSM-IVTR criteria. Results: The NEO-PI-R provides a comprehensive assessment of five broad
dimensions of personality. Preliminary results form the data reveal high scores on Neuroticism
scale (N) and low scores on Extraversion (E) and Conscientiousness (C) dimensions.
Discussion: Further research need to be done to specify and better understand the role that
some personality traits play enhancing the vulnerability to develop an AD. This findings may
also help in the design of both prevention and treatment strategies.
New developments in meta-analyses of cognitive and behavioral therapies for mental
disorders
Pim Cuijpers1, John Weisz2, Toshi Furukawa3, Andrea Cipriani4, Rachel Churchill5, Vivien
Hunot5, Deborah Caldwell5, Stefan Leucht6, Georgia Salanti7, Stefan Hofmann8, Gerhard
Andersson9, Hanna Stalby9, Bogdan Tulbure9, Pim Cuijpers1, Pim Cuijpers1, Liesje Donkin1,
Gerhard Andersson9.
1. VU University Amsterdam, Amsterdam, Netherlands, 2. Harvard University, Boston, MA,
USA, 3. Kyoto University, Kyoto, Japan, 4. University of Verona, Verona, Italy, 5. University of
Bristol, Bristol, United Kingdom, 6. Technical University of Munich, Munich, Germany, 7.
University of Ioannina, Ioannina, Greece, 8. Boston University, Boston, MA, USA, 9. Linkping
University, Linkping, Sweden.
The number of randomized trials examining the effects of psychological treatments for mental
health problems is increasing every year. For example, between 2006 and 2010 a total of 89
trials examined the effects of psychotherapies for adult depression, while in the period between
2001 and 2005 the number of trials was 56. This is an increase of almost 60%, and this
increase has continued since 2010. In order to assess the effects of psychotherapies for mental
disorders it is important to integrate the results of these individual trials, in order to be able to
adequately estimate the effects of these therapies.
Meta-analyses are aimed to integrate the results of individual randomized trials into one overall
estimate. The methods of meta-analyses have been improved considerably since their first
development in the 1970s. Their results are at the core of treatment guidelines for mental
disorders, and they help policy makers, clinicians and patients to decide about which treatments
should be given in which patients.

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In this symposium, world leading experts in the field of meta-analyses of psychotherapies for
mental disorders will present recent findings in specific subfields of psychotherapy research.
COmprehensive Meta-Analysis for Depression (COMAD): a network meta-analysis of all
major psychotherapies and drugs in the acute phase treatment of major depression
Psychological and pharmacological therapies represent two most commonly recommended
treatment options for major depression. Broadly speaking, these two classes of treatment
appear to be equally efficacious, while, for either of them, adherence may remain less than
optimal. Moreover, there are so many different approaches and compounds within each class.
Which then of the various available options within these two broad groups of interventions can
be more efficacious and acceptable in the acute phase treatment of major depression? Is there
any particular psychotherapy or drug that is clinically superior to all the others?
When a range of interventions are available for the same disorder, of which some are compared
against others in randomised trials, indicating possible yet no definitive superiority or inferiority
of one over the other, a new meta-analytical approach may be of particular value in making
maximum use of the available evidence. Network meta-analysis (NMA), also known as multiple
treatments meta-analysis, is a statistical technique that allows both direct and indirect
comparisons to be undertaken, even when two of the treatments have not been directly
compared. NMA has been used successfully in psychiatry for drug treatments of major
depression, suggesting statistically significant and clinically meaningful differences among them
1.
The present COMAD project incorporates the previous evidence network of first and second
generation antidepressants and that of all major schools of psychotherapies (including
behaviour therapy, cognitive-behaviour therapy, 3rd wave cognitive therapy, psychodynamic
therapy, humanistic therapy and interpersonal psychotherapy) for the treatment of major
depression. We are currently synthesizing evidence from more than 400 drug trials and more
than 100 psychotherapy trials. The results will be discussed at the symposium, highlighting
strengths, weaknesses and clinical implications of the methodology.
Reference
1. Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 12 newgeneration antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373: 746-758.
A review of mega-analyses examining the efficacy of cognitive behavioral therapy
In this presentation, I will review the literature of meta-analyses examining the efficacy of
cognitive behavioral therapy (CBT) for the range of mental disorder. A total of 269 meta-analytic
studies were identified. Of those a representative sample of 106 meta-analyses will be
examined in more detail. These meta-analytic studies examined the following problems:
substance use disorder, schizophrenia and other psychotic disorders, depression and
dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders,
insomnia, personality disorders, anger and aggression, criminal behaviors, general stress,
distress due to general medical conditions, chronic pain and fatigue, distress related to
pregnancy complications and female hormonal conditions. Additional meta-analytic reviews
examined the efficacy of CBT for various problems in specific subpopulations, including children
and elderly adults. The strongest evidence exists for CBT of anxiety disorders, somatoform
disorders, bulimia, anger control problems, and general stress. Eleven meta-analytic studies
compared response rates between CBT and other treatments or control conditions. The results
of these studies showed that CBT showed higher response rates than the comparison
conditions in 7 of these 11 reviews and only one review reported that CBT had lower response
rates than comparison treatments. In sum, the evidence-base of CBT is very strong. However,
more research is needed to examine the efficacy of CBT for randomized-controlled studies.

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Meta-analysis of the effects of internet treaments for social anxiety disorder


Previous meta-analyses have showed that CBT is an effective treatment for social anxiety
disorder (SAD), with moderate to large between group effect sizes. Moreover, there are also
systematic reviews and meta-analyses showing that computerized CBT is effective in the
treatment of anxiety disorders (Cuijpers et al., 2010). However, fewer systematic reviews exist
in which the effects of guided internet-delivered CBT (ICBT) has been tested in isolation from
other forms of computerized treatments. In the area of SAD there are now several controlled
trials and only one small preliminary meta-analysis (Tulbure, 2011) which did not include all
controlled trials but clearly showed a large between group effect suggesting that guided ICBT
can be as effective as face-to-face CBT. The aim of this study was to conduct an updated metaanalysis of the published trial on ICBT for SAD. We had three aims. First, we wanted to
investigate the effects of ICBT against no treatment control groups. Second, we wanted to
compare guided ICBT against face-to-face treatment. Third, we investigated the difference
between guided and unguided ICBT for SAD. The studies were coded and analysed with the
help of the program Comprehensive meta-analysis. We identified 10 studies in which ICBT had
been tested against no treatment control, and four studies in which ICBT was compared against
face-to-face treatment. We also found five studies where guided ICBT was compared against
unguided ICBT. An updated search will be conducted closer in time to the conference.
Preliminary results suggests that large between group effects are found against no treatment
control and that there are no difference between face-to-face and ICBT. Unguided treatments
had a slightly smaller effect than guided. We conclude that ICBT is an effective treatment for
SAD.
The next step in meta-analyses of psychological treatments: Towards Individual Patient
Data meta-analyses
One important way to improve the impact of treatments of mental disorders is to develop
personalized treatments, which is aimed at identifying which characteristics of an individual
predict the outcome of a specific treatment in order to get a better match between the individual
and the treatment received. Research in this area is limited because hardly any randomized
controlled trial has sufficient statistical power to identify predictors and moderators, which are
needed for the development of personalized treatments. Individual Patient Data (IPD) metaanalyses may solve this power problem. They also have the advantage that the analyses (e.g.,
imputation of missing data) can be done in the same way for all included studies. Research
questions that can be answered with IPD meta-analyses include for example: is psychotherapy
effective in severe depression, is combined treatment more effective in severe depression than
psychotherapy or pharmacotherapy alone, and is guided self-help and internet-based treatment
can also be effective in severe depression. Furthermore, IPD meta-analyses can examine the
moderating effects of comorbid anxiety, personality disorders, suicidality, type of depression,
number of previous episodes, and somatic disorders have not been established very well, as is
the case for demographic characteristics such as gender, age, ethnicity, education and marital
status.
At the VU University Amsterdam, we have started with collecting the primary data of studies on
psychotherapy for adult depression. As a pilot project we are collecting the data from
randomized controlled trials on Internet-based guided self-help for adult depression. Of the 17
studies identified through the literature, 16 have agreed to submit the data to this project.
Currently we are still integrating the datasets, but at the conference we will present some first
results of this pilot project.
Reference
Cuijpers P, Reynolds CF, Donker T, Li J, Andersson G, Beekman A (2012). Personalized
treatment of adult depression: Medication, psychotherapy or both? A systematic review.
Depression and Anxiety, 29, 855-864.

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Case Study of a Patient with Bipolar Disorder: Use of a 20 Session Protocol in Cognitive
Therapy
Renata De Souza Coelho.
SEJA, belo horizonte, Brazil.
The present study aimed to demonstrate the favorable impact of cognitive therapy for the
treatment of patients diagnosed with bipolar disorder. The method used was the a 20 session
protocol proposed by Basco and Rush (2009). This case report refers to a 47-year-old patient
diagnosed with bipolar disorder since 2008. The patient is a Catholic music singer, active
throughout Brazil, divorced with two children, living in the city of Belo Horizonte, State of Minas
Gerais. The sessions were held in a private practice clinic, located in the capital city of Belo
Horizonte. The patient came to the clinic already medicated. Her initial scores were BDI= 45,
BAI= 52, BHS=15. The case is presently in its 16th session. As a main complaint, the patient
reported inability to manage professional, social and family problems, resulting from her
impulsive and aggressive behavior, typical of patients with this disorder. As hypotheses of
cognitive conceptualization, the therapist proposed primary schemas of inadequacy ("I'm not a
suitable person"), unlovability ("I am not worthy to receive people`s love"), and incompetence ("I
am a failure"). In addition, a secondary vulnerability schema ("I am not able to withstand another
crisis"). Due to her professional activity, the patient experiences constant activations of the
characteristic bipolar disorder symptoms: depression and mania; changes in cognition,
emotions and behaviors; reduction in psychosocial functioning; insomnia, stress and other
symptoms. The mental confusion and disorganization caused by depression, mania and mixed
states, as well as the external distractions of the environment, make adherence and therapeutic
alliance harder than usual. As an initial goal, a therapeutic alliance was developed which
facilitated a collaborative intervention planning. The psychoeducation about the model relevant
to the disorder was an important achievement. The family members were invited to participate in
this phase. The clinical intervention included: developing skills for managing her lifestyle,
summary of symptoms spreadsheet, mood tracking chart, control of trigger factors, cognitive
symptoms management (challenging automatic thoughts, attention to typical cognitive errors,
advantage/ disadvantage and cost/benefit inventories), management of behavioral symptoms
(role plays, behavioral activation, a, relaxation training activity scheduling, problem solving
techniques, stress management), relapse prevention, maintenance of adherence and
achievement of goals of therapy. To date, considering the initial intervention goals, the results
suggest attainment of cognitive flexibility and the initiation of cognitive restructuring. Current
scores are BDI= 05, BAI= 06, BHS= 01. Based on standard cognitive therapy, the patient
maintains a strong therapeutic alliance with the cognitive model and the therapist. She has
given TV interviews, when she has disclosed the fact that she is in therapy, and talks positively
about her treatment, mentions her clinical experience in her song writing, in her attempt to
benefit other people.
Internet-delivered Interpersonal Therapy vs. Internet-Delivered Cognitive Behaviour
Therapy for Adults with Depressive Symptoms: A Randomized Controlled Noninferiority
Trial
Tara Donker1, Kylie Bennett2, Anthony Bennett2, Andrew MacKknnon4, Annemieke Van
Straten3, Pim Cuijpers3, Helen Christensen1, Phil Batterham2, Lisanne Warmerdam3, Kathy
Griffiths2.
1. Black Dog Institute, Sydney, NSW, Australia, 2. Centre for Mental Health, Canberra, ACT,
Australia, 3. VU University, Amsterdam, Netherlands, 4. University of Melbourne, Melbourne,
VIC, Australia.

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Abstract Central: Background: Face-to-face Cognitive Behavioural Therapy (CBT) and


Interpersonal Psychotherapy (IPT) are both effective treatments for depressive disorders, but
access is limited. Online CBT interventions have demonstrated efficacy in decreasing
depressive symptoms and can facilitate the dissemination of therapies among the public.
However, the efficacy of internet-delivered IPT is as yet unknown. Furthermore, by identifying
which predictors and moderators lead to beneficial outcomes, accurate selection of the best
initial treatment could have tremendous benefits for people living with depression. Objectives:
The aim of this study is two folded. First, it examines whether IPT is effective, noninferior to, and
as feasible as CBT when delivered online to spontaneous visitors of an online therapy website.
Second, it identifies predictors and moderators of depression outcome Methods: An automated,
three-arm, fully self-guided online noninferiority trial compared two new treatments (IPT [n=620]
and CBT [n=610]) to an active control treatment (MoodGYM, n=613) over a four week period in
the general population. Outcomes were assessed using a range of online self-report measures
completed immediately following treatment and at 6-month follow-up. Results: Completersanalyses showed a significant reduction in depressive symptoms at post-test and follow-up for
both CBT and IPT, and were noninferior to MoodGYM. Within-group effect sizes were medium
to large for all groups. There were no differences in Clinical Significant Change between the
programs. Reliable Change was shown at post-test and follow-up for all programs, with
consistently higher rates for CBT. Participants allocated to IPT showed significantly lower
treatment satisfaction compared to CBT and MoodGYM. There was a drop-out rate of 70% at
post-test, which was highest for MoodGYM. Intention-to-treat analyses confirmed these findings.
Furthermore, female gender, lower mastery and lower dysfunctional attitudes predicted better
outcome at post-test and/or follow-up regardless of intervention. No overall differential effects
for condition on depression outcome were found. However, based on the time-specific
estimates, a significant interaction effect of age was found. For younger people, internetdelivered IPT may be the preferred treatment choice, whereas older participants derive more
benefits from internet-delivered CBT programs. Conclusions: Despite a high drop-out rate and
lower satisfaction scores, this study suggests that Internet-delivered self-guided IPT is effective
in reducing depressive symptoms, and may be non-inferior to MoodGYM. The completion rates
of IPT and CBT were higher than MoodGYM, indicating some progress in refining internetbased self-help. Internet-delivered treatment options available for people suffering from
depression now include IPT. Different e-mental health programs may be more beneficial for
specific age groups.
Does Executive Functioning in Daily Life Predict Depression Symptoms?: A Test of
Incremental Validity
Greg Feldman1, Laura Knouse2, Anna Robinson1, Emily Blevins1.
1. Simmons College, Boston, MA, USA, 2. University of Richmond, Univ. of Richmond, VA,
USA.
Executive function (EF) has been defined as cognitive self-regulation in the service of attaining
goals (Barkley, 2012). Recent integration of neuroscience findings with Becks cognitive theory
of depression suggest that EF impairments such as inhibitory deficits may help explain clinical
phenomena of rumination, cognitive bias, and problem-solving difficulty (Beck, 2008; Disner et
al., 2011). However, associations between neuropsychological tests of EF and depression
severity are inconsistent (McClintock et al., 2010) and the ecological validity of laboratory EF
tasks is often poor (Barkley & Murphy, 2011). In one study, self-reported measures of deficits in
EF in daily life were stronger than EF neuropsychological tests in predicting both self- and
clinician-rated depression in a clinically-referred sample (Knouse et al., in press). Relatively less

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is known about the association of deficits in executive function in daily life and depression
symptoms in non-clinical samples and whether this construct adds to the prediction of
depression symptoms above and beyond established individual differences associated with
depression such as Big Five personality traits (Kotov et al., 2010). Female college students ( N
= 438) completed measures of depression symptoms (Center for Epidemiologic Studies Depression scale, CES-D; Radloff, 1977), personality traits (Big-Five Inventory, BFI; John,
Naumann, & Soto, 2008), and the Barkley Difficulties in Executive Functioning Scale - Short
Form (BDEF-SF, Barkley, 2012), which consists of five subscales measuring deficits in various
domains of executive functioning: Self-Management to Time (procrastination), Self-Organization
(information-processing inefficiency), Self-Discipline (impulsivity), Self-Motivation (difficulty with
sustained effort), and Self-Regulation of Emotions (delayed emotional recovery). Depression
symptoms were associated with all five BDEFS subscales (Time r = .24; Self-Organization r =
.32; Self-Restraint r = .21; Self-Motivation r = .32; Emotion-Regulation r = .54), BDEFS total
score (r = .49), as well as four of the Big Five traits (Neuroticism r = .50, Extroversion r = -.22;
Conscientiousness r = -.21; and Agreeableness r = -.17). When simultaneously entered in a
multiple regression analysis, the five BDEFS subscales accounted for 33% of the variance in
depression symptoms with Self-Organization, Self-Motivation, and Emotion Regulation
emerging as unique significant predictors of depression symptoms. In two separate hierarchical
multiple regression analyses, Big Five personality traits accounted for 26% of the variance in
depression symptoms, but both the BDEFS total score and its five subscales predicted
additional variance in depression symptoms (9% and 12%, respectively). Results suggest that
self-reported difficulties in executive functioning in daily life are strong predictors of depression
symptoms and have incremental validity above and beyond other widely-studied individual
differences implicated in depression including neuroticism and other Big Five traits. Data
collection is on-going with additional results anticipated in time for WCBCT 2013 including a
prospective study to complement the current cross-sectional analyses as well as data collected
from a co-ed sample.
Evaluation of Common Mental Disorders in Women with Polycystic Ovary Syndrome and
its Relationship with Body Mass Index
Luana Ferreira, Luciano Souza.
Universidade Catlica de Pelotas, Pelotas, Brazil.
Purpose: To evaluate the prevalence of common mental disorders in women diagnosed with
Polycystic Ovary Syndrome (PCOS) and compare with controls paired without PCOS. Methods:
cross-sectional study with a control group in which women between 18 and 30 who did not use
antidepressant and sought the Gynecology Service of the research sites. For every woman
diagnosed with PCOS was sought another without this diagnosis with the same age,
educational status and presence or absence of sexual partners. In total, 166 patients agreed to
participate it is 95 diagnosed with PCOS and 71 in control group. For the diagnosis of PCOS
was necessary to have two of three criteria: oligomenorrhea or amenorrhea, clinical or
biochemical hyperandrogenism, polycystic ovaries on transvaginal ultrasound and exclude the
presence of Cushing's Syndrome, Congenital Adrenal Hyperplasia and androgen-secreting
tumors. Weight and height were measured to calculate body mass index (BMI) as the indicator
of common mental disorders was evaluated by the Self-Reporting Questionnaire 20 items. It
was realized chi-square in analysis stratified by category of body mass index to compare the
prevalence of CMD in the group of women with and without PCOS. Results: There were not
significant differences in age, education, presence of sexual partners, ethnicity, socioeconomic
status, use of psychiatric medication and search for consultation in mental health. The
proportion of obese women with and indicative of common mental disorders was significantly

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higher in women with PCOS than the control group. In the group with healthy BMI, the
difference of the proportions related to the indicative of common mental disorders among
women with and without PCOS were statistically significant (0.008). Conclusions: Women with
PCOS have almost three times higher proportion of common mental disorders compared with
women without PCOS. Even women with PCOS and healthy BMI have an increased risk of
psychiatric comorbidity. Keywords: Polycystic ovaries, mental health problems, obesity, Body
Mass Index, Women's Health
Understanding Differential Treatment Response to CBT in Depressed Patients: The
Effects of Self-Criticism, Dependency, and Efficacy on Daily Stress, Coping, and Affect
J. Elizabeth Foley1, 2, David Dunkley1, 2, David Zuroff2, Ruta Westreich1, Gail Myhr3.
1. Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC,
Canada, 2. McGill University, Montreal, QC, Canada, 3. McGill University Health Centre,
Montreal, QC, Canada.
Clinicians and researchers alike have long known that significant heterogeneity exists within
depressed patients (see Beutler, 2010; Blatt et al., 2010). One important factor that negatively
influences treatment process and outcome in depression is self-criticism (see Blatt & Zuroff,
2005). Other individual factors that are yet to be fully understood in depression are the roles
played by dependency and efficacy. Studies need to address more directly the mechanisms
through which these individual differences impact clinically depressed populations because an
understanding of daily processes responsible for the persistence of depressive symptoms will
facilitate the development of more effective and individually targeted treatments. In a sample of
depressed outpatients (N = 65) referred for CBT treatment, this study examined: (1) the extent
to which there are consistent individual differences among depressed patients; and (2) the
relations between self-criticism (SC), dependency, and efficacy and individual differences in
daily stress, coping, and depressive symptoms (e.g., sadness). Prior to CBT-treatment,
participants completed a battery of questionnaires, including measures of SC, dependency, and
efficacy. At pre-treatment (T1) and follow-up 6 months later (T2), participants completed
questionnaires assessing daily stress, coping, social support, and depressive symptoms at the
end of the day for 7 consecutive days. Moderate to large individual differences were found
between depressed patients in the daily reports of stress, coping, and depressive symptoms.
Zero-order correlations showed that SC was moderately to strongly associated (rs > .30) with
T1 aggregated daily stress, perceived criticism from others, lower perceived control, self-blame,
avoidant coping, and sadness. At T2, however, SC remained moderately to strongly associated
with aggregated daily perceived criticism, self-blame, and avoidant coping, but no longer
exhibited significant correlations with aggregated daily stress, lower perceived control, and
sadness. On the other hand, dependency exhibited moderate to strong correlations with
aggregated daily fear, but mild to moderate correlations (rs > .20) with received social support at
T1 and T2. In contrast, efficacy was moderately associated with aggregated daily positive affect
and positive reinterpretation at T1 and T2, and also became moderately related to problemfocused coping and received social support at T2. Path analyses results demonstrated that selfcriticism was indirectly related to T2 aggregated daily sadness through persistent daily avoidant
coping tendencies. On the other hand, dependency was indirectly related to T2 aggregated daily
positive affect through higher daily received social support. The relation between efficacy and
T2 aggregated daily positive affect was mediated by daily tendencies to engage in positive
reappraisal and receive social support. These results suggest that CBT treatments of
depression should tailor the techniques used to the specific agents of change shown to be most
(in)effective for different individuals to more effectively alleviate depressive symptoms.

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Cognitive-Behavioral Therapy Applied to Dysthymia: A Case Study


Luiz Gonzaga, Vanessa Gibran, Andressa Becker da Silva.
Catholic University of Campinas, Campinas, Brazil.
Abstract Central: Cognitive-Behavioral Therapy (CBT) is the integration of behavioral therapy
and cognitive therapy techniques and is based on the assumption that the individual's affection
and behavior are determined by the way in which he structures his world in cognitive terms. In
this sense, CBT as an active, directive and structured approach can be used successfully in the
treatment of various psychological disorders and can be applied in many situations to which
people are exposed. Within this context, we conducted a case study from the perspective of
CBT, with a 30-year-old woman working as a government employee who had been directed to
psychotherapy by psychiatrists and who had been diagnosed with dysthymia. Dysthymia is
defined, according to ICD-10, as a chronic mood depression. It may last for several years, but
its seriousness or the frequency of the crisis are not sufficient to meet the criteria of a serious,
moderate or low recurrent depressive disorder (F33). According to her anamnesis, the patient
had been dating someone for 7 years and had brought, as a major complaint, a situational
involvement with a third person, which triggered a recurrent emotional crisis. Throughout the
sessions (24), it was noticed that the patient had the same pattern of dysfunctional behavior and
cognitive distortions (arbitrary inference) in situations involving decision-making regarding
emotional aspects. She also represented a clinical case of Moderate Depression as described
by the Beck Depression Inventory (BDI) with 27 points. We used some tools and interventions in
the therapeutic process, such as BDI, semi-directed framework of self-perception, problem
solving techniques, Socratic questioning, cognitive restructuring, record of dysfunctional
thoughts, relaxation, etc. Such strategies played the role of working on issues related to the
patients life that were affecting her socially, as well as of heading towards a main focus on the
development and progression of the process of therapy. Throughout the process we could
notice the patients engagement in some cognitive, behavioral and emotional changes in
situations that required self-control, such as: evaluating positive aspects in contrast with
negative ones, assertiveness, engagement in pleasurable activities, participation in groups of
social support l (friends, co-workers), etc. She also showed a significant change in
symptomatology defined as a BDI 2 Minimum Depression. We emphasize the importance of
CBT based on a focal and directive approach, which provides the patient with the urgency in
treatment required, as patients usually seek for treatment when the symptoms are already
visible and chronic. We also emphasize the importance of this therapy as a relatively successful
approach in the treatment of mood disorders as a measure of prevention and intervention.
Afectividad Negativa en Pacientes con Trastorno Afectivo Unipolar
Yvonne Gmez Gmez Maquet, Diana Agudelo, Mariantonia Lemos, Maria Claudia Lattig,
Gabriela Blanco.
Universidad de lso Andes, Bogota, Colombia.
Abstract Central: Se presentan los resultados de un estudio piloto con un diseo de casos y
controles cuyo objetivo fue establecer la relacin entre los trastornos afectivos unipolares y el
rasgo de afectividad negativa. La muestra estuvo conformada por 20 pacientes hospitalizados
en una institucin psiquitrica y diagnosticados con trastorno de depresin mayor o distimia
(grupo casos) y 17 personas de la comunidad general, sin diagnstico de trastorno mental, y
sin lazos de consanguinidad con el grupo caso, pareados por sexo, edad y nivel educativo. Los
participantes fueron sometidos a la Entrevista Estructurada MINI para confirmar el diagnstico
psiquitrico en los casos y asegurar que el grupo control no cumpliera criterios diagnsticos de
un trastorno afectivo. Adems diligenciaron un formato de datos clnicos y familiares, el

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Cuestionario de Depresin Estado-Rasgo IDER y el Inventario de Ansiedad Estado Rasgo


STAI. Se encontraron diferencias en el rasgo de depresin; Me IDER-R casos = 29, IR = 7.0,
Me IDER-R controles = 20, RI = 2.5, p<0.01; y de ansiedad, Me STAI-R casos = 36, RI = 24,
Me STAI-R controles = 13, RI = 18.5, p<0.01. La afectividad negativa se entendi como una
puntuacin superior al percentil 75 en depresin y ansiedad rasgo. Se encontr que el 88.2%
de los controles no presentaban afectividad negativa, mientras que el 60% de los casos la
presentaban. Estos resultados sealan una asociacin entre trastorno afectivo y afectividad
negativa, p<0.01. A pesar del tamao de la muestra, estos resultados indican una posible
relacin entre la afectividad negativa y los trastornos afectivos que soporla hiptesis de la
dimensionalidad en la psicopatologa y apoya el modelo tripartito de la ansiedad y depresin
(Watson et al, 1988; Watson et al, 2011).
Percepcin de Estrs en Pacientes con Trastorno Afectivo Unipolar
Yvonne Gmez Gmez Maquet, Diana Agudelo, Mariantonia Lemos, Maria Claudia Lattig,
Maria Vicotria Benavides, Rossana Lopez.
Universidad de lso Andes, Bogota, Colombia.
Abstract Central: La percepcin de estrs fue evaluada en una muestra de 20 pacientes con
trastorno de depresin mayor o distimia, hospitalizados en una clnica psiquitrica (grupo caso)
y 17 personas sin diagnstico de trastorno mental, y sin lazos de consanguineidad con el grupo
caso, pareados por sexo, edad y nivel educativo (grupo control). La Entrevista Estructurada
MINI se utiliz como gold standard para confirmar el diagnstico psiquitrico en los casos y
asegurar la no existencia de diagnstico afectivo en el grupo control. Los pacientes
diligenciaron un formato de datos clnicos y familiares y el Cuestionario de Sucesos Vitales,
para establecer el nmero de estresores, la valoracin del grado de estrs que generaban y la
percepcin del suceso como positivo/negativo, esperado/inesperado y controlado/fuera de
control. Se encontraron diferencias significativas entre ambos grupos para el grado de estrs
que generan los eventos vitales, Me casos = 51.50, RI=48.5 vs Me controles =26.0, RI=13.5
controles, p<0.01, la frecuencia de eventos, Me casos = 13.5, RI=11.50 vs Me controles =7.0,
RI=5.0 controles, p<0.01. Igualmente, hubo diferencias en la valoracin de eventos vivenciados
como negativos, inesperados y fuera de control, p<0.05 para todas las comparaciones. Estos
resultados apoyan lo reportado la literatura en diferentes contextos y grupos poblacionales
(Brown & Harris, 1986; Kessler, 1997; Spinhoven et al, 2010; Stegenga et al, 2012). El estilo en
la valoracin de los eventos (negativo, inesperado y fuera de control) se relaciona con un estilo
atribucional negativo identificado en las personas depresivas (Abramson et al, 1989; Haeffel
&Vargas, 2011; Leitenberg et al, 2004).
Interventions that Address Depression and Anxiety Disorders in the Workplace
Samuel Harvey1, 2, Sadhbh Joyce1, 2, Matthew Modini1, 2, Helen Christensen2, 1, Richard Bryant1,
2
, Arnstein Mykletun2, Philip Mitchell1, 2.
1. UNSW, Sydney, NSW, Australia, 2. Black Dog Institute, Randwick, NSW, Australia.
Abstract Central: Common psychological disorders such as depression and anxiety are now
the leading cause of sickness absence and long term work incapacity in most developed
countries. This results in significant economic, social and personal costs to employees,
employers and society. In response to this phenomenon, researchers have increasingly focused
on the effectiveness of workplace interventions that may alleviate depression and anxiety.
Interventions can be classified as primary, secondary or tertiary interventions. Primary
interventions are proactive in the sense that they aim to prevent exposure to psychological and

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physical risk factors in the workplace among healthy employees. Secondary interventions aim to
manage symptoms and are typically implemented after a stressful event in the workplace or
following a diagnosed illness. Tertiary interventions are reactive and aim to minimise the impact
that symptoms have on work functioning. The present study aimed to carry out a detailed
systematic meta-review that addressed what interventions have been effective in addressing
depression and anxiety disorders in the workplace. A meta-review is a method of systematically
appraising the results of existing reviews. It includes within its scope systematic literature
reviews, narrative literature reviews and meta-analyses and excludes primary research articles.
A systematic search for reviews of the academic databases of Medline, PsychInfo and Embase,
electronic searches of Cochrane Summaries and a request for grey literature from experts in the
field resulted in more than 5000 articles. All articles were screened for relevance and subjected
to a rigorous quality appraisal. Twenty seven review studies met the quality assessment criteria,
24 of which were deemed to be of moderate quality. In total, these reviews analysed 709
studies. Results of this meta-review consider various interventions that can be categorised as
primary, secondary or tertiary. The secondary intervention of cognitive behavioural therapy
appears to be a promising intervention in addressing work based adjustment disorder but further
research is required to determine its effectiveness for workers with depression or anxiety.
Surprisingly medications such as selective serotonin reuptake inhibitors and tricyclics
antidepressants, a tertiary intervention, produce little to no change on organisational outcomes
(e.g. absenteeism) among workers with depression. The quality of the current research in this
area is comprised by a number of methodological limitations which are outlined and discussed.
One concerning limitation is that the risk factors known to increase psychological stress in the
workplace are typically omitted during the development and evaluation of when workplace
mental health interventions. Our results have important clinical findings for the treatment of
individuals with psychological based work injuries. Further primary research is warranted
however and recommendations for intervention based studies are provided.
The Role of Work in the Development of Depression and Anxiety Disorders
Samuel Harvey1, 2, Sadhbh Joyce1, 2, Matthew Modini1, 2, Helen Christensen2, 1, Richard Bryant1,
Arnstein Mykletun2, Philip Mitchell1, 2.
1. UNSW, Sydney, NSW, Australia, 2. Black Dog Institute, Randwick, NSW, Australia.
Abstract Central: Psychological disorders are now the leading cause of sickness absence and
long term work incapacity in most developed countries. The majority of mental illness difficulties
seen in the workforce are attributed to the most common disorders, specifically depression and
anxiety. These common mental health disorders can result in significant social and personal
costs to both workers and their employers as well as considerable economic costs to society at
large. Consequently, in the past decade, a growing body of research has emerged examining
the relationship between work and mental health. A consensus regarding the various aspects of
workplace mental health has not been reached. While numerous reviews have addressed
specific sub-topics (causal factors, costs, interventions etc), an overarching systematic review
that links all relevant topics on workplace mental health has yet to be conducted. Given this the
present study aimed to carry out a detailed systematic meta-review that addressed how work
contributes to the development of depression and anxiety disorders. A meta-review is a method
of systematically appraising the results of existing reviews. It includes within its scope
systematic literature reviews, narrative literature reviews and meta-analyses and excludes
primary research articles. A systematic search for reviews of the academic databases of
Medline, PsychInfo and Embase, electronic searches of Cochrane Summaries and a request for
grey literature from experts in the field resulted in more than 5000 articles. All articles were
screened for relevance and subjected to a rigorous quality appraisal. Eight review studies met

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the quality assessment criteria, six of which were deemed of moderate quality. Several major
themes were identified by this meta-review when exploring how work may contribute to the
development of depression and anxiety disorders including; psychosocial risk factors,
organisational change, employment status, job dissatisfaction and traumatic events. More
specifically, it was found that high job demands, low job control, job dissatisfaction and low
social support are associated with reduced mental health in the workforce. These findings have
important clinical implications for the development and implementation of workplace
interventions aimed at reducing/treating psychological illness. Psychologists and psychiatrists
need to be aware of such factors when treating individuals with work related psychological
injuries. The current research in this area has a number of concerning methodological
limitations which are discussed and recommendations for improving the quality of future
research are outlined.
Relationship Between Depressive Rumination and Past Depression After Controlling for
Worry
Akira Hasegawa1, Munenaga Koda2, Yosuke Hattori3, Tsuyoshi Kondo2, Jun Kawaguchi4.
1. Faculty of Human Relations, Tokai Gakuin University, Kakamigahara City, Gifu, Japan, 2.
Graduate School of Medicine, University of the Ryukyus, Nakagami District, Okinawa, Japan, 3.
Graduate School of Arts and Sciences, University of Tokyo, Meguro-ku, Tokyo, Japan, 4.
Department of Psychology, Graduate School of Environmental Studies, Nagoya University,
Nagoyashi, Aichi, Japan.
Introduction: The Ruminative Responses Scale (RRS; Treynor et al., 2003) is a measure of
depressive rumination and composed of two subscales, brooding and reflection. Previous
studies confirmed that brooding was related to experience of past Major Depressive Episode
(MDE), but studies of the relationships between reflection and past MDE showed mixed results.
Hasegawa (2012) showed that formerly depressed groups scored higher than never-depressed
groups on both subscales. However, after controlling for brooding, reflection was not
significantly associated with past depression. The present study aims at replicating these
findings. Also, we examine the relationships among RRS subscales and past MDE after
controlling for worry, which is a construct similar to rumination. Some researchers suggested
that rumination is a vulnerability factor for depression and worry is a central cognitive process of
anxiety disorders, but these suggestions have been rarely examined in empirical studies. If
brooding is related to past MDE even after controlling for worry, we believe that brooding is a
vulnerability factor for depression. Method: Japanese undergraduate students (N=414)
completed the Center for Epidemiologic Studies Depression Scale (CES-D; Shima et al., 1985),
the Inventory to Diagnose Depression, Lifetime Version (IDDL; Uehara et al., 1995), the
Japanese RRS (Hasegawa, 2012), and the Penn State Worry Questionnaire (PSWQ; Sugiura &
Tanno, 2000). The data of currently dysphoric participants who scored more than 16 points on
the CES-D and had experienced depressive mood for two successive weeks within the past two
months were eliminated. Next, based on their responses to the IDDL, a formerly depressed
group and a never-depressed group were selected. Participants who had experienced past
MDE were selected as the formerly depressed group (n=27). Never-depressed individuals
(n=185) had never experienced depressive mood for two weeks. The mean age of two groups
were 19.62 (SD=1.77), 18.87 (SD=1.06), respectively. Results: The formerly depressed group
scored higher than the never-depressed group on brooding (p<.01), reflection (p<.001), and
RRS total scores (p<.001). There were no group differences for CES-D and PSWQ scores
(p>.27). Logistic regression analysis was conducted with CES-D, brooding, reflection, and
PSWQ scores as independent variables and experience of past MDE as the dependent
variable. Brooding was significantly associated with past MDE (Wald=4.09, p=.043, odds

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ratio=1.15). Also, odds ratio for reflection was significant and stronger than that for brooding
(Wald=11.26, p=.001, odds ratio=1.27). CES-D and PSWQ were not associated with MDE.
Discussion: The results showed that brooding is related to past MDE after controlling for worry.
This finding indicates that the brooding component of rumination is a vulnerability factor for
depression, rather than worry. Contrary to the findings of Hasegawa (2012), in the logistic
regression analysis, reflection was significantly associated with the experience of past MDE. We
thought that moderator variables (e.g., negative self schema and episodic memories, deficits in
cognitive control, and avoidant behavioral patterns) may be one factor which contributes to this
inconsistency.
Pathways from Self-Criticism to Dysphoria: Mediating Roles of Perceived Social Support
and Psychological Need Satisfaction
Nicola Hermanto, David Zuroff, Daniel Kopala-Sibley, Keven Joyal-Desmarais.
Psychology, McGill University, Montreal, QC, Canada.
Self-criticism is a dysfunctional personality configuration that is characterized by intense feelings
of inferiority, guilt, worthlessness, and failure to live up to expectations (Blatt, 1974). In both
non-clinical and clinical populations, self-critics experience greater dysphoria in the form of
increased negative affect and depressive symptoms (Blatt & Zuroff, 1992). Although selfcriticism is well-established in the literature as a personality vulnerability to depression, there is
limited research that examines the underlying interpersonal (e.g., social support) and
intrapersonal mechanisms (e.g., psychological need satisfaction). Strong social support
networks have been shown to promote psychological health (Rhodes & Lakey, 1999). However,
self-critical individuals make fewer requests for social support and perceive less support than
what is available to them (Mongrain, 1998). According to self-determination theory (Deci &
Ryan, 2000), there are three basic psychological needs of autonomy, competence, and
relatedness whose satisfaction is essential for psychological growth, integrity and well-being. An
individuals social context (e.g., social support) is posited to facilitate the satisfaction of these
basic psychological needs. When these needs are not met, less than optimal outcomes accrue.
This study aimed to examine the combined mediating roles of perceived social support and
psychological need satisfaction in the association between self-criticism and dysphoria. It is the
first known study that attempts to integrate the research areas of personality vulnerability, social
support, and self-determination theory. 115 undergraduate students completed measures of
self-criticism (Depressive Experiences Questionnaire), personal inadequacy (Forms of SelfCriticising/Attacking & Self-Reassuring Scale), perceived social support (Relational Support
Inventory), psychological need satisfaction (Basic Psychological Needs Scale), depressive
symptoms (BDI), and negative affect (PANAS). Structural equation modelling (2/df = 1.80, GFI
= .90, CFI = .96, RMSEA = .08) supported the hypothesized model and demonstrated a
significant indirect path: increased self-criticism predicted decreased perceived support, which
predicted decreased need satisfaction, which, in turn, predicted increased dysphoria. The
association between self-criticism and need satisfaction was partially mediated by perceived
support, and the association between self-criticism and dysphoria was partially mediated by
both perceived support and need satisfaction. The association between support and dysphoria
was fully mediated by need satisfaction. Results support the theory that interpersonal (i.e.,
social support) and intrapersonal processes (i.e., psychological need satisfaction) interact
dynamically to increase vulnerability to psychopathology for self-critics (Zuroff, Santor, &
Mongrain, 2005). Results also accord with self-determination theory, which proposes that social
contexts that support versus thwart the satisfaction of basic psychological needs will influence
well-being. Lastly, clinical implications of the results suggest that targeting a self-critics

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maladaptive social context early in therapy may subsequently bring about positive intrapersonal
outcomes.
Self-Reported Responses to Positive Affect and the Impact of a Positive Experience
Kate Hetherington, Michelle Moulds.
School of Psychology, University of New South Wales, Sydney, NSW, Australia.
There has been recent acknowledgement of the need to better understand the role of the
regulation of positive emotions in depression. The ways people respond to positive affect,
specifically the tendency to engage in dampening or positive rumination have been highlighted
as potential mechanisms of interest. To date, no published studies have examined whether
peoples self-reported responses to positive affect have consequences for the affective impact
of a positive event. We present data from a study examining whether self-reported responses to
positive affect (i) varied with level of dysphoria, and (ii) were associated with the affective impact
of an experimentally manipulated positive experience. Results indicated that engaging in more
dampening, being less emotion focused and less self-focused in response to positive affect was
associated with more depressive symptoms. A self-reported tendency to be more self-focused
(but not engaging in dampening or being emotion focused) was also associated with a greater
increase in positive affect following a positive experience. Future research directions and
potential clinical implications will be considered.
Does Abstract Recall of a Happy Memory Have Consequences for Memory
Characteristics in Depression?
Kate Hetherington, Michelle Moulds.
School of Psychology, University of New South Wales, Sydney, NSW, Australia.
The capacity to repair sad mood through the deliberate recall of happy memories has been
found to be impaired in depressed individuals. There is some preliminary support for the
hypothesis that this may be the consequence of adopting an abstract processing mode during
happy memory recall resulting in a dampening of the memories positive affective impact. These
findings highlight the importance of understanding the consequences of recalling happy
autobiographical memories in either an abstract or concrete way. In a recent study, we
examined the differential consequences of processing positive material in either an abstract or
concrete way (Hetherington & Moulds, 2012). Data from a subsequent study examining the
impact of abstract and concrete recall of a happy autobiographical memory on memory
characteristics (including vividness, distancing) as well as affect will be presented. Implications
for memory as a clinical target in depression will be considered.
The Therapeutic Relationship, and Therapeutic Process as Change Agents in Cognitive
Behavior Therapy for Depression
Nikolaos Kazantzis1, John Tee1, Keith Dobson2, Mathew Stuckey1, Nikolaos Kazantzis1, Keith
Dobson2, Alexandra Petrik1, Nikolaos Kazantzis1, Keith Dobson2, Amy Cummins1, Nikolaos
Kazantzis1, Keith Dobson2, Ana Maria Martins Serra3, Frank Dattilio4, Keith Dobson2.
1. Cognitive Behavior Therapy Research Unit, La Trobe University, Melbourne, VIC, Australia,
2. University of Calgary, Calgary, AB, Canada, 3. Institute of Cognitive Therapy, So Paulo,
Brazil, 4. Harvard Medical School, Boston, MA, USA.

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The therapeutic relationship has been considered necessary, but not sufficient to ensure
clinically significant emotional, cognitive, behavioral, and other functional changes in standard
Cognitive Behavior Therapy for depression (CBT; Beck, Rush, Shaw, & Emery, 1979). When
appearing in the field of clinical psychology and psychotherapy, CBTs blend of pragmatic
strategies and interventions within the context of an individually tailored cognitive
conceptualization and treatment plan represented a marked departure from the therapies of the
time. As a consequence of CBTs important contributions, psychotherapy research has evolved
to a point where there is now a high degree of specificity in its clinical trial methodologies when
comparing and contrasting therapeutic approaches, as well as in evaluating the explicit benefit
of particular interventions. Despite these important advances, distinctive features of the
therapeutic relationship in CBT (e.g., empiricism), as well as relational processes (i.e., guided
discovery, practice of strategies between-sessions with therapeutic homework), and stylistic
elements of the therapists way of relating to the patient (e.g., active collaboration or team
work, through Socratic dialogue) have received little research attention. This symposium
presents a series of papers designed to further advance the fields understanding of these
relational constructs and processes, in describing the development of new process measures
and examination of their relationship to short and longer term symptom outcomes in CBT for
depression. In the context of the treatment of depression among adults, new research studies
are presented on collaborative empiricism (Paper #1), guided discovery through Socratic
dialogue (Paper #2), therapeutic homework (Paper #3), therapist allegiance to CBT in using
interventions (Paper #4), and the role of cognitive flexibility as an implicit process in
collaborative empiricism (Paper #5).
The Collaborative Empiricism Scale: Psychometric Properties and Relation to Short and
Long Term Outcomes in Cognitive Behavior Therapy for Depression
Seminal resources for the practising clinician of Cognitive Behavior Therapy (CBT; A. T. Beck,
Rush, Shaw, & Emery, 1979, J. Beck, 2011) define a construct of collaborative empiricism as
a distinguishing feature of the therapeutic relationship within the approach. Collaborative
empiricism is central to cognitive case conceptualization (Kuyken, Padesky, & Dudley, 2009),
and is interwoven throughout techniques and in-session structural processes such as agenda
setting and homework review and planning (D. Dobson & K. S. Dobson, in press). Until recently,
there has been relatively little theoretical analysis of the construct (c.f. Tee & Kazantzis, 2011)
and no previous research has attempted to measure the construct. This paper presents an
overview of the development and evaluation of a new process measure, entitled the
Collaborative Empiricism Scale (CES; Tee, Kazantzis, & Stukas, 2012). The CES measures
collaborative empiricism in detail on multiple levels, both as a therapist competency, and as an
emergent property of the therapist-client dyad. First, this paper will present a summary of the
development and psychometric evaluation of the scale, including a survey of identified experts
(N = 33) in the field of CBT regarding CES item validity. Second, this paper will present data
from 132 ratings from trained observers based on recorded sessions for a subgroup of
depressed patients (n = 44) from a NIMH-funded component analysis of CBT (Jacobson et al.,
1996) used to test the hypothesis that greater collaboration and empiricism is predictive of
symptom change (i.e., Beck Depression Inventory, BDI; Beck et al., 1979) pre to post treatment
after taking into account the working alliance, and a broad assessment of therapist competence
on the Cognitive Therapy Rating Scale (Young & Beck, 1980). The data showed that the CES
was rated with a satisfactory level of inter-rater reliability (i.e., overall ICCs ranged .77 - .79,
Finns r ranged .95 - .96). Higher CES scores were found to be a significant predictor of
symptom reduction from pre to post session, (F (1,42) = 4.154, p = .048, R2 = 0.09). Additional
findings in relation to change in cognitions, and the prediction of symptom change at follow-up
assessments are also presented.

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The Socratic Dialogue Scale: Psychometric Properties and Relation to Short and Long
Term Outcomes in Cognitive Behavior Therapy for Depression
A central tenet of Cognitive Behavior Therapy (CBT; Beck, Rush, Shaw, Emery, 1979) is that
alleviation of emotional distress occurs through a re-appraisal of the content, and process of
cognition. In defining the therapeutic relationship in CBT, founding works positioned the
therapists skill in facilitating client discovery of new ideas and perspective taking through a
process of Socratic questioning as central to cognitive change. The Cognitive Therapy Rating
Scale (CTRS; Young & Beck, 1980) includes a guided discovery process as a base level
competency for the practice of CBT. However, expert commentary and guidance for the
integration of Socratic dialogue have highlighted inconsistencies about the definition of Socratic
dialogue and guided discovery and its best practice (c.f. Carey & Mullen, 2004, 2007; Dattilio &
Padesky, 1990). Central to this controversy concerns the extent to which the discovery is to
involve a process for the therapist to persuade the client to reach a specific outcome, or rather,
to guide the client to reach a discovery with minimal therapist influence on the direction or
outcome. This paper presents an overview of the development and evaluation of a new process
measure, entitled the Socratic Dialogue Scale (SDS; Stuckey, Kazantzis, & Stukas, 2012). The
SDS assesses the process (i.e., identification and exploration of client concerns), therapist
influence (i.e., degree of suggestion and guidance), and impact (i.e., patient evaluation/
feedback) of Socratic dialogue for therapy. First, this paper will present a summary of the
development and psychometric evaluation of the scale. Second, this paper will present data
from 100 ratings from trained observers based on recorded sessions for a subgroup of patients
(n = 50) from a NIMH-funded trial of CBT for depression (Jacobson et al., 1996). It was
hypothesised that greater therapist competency in Socratic dialogue is predictive of both
symptom (i.e., Beck Depression Inventory; Beck et al., 1979) and cognitive (i.e., Automatic
Thoughts Questionnaire; Hollon & Kendall, 1980) change at termination, and relapse prevention
at 6 month, 12 month, 18 month, and 24 month follow up assessment points, after taking into
account the working alliance, and a broad assessment of therapist competence on the CTRS.
Additional findings and implications of this work are presented.
Therapist Competence in Using Homework Assignments as a Predictor of Short and
Long Term Outcomes in Cognitive Behavior Therapy for Depression
The collaborative design, plan, and review of therapeutic homework assignments is considered
crucial for symptom reduction, and the generalization of therapeutic gains in Cognitive Behavior
Therapy (CBT; Beck, Rush, Shaw, & Emery, 1979). While there is evidence indicating that
homework enhances CBT outcomes, and that patient adherence with homework is associated
with greater symptom reduction (Kazantzis, Whittington, & Dattilio, 2010), relatively little is
known about the role of therapist skill, or competence in facilitating therapy outcome. It is
possible that the overall effectiveness of CBT, may be enhanced when therapist engage in
those behaviors that are theorized to determine homework adherence. A complication is that
previous research has focused on global measures of the quantity of homework completion, and
missed the opportunity to assess the quality of the patients homework, or those patient beliefs
about the homework that may determine adherence. Similarly, previous research has assessed
overall therapist competence, and missed the theoretically important behaviors that therapists
can utilize to ensure a good therapeutic process (e.g., exploring quantity, quality, difficulty,
problem-solving obstacles, beliefs about the homework and link to case conceptualization in
homework review). First, this paper will present a summary of psychometric work on two
therapy process measures, the Homework Rating Scale - Revised (Kazantzis, Deane, & Ronan,
2005) capturing homework adherence and theoretically meaningful determinants of adherence,
and the Homework Adherence and Competence Scale (Kazantzis, Wedge, & Dobson, 2006)
assessing therapist competence in using homework in-session. Second, this paper will present
data from 200 competence ratings from trained observers based on recorded sessions for a

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subgroup n = 50 patients from a NIMH-funded trial of CBT for depression (Jacobson et al.,
1996) used to test the hypothesis that therapist competence in using homework is predictive of
symptom change (i.e., Beck Depression Inventory, BDI; Beck et al., 1979) and cognitive change
(i.e., Automatic Thoughts Questionnaire; Hollon, & Kenda1l, 1980), after taking into account
patient homework adherence, the working alliance, and a broader assessment of therapist
competence on the Cognitive Therapy Rating Scale (Young & Beck, 1980). The outcome
measures were compared at pretreatment, post treatment, and 12-month follow-up. The data
showed that HRS-II and HAACS were rated with a satisfactory level of inter-rater reliability (i.e.,
overall ICCs .84 and .83, respectively). Therapist competence in reviewing homework was
found to be a significant predictor of both treatment outcome ( =-.40, p < .01) and client beliefs
about homework ( = .57, p < .01). More positive client evaluations of homework were found to
he associated with greater symptom change (r = .47, p < .01). Finally, quality, but not quantity of
homework completion, was found to be a significant predictor of treatment outcome ( = -.30, p
= .04). Additional findings and implications of this work are presented.
A Multi-Level Analysis of Therapist Allegiance to Cognitive Behavior Therapy as a
Predictor of Short and Long Term Outcomes in Treatment for Depression
The field of psychotherapy research has suggested that therapist allegiance, or adherence to
the central theoretical tenets of a therapeutic approach accounts for a small proportion of the
variance in the reduction of symptoms, as an index of positive therapeutic outcome. However, it
is also the case that prior research has adopted static global categorizations of theoretical
orientation, and at best, has focused on the categorization of interventions as a means of
defining orientation (e.g., Thoma & Cecero, 2009). Thus, there is a missed opportunity to study
the extent to which therapists use of techniques in-session are consistent with the theoretical
underpinnings of their therapeutic approach (David & Montgomery, 2011). Such a fine-grained
analysis promises a more sophisticated representation of orientation, or allegiance in the
practice of a therapeutic approach. This paper presents an overview of the development and
evaluation of a new measure, entitled the Cognitive Therapy Orientation Scale (CT-OS; Petrik,
Kazantzis, & Farhall, 2012). The CT-OS provides an evaluation of therapeutic intervention and
its link to underlying mechanisms (e.g., cognitive processes) as described by the therapist
during sessions. First, this paper will present a summary of the development and psychometric
evaluation of the scale. Second, this paper will present data from 191 ratings from trained
observers based on recorded sessions for a subgroup depressed patients (n = 48) from a
NIMH-funded component analysis of CBT (Jacobson et al., 1996) used to test the hypotheses
that greater consistency and clarity in the delivery of the rationale for interventions in a manner
consistent with its theoretical tenets is predictive of symptom change (i.e., Beck Depression
Inventory, BDI; Beck et al., 1979) assessed post-treatment, and at 6 months, 12 months, 18
months, and 24-months follow-up points after taking into account the working alliance, and a
broad assessment of therapist competence on the Cognitive Therapy Rating Scale (Young &
Beck, 1980). The data showed that the CT-OS were rated with a satisfactory level of inter-rater
reliability (i.e., overall ICCs .74 - .79; freemultirater kappa = .81). Higher CT-OS scores were
found to be a significant predictor of treatment outcome at post-treatment ( = -.39, p = .004),
and at 6 months follow-up ( = -.262, p = .007). Additional findings and implications of this work
are presented.
Cognitive Flexibility as Implicit Processes in Collaborative Empiricism in Cognitive
Behavior Therapy: A Qualitative Study
In collaborative empiricism, one of the cornerstones of Cognitive Behavior Therapy (CBT),
therapist and patient work collaboratively towards an empirical investigation of the patients
automatic thoughts, inferences, conclusions and assumptions (Beck et al., 1979, p. 6). There is
a focus on those aspects of the patients experience that are inconsistent with reality, and that

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have an adverse effect on patients emotions and behaviors, so the collection of new data
enables the patient to more accurately evaluate their experience. In cognitive psychological
literature, Cognitive Flexibility (CF) is referred to as the ability to adaptively reconfigure our
cognitive system and activate readiness for the dynamic selection and change of cognitive
processes and concepts, in response to internal and external demands (Deak, 2003; Badre &
Wagner, 2006; Spiro & Jehng, 1990). In this paper, the process of assisting patients to develop
CF will first be proposed as a process implicit in collaborative empiricism and guided discovery
through Socratic dialogue. Second, data are presented from a non-clinical sample of members
of the general population (N = 51) in So Paulo, Brazil. Participants were contacted by email
and presented with a hypothetical situation designed to induce a distressed mood state. Using
an open ended response format, and qualitative analytic methods, participants were asked to
(a) indicate their emotional state after reading the scenario using a visual analogue scale (as a
check on the mood induction), (b) outline their cognitions, and (c) identify what strategies they
would used to neutralize the distressing emotion. The most important finding in support of CF
was that 53%, in order to neutralize emotions, reported seeking alternative cognitions that
were thematically different from the distressed cognitions. CBT involves supporting patients in
an active search for alternative interpretations, and these data provide preliminary support for
the assertion that the search process, in the absence of specific cognitive intervention, may
itself reduce the emotional valence of the original thought. The search process may operate by
means of dislocation of attention/ attention retraining, enhancing patient motivation and
expectation that an alternative is possible, thereby modulating and normalizing emotions.
Additional findings and implications will be discussed within the context of CF as an implicit
regulatory process through the distinctive relational features of CBT (i.e., collaborative
empiricism, guided discovery via Socratic dialogue).
Family Psychoeducation on Bipolar Disorders
Evelin Kelbert, Luciano Souza, Karen Jansen, Taiane Cardoso, Amanda Reyes, Marlia Souza,
Ricardo Pinheiro, Ricardo Silva.
Programa de Ps-Graduao em Sade e Comportamento, Universidade Catlica de Pelotas,
Pelotas, Brazil.
Abstract Central: Bipolar disorder (BD) is a severe mental disorder, a chronic and recurrent
medical condition that although observed in only about 2% of the general population, is the sixth
leading cause of disability worldwide. BD has a significant social impact because it is
considered the psychiatric disorder that receive more mental health services. Thus, it can be
considered a public health problem by its substantial economic impact, high mortality rates and
adverse effects on the patient's relatives. This disorder appears to be associated with marital
status. Married subjects have significantly lower occurrence of such psychopathology than
single or divorced individuals. This finding may reflect the consequent difficulties of relationships
of people with that clinical condition. Moreover, changes in the Brazilian public health system
resulted in greater involvement of family in the treatment of patients with bipolar disorder or any
other chronic disorder. Although stress and functional impairment of these caregivers are
substantial, their identification is still neglected. Therefore, clinically effective and feasible
interventions are necessary. The psicoeduao can be considered a form of intervention that
aims to provide better understanding and comprehension of BD, as well as highlight and
enhance the positive aspects of the patient. Drug treatment is critical for patients with BD and
psychoeducation as intervention group or individual, must be part of the combined treatment. In
this sense, psychoeducational intervention for patients with bipolar disorder and their families
have improved knowledge about both the disorder and decreased the stress caused by this. Its
usefulness in medication adherence and therapeutic results obtained in patients with BD is
unquestionable. The patients had fewer recurrences, and when they occur, are of lesser

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intensity. Thus, this study aims to evaluate the effects on health of the family of patients
between 18 and 29 years diagnosed with BD of psychoeducational intervention. All patients
diagnosed with BD in centers linked to UCPel are invited to participate in this clinical trial.
Psychoeducation aims at understanding the nature of BD, the definition and description of
episodes of symptoms, treatment guidelines and procedures in prodromal phase and
information about the impact of BD, regulation strategies habits and the role of family in
treatment. This psychoeducational model are administered in six weekly meetings, individually
for 1 hour. The quality of life will be assessed using the World Health Organization Quality of
Life - Brief, self-administered instrument of 26 items, family burden by Family Burden Interview
Schedule, the psychological well-being is assessed by Faces of Scale and Common Mental
Disorders symptoms by Self -Reporting Questionnaire. These research instruments are
evaluated before the randomization process and two months after. So far, 13 caregivers
participated in the study (8 in psychoeducation and 5 with usual care). The eight familiars who
completed the process psychoeducational showed an increase in scores of well-being and
reduction of psychiatric symptoms. These preliminary results indicate the potential efficacy of
psychoeducation for healthy relatives of patients with BD.
Impact of Symptoms in Anxious Remission of Depressive Symptoms in Brief
Psychotherapies for Depression: Follow-up of Six Months
Evelin Kelbert, Taiane Cardoso, Thase Mondn, Ricardo Silva, Luciano Souza, Karen Jansen.
Programa de Ps-Graduao em Sade e Comportamento, Universidade Catlica de Pelotas,
Pelotas, Brazil.
Introduo: A literatura demonstra alta ocorrncia de sintomas ansiosos em indivduos que
apresentam depresso, este ndice simultneo sugere a importncia de se estudar o impacto
dos sintomas ansiosos no tratamento para depresso. Objetivo: Avaliar o impacto dos sintomas
ansiosos na remisso de sintomas depressivos em psicoterapias breves para depresso no
follow-up de seis meses. Mtodo: Ensaio clnico randomizado com jovens de 18 29 anos que
preencheram critrio diagnstico de depresso avaliado atravs da Structured Clinical Interview
for DSM (SCID). Os sintomas depressivos foram avaliados atravs da Hamilton Depression
Scale (HAM-D), enquanto os sintomas ansiosos foram avaliados atravs da Hamilton Anxiety
Scale (HAM-A). Os protocolos de psicoterapia utilizados foram: Psicoterapia Cognitiva
Narrativa (PCN) e Psicoterapia Cognitivo Comportamental (PCC), ambos com sete sesses. Ao
fim do tratamento, bem como, no follow-up de seis meses foi realizada uma avaliao com as
escalas HAM-D e HAM-A. Resultados: A amostra total contou com 97 pacientes distribudos
homogeneamente entre os protocolos de psicoterapia. Houve uma correlao moderada
positiva significativa entre a severidade dos sintomas ansiosos no baseline e a remisso de
sintomas depressivos no ps-interveno (r=0,444 p<0,001), enquanto no follow-up de seis
meses verificou-se uma correlao fraca positiva significativa (r=0,279 p=0,035). Houve
remisso de sintomas ansiosos (8,638,22) e de sintomas depressivos (6,315,34) aps as
psicoterapias breves. A remisso dos sintomas ansiosos manteve-se no follow-up de seis
meses (7,518,46; p=0,609) e o mesmo ocorreu para a remisso se sintomas depressivos
(6,754,96; p=0,326). Concluso: A severidade dos sintomas ansiosos contribuiu para maior
remisso de sintomas depressivos aps psicoterapias breves e as mesmas demonstram
eficcia na remisso de sintomas ansiosos e depressivos.
Major Depressive Disorder Symptoms in Male and Female Young Adults
Evelin Kelbert, Luciano Souza, Mariane Molina, Karen Jansen, Ricardo Silva.

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Programa de Ps-Graduao em Sade e Comportamento, Universidade Catlica de Pelotas,


Pelotas, Brazil.
This research aimed to compare the prevalence rates of Major Depressive Disorder (MDD) and
differentiate between the presence and the severity of depressive symptoms for women and
men aged 18 to 24 years. In a population-based cross-sectional study (n = 1560) young adults
were screened with the Mini International Neuropsychiatric Interview (MINI) for MDD (n = 137).
Participants then answered a self-report questionnaire to gather sociodemographic data and the
presence of each symptom of depression was assessed with the Beck Depression Inventory
(BDI). The proportion of women (12.2%) with MDD was higher than that of men (5.3%).
Sadness and self-criticism were significantly more severe in women. Symptoms of sadness,
crying, difficulty to take decisions and lack of energy as well as self-critcism, irritability, change
in self-image, difficulty to work and loss of interest in sex were more prevalent in women. The
expression of depressive symptoms in young adults with a MDD is different in men and women.
Cognitive Behavioural Therapy as an Adjunct to Pharmacotherapy for Primary Care
Based Patients with Treatment Resistant Depression: Results of the CoBalT Randomised
Controlled Trial
Willem Kuyken.
University of Exeter, Exeter, United Kingdom.
Abstract Central: Background: Only one-third of patients with depression respond fully to
antidepressant medication but there is little evidence regarding the best next step treatment for
those whose symptoms are treatment resistant. The CoBalT trial examined the effectiveness of
CBT as an adjunct to usual care (including pharmacotherapy) for primary care patients with
treatment resistant depression (TRD) compared with usual care alone. Methods: This two
parallel-group multi-centre randomised controlled trial recruited 469 patients with TRD (on
antidepressants for 6 weeks, Beck Depression Inventory (BDI) score 14 and ICD-10 criteria
for depression) from 73 UK general practices. Participants were randomised, using a computer
generated code, to one of two groups: usual care (n = 235) or CBT in addition to usual care (n =
234), and were followed up for 12 months. The primary outcome was response, defined as
50% reduction in depressive symptoms (BDI score) at 6 months compared to baseline. Trial
registration was ISRCTN38231611. Findings: 422 participants (90%) were followed up at 6
months and 396 (84%) at 12 months. 95 participants (46.1%) in the intervention group met
criteria for response at 6 months compared with 46 (21.6%) in the usual care group (odds ratio
(OR): 3.26 (95%CI: 2.10, 5.06) p<0.001). In repeated measures analyses using data from 6 and
12 months, the OR for response was 2.89 (2.03, 4.10), p<0.001 and for a secondary
remission outcome (BDI score <10) was 2.74 (1.82, 4.13), p<0.001. Interpretation: Amongst
patients who have not responded to antidepressants, CBT in addition to pharmacotherapy is
effective in reducing depressive symptoms, and these effects, including outcomes reflecting
remission, are maintained over 12 months. The Trial was funded by the UK National Institutes
for Health Research, is in press at the Lancet and was carried out by a study team as follows:
Nicola Wiles (Chief Investigator), Laura Thomas, Anna Abel, Nicola Ridgway, Nicholas Turner,
John Campbell, Anne Garland Sandra Hollinghurst, Bill Jerrom, David Kessler, Willem Kuyken,
Jill Morrison, Katrina Turner, Chris Williams, Tim Peters, Glyn Lewis.
Determinants of Depressive Symptoms: Affect and Personality
Bahar Kse, znur ncl, Tulin Gencoz.
Middle East Technical University, Ankara, Turkey.

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Abstract Central: Abstract Based on tripartite model of Clark and Watson (1991), it is wellknown that low positive affect and high negative affect are important associates of depressive
symptoms. Accordingly, the aim of the present study was to examine the importance of different
personality dimensions (i.e., Extraversion, Agreeableness, Neuroticism, Openness, Negative
Valence, and Conscientiousness) on depressive symptoms, after controlling for the variance
accounted for by the affect measures. The participants of the study were 955 Turkish adults
whose ages varied between 17 and 61. After controlling for the significant variance accounted
for by positive affect and negative affect, regression analyses revealed that depression
symptoms were significantly associated with having higher levels of Neuroticism, Negative
Valence, and lower levels of Openness to Experience. Importance of these personality
dimensions were discussed in line with the literature.
Effectiveness of CBT used in Patients with Bipolar II Disorder in BeijingCase Report
Xianyun Li.
Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China.
I provided CBT for two patients with bipolar II disorders in Beijing. The two patients were young,
married, and Han-nationality women. After taking a certain time of medication (mood
stabilizers), both of them refused taking medication again. Then I provided them CBT therapy.
The one had four-times major depressive episodes with a ten-year history of mental illness. She
had at least twice hypo-mania episodes. She also had a history of deliberate self harm. Axis I:
Bipolar II Disorder: Major Depressive Episode, Recurrent, Severe; comorbid anxiety. Axis II:
Unspecified Personality Disorder: Avoidance, Dependence. Axis III: None. Axis IV: Pressure of
having a baby, especially a girl; chronic poor relationship with father; facing father-in-law who
abused her; unsatisfied sex with husband. Axis V: GAF Current51; Best in Past Year72.
Her main core belief is listed here: I am unlovable and I am defective. The another one had at
least twice major depressive episode for many years. Two years ago she had a nearly one-year
major depressive episode. Then she started to have a below cycle: one-week hypomania
episode, 3 to 4 days stable mood, one-week transition days, and then 5 to 10 days or longer
depression. Her father had an extra affair with a woman for many years, which was known by
everyone including her as a child. Her main core belief is listed here: I will be abandoned and I
am unlovable. After the CBT treatment, their symptoms were greatly improved and their mood
was becoming more stable.
How Long Does it Take? Time to Recover and Improve from Depressive Symptoms and
Interpersonal Problems in a Randomized Clinical Trial
Rodrigo Lopes1, Miguel Gonalves1, Bernardo Lustosa2.
1. School of Psychology, University of Minho, Braga, Portugal, 2. Fundao Getlio Vargas,
So Paulo, Brazil.
Abstract Central: Em um ensaio clnico anterior, a Terapia Narrativa demonstrou ser eficaz no
tratamento da depresso, com resultados comparveis Terapia Cognitivo-comportamental
(TCC) - na atualidade o tratamento para a depresso mais fundamentado empiricamente na
literatura - principalmente para os clientes que completaram o protocolo de interveno. Foram
constatados melhores resultados da TCC quando todos os clientes (os que completaram e os
que terminaram prematuramente) foram includos na anlise. Esse dado sugere que o tempo
em que os clientes levam para se recuperar do quadro depressivo seja diferente nas duas
abordagens. Nesse trabalho re-analisamos os dados usando a anlise de sobrevivncia. Foi

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confirmado que o grupo de tratamento no prediz o resultado final. Entretanto, foi encontrado
que a melhoria nos sintomas depressivos se d de maneira significativamente mais rpida que
a melhoria nos problemas interpessoais, que se mantm estveis ao longo do tratamento. De
novo, essa diferena independente do tratamento utilizado.
Stressful Life Events Are Longitudinally Associated with Depression In a PopulationBased Sample of Young Adults
Nancy Low1, Giselle Kraus1, Igor Karp2, Erika Dugas3, Erin O'Loughlin2.
1. Psychiatry, McGill University, Montreal, QC, Canada, 2. Univeristy of Montreal, Montreal, QC,
Canada, 3. University of Montreal Hospital Centre, Montreal, QC, Canada.
BACKGROUND: In samples from clinical settings, stressful life events can often precipitate
depressive episodes in the early course of major depression. However, it is not known if there is
an association between life events and depressive symptoms in young adults in populationbased settings. Despite life events being ubiquitous, only 10-20% of young adults develop
depression. Therefore, events likely result in depression only in those with other risk factors,
such as poor social support, poor coping skills, or subthreshold mood symptoms during early
adolescence. OBJECTIVE: This study tests if past-year life events predict current depressive
symptoms in a population-based cohort from the Nicotine Dependence in Teens (NDIT) Study.
METHOD: The analytical sample includes 823 adolescents in Montreal who completed selfreport questionnaires 22 times between the ages of 12 and 21 years. Data from the 21st cycle
of questionnaires was analyzed for this study. The exposure was stressful life events in the
previous 12 months (for example, the break-up of a relationship, losing a job, or the death of a
family member) and was based on the List of Threatening Events. The outcome measure was
depression symptoms in the past 2 weeks, assessed with the Major Depression Inventory
(MDI). We tested for effect modification by social support, ability to cope, anxiety disorder
diagnosis, and depressive symptoms in early adolescence. RESULTS: Results indicated that
the number of life events in the past year predicted current depressive symptoms. Also, the
ability to cope with stressful daily events and early adolescent depressive symptoms each
interacted with events to increase depression symptoms. In other words, in the presence of a
poor ability to cope with daily events or high depressive symptoms during early adolescence,
the association between stressful life events and current depressive symptoms was increased.
CONCLUSIONS: These findings highlight the importance of fostering individuals positive
coping skills when faced with stressful life events. Teachers, parents, and healthcare
professionals should remain vigilant for the presence of depressive symptoms during
adolescents and stressful life events as a significant source of stress.
EFECTO DE UN PROGRAMA PSICOTERAPUTICO, APLICANDO EL MODELO TREC. EN
PACIENTES CON DEPRESIN
Gina Maria, Raquel Tello Cabello, Susan Colmenares, Gina Maria.
Lima, Sentirse bien Per SAC., Lima, Peru.
GINA MARIA ROJAS DE ESCUDERO : PRESIDENTE Y PRESENTADORA
RAQUEL TELLO CABELLO: AUTORA Y EXPOSITORA
SUSAN COLMENARES SAAVEDRA: AUTORA Y EXPOSITORA
El presente trabajo fue elaborado en el Centro Psicolgico y Psicoteraputico Sentirse Bien
Per que se encuentra ubicado en el distrito de la Molina - Lima - Per. Centro donde
laboramos los psiclogos a cargo de la investigacin
Como sabemos nuestro pas Per sufri mucho los 80 hasta los aos del 2000 las huestes del

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terrorismo afectaron a la capital y sobre todo a las poblaciones de los departamentos alejados
de este, motivo por el cual diferentes familias emigraron buscando un mejor porvenir para sus
hijos a la capital donde trabajaban ambos cnyuges arduamente, tratando de salir adelante lo
mismo sucedi con la corrupcin y sus efectos sobre la economa peruana, y sobre las
emociones de las personas quienes tenan que sobrevivir arrastrando con ello a los hijos, sin
darse cuenta que esto afectara mas tarde. Considerando las estadsticas del Colegio de
Psiclogos del Per, en el 2009 se detect que 20 de cada 100 peruanos sufre de depresin y
el 60% no obtiene la ayuda que necesita a pesar de asistir a centros de tratamiento. Es por
esto que surge la necesidad de crear nuevos programas de tratamiento que posibiliten la
recuperacin eficaz de pacientes con esta problemtica. Es por ello que en Agosto 2011 se
comenz a realizar hiptesis sobre este tema, posteriormente se realiz el presente trabajo de
investigacin que nos permite ser mas objetivo ante esta situacin.Es por ello que se inici con
la estructuracin del programa sobre la base cognitiva y TREC para pacientes con depresin.
Se inici el trabajo en diciembre 2011 seleccionando a jvenes de 18 a 25 aos de edad, la
muestra consta de 20 mujeres y 4 varones a quienes se les propuso trabajar en sesiones y se
les explic sobre los beneficios del trabajo as como el objetivo central de la terapia que es
flexibilizar sus esquemas mentales, pensamientos irracionales sobre visin negativa,
desesperanza, tristeza, sentimientos de culpa, pensamientos aprendidos desde edades
tempranas que en la actualidad estn influenciado poderosamente en sus emociones y
conductas, que les impide ver las situaciones positivas que experimentan y perjudica las
diferentes reas de vida.
Se formaron 2 grupos de 12 pacientes, 10 mujeres y 2 varones, se trabajo 2 veces a la semana
por 30 sesiones los das martes y jueves de 6 a 7 pm. Las muestras fueron el azar y los
pacientes, de condicin social media, se agrup en 30 sesiones del 1 al 10 trabajando las
inferencias y distorsiones cognitivas que afectan al paciente, las sesiones del 11 al 20 tuvo por
objetivo trabajar los pensamientos irracionales o pensamientos exagerados que presentaba el
paciente. De la 21 a la 30 sesin fue donde haba nos trabajo con las emociones y las
conductas utilizando diversas tcnicas cognitivas, emocionales y conductuales.
Descripcin de la teora y modelo psicoteraputico cognitivo y TREC as como sus
aportes al entendimiento de la depresin
La Psicoterapia Racional Emotiva Conductual (TREC) propuesta por Albert Ellis percibe los
sntomas y signos de la depresin como consecuencias de la activacin de patrones cognitivos
negativos.
Los sntomas motivacionales como la falta de iniciativa y pensamientos de evitacin son
tambin un efecto del pesimismo y desesperanza. Es as que el suicidio es concebido como la
expresin de evitacin de circunstancias que la persona concibe como insolubles o intolerables.
La TREC propone el modelo ABC de la Depresin:
El componente A se refiere a los antecedentes o situaciones desafortunadas que experimenta
la persona, por ejemplo puede ser una prdida significativa (trabajo, relacin, salud,
fallecimiento de alguien) o una experiencia de fracaso. No obstante, para que haya presencia
de nimo deprimido, a lo anterior debe sumarse la existencia de distorsiones cognitivas o
inferencias frente a dichas situaciones.
El componente B de la Depresin contiene todas las creencias irracionales (principales y
secundarias) que posee la persona y que se interrelacionan con los eventos antecedentes para
producir nimo deprimido.
En la depresin se manifiestan ideas del tipo: No debera haber sucedido lo que pas, Ya no
podr vivir as, No soy una persona valiosa, soy dbil, intil, Todo lo malo me pasa a m,
Ya no podr reponerme de esto.
Sealaremos las creencias irracionales principales y las secundarias:
a) Creencias Irracionales Principales

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- Debo ser querido y/o conseguir la aprobacin de las personas que me son
significativas.
- Debo ser competente, adecuado, y lograr todo aquello que deseo y me propongo, de lo
contrario significara que no soy valioso.
b) Creencias Irracionales Secundarias
- Es horrible cuando las cosas no son como quisiera.
- Las cosas en esta vida no deberan ser tan difciles ni desagradables.
- Mis sentimientos se deben a aquello que me ha sucedido, no hay mucho que
pueda hacer por mi tristeza.
- Es ms fcil evitar las dificultades o postergar las responsabilidades que la vida me pone.
- Necesito alguien en quien depender. No puedo dirigir mi propia vida.
El componente C de la depresin hace referencia a las consecuencias de los antecedentes y
de las creencias irracionales, es decir a los signos fsicos y sntomas emocionales. Entre los
signos fsicos se destacan los trastornos del sueo y la prdida del apetito; y en los sntomas
emocionales, la disminucin de la atencin y concentracin, la prdida de la confianza en s
mismo y sentimientos de inferioridad, ideas de culpa, perspectiva sombra del futuro y
pensamientos o actos suicidas. (CIE 10, 1992).
Descripcin de objetivos y metodologa de la investigacin
OBJETIVO DEL PROGRAMA: Estudiar los efectos de un Programa de Psicoterapia Racional
Emotiva Conductual en adultos diagnosticados con Depresin, que presentaban ideacin
suicida.
MTODO
Sujetos.
Fueron 24 pacientes diagnosticados con depresin severa e ideacin suicida, que asistan al
Consultorio Psicolgico Sentirse Bien Per entre Diciembre de 2011 a Agosto2012; 4 de ellos
eran varones y 20 de sexo femenino. Las edades de los participantes variaban entre los 18 y
25 aos. Todos pertenecan a la clase media alta, sin experiencia previa en programas o
experimentos de psicologa. Cabe sealar que los pacientes fueron seleccionados mediante
muestreo no probabilstico, de casos-tipo.
Variables.
Variable independiente:
1) Programa de investigacin con modelo TREC
Variables dependientes:
1) Depresin- Inventario de Depresin de Beck
2) Ideacin Suicida- Escala de Ideacin Suicida de Beck
Instrumentos.
- Inventario de Depresin de Beck
Creado por Beck y sus colaboradores en 1979. Es un cuestionario autoaplicado de 21 tems
que evala un amplio espectro de sntomas depresivos. De los 21 tems, 15 hacen referencia a
sntomas psicolgicos-cognitivos y los restantes 6 a sntomas somticos vegetativos.
Se sistematizan 4 alternativas de respuesta para cada tem, que evalan la gravedad /
intensidad del sntoma y que se presentan igualmente ordenadas de menor a mayor gravedad.
El marco temporal hace referencia al momento actual y a la semana previa.
El rango de puntuacin obtenida es de 0-63 puntos. Los puntos de corte usualmente aceptados
para graduar la intensidad/severidad son los siguientes:
No depresin : 0 - 9 puntos
Depresin leve : 10 - 18 puntos
Depresin moderada : 19 - 29 puntos
Depresin grave : 30 a ms
La confiabilidad de esta prueba oscila alrededor de 0.8. As mismo presenta una buena

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consistencia interna (Alfa de Crombach 0.76- 0.95).


Respecto a su validez, muestra correlacin con otras escalas. En pacientes psiquitricos se
han encontrado valores entre 0.55 y 0.96 (media 0.72), y en sujetos no psiquitricos entre 0.55
y 0.73 (media 0.6).
- Escala de Ideacin Suicida de Beck
Esta escala fue diseada para cuantificar y evaluar la recurrencia consciente de pensamientos
suicidas; poner en la balanza varias dimensiones de autodestructividad: pensamientos o
deseos. La ideacin suicida tambin puede abarcar la amenaza de suicidarse, expresada
abiertamente a otros (Beck y cols,1979). Este test consta de 19 reactivos aplicados en el
contexto de una entrevista clnica semiestructurada. Estos reactivos miden la intensidad de las
actitudes, conductas y planes especficos para suicidarse. Cada reactivo se registr en un
formato de respuesta de 3 opciones, con un rango de 0 a 2. Las mediciones se suman para
obtener un puntaje global. De este modo, el rango terico del puntaje es de 0 a 38.
- Cuaderno de Trabajo para Paciente Deprimidos de Sentirse Bien Per
Diseado por Rojas, Gina (2011). Consta de ejercicios y dinmicas para tratar con personas
deprimidas. Las reas que se trabajan son: Sentimientos de culpa, Melancola, Desesperanza,
Seguridad, Pertenencia, Autoestima, Terapia, cognitiva, emocional y conductual, Ideacin
Suicida. El trabajo en cada una de estas reas tiene por objetivo identificar y eliminar las
distorsiones cognitivas e ideas irracionales presentes en cada sntoma de la depresin.
Se tomo en cuenta algunos ejercicios desarrollados en los cursos formativos de Terapia
Racional Emotiva Conductual. (TREC).
Diseo.
El diseo es de tipo Experimental con diseo de preprueba/posprueba con dos grupos.
Programa Psicoteraputico cognitivo y TREC elaborado por el centro psicolgico
psicoteraputico "Sentirse bien Per"
Procedimiento.
PROCEDIMIENTO
1) FASE PRE-TRATAMIENTO
- Seleccin de los pacientes del Centro Psicolgico y Psicoteraputico Sentirse bien Per.
- Explicacin del tratamiento a los participantes.
- Aplicacin del Inventario de Depresin de Beck y de la Escala de Ideacin Suicida segn el
caso lo requiera.
- Interconsulta psiquitrica segn si presentan ideacin suicida.
- Firma del compromiso con los pacientes con ideas suicida, antes de ingresar al tratamiento.
- Ambientar el ambiente donde tendramos que trabajar con los pacientes, colocando sus
metas, y los sobres donde cada uno colocara el resumen de lo prendido en cada sesin.
SESIN 1-10
1) Explicacin del modelo ABC.
2) Comprometer al paciente a posponer hacerse dao hasta haber explorado sus
pensamientos.
3) Ventajas y desventajas del suicidio. (video con documental).
4) Identificar las situaciones agradables, que generaba placer antes del problema
5) Entrenamiento en la deteccin de inferencias, hiptesis, atribuciones acerca de la situacin,
mediante ejemplos y hojas de autoayuda.
6) Ensear a debatir sus pensamientos, en forma lgica, emprica y funcional en los pacientes.
7) Trabajar con los pacientes para introyectar que son sus pensamientos los que los hace sentir
emociones no saludables y no las situaciones que se les presenta.
8) Identificar y revisar los pensamientos autodestructivos, debatirlo en forma individual, luego
en 2 grupos para sacar conclusiones.

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9) Identificar y trabajar la autocrtica, fomentando en ellos la autoestima.


10) Discutir las actividades que piensan que no son capaces de realizarlos, tareas sencillas en
coordinacin previa con los pacientes.
11) Se realiz los horarios sobre sus actividades agradables bsicas del da.
12) Analizar frases como Nadie logra todo lo que planea, no te sientas mal si no logras todo
lo que te propones Aunque no logres recuerda que el paso ms importante es tratar
SESIN 11-20
1) Revisar el disfrute de realizar las actividades planificadas en sesiones anteriores.
2) Identificar del 1 al 10 que identifique si disfruto de las actividades realizadas, ensearle a
cuantificarlos y registrarlo cuando se presentaban.
3) Identificar de manera objetiva como algunas actividades que cambiaron su estado de nimo,
refutar las ideas como no soy capaz no disfruto
4) Empezamos a replantear actividades semanales.
5) Se inici el trabajo de juego de roles, poniendo en prctica las tareas que va a realizar,
incluyendo la manera cmo va a realizar dicha tarea, poniendo en prctica su imaginacin.
6) Explicacin de la relacin entre lo que ellas piensan con respecto a si mismo, a su entorno y
al futuro, en cuanto a sus emociones y conductas.
7) Darse cuenta de cmo las personas en las historias presentadas, seleccionan
constantemente solo alternativas negativas, dejando de lado lo positivo.
8) Los pacientes identificaron anotando los pensamientos que su compaeros expusieron, para
luego analizarlos entre todos.
9) Cada uno registraba todos los das en la noche, las cosas positivas que pasaba en el da y
los registraba en la tabla de disfrute que le entregamos.
10) Psico-educacin sobre depresin, como se forma, definicin, que sucede cuando estamos
deprimidos.
11) Completamiento de oraciones sobre Como me siento
12) Continuamos con la tcnica Juegos de roles individual
Sesin 20-30
1) Revisar las tareas acordadas y las especficas para su desarrollo en el transcurso de la
semana.
2) Reforzar el inters por continuar con las terapias.
3) Trabajo con el Termmetro emocional, previa explicacin, y como acta en cada uno.
4) Se trabaj la responsabilidad emocional con las tarjetas: Quien es responsable de mis
emociones
5) Revisar y discutir en la pizarra sus razones para vivir y sus razones para morir.
6) Tcnicas de discusin para ayudar al paciente a comprobar que no hay evidencia que
respalde sus conclusiones como: Que el suicidio es el nico camino para no sufrir
7) En grupo de 2, se trabaj las posibles alternativas al suicidio mediante lluvia de ideas
8) Se utilizo la Tcnica intervenciones paradjica, PROHIDO ESTAR TRISTE DURANTE EL
DA.
9) Como expreso mi tristeza y en que intensidad (1-10)
10) Las actividades que disfrutaba antes y ahora ha perdido el inters por ellas, las
consecuencias, continuar trabajando.
11) Diferencia entre tristeza y depresin, trabajo individual, luego salan a la pizarra
voluntariamente
12) Trabajamos Consecuencias de estar deprimido
13) Discutir la idea quisiera no haber nacido Qu lograra con el suicidio y otros.
14) Horarios con tareas bsicas, actividades que dej de realizar y que le eran gratificantes y
sencillas, en esta etapa ya los ve ms claro.
15) Tcnicas conductuales: trabajamos tareas para encontrar evidencias contrarias a sus
distorsiones, reconociendo que su problema se encuentra a nivel cognitivo, porque piensa que

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es incapaz, dbil y poco valioso.


16) Aplicamos la tcnica Re - atribucin Cognitiva:
17) Continua los registros: Lo positivo del da.
18) Se le enseo a manejar el Termmetro de Catstrofe
19) Se volvi a trabajar el Termmetro emocional e identificaron en ello su emocin.
3) FASE POST TRATAMIENTO
- Aplicacin del Inventario de Depresin de Beck y de la Escala de Ideacin Suicida.
- Se realiz un seguimiento para evaluar el nivel de depresin e ideacin suicida que
presentaban los pacientes luego de 3 meses de terminado el tratamiento.
The Role of Self-Criticism and Self-Compassion in the Development and Treatment of
Adolescent Depression
Ana Paula Matos, Andreia Azevedo.
CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra,
Portugal.
Abstract Central: Depression is one of the most common, disabling and fatal
psychopathological condition (Monroe & Harkness, 2011). In adolescence, has gained
increasing recognition due to its serious psychosocial consequences (Lewinsohn, Rohde,
Seeley, Clarke & Stice, 2005). In literature we find evidence that depressive episodes in
adolescents are very recurrent, and that its cumulative probability of recurrence increases as
the years go by (Monroe & Harkness, 2011). For this reason, it is necessary to treat them as
early as possible. Intervention programs in depression with greater empirical support are based
on cognitive-behavioral model, but have proved to be ineffective in the maintenance of
treatment gains. Components of the "3rd generation therapies", including Acceptance and
Commitment Therapy and Self-Compassion, have proved to be important in the prevention of
recurrence of depression and maintenance of treatment gains. In addition to the integration of
these components into cognitive-behavioral classic programs, literature also suggests that
programs developed should be manualized and that the follow up should have a duration of at
least 24 months. The main aim of this research (a randomized control trial) is to develop and
study the efficacy of a new cognitive-behavioral treatment for depressed adolescents,
manualized, which includes i) components of the "3rd generation therapies" - self-compassion,
acceptance and commitment ii) and monthly booster sessions over a follow up of 24 months.
This study is pioneer in Portugal and enables advances in the knowledge concerning relapse
prevention, one of the main issues that arise in the treatment of depression. This research also
includes a study of characterization of depression that identifies variables that are associated
cross-sectionally and longitudinally with depression in adolescence and analyzes relationships
of mediation and moderation. In this paper, we present results regarding the study of variables
of third-generation therapies, namely self-criticism and self-compassion, and its relationships to
depressive symptoms, with intra-group (in a group of depressed adolescents) and inter-group
(comparing depressed adolescents with adolescents in the general population) analyzes. The
sample, composed of adolescents between 14 and 18 years, is collected in schools, hospitals
and private clinics. The Self-Compassion variable is measured using The Self-Compassion
Scale (Neff, 2003), the Self-Criticism variable is measured with The Forms of Self-Criticizing
and Reassuring Scale (Gilbert et al., 2004) and Depressive symptomatology is identified by the
Children Depression Inventory (CDI; Kovacs, 1985). The results evidence the role of selfcriticism and self-compassion in the development of depression in adolescence. Other studies
had highlighted that self-critical individuals are more likely to become and remain depressed
(Kelly, Zuroff & Shapira, 2009) and that individuals with more experiences in self-compassion
show decreases in depressive symptoms (Shapira & Mongrain, 2010).

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Moderators of Depression Treatment Response: Novel Directions in Biobehavioural


Research
Bjrn Meyer5, 6, Christopher Beevers1, Christopher Beevers1, John McGeary3, 4, Rohan Palmer4,
Valerie Knopik4, Seth Disner1, David Schnyer1, Christopher Beevers1, Warren Greig5, Julia
Bierbrodt5, Nadine Navarro-Schmidt5, Christine Dwinger5, Nick Titov2.
1. Institute for Mental Health Research and Department of Psychology, University of Texas at
Austin, Austin, TX, USA, 2. MindSpot Clinic, Centre for Emotional Health, Department of
Psychology, Macquarie University, Sydney, NSW, Australia, 3. Providence VA Medical Center,
Providence, RI, USA, 4. Division of Behavioral Genetics, Rhode Island Hospital, Providence, RI,
USA, 5. GAIA AG, Research Department, Hamburg, Germany, 6. Department of Psychology,
City University, London, London, United Kingdom.
The established array of evidence-based treatments for depression, such as cognitivebehavioural therapy and antidepressant medication, is being augmented by novel interventions,
such as internet-based treatment and attention training. However, not all depressed individuals
benefit equally from these interventions, and there continues to be a dearth of knowledge with
regard to the moderators influencing treatment response. In this symposium, several traditional
and novel depression treatments and potential moderators will be considered. In the first talk,
McGeary and colleagues discuss how a novel bioinformatics technique, genome-wide complex
trait analysis (GCTA) can be used to understand how genetic variation influences
antidepressant treatment response. Analyses using the STAR*D sample will be presented, and
the relevance of these findings for treatment matching and the move towards personalized
behavioral therapies will be discussed. In the second presentation, Beevers and colleagues
present data from a randomized controlled trial suggesting that active attention training leads to
more rapid symptom reduction than placebo attention training among adults diagnosed with
Major Depressive Disorder. Brain imaging data suggest that baseline differences in neural
circuits supporting emotion processing moderate treatment response and differentially predict
depressive symptom reduction in response to attention training. In the third presentation, Meyer
and colleagues present moderator analyses based on data from several studies of an internetbased treatment programme for depression (deprexis). This programme aims to tailor the form
and content of cognitive-behavioural treatment elements to match individual user preferences
and requirements. Three RCTs attest to its efficacy, and re-analyses of the RCT data are
beginning to shed light on the moderators influencing treatment response. For example, factors
such as baseline severity, depression chronicity, educational achievement and social support
appear to predict symptomatic response, sometimes in counterintuitive patterns. These findings
are also being used to optimize the treatment for individuals who might have derived less
benefit in earlier versions. The three presentations illustrate current directions in biobehavioural
research on moderators of depression treatment, and they point towards the diversity of current
methods and interventions as well as areas of methodological convergence.
Contribution of Common Single Nucleotide Polymorphisms to Antidepressant Treatment
Response
It is well known that treatment response to antidepressant treatments is quite variable. However,
the extent of the genetic contribution to this variable treatment response is relatively unknown.
We are proposing to use a newly developed bioinformatic technique, genome-wide complex trait
analysis (GCTA), to estimate variance explained by genetic variation in antidepressant
treatment response for Major Depressive Disorder (MDD) in the STAR*D sample (N=1,441).
GCTA will estimate the aggregate effect of single-nucleotide polymorphisms (SNPs) on
antidepressant treatment response, provide an upper limit estimate of the variance in
antidepressant treatment response that can be explained by the SNPs previously characterized
using GWAS, determine whether this estimate differs by participant gender, and identify the

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presence of any major chromosomal effects (versus a model in which the critical variation is
distributed evenly across the genome). We believe these analyses will provide fundamental
insight into how genetic variation impacts antidepressant treatment response. We will discuss
the relevance of these findings to behavioral treatment matching and opportunities to extend
pharmacogenetic methods to apply to personalized behavioral therapies. We have obtained the
data and analyses are currently underway.
Biobehavioral Moderators of Attention Training Treatment for Depression
Selective attention towards negative information is posited to maintain Major Depressive
Disorder. Thus, treatments that alter this bias may be promising adjunctive treatments. This talk
will present preliminary data from an ongoing attention training study that examines whether
training individuals to shift attention away from negative information leads to more rapid
decreases in depression compared to placebo attention training. Preliminary findings with adult
participants diagnosed with Major Depressive Disorder randomized to active (n = 15) and
placebo (n = 18) training suggest that active attention training leads to a more rapid decrease in
depressive symptoms than placebo attention training. Brain imaging assessed prior to
randomization to attention training condition suggests that increased activity in the right
amygdala and left dorsal anterior cingulate cortex when shifting attention away from emotion
stimuli both predict slower improvement in depression change across groups. Further, activity in
the right precuneus (a region involved in attention processing) during shifting of attention
uniquely predicted slower symptom improvement in the active training condition. Finally,
depression severity also moderated effects of attention training, where participants with lower
symptom severity appeared to respond more rapidly to active attention training than participants
with higher depression symptoms. This preliminary evidence suggests that training depressed
individuals to shift attention away from negative material may facilitate depression improvement.
Further, individual differences in activity in neural circuits that support emotion processing may
predict response to this treatment, as might initial depression severity. Implications for the
treatment of depression will be discussed.
Who Benefits from Internet-based Depression Interventions? Moderators of Response to
the deprexis Treatment Programme
Introduction: More than 25 RCTs have demonstrated the efficacy of internet-based treatments
for depression, with effect sizes sometimes equaling those found in face-to-face cognitive
behavioural therapy (CBT). Whereas early forms of online depression treatment often
resembled generic online versions of printed self-help manuals, there is a trend towards
developing more tailored and responsive treatments that integrate mobile technology. However,
developing optimally tailored treatments requires an understanding of differential treatment
response, which can be informed by moderator research. In part because of a lack of statistical
power in many previous RCTs of online treatments, though, such moderator analyses are still
rare in this field. Method: This presentation focuses on potential moderators of treatment
response among adults who participated in trials of online depression treatment using the
programme deprexis, which has been evaluated in several large randomized studies. The
deprexis programme, which is available in three languages, aims to tailor treatment elements to
match individual user requirements. It is broadly consistent with a CBT perspective and
emphasizes the principles of behavioural activation and acceptance/mindfulness. Data from
previous RCTs and routine usage data were analyzed with the aim of identifying moderators of
treatment response. Results: Findings suggest that the benefit conferred by this online
treatment might be influenced by several baseline variables, such as depression chronicity,
educational attainment and relationship status/social support. Furthermore, aetiological
attributions, response styles within the programme, and the deployment setting also appear to
influence symptom course over time. Discussion: These analyses suggest both baseline and

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process variables that predict the extent to which individuals benefit from the deprexis online
intervention. The findings are currently being applied to improve the programme with the aim of
maximizing its efficacy for all users. For example, recent developments include more elaborate
tailoring for those with different levels of educational attainment, integration of mobile
technology, adjunctive text messages, and motivational support.
Manifestacin Conjunta de la Sintomatologa Depresiva y Ansiosa en Adolescentes
Costarricenses: El Papel de Estilos de Pensamiento Perseverativo y Variables
Metacognitivas
Esteban Montenegro, David Campos.
Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica.
Lic. Esteban Montenegro Montenegro & Lic. David J. Campos Miranda Instituto de
Investigaciones Psicolgicas, Universidad de Costa Rica San Jos, Costa Rica. La rumiacin
es la tendencia a activar y sostener un proceso repetitivo de pensamiento negativo usualmente
vinculado con el desarrollo y el mantenimiento de la depresin (Lyobomirsky y Tkach, 2004;
Papageorgiou y Siegle, 2003). El objetivo del presente estudio consisti en evaluar, empleando
el modelado de ecuaciones estructurales, el modelo clnico metacognitivo de la rumiacin y la
depresin, propuesto por Papageorgiou y Wells (2003), en una muestra de 212 adolescentes
costarricenses sin trastornos psicopatolgicos. Asimismo, empleando esta misma muestra se
evalu una extensin del modelo original en el cual se incluyeron medidas de preocupacin y
ansiedad; esto con el fin de poner a prueba las afirmaciones que se hacen acerca de la
presentacin conjunta de ansiedad-depresin. En un primero momento se estim el modelo
original de Papageorgiou y Wells (2003) resultando en un modelo con un buen ajuste
2(94)=168.42 p <.001, RMSEA=.06(.05 - .08) p>.05,CFI= .96, TLI=.94. Sin embargo, se
realizaron modificaciones al modelo terico de base resultando en una relacin directa entre la
rumiacin y los sntomas depresivos; esto coincide con los hallazgos de Roelofs,
Papageorgiou,Gerber,Huibers,Peeters y Arntz (2008) quienes someten a prueba este modelo
en jvenes sin diagnostico de trastornos psicopatolgicos. El modelo fijado sostuvo la relacin
entre las creencias metacognitivas positivas acerca de la rumiacin y la respuesta de
rumiacin, hallazgo que se ve respaldado por las investigaciones de Papageorgiou y Wells
(2003) y Roelofs et al (2008). No obstante, es resaltable la ausencia de relacin entre las
creencias metacognitivas negativas de incontrolabilidad y dao y los sntomas depresivos tal
como lo proponen Papageorgiou y Wells (2003). Como segundo anlisis se estim el modelo
extendido el cual se busc examinar una de los postulados del modelo que ha recibido escasa
atencin: que tras la ocurrencia de episodios depresivos, la persona puede desarrollar un
patrn de preocupacin acerca de la recurrencia de la sintomatologa, el cual a su vez origina la
manifestacin de sintomatologa ansiosa, y la presentacin conjunta de estados de ansiedad y
depresin (Wells,2009). El modelo estimado present un buen ajuste 2(197)=313.62 p <.001,
RMSEA=.06(.05 - .08) p>.05,CFI= .95, TLI=.94 y respalda la hiptesis del disparo de
pensamientos de preocupacin asociados a la sintomatologa depresiva y el incremento de los
niveles de ansiedad. Los resultados del presente estudio sustentan los postulados del modelo
metacognitivo referentes a las relaciones existentes entre variables metacognitivas, rumiacin y
depresin. Esto es de especial inters al tener en cuenta que la evaluacin del modelo se
realiz con una muestra de adolescentes latinoamericanos. Es menester resaltar que este es el
primer estudio que proporciona evidencia emprica que da apoyo a la hiptesis de que el
desarrollo de un patrn de preocupacin en torno a la recurrencia de episodios depresivos sea
fuente importante de la alta comorbilidad de sintomatologa ansiosa y depresiva, ahora bien, es
notoria la necesidad de desarrollar ms investigaciones en torno a esta cuestin antes de poder
brindar conclusiones slidas.

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Psychiatric Morbidity and Its Relationship to Psychosocial Factors among First Year
Engineering Students in Malaysia
Firdaus Mukhtar, Tiong Wen, Noor Aulia Ahmad.
Universiti Putra Malaysia, Serdang, Malaysia.
Abstract Central: Introduction: Psychiatric morbidity among undergraduate students is a global
issue. The objective of this study is to investigate the prevalence of psychiatric morbidity and its
relationship to negative emotions, cognitive styles and quality of life amongst undergraduate
Engineering students in Malaysia. Method: A total of 173 first year undergraduate engineering
students completed the Saringan Status Kesihatan Mental (SSKM-20), Depression, Anxiety and
Stress Scale (DASS-21), Automatic Thought Questionnaires-Malay (ATQ-Malay), Positive
Automatic Thought Questionnaires (ATQ-P) and Quality of Life Questionnaires (WHOQOLBref). Result: The prevalence of psychiatric morbidity was 68.4% among engineering students
Results also revealed there were also significant differences in SSKM-20 and ATQ-Malay
scores and there were significant relationship between SSKM-20 scores to negative emotions,
cognitive styles and quality of life. Conclusion: The high prevalence of psychiatric morbidity is
found among engineering students. This suggests early screening, prevention program and
early intervention are necessary to overcome this problem The academician should not just
targeting the academic performance of their students, but psychosocial issues also should be
concerned
Effect of Interactional Contingency Between Caregiver and Depressed Individuals on
Distress in Caregivers - Functional Analysis Using Retrospective Episodes
Kyoko Nagano1, Hiroaki Chiba1, Kyoko Tashiro1, Tomoya Sato1, Takahiro Yokoyama1, Shunta
Maeda1, Kohji Minosaki1, 2, Hironori Shimada3.
1. Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan, 2. Research
Fellow of Japan Society for the Promotion of Science, Tokorozawa, Japan, 3. Faculty of Human
Sciences, Waseda University, Tokorozawa, Japan.
To play a functional part as a co-supporter, the distress in caregivers with depressed individuals
should be considered in support for caregivers. A main factor affecting distress in caregivers is
the vicious spiral in interactions with depressed individuals. This study aims to examine how
interactional contingency affects caregiver distress by describing retrospective episodes of the
interactions. It should be noted that this study was classified again from the behavior theory,
what was presented at the 45th Congress of the Japanese Association of Counseling Science in
2012. The subjects in this study were five caregivers of individuals who have recovered from
depression (all wives of depressed individuals, M = 40.0, SD = 5.6). Using semi-structured
interviews, subjects retrospectively described interpersonal situations with their wards during the
onset of depression. Episodes at three time points (early in onset, the middle of treatment, and
convalescence) were described. Using a framework that consists of: (a) things said by their
spouse and the activities their spouse engaged in (antecedent stimuli for caregiver), (b)
caregivers behavior (her behavior/antecedent stimuli for her spouse), and (c) the spouses
response (consequent stimuli for caregiver/spouses behavior), the interaction was described
and organized according to differences in function and phenotype of each point in the
contingency model. First, early in onset, most caregivers stated that they expected to observe
speedy recovery after treatment. At that time, they felt a sense of security and accepted the
prospect of treatment as a short-term occurrence. However, as the treatment became longterm, participants began to have difficulty understanding their spouses and depressive disorder.
Secondly, in the middle of treatment, caregivers reported sighing or making harshly critical
remarks when their spouses were uncooperative. This critical attitude of the caregiver might

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have led to self-condemnation in caregivers, which then exacerbates caregivers impatience,


thus causing a vicious cycle. In addition, most caregivers reported caring for depressed
individuals by themselves without support from others. The common behavior have functions to
avoid from ambient repercussion and noise than necessary, coming to light what my husband
have depressive disorder. Then, it is indicated that caregivers have difficulty seeking support.
Finally, during convalescence, caregivers reported distancing themselves from the situation in
order to avoid perceiving the situation negatively when their wards were unstable. On the other
hand, when the depressed individuals were stable, caregivers give them responsibilities or
asked favors from them. These resulted in activating depressed individuals and decreasing the
burden on caregivers, which produced positive, reverberating effects. Thus, our results
indicated that, to provide effective support for caregivers of depressed individuals, the supports
that promote understanding of depressed individuals are required in addition to
psychoeducation. Caregivers could also be taught to select the proper skills from their repertoire
of skills to cope with caring for depressed individuals and then caregivers are able to become
monitoring the interactions.
What are the Antidepressant Effects of Exercise? Identifying Depressive Symptom
Changes in Response to Exercise Among Young People
Yasmina Nasstasia1, Robin Callister1, Amanda Baker1, Sean Halpin1, Leanne Hides2, Brian
Kelly1, Adriana Giles1.
1. University of Newcastle, Callaghan, NSW, Australia, 2. Queensland University of Technology,
Brisbane, QLD, Australia.
Abstract Central: Major depressive disorder (MDD) is a prevalent and reoccurring disorder
best understood as a syndrome of cognitive, physiological and behavioural symptoms. Negative
thinking, hopelessness, sleep and appetite changes, poor concentration, withdrawal, suicidal
ideation, low energy, feelings of worthlessness, loss of pleasure, and affective constriction are
all part of the clinical picture. MDD is treated with antidepressant medications, electroconvulsive
and psychological therapies. Studies with adults show exercise can also play a substantial role
in reducing and preventing depression. Less is known about the effects of exercise on
depression in young people and how exercise targets depressive symptoms (cognitive,
physiological and behavioural symptoms). Aims: This pilot study aims to evaluate the
effectiveness of exercise on depression and depressive symptoms among young people.
Methods: 12 participants aged 18-24 years who met DSM-IV diagnostic criteria for depression
completed a number of psychological measures including; the Beck Depression Inventory II;
Automatic Thoughts Questionnaire and Behavioural Activation for Depression Scale.
Participants then received an initial motivational interviewing (MI) session followed by a 12-week
small group, personal training exercise program facilitated by an exercise scientist, 3 times per
week for 1 hour duration. Participants were also encouraged to exercise for 30 minutes on all
other days and to monitor their physical activities and mood online. Psychological, physiological
and exercise testing outcome variables were collected at pre/post and 3 month follow up.
Results: The impact of exercise on depression and depressive symptoms will be presented and
the effectiveness of MI in engaging participants in exercise treatment discussed. Conclusions:
Identifying how exercise targets depressive symptoms may provide important clues about how
and why exercise works to reduce depressive symptoms and help guide treatment planning.
The results of the pilot study will inform the development of a larger randomised controlled trial.
Memory Phenomena in Depression

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Sabine Nelis1, Jorien Smets1, Willem Kuyken2, Michelle Moulds3, Kate Hetherington3, Aliza
Werner-Seidler4, Sabine Nelis1, Emily Holmes4, Filip Raes1, Lynn Watson5, Dorthe Berntsen5,
Jorien Smets1, Filip Raes1, Ineke Wessel6, Filip Van Den Eede7, 8, Erik Franck8, Yves
Jacquemyn7, 8, Myriam Hanssens9, 1.
1. KU Leuven, Leuven, Belgium, 2. University of Exeter, Exeter, United Kingdom, 3. The
University of New South Wales, Sydney, NSW, Australia, 4. MRC Cognition and Brain Sciences
Unit, Cambridge, United Kingdom, 5. University of Aarhus, Aarhus, Denmark, 6. University of
Groningen, Groningen, Netherlands, 7. Antwerp University Hospital, Antwerp, Belgium, 8.
Antwerp University, Antwerp, Belgium, 9. University Hospital Gasthuisberg, Leuven, Belgium.
This international symposium will focus on memory phenomena in depression. Past events can
be retrieved in different ways. To start with, they can be remembered either voluntarily or
involuntarily. Involuntary memories are memories that pop into your mind spontaneously, with
no attempts of retrieval. Intrusive memories about a stressful or traumatic event are one
example of such involuntary memories. Voluntary memory retrieval, on the other hand, is
deliberate and goal-directed. Research indicates that involuntary memories have a greater
impact on mood and are accompanied with more bodily reactions in comparison to voluntary
memories. Second, people differ in how they react on these voluntarily or involuntarily retrieved
memories. They may talk about them, suppress them, relive them, ruminate about them, try to
avoid them, etcetera. These various ways of processing memories can differentially influence
affect and cognitions. An abstract, evaluative, ruminative processing style, for example, seems
to have a more negative effect on mood in comparison to a concrete, experiential thinking style.
Given these differential effects, an important issue concerns whether memory retrieval styles
play a role in the development and maintenance of depressive psychopathology. The present
symposium consists of four presentations in which voluntary and involuntary memories will be
discussed, and cognitive reactions on these memories. The first two presentations will focus on
voluntary memories, and more specifically positive voluntary memories. The study of positive
affect in depression gained attention over the last years. The effect of an abstract versus
concrete processing mode of positive memories on mood as well as on the endorsement of
negative self-judgments will be examined in the first presentation (Prof. Dr. Michelle Moulds,
The University of New South Wales, Australia). In the second talk (Sabine Nelis, University of
Leuven, Belgium), a study on the dampening of positive affect in response to positive memories
will be presented. Previous research has shown that this specific processing style is associated
with depression. In the third presentation (Dr. Lynn Watson, University of Aarhus, Denmark),
recent research into involuntary, voluntary and intrusive memories will be reviewed. Jorien
Smets from the University of Leuven will present the results of a study on the role of rumination,
intrusive memories, and other memory phenomena in the development of depressive symptoms
after childbirth. To conclude, this symposium may contribute to the understanding of a highly
prevalent disorder, depression. Prof. Dr. Willem Kuyken (University of Exeter, UK), an expert in
mood disorders, will conclude the symposium by providing a summary and inviting for
discussion.
The Consequences of Ruminating about Positive Memories in Depression
For healthy individuals, recalling positive memories is an effective way to repair mood. However,
depressed and formerly (i.e., recovered) depressed individuals do not report improved mood
following positive memory recall. Such findings have prompted the proposal that for currently
and formerly depressed individuals, positive memories may cue abstract rumination, which
undermines the potential mood-bolstering effects of remembering positive events. In this talk we
will present the findings of two experiments in which we investigated the affective consequences
of rumination about positive memories. In Experiment 1, we examined the relative
consequences of adopting an abstract or concrete processing mode during happy memory

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recall or engaging in distraction for: (i) mood repair and (ii) the endorsement of negative selfjudgments, in high and low dysphoric participants. Our key finding was the high dysphoric
participants who adopted an abstract processing mode during positive memory recall generated
more negative evaluations and negative generalisations than high dysphoric participants in the
concrete condition. In Experiment 2, currently and formerly depressed participants recalled a
positive memory while adopting either an abstract or concrete processing mode. Regardless of
depression status, participants in the abstract condition reported no change in mood, while
those in the concrete processing condition reported improved mood following memory recall.
The findings of these studies demonstrate that the process by which positive autobiographical
memories are recalled can have implications for both mood and subsequent cognition, and
highlight the need for researchers to further investigate the consequences of rumination about
positive material in depression.
Dampening of Positive Affect
Positive memories or situations do not always elicit a positive response. Depressive persons
often show a maladaptive, dampening response to positive emotions. For example, they remind
themselves that the positive feelings wont last or that they do not deserve the success.
Furthermore, depression has also been associated with the use of an observer (third-person)
perspective in the retrieval of (positive) memories. Imagining memories from an observer
perspective is found to be less emotional compared to a field perspective. Consequently, is
there a relationship between the use of an observer perspective and a dampening response
style to positive affect? First, we present tentative correlational evidence for a link between a
dampening response style and the use of an observer perspective while imagining positive
situations. Second, we wanted to experimentally test this link between a dampening response
style to positive affect and an observer perspective as well as the effect of dampening on
positive affect. Therefore, after the retrieval of positive memories, a dampening response style
was induced (vs. sensorial processing). To our knowledge, this is the first study with an
experimental induction of a dampening response style to positive affect. The experimental study
is in progress, results will be discussed. Results could provide further understanding of how
depression may be related to reduced positive affect and the use of an observer perspective.
Involuntary and Intrusive Memories in Clinical Disorders and Daily Life
Involuntary autobiographical memories are memories for life-events which come to mind
spontaneously. Such memories are common following a variety of everyday activities both in
healthy individuals and in clinical populations. Intrusive memories are also spontaneous in
nature; however, these memories are often associated with negative, stressful or traumatic
events and are more commonly studied within or in relation to clinical populations. Traditionally
researchers have employed differing research methodologies and theoretical models to
investigate and explain these memory phenomena. We argue that intrusive memories form a
dysfunctional subclass of the broader category of involuntary memories which forms a basic
mode of remembering. Recent research into involuntary, voluntary and intrusive memories will
be reviewed across both healthy and clinical populations. The characteristics of these memories
and the context in which they are retrieved will then be compared. The results suggest that
involuntary and intrusive memories share a striking number of similarities. We argue that
involuntary memories are commonly defined as intrusive under a set of general conditions.
Such conditions relate to features of the event itself and/or how the event is
appraised/interpreted. Finally, we argue that these conditions are influenced by individual
difference variables such as personality, cognitive style and prior experience of traumatic lifeevents.

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Cognitive Risk Factors in the Development of Postpartum Depressive Symptoms and


Postpartum Delivery-related Intrusive Memories
Depression is a frequently occurring and disabling disorder. Researching its risk factors is
important both for theoretical and clinical purposes. In this talk, a prospective study will be
presented in which we examined four potential cognitive risk factors for the development of
depressive symptoms after a stressful life event, giving birth. The following memory phenomena
were investigated: rumination, resistance to proactive interference, autobiographical memory
specificity, and intrusive memories. During the third semester of pregnancy, 210 women carried
out tasks measuring autobiographical memory specificity and proactive interference, and filled
out questionnaires regarding rumination, intrusions, and depression. At 12 and 24 weeks after
delivery, they completed questionnaires on depression and delivery-related intrusions. Key
results were that depressive rumination during pregnancy predicted postpartum depressive
symptoms, irrespective of initial depression levels. Second, lack of resistance to proactive
interference predicted depressive symptoms and delivery-related intrusions after childbirth,
irrespective of depressive symptoms before childbirth. Third, autobiographical memory
specificity and the presence of intrusions predicted postpartum depressive symptoms at 12
weeks postpartum, irrespective of depressive symptoms during pregnancy. Thus, the results
suggest that the examined memory phenomena are risk factors for the onset of symptoms after
a stressful life event. These results will be discussed in relation to prior empirical findings and
theories.
Verifying the Effectiveness of Cognitive Behavioral Therapy for Depressed Patients
carried out by Nurse in Japan
Yoshie Okada1, Makiko Nakano2, Daisuke Fujisawa3.
1. University of Tsukuba, Tsukuba-city, Japan, 2. Tama Kokubunnji Kokoro no Clinic, 3-17-2,
Minami-cho, Kokubunnji-city, Tokyo, Japan, 3. Division of Psycho-oncology, National Cancer
Center East, 6-5-1, Kashiwanoha, Kashiwa-city, Chiba, Japan.
1. Objective Patients with depressive disorders are increasing worldwide. Because of its grave
influence on everyday life and risk of suicides, urgent measures are called for in Japan as well.
Cognitive Behavioral Therapy (CBT) with its good track record of evidence of effectiveness for
treating depression, has now been introduced to Japan; however, it is not sufficiently utilized
due to the lack of trained professionals. With this background it is suggested that nurses be
trained to carry out CBT, not only doctors and clinical psychotherapists. In western countries,
the effectiveness of CBT for patients with depressive disorder, carried out by nurses, has been
verified. But in Japan, there is not a sufficient number of trained nurses nor has the evidence of
the effectiveness of CBT carried out by nurses been verified. The aim of the study is to verify
the effectiveness of CBT by nurse, by carrying out a Randomized Controlled Trial (RCT). 2.
Method 1) Participating centers: Neuropsychiatry departments/clinics in general hospitals in
Kanto region 2) Study duration: From 1 October 2010 to 30 October 2012 3) Subjects: Eight
outpatients, aged between 20 and 64 years old, diagnosed with major depressive disorder,
without organic psychosis, personality disorder or alcoholic dependency, were selected for the
study. 4) Intervention: The subjects were divided randomly into CBT and control groups. The
CBT group was treated using the protocol based on the Manual for Cognitive Therapy and
Cognitive Behavioral Therapy for depressive disorder by the Ministry of Health, Labor and
Welfare, which had been modified for nurses. The control group received a normal nurses
consultation, which consists of listening, sympathizing and seeking a solution together with the
patient on everyday life matters. 5) Measurement tools: Measurements were taken using the
following scales for both groups at 3 time points, at the commencement, upon completion and
after 3 months of completion of the therapy: 1. Beck Depression Inventory-Second Edition (BDIII), 2. Quick Inventory of Depressive Symptomatology (QIDS-J), 3. GRID-Hamilton's Rating

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Scale for Depression (GRID-HAM-D), 4. Dysfunctional Attitude Scale 24-Japanese Version


(DAS24-J), 5. MOS Short-Form 36-Item Health Survey version 2(SF-36v2) 6) Analyses: twoway analysis of variance is conducted for both groups at the 3 time points mentioned in 5), and
the Friedman test was conducted for the CBT group, also at the 3 time points. 3. Results Five
subjects were in the CBT group and three other subjects were in the control group. As a result
of the two-way analysis of variance, interactions (F=9.68, p<.015) were shown on the item
Everyday life function (mental) in the SF-36v2, between the 3 time points and the two groups.
The CBT group scored especially high at the completion and 3-months-after measurements. No
interactions were found among other scales. Significant differences (F=9.29, p<.05; F=9.57,
p<.01; F=7.6, p<.05) were found between the 3 time points on the item of everyday life function
(mental) in the BDI-II and the QIDS-J among the CBT group. 4. Consideration Mental hardship
in everyday activities was relieved more successfully among the subjects in the CBT group than
among the control group. The result suggested that CBT is more effective than the standard
nurses consultation in improving everyday life functions that are affected by the mental state of
the individuals. The result also suggested that CBT carried out by nurse could relieve a patients
symptoms of depression and improve everyday life functions.
Pilot Testing of a Manualised Cognitive Behavioural Therapy (CBT) Intervention for
Young People Diagnosed with Major Depressive Disorder
Alexandra Parker1, 2, Magenta Simmons1, 2, Sarah Hetrick1, 2, Simon Rice3, Christopher Davey1,
3
, Kandice Varcin1, 2, Mark Phelan3.
1. Orygen Youth Health Research Centre, University of Melbourne, Melbourne, VIC, Australia,
2. headspace, the National Youth Mental Health Foundation, Centre of Excellence in Youth
Mental Health, Melbourne, VIC, Australia, 3. Orygen Youth Health Clinical Program, Melbourne,
VIC, Australia.
Background: Depression is the leading cause of disability in young people worldwide, posing the
largest burden on the community of any psychiatric illness. Despite the high rates of depression
over adolescence and early adulthood, evidence-based treatments specific to this
developmental period are lacking. While cognitive behavior therapy (CBT) is currently the most
studied treatment for depression in young people and is considered a first-line treatment, it
remains only modestly effective with a significant number of young people not responding to the
treatment as it currently stands. These modest effects have led to an interest in investigating the
contributions of specific components of CBT to the improvement in depression symptoms.
Indeed, there is emerging evidence for a modular approach to treatment delivery rather than
delivering all components of CBT, supported by analyses that show young people who receive
problem solving or social skills training as part of CBT are more likely to respond to the
treatment. Existing treatment manuals that have targeted either child and adolescent or adult
populations are potentially limited in the ability to address the specific developmental and
treatment needs of young people in the age range 15-25years. Aim: The current study aimed to
explore the helpfulness and efficacy of the components of CBT by pilot testing a youth-specific
CBT manual, developed for the treatment of depression in young people aged 15-25 years,
thereby filling the gap between child/adolescent and adult treatment manuals. Method: A team
of youth mental health clinicians and researchers developed the manual, with input from young
consumer experts. Clinicians (N = 8) within a specialised youth mental health service delivered
the 12-session intervention according to the CBT manual to young people (N = 15) with a
diagnosis of Major Depressive Disorder (MDD). Semi-structured interviews were conducted with
clinicians pre- and post- intervention, and with young people post-intervention, to assess the
perceived efficacy of, and attitudes toward, the CBT manual in treating MDD in young people.
All interviews were transcribed verbatim and analysed with thematic analysis in order to explore

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themes related to the helpfulness and efficacy of the CBT manual and its components. Results:
Data, complemented with illustrative quotes, from the semi-structured interviews with clinicians
and young people will be presented. The results will highlight the themes that were identified in
the qualitative analysis of the experience of CBT delivered in accordance with the therapy
manual. Discussion: The current qualitative pilot study provides the first assessment of
clinicians, and young peoples perceptions and attitudes towards a specifically developed CBT
manual for youth depression. The assessment of client and clinician attitudes and experiences
regarding the various components of CBT provides an important step towards identifying
potential factors associated with positive treatment outcome. Results are discussed in the
context of key developmental and clinical factors, and a future research agenda is proposed.
Treating the Complex Chronically Depressed Patient: Applications and
Psychoneurocognitive Mechanisms of Action of Cognitive Behavioral Analysis System of
Psychotherapy (CBASP)
Jennifer Kim Penberthy1, Knut Schnell5, Todd Favorite2, Liliane Sayegh3, Dieter Schoepf4,
Christopher Gioia1, Andrea Konig1.
1. University of Virginia School of Medicine, Charlottesville, VA, USA, 2. University of Michigan,
Ann Arbor, MI, USA, 3. McGill University, Montreal, QC, Canada, 4. University of Bonn, Bonn,
Germany, 5. University of Heidelberg, Heidelberg, Germany.
Cognitive Behavioral Analysis System of Psychotherapy (CBASP) has demonstrated significant
effects for treatment refractory patients with chronic depression. This subpopulation of
depressive patients is quickly rising, with up to 15% of patients not responding to aggressive
pharmacological and psychotherapeutic approaches. McCullough suggests that chronically
depressed individuals have a primitive cognitive functioning that is unaffected by the logical
reasoning and reality-based views of others. These patients most often perceive that the causal
influences in their life are beyond their personal control. They have a poor ability to use a
problem-focused coping style and problems are described in a global way, resulting in feelings
of hopelessness and helplessness. Chronically depressed patients suffer from a reduction of
perceived functionality, i.e. the ability to detect the effects of their own behavior on others. This
results in a pervasive degree of social isolation, which worsens the depressive mood. These
patients have maladaptive interpersonal styles often playing out a victim lifestyle when
interacting with others and often adopt a submissive style of interacting that makes it difficult for
the therapist not to assume a more dominant role. Difficult life histories, childhood trauma, as
well as co-morbidities such as substance use and PTSD compound the treatment challenges for
the chronically depressed patient. CBASP is the only psychotherapy model developed
specifically for, and found to be effective in, treating the chronically depressed patient.
Additionally, CBASP has demonstrated greater efficacy than antidepressant medication for
patients with histories of trauma. CBASP focuses on central mechanisms of affective and
motivational regulation via an interpersonal contemporary learning acquisition model, utilizing
disciplined personal involvement to aid acquisition of perceived functionality in the patient. The
major goals of CBASP are: a) to enable patients to feel increased emotional safety, thus
allowing them to more fully approach and engage in treatment and reduce avoidance behavior
and b) to allow patients to recognize how they contribute to their own interpersonal
psychopathology (called perceived functionality) and begin to learn how to negotiate
interpersonal situations successfully and without the use of maladaptive coping behaviors such
as avoidance, acting out behavior, or abuse of substances. In this symposium, Dr. Liliane
Sayegh presents research on the interpersonal characteristics and changes in response to
group CBASP. Dr. Dieter Schoepf presents research exploring the use of an intensified
significant other history in promoting interpersonal felt safety in a group of patients with major

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depression, dysthymia and early childhood trauma. Dr. Favorite presents findings from his
research utilizing CBASP in a group format for veterans with chronic depression and PTSD. The
use of CBASP for treating chronically depressed alcoholics is addressed by Dr. Penberthy and
her team. Finally, Dr. Schnell presents fMRI evidence for neural correlates to the behavioral
components of depression and neural changes associated with improved emotional regulation
and increased perceived functionality learned via CBASP.
Interpersonal Characteristics and Changes in Chronically Depressed Outpatients
Receiving Group CBASP
We examined a sample of chronically depressed outpatients (N=102) who were suitable and
interested in participating in Group-CBASP to see how their interpersonal dispositions relate to
those described as appropriate for CBASP and to their depressive symptoms and coping styles.
Our findings showed that chronic depression is associated with a lack of interpersonal agency.
Compared to the general population, chronically depressed patients (a) place more importance
avoiding conflict, disapproval, and social humiliation, (b) lack confidence that they can be
expressive, assertive, or aggressive, even in situations that require a forceful response, and (c)
experience more problems associated with being too socially meek, inhibited, and
accommodating. These differences between the normative and clinical samples were more
pronounced for females than males. Moreover, even within our clinical sample, the patients who
reported the lowest levels of interpersonal agency (with respect to values, self-efficacy, or
problems) also reported the highest levels of depression. These results support the findings
outlined by McCullough that chronically depressed patients have A submissive style of
interacting that makes it difficult for clinicians to avoid assuming a dominant role. These
patients appear to value submission, lack self-efficacy for self-assertion but not for avoiding
conflict and thus report problems with being too inhibited, submissive and exploitable. In our
pilot study of Group-CBASP with chronically depressed outpatients, 12 sessions of group
therapy resulted in significant decreases in self-reported symptoms of depression and in the use
of Emotion-Oriented Coping, as well as increases in overall social adjustment and Interpersonal
Self-Efficacy when compared to their pre-treatment levels. Moreover, the beneficial effects on
overall depression and adjustment were significant. Group-CBASP appears to facilitate the
acquisition of interpersonal skills as seen in patients improved Interpersonal Self-Efficacy in the
area of agentic behaviors that include assertive, self-confident, and independent behaviors. We
review how the CBASP conceptualizes why a lack of agency may be the most prominent
interpersonal characteristic of chronically depressed patients, and suggest how the prevalence
of submissive interpersonal dispositions may influence or guide clinical work with this population
using the Group-CBASP model of treatment.
CBASP with Intensified Significant Other History for Chronic Major Depression with
Antecedent Dysthymia and Childhood Trauma History
We provide a comprehensive overview of the rationale and benefits of an intensified Significant
Other History (I-SOH) exercise from CBASP, and provide early positive results in a subgroup of
chronic MDD patients with antecedent dysthymia. A key feature in the conceptualization of
chronic MDD with antecedent dysthymia is the explicit emphasis of childhood trauma. The
impact of childhood trauma remains prevalent over time with an often refractory cognitiveemotional dilemma in these patients. Specifically, the destructiveness of the learned
helplessness effect on perception allows interpersonal fear to persist, a condition that strongly
prevents full remission of major depressive episodes in chronic MDD with antecedent dysthymia
compared to pure MDD. The conceptualization is supported by recent imaging studies that have
shown how chronic child maltreatment - physical abuse, neglect and verbal abuse - primes the
brain of the on growing child for future affective mental illness by setting the stress system in a
permanent state of high alert. The Significant Other History (SOH) exercise in CBASP is an

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important component of treatment to address the patients in-session interpersonal fear and
learned avoidance patterns. We provide an intensified SOH (I-SOH) with this population to
address these interpersonal variables using the patient-therapist relationship as a therapeutic
tool for learning. A focus on evaluation of the safety-signal impact on the hypothesized core
content of the patients in-session interpersonal fear is described. Standardized ratings of insession emotional safety with respect to CBASP`s transference hypothesis construct are
completed by the patient blind to the therapist before the beginning of every session. Our data
supports that these ratings increase over the course of treatment, indicating increased felt
safety in the patient, which is a primary therapeutic learning objective in this population.
Feasibility and the implications of the I-SOH exercise on the learning acquisition of the major
CBASP treatment goals (i.e. learning of perceived functionality, learning the accurate
discrimination between therapist and significant others, learning assertiveness interpersonal
skills) as well as the short term effects and the effects over time are presented and discussed.
Group CBASP in the Treatment of Chronic Depression and Co-Occurring Post Traumatic
Stress Disorder
A significant proportion of veterans diagnosed with Post Traumatic Stress Disorder (PTSD) also
carry a diagnosis of depression, including chronic depression. This population has a high
treatment refractory rate for both antidepressant medication and psychosocial interventions.
Previous studies exploring the use of CBASP with veterans with PTSD suggest that individual
CBASP treatment was effective in reduction of both depressive and trauma related symptoms.
This study explores the adaptation of CBASP methodology to a group format with the following
rationale: i) Social isolation for veterans with PTSD/MDD is high providing limited opportunities
to experience social interaction and support; ii) Veterans may learn new behaviors, and offer
support more readily from other veterans; iii) Group interactions provide an in vivo learning
environment that may maximize interpersonal skills; iv) Peer modeling may improve attendance
and enhance compliance with homework assignments; v) Group psychotherapy provides
greater access to treatment for veterans waiting for mental health services. It was hypothesized
that veterans in Group CBASP would exhibit reduction in PTSD symptoms as well as
depressive symptoms, measured by the PTSD Distress Scale (PDS) and the Patient History
Questionnaire -9(PHQ-9), respectively. It was hypothesized that veterans would report
improvement in areas of social/interpersonal functioning as measured on the Quality of Life
Inventory (QoLI). There were significant reductions in total scores for PCL-C and PHQ-9 at posttest, and at 1month intervals. Specific areas of symptom overlap between depression and
PTSD, such as avoidance and hyperarousal, evidenced moderate reduction at post treatment,
but continued to improve at 1 month. Interpersonal and social functioning also evidenced
improvement at post treatment and at 1 month follow-up. CBASP, in group format, is a feasible
treatment delivery system, and the structure of the CBASP method is useful in addressing this
complex symptom combination. Further study in this area may improve our understanding of the
development of this comorbidity and improve interventions for this chronic population.
Individual CBASP for Co-Occurring Chronic Depression and Alcohol Dependence
Depression and alcoholism frequently co-occur and make effective treatment more complex and
challenging. Co-morbid depression is associated with poorer prognosis during and after
alcoholism treatment and depressed mood may be an important trigger of alcoholic relapse.
Chronically depressed and alcohol dependent individuals possess unique characteristics that
make their treatment more challenging. They may be ambivalent about change and often fail to
recognize the connection between their behavior and interpersonal/ environmental
consequences. There is a growing interest in the co-occurrence of substance use disorders and
mood disorders, but research suggests a lack of successful treatment options targeted
specifically for chronically depressed alcohol dependent individuals. This may be due to the

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complex characteristics these individuals possess that make their treatment more challenging.
There are currently several empirically supported behavioral treatments for depression and
alcoholism as individual disorders; however, few interventions have shown consistent results for
treating these disorders concurrently. CBASP has demonstrated effectiveness in treating
chronic depression, but has not yet been studied with persons with co-occurring alcohol
dependence and chronic depression. We examine the feasibility of utilizing CBASP in two
individuals who have co-occurring chronic depression and alcohol dependence, and explore its
impact upon depression and alcohol intake. We conduct 2 case studies and implement 20
weeks of manualized CBASP adapted for use with alcohol dependent individuals. Participants
tolerated the therapy well and completed the study. CBASP was effective in reducing symptoms
of chronic depression and significantly reducing alcohol intake to healthy drinking levels.
CBASP appears ideally suited for this population, which has extensive avoidance learning, high
rates of early trauma, repeated interpersonal failures, and uses alcohol to cope. We propose
that treatment for this population must be tailored to the underlying interpersonal issues and skill
deficits described above in order to be effective, and that CBASP can be the therapy for the
chronically depressed, alcohol dependent individual.
An fMRI Model of Perceived Functionality in Chronic Depression: Insights into the
Helpless Brain and Improved Interpersonal Functionality with CBASP
Focusing on this central mechanism of affective and motivational regulation in healthy and
chronically depressed subjects, we designed a functional magnetic resonance imaging (fMRI)
study to explore: i.) the neural and behavioral correlates of causal contingencies between action
and response in social interaction and ii.) the regulatory effect of successful/erroneous
interpersonal response prediction on subjective affective reactions. In a basic fMRI study 21
healthy subjects had to repeatedly select a simple sentence with positive or negative denotation
to interact with a previously presented partner. They had to predict the responses of their
partner before they were presented with the actual response (i.e. the facial expression). The
three partners were differentiated a priori by systematically varying the predictability of their
responses, but responded with equal total individual numbers of aversive and positive facial
expressions. Behavioral results indicated that healthy subjects were able to detect this
difference between partners. fMRI data revealed that unpredictable compared to predictable
partners induced a significantly higher activation of a network of posterior medial and
ventrolateral prefrontal cortex as well as in inferior-parietal cortices, which has already been
associated with action monitoring and error detection during action execution. In our study this
activation was associated with social partners before action planning. The congruence of
predicted and actual responses modulated activations of amygdala (aversive responses) and
ventral striatum (positive responses). Thus the basic experiment actually demonstrates the
existence of a functional system that represents functionality (contingencies) in social interaction
by means of learned individual probabilities of causal influence on the reactions of a certain
partner. In the second fMRI study we use the same experiment to assess neural and behavioral
differences between chronically depressed and healthy subjects. Preliminary results indicate
dysfunctional differentiation of predictability of different social partners in chronic depression.
Finally, we demonstrate pre-post measurements of neural and behavioral changes in the
perception of interpersonal functionality after 12 sessions of CBASP therapy, and present the
implications for developments in the new field we call neuropsychotherapy.
Comorbid Anxiety Disorders in Canadians with Bipolar Disorder: A Population Study
Based on the Canadian Community Health Survey Data
Martin Provencher1, 2, Lisa Hawke1, 3, Sagar Parikh3, 4.

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1. Ecole de psychologie, Universite Laval, Quebec, QC, Canada, 2. Institut universitaire en


sante mentale de Quebec, Quebec, QC, Canada, 3. University Health Network, Toronto, ON,
Canada, 4. University of Toronto, Toronto, ON, Canada.
This study examines the impact of anxiety disorders (AD) comorbid to bipolar disorder (BD) in a
large, nationally representative sample. The purpose is to describe the sociodemographic and
clinical profiles of Canadians living with bipolar disorder and with or without comorbid anxiety
disorders, to identify the characteristics uniquely associated with comorbid anxiety, and examine
treatment patterns. Data from the Canadian Community Health Survey, conducted among
38,492 Canadians, was analyzed. Individuals meeting the criteria for bipolar disorder (N = 808)
were compared based on the presence or absence of an assessed AD (social phobia, panic
disorder, agoraphobia). Results show that individuals with BD and a comorbid AD fare worse in
terms of BD relapses, suicidality, and sleep disturbance, and are more likely to be taking
psychiatric medication. They have more impairment in their work and social functioning and rate
their health and life satisfaction lower. Despite the greater severity, they are not receiving
additional psychological treatment, they feel they are not receiving the treatment they need, and
they report more barriers to treatment. This study confirms the critical impact of comorbid
anxiety on the course of bipolar disorder in a large, nationally representative sample and reveals
that the psychological treatment needs of this population are not being met. Clinical and
research implications are discussed.
The Development and Implementation of a Clinical Pathway for Treatment of Depression
in Primary Care: A Pilot Study
Leanne Quigley1, Dennis Pusch2, Keith Dobson1, Paul Ragusa2, Bob Acton2, Mike Trew2.
1. University of Calgary, Calgary, AB, Canada, 2. Alberta Health Services, Calgary, AB,
Canada.
Abstract Central: Major depressive disorder is among the most prevalent, debilitating, and
costly mental disorders. Depression is also commonly encountered in primary care settings. In
order to improve the identification and treatment of depression, an evidence-based clinical
pathway, based on a combination of cognitive-behavioral therapy (CBT) and pharmacotherapy,
was developed in Alberta, Canada for the treatment of adult depression by primary care
providers. This paper describes the clinical pathway and presents data collected from 158
patients from five clinics involved in a pilot test of the pathway. Depression severity was
assessed using the Patient Health Questionnaire-9 (PHQ-9), which is based on the diagnostic
criteria for depression. Patients who scored in the clinical range on the PHQ-9 were assigned to
one of three branches of the clinical pathway based on initial scores. Patients who scored 10 14 on the PHQ-9 (n = 61) were assigned to the Watchful Waiting level of intervention, patients
who scored 15 - 19 (n = 54) were assigned to the Moderate Intervention level, and patients who
scored 20 or higher (n = 43) were assigned to the High Intervention level. Watchful Waiting
patients did not receive any intervention, but were monitored at regular intervals. Patients at the
Moderate Intervention level were offered one specific intervention, either antidepressant
medication or CBT-based psychotherapy with a trained Behavioural Health Consultant, and
were monitored at regular intervals. Patients at the High Intervention level were offered more
than one specific intervention strategy (e.g., both antidepressant medication and CBT with a
Behavioural Health Consultant) and were monitored at regular intervals. Successful completion
of the pathway was defined as scoring in the non-clinical range (< 10) on the PHQ-9. The
overall six-month successful completion rate was 56% and the mean reduction in PHQ-9 scores
was -8.29 (SD = 6.03). At a three-month follow-up after successful completion of the pathway,
80% of the patients assessed continued to score in the non-clinical range on the PHQ-9,

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demonstrating maintenance of improvements. These positive outcomes were obtained with less
investment of time and resources than typically required by psychotherapies for depression.
Variances in terms of inappropriate treatment and patients exiting the pathway prematurely, as
well as practical barriers to widespread implementation of the clinical pathway will be
addressed. Future directions and suggested improvements to the pathway protocol will be
discussed.
Investigating Differences in Emotion Regulation Use and Ability between Dysphoric and
Non-Dysphoric Individuals
Leanne Quigley, Keith Dobson.
University of Calgary, Calgary, AB, Canada.
Emotion dysregulation is thought to contribute to the persistent negative affect that
characterizes depression. In particular, research has suggested that depressed individuals may
engage in more maladaptive emotion regulation strategies such as suppression and rumination,
and less adaptive strategies such as reappraisal, than non-depressed individuals. However, few
studies have examined whether these differences in emotion regulation reflect spontaneous
differences in the emotion regulation strategies used by depressed and non-depressed
individuals, or whether deficits in depressed individuals ability to use adaptive emotion
regulation may be observed even when they are instructed to use a particular emotion
regulation strategy. The present study investigated trait, spontaneous, and instructed emotion
regulation in dysphoric (n = 66) and non-dysphoric (n = 86) participants. In Phase 1, participants
completed online self-report questionnaires of trait emotion regulation. In Phase 2, sad mood
was induced using a film clip and participants were randomly assigned to use reappraisal while
watching the clip, or were not given specific viewing instructions. Participants spontaneous use
of emotion regulation strategies was assessed for those not given specific viewing instructions,
whereas participants ability to effectively use reappraisal was assessed for those instructed to
use this strategy while watching the sadness-inducing film clip. Dysphoric individuals reported
greater spontaneous use of rumination and suppression than non-dysphoric individuals, and
these strategies were associated with greater negative emotional reactivity to the sadnessinducing film clip. Greater spontaneous use of reappraisal predicted less negative emotional
reactivity to the film clip. Both participant groups were able to effectively use reappraisal when
instructed to do so; however, dysphoric individuals continued to engage in greater levels of
rumination in this condition than non-dysphoric individuals. The implications of these results for
models of emotion regulation in depression and clinical interventions for depression will be
discussed.
Attribution Therapy: Perspectives for a Different Cognitive Behavioral Therapy
Michael Sam-Vargas.
1. private practice, San Isidro, Lima, Peru, 2. Univ of Miami, Jackson Mem Hospital, Miami, FL,
USA.
Abstract Central: Attribution therapy centers on applying the principles of attribution theory to
practical clinical situations. Although the term was launched in the 1970's the process continues
to exert an important influence in social-cognitive processes. Attribution processes deals with
how we interpret and explain causality in our daily behaviors and possesses a key contributing
role in the development and treatment of emotional disorders. Attribution therapy consists in
helping the client correctly "explain" their world and realize the consequences of previously
made disfunctional misattribuitions. This paper consists in explaining the theoretical foundations

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of the attribution process, followed by presenting an outline of the structured clinical intervention
and examples of clinical cases pertaining to depression and other disorders. It is hoped that the
attributional perspective continues to provide the basis for a different modality of cognitive
behavioral therapy.
Rumination and Repetitive Thought: Evidence for causal mechanisms, mediators, and
subtypes from experimental and measurement research
Suraj Samtani1, Michelle Moulds1, Peter McEvoy3, 7, Alison Mahoney2, Suraj Samtani1, Michelle
Moulds1, John Roberts4, Christopher Sova4, Nicholas Moberly5, Felicity Southworth6, Edward
Watkins6, Colin MacLeod7, Ben Grafton7.
1. The University of New South Wales, Sydney, NSW, Australia, 2. Clinical Research Unit for
Anxiety and Depression, University of New South Wales at Vincents Hospital, Sydney, NSW,
Australia, 3. Centre for Clinical Interventions, Perth, WA, Australia, 4. The State University of
New York, Buffalo, NY, USA, 5. Mood Disorders Centre, University of Exeter, Exeter, United
Kingdom, 6. The University of Exeter, Exeter, United Kingdom, 7. The University of Western
Australia, Perth, WA, Australia.
Over the past three decades evidence has accumulated supporting the causal relationship of
rumination and worry in the onset and maintenance of depression and anxiety. Recent trends in
research in this area have placed rumination and worry under the broader umbrella term of
Repetitive Thought. Additionally, an emerging avenue of research is that investigating the onset
of rumination and the causal pathways that lead from rumination to psychopathology. This
symposium will present recent experimental and measurement studies that have applied
diverse paradigms and novel methodologies to investigate these factors in both analogue and
clinical populations. This research promises to pave the way for the development of novel
treatments for this transdiagnostic process.
The first paper will be delivered by Peter McEvoy, and will present evidence regarding the role
of metacognitive beliefs and intolerance of uncertainty as mediators in the neuroticism-repetitive
thought relationship in clinical samples (e.g. GAD). The second paper by Suraj Samtani will
report on three studies evaluating the validity and reliability of a new subtype-level,
transdiagnostic measure of repetitive thought (the RTS). The outcomes indicated that the RTS
showed good factor structure across samples, and good convergent and discriminant validity
with other measures of rumination, and with well-validated measures of psychopathology. John
Roberts will then present a study that investigated the instability of self-esteem as a result of
rumination in previously depressed versus never depressed individuals. The results indicated
that rumination led to depletions in self-esteem relative to distraction only among previously
depressed individuals. Nicholas Moberly will then outline research focused on an experiencesampling method of measuring rumination. This research supports the bi-directional link
between rumination and negative affect. Felicity Southworth will then present a series of studies
investigating the role of impairments in disengaging attention from negative information in the
onset and maintenance of rumination.
Finally, Michelle Moulds will draw the findings together and reflect on their implications for
theory and practice.
Evaluation of a hierarchical model of vulnerability to repetitive negative thinking:
Intolerance of uncertainty and metacognitive beliefs as transdiagnostic mediators
Recent evidence suggests that repetitive negative thinking (RNT), metacognitive beliefs, and
intolerance of uncertainty (IU) are associated with a range of emotional disorders and thus may
represent important transdiagnostic processes. This study aimed to replicate and extend a
hierarchical model of vulnerability to worry with neuroticism and extraversion as higher-order

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factors, and negative metacognitions and IU as second-order factors. The model also included
RNT and depression symptoms as outcome variables to determine whether relationships would
extend beyond worry, which has traditionally be studied within the context of generalized anxiety
disorder (GAD). Participants (N = 99) were referrals to a specialist anxiety disorders clinic with a
principal anxiety disorder who completed a battery of self-report questionnaires assessing
neuroticism, extraversion, metacognitions, intolerance of uncertainty, worry, RNT, and
depression symptoms. Previous research in this area has been hampered by the use of
diagnosis-specific measures of IU, metacognitions, and RNT. This study used measures with
diagnosis-specific confounds removed. Mediational analyses using bootstrapping were used to
estimate direct and indirect effects. Support for transdiagnostic and diagnosis-specific mediation
effects was found. Negative metacognitions fully mediated the relationship between neuroticism
and RNT (but not worry) for the whole sample and for subsamples with and without GAD. IU
mediated the relationship between neuroticism and worry for the whole sample and for the
subsample with GAD (but not for the subsample without GAD), and between neuroticism and
RNT for the subsample with GAD. In summary, negative metacognitive beliefs were a robust
mediator for RNT, but not worry, regardless of the diagnostic profile of the sample. IU was
mediator of worry for the whole sample, and of worry and RNT for those with GAD. Implications
for diagnosis-specific and transdiagnostic theory, treatment, and nosology will be discussed.
Is there a better way to ruminate? Assessing the maladaptive and adaptive subtypes of
Repetitive Thought
Rumination and worry have recently been grouped under the broader construct of Repetitive
Thought (Watkins, 2008). This is in line with a trend towards understanding concepts in a
transdiagnostic manner. Models of repetitive thought divide the construct into two subtypes:
maladaptive analytical thought and relatively adaptive experiential thought. Current scales of
this construct only assess the maladaptive subtype, and also confound repetitive thinking with
depressive symptoms (Treynor et al., 2003). The current project is aimed at creating a selfreport measure (the RTS) that is transdiagnostic in nature, assesses both of these subtypes,
and is content valid. Two community sample studies (N= 614 and N= 595) and one university
sample study (N= 410) have been conducted to test the factor structure, reliability, and validity
of this measure. Exploratory and confirmatory factor analyses conducted using the community
samples revealed the presence of six subscales, which can be grouped under two higher-order
factors: analytical (causes, implications, behaviour) and experiential (reliving, physical
sensations, emotions). The measure demonstrated good reliability (= .863-.939), and good
convergent and discriminant validity with other measures of repetitive thought and
psychopathology. The measure demonstrated good factor structure, which was also replicated
in the university sample.
Implicit and Explicit Self-Esteem Reactivity to Rumination among individuals with a Past
History of Depression
Past theory and research has suggested that vulnerability to depression is associated with
unstable self-esteem (SE) that is highly reactive to triggers such as daily life stressors and
fluctuations in mood. The present study tested whether rumination triggers reactivity in implicit
and explicit SE more strongly among previously depressed (PD) relative to never depressed
(ND) individuals. We compared a rumination condition to both a passive distraction condition
and an active distraction condition designed to prevent rumination. Participants were 34 PD and
26 ND college students. Rumination, passive distraction and active distraction tasks were
conducted in three separate sessions in a counterbalanced order. The rumination task
presented 45 self-focused sentences on a computer, whereas the passive distraction task
presented 45 externally-focused sentences. The active distraction task used 7-10 sentence
length passages describing the sensory details of the sentences from the passive distraction

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task. In each session, participants completed baseline measures of implicit and explicit SE, the
experimental manipulation, and post-manipulation measures of SE. Implicit SE was measured
with both the Implicit Associate Task (IAT) and the Name Letter Task (NLT), whereas visual
analogue scales measured state explicit SE. Initial analyses found that active and passive
distraction did not differ in their effects and were therefore collapsed. Hypotheses were tested
with a 2 Group (PD, ND) x 2 Condition (rumination, distraction) mixed effects models with Time
1 SE, Session number, Current depressive symptom severity, and Trait rumination as
covariates and Time 2 SE as the dependent variable. Results found a significant Condition x
Group interaction, p< .05, for the IAT, such that rumination led to depletions in SE relative to
distraction among previously depressed individuals, but not never depressed individuals. This
interaction was not significant for either the NLT or explicit SE. In conclusion, implicit SE
measured by the IAT appears to be more reactive to rumination among PD compared to ND
individuals. Reactivity in implicit SE triggered by rumination may serve as a trait vulnerability to
depression.
Dimensions of ruminative thought and their relationship with negative affect: Evidence
from experience-sampling
Although rumination has often been considered as a maladaptive response, some perspectives
have suggested that rumination may sometimes be adaptive, particularly when it serves to
reduce goal discrepancies (Martin & Tesser, 1996, 2006; Watkins, 2008). Although researchers
have attempted to parse rumination into more or less deleterious subtypes (e.g., brooding and
reflection; concrete and abstract modes), few studies have explored how people adopt these
different modes of rumination in daily life. Relatedly, the dimensional structure of repetitive
thought in ecological contexts has not been examined. In this study, experience-sampling
methodology (ESM) was used to investigate fluctuations in ruminative thought and affect.
Undergraduate participants (N = 109) completed self-report measures of depressive symptoms,
before the experience-sampling procedure was explained with reference to an electronic wristworn PRO-Diary unit (Cambridge Neurotechnology, UK). At eight quasi-random occasions each
day over the next fortnight, the PRO-Diary cued participants to report on several dimensions of
ruminative thought and provide ratings of positive and negative affect. In addition to
conceptually replicating previous findings (Moberly & Watkins, 2008) showing that ruminative
thought is bidirectionally associated with negative affect, results will explore whether these
relationships are moderated by different facets of ruminative thought, particularly those relating
to self-evaluative and abstract modes. Further analyses will investigate whether the association
between maladaptive features of ruminative thought and negative affect may be explained in
terms of poorer rates of goal discrepancy reduction.
Selective attention and depressive rumination: Do impairments in disengaging attention
from negative information underlie the tendency to ruminate?
There is now robust evidence implicating depressive rumination in the onset and maintenance
of depression (i.e., examining the consequences of rumination). However, the factors that
underlie the onset and maintenance of rumination itself have been less delineated. Since
depressive rumination primarily involves negative content, we might expect selective processing
of negative information to underlie the tendency to ruminate. In particular, some researchers
have suggested that higher levels of trait rumination may be due to impairments in disengaging
attention from negative information (e.g. Koster et al., 2010). Consistent with this theory, studies
with depressed participants have found that trait rumination is associated with an attentional
bias towards negative stimuli (e.g. Donaldson, Lam, & Mathews, 2007; Joorman, Dkane &
Gotlib, 2006). We will present a series of experimental studies further investigating the
relationship between selective attention and rumination using a recent adaptation of the
attentional probe paradigm that is able to separate biases in engagement versus

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disengagement of attention (Grafton, Watkins, & MacLeod, 2012). Findings from our first study
using a non-depressed sample suggested that higher levels of both state and trait rumination
are associated with slower disengagement from negative information, although the relationship
was only significant for threatening rather than dysphoric stimuli. Consistent with the
conceptualisation of depressive rumination as a response to sad or depressed mood (NolenHoeksema, 1991), additional studies investigated the possibility that a relationship with attention
for dysphoric stimuli might emerge following a sad mood induction. Further studies are also
intended to investigate the causal relationship using attention bias modification paradigms. This
research will further our understanding of the underlying processes maintaining depressive
rumination, with implications for the development of new interventions (e.g. cognitive bias
modification) aimed at reducing the tendency to ruminate in response to depressed mood.
Metacognition as a Predictor of 12-month Status in a Sample of Remitted Depressed
Patients
Alisa Singer2, Jennifer Prentice1, Keith Dobson1.
1. Psychology, University of Calgary, Calgary, AB, Canada, 2. Alberta Health Services, Calgary,
AB, Canada.
Metacognition has been identified as a significant predictor of relapse for depression. The goal
of this study was to investigate metacognition predictors of depressive symptoms and relapse
status independently and in conjunction with negative life events. One hundred and sixty
remitted depressed participants were recruited for the current study as part of a larger project
investigating the role of metacognitive awareness in depression. Participants were interviewed
on the SCID-I and completed the BDI-II in order to determine their eligibility to participate.
Participants then completed measures assessing various life events over the past year and
state-like beliefs in depressive experiences. Specifically, positive and negative beliefs about
depressive experiences, as well as acceptance of negative experiences were measured using
the ATNES. Participants who consented to be contacted for future research were administered
the LIFE interview, the BDI-II and LES 12 months after the initial assessment. For individuals
who experienced depressive relapse, the number of well weeks prior to meeting criteria for an
episode of major depression was also determined. Results suggest that the interaction among
acceptance attitudes and negative life events is a significant predictor of depressive symptoms
and number of well weeks during the follow-up period prior to depressive relapse even after
controlling for well-known predictors of depressive relapse. Negative attitudes and positive
attitudes, alone or in interaction with negative life events, did not uniquely contribute to the
prediction of depressive symptoms or number of well weeks. The metacognitive variables, alone
or in interaction with negative life events, did not uniquely contribute to the prediction of relapse
status. The implications of these results for future research are discussed.
Efficacy of Two Activation-Based Guided Self-Help Interventions to Reduce Depressive
Symptoms
Isabelle Soucy Chartier, Martin Provencher.
cole de psychologie, Laval University, Quebec, QC, Canada.
A randomized controlled clinical trial evaluated the efficacy and feasibility of two guided self-help
interventions for the treatment of depression: a guided self-help behavioural activation
intervention and a guided self-help physical activity-based intervention. Fifty-nine participants
presenting mild-to-moderate symptoms of depression were randomized to a behavioural
activation intervention, a physical activity-based intervention, or a wait-list control group. All
participants met with a doctoral-level clinical researcher at the start of their participation in the

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study to obtain informed consent, be randomized to one of the three conditions, and to plan and
initiate the individualized program if randomized to one of the two intervention conditions. All
participants received follow-up calls to monitor symptom severity and guide the participants
through their intervention (if in one of the two intervention-conditions), and completed
psychosocial and symptom measures at the start of their participation (pre), at 4-weeks (mid)
and at 8-weeks (post-intervention). ANOVA analyses indicated that participants in the three
conditions showed reductions in depressive symptoms at the end of the 8-weeks; however, a
significant group x time interaction was found, and orthogonal contrasts indicated that both the
behavioural activation and the physical activity interventions resulted in significantly greater
reductions in PhQ-9 depression severity scores when compared with the control condition
(p<.05). Such results suggest that both of these activation-based guided self-help interventions
are more effective in reducing depressive symptoms than the simple passage of time. No
significant difference was detected when comparing pre-post depression scores between the
physical activity and behavioural activation conditions, suggesting that they are two efficient
forms of guided self-help interventions for the treatment of mild-to-moderate depressive
symptoms. As such, both options could be offered to depressed individuals by health care
professionals and could be prime candidates for widespread dissemination of minimal
interventions for mild to moderate depressive symptoms.
Remission of Depressive Symptoms and Improve of Quality of Life in Brief Cognitive
Interventions for Depression at Primary Care
Luciano Souza, Taiane Cardoso, Thase Mondn, Karen Jansen, Ricardo Pinheiro, Ricardo
Silva.
Programa de Ps-Graduao em Sade e Comportamento, Universidade Catlica de Pelotas,
Pelotas, Brazil.
Abstract Central: Major Depressive Disorder has a high prevalence in the general population,
with high relapse rates and significant functional impairment associated. In primary care, this is
the most frequent mental disorder. Despite the recognized effectiveness of Cognitive Therapies
for the treatment of MDD, studies conducted in Latin American cultural context and populations
served in public health service are scarce. The present study aims to evaluate the efficacy of
cognitive therapy (cognitive behavioral and cognitive narrative) for the treatment of MDD in
primary care. A randomized clinical trial with 62 youth from 18 to 29 years old who met
diagnostic criteria for MDD assessed by the Structured Clinical Interview for DSM (SCID).
Depressive symptoms were assessed using the Hamilton Depression Scale (HAM-D), whereas
quality of life were assessed using MOS SF 36. The models of psychotherapy used were:
Cognitive Narrative Therapy (TCN) and Cognitive Behavioral Therapy (CBT), both with 7
sessions, once a week. After the end of treatment, an evaluation was performed with the HAMD and SF36. The mean of remission of depressive symptoms in the CBT and TCN were 8.22
and 6.21, respectably (p>0.05). At the end of treatment there was significant improvement in
quality of life scores in all domains assessed (Physical Functioning 8,1 points; Role Physical
28,6 points; Bodily Pain 12,7 points; General Health Perceptions 12,9 points; Vitality 27,7
points; Social Functioning 23,1 points; Role Emotional 45,8 points; General Mental Health 33,1
points). Cognitive psychotherapeutic interventions showed remission of depressive symptoms
and a significant quality of life improvement. It is suggested that professionals of public health
service might be trained with specific protocols for cognitive therapy for depressive disorders.
Evaluation of Biological Rhythm in a Clinical Trial for Depression
Luciano Souza, Thase Mondn, Taiane Cardoso, Karen Jansen, Ricardo Silva.

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Programa de Ps-Graduao em Sade e Comportamento, Universidade Catlica de Pelotas,


Pelotas, Brazil.
Introduo: H evidncias de que o ritmo biolgico influencia nos transtornos de humor de
forma a contribuir manuteno dos sintomas. Estudos indicam que quando os marcadores de
ritmo biolgico esto desregulados h uma maior probabilidade de ocorrer um episdio de
transtorno de humor. Objetivo: O objetivo do estudo foi verificar a regularizao do ritmo
biolgico em pacientes deprimidos atendidos em dois modelos de psicoterapia breve para
remisso de sintomas depressivos. Mtodo: Trata-se de um ensaio clnico randomizado com
jovens de 18 a 29 anos que preencheram critrios diagnsticos para depresso segundo a
Structured Clinical Interview for DSM (SCID). O ritmo biolgico foi avaliado atravs da
Biological Rythm interview of assessment in neuropsychiatry (BRIAN), enquanto a severidade
da depresso foi avaliada atravs da Hamilton Depression Scale (HAM-D). Os modelos de
psicoterapia cognitiva utilizados foram: Terapia Cognitivo Narrativa (TCN) e Terapia CognitivoComportamental (TCC), ambos com sete sesses. Foram realizadas avaliaes psinterveno e follow-up de 6 meses. Resultados: A amostra final contou com 97 indivduos
distribudos de forma homognea entre os modelos de psicoterapia. Na avaliao do ritmo
biolgico no houve diferenas entre os modelos no ps - interveno (p=0.209) e follow-up de
6 meses (p=0.599). Para a remisso dos sintomas depressivos a TCC obteve uma maior
eficcia na avaliao final (p=0.018), no entanto, no follow-up de 6 meses as psicoterapias
mostraram-se homogneas quanto sua eficcia (p=0.147). Houve uma correlao moderada
positiva (r= 0.556 p=0.001) entre a regularizao do ritmo biolgico e a remisso dos sintomas
depressivos. Concluso: As psicoterapias breves mostraram-se eficazes na remisso da
sintomatologia depressiva bem como na regularizao do ritmo biolgico no follow-up de 6
meses. Psicoterapias breves so de baixo custo para sade pblica e demonstram neste
estudo que atuam regulando o ritmo biolgico.
Dissemination of MBCT in mental health: opportunities and threats
Anne Speckens1, Willem Kuyken2, Steve Hollon3.
1. Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands, 2. Mood Disorders
Centre, University of Exeter, Exeter, United Kingdom, 3. Psychological Sciences, Vanderbilt
University, Nashville, TN, USA.
Mindfulness-based approaches have rapidly grown in popularity in both mental and general
health care. Meta-analyses and randomized controlled trials have provided evidence for the
effectiveness of mindfulness in patients with a broad variety of both psychological disorders,
such as (recurrent) depression, anxiety disorders and substance abuse and somatic conditions,
such as chronic pain, multiple sclerosis and cancer. Given the growing evidence for the clinical
effectiveness, implementation of mindfulness-based approaches in mental and general health
settings is important. In this regard, training of mindfulness teachers is crucial. Questions that
will be approached in the panel discussion will be: what are the requirements for a welldesigned teacher training programme, how to assess teacher competency in mindfulness based
approaches, how to integrate mindfulness in existing health service programmes? Recent
findings about the relationship between therapist competency and treatment outcome in a multicentre randomized controlled trial on Mindfulness Based Cognitive Therapy (MBCT),
antidepressant medication and its combination for recurrent depression in the Netherlands will
be presented. Training sessions of 15 trial teachers were evaluated using the MindfulnessBased Interventions: Teaching Assessment Criteria. Multi-level analysis in 202 patients showed
that teacher competence was associated with a change in cognitive reactivity, but not
depressive symptoms, rumination or mindfulness skills. Evidence from the United Kingdom

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regarding the exchange, synthesis and application of evidence and guidance on MBCT between
the academic settings generating the evidence and delivering practitioner training and the
practice settings where implementation takes place, will be discussed. Fifty -seven participants
in a workshop on MBCT implementation were asked for their experience of facilitators and
barriers and a UK-wide online survey of 103 MBCT teachers was conducted. A series of
structural, political, educational, emotional and physical obstacles and facilitators to
implementation were identified. Experiences from experts from the Netherlands, United
Kingdom, and, hopefully, South America will be shared.
Cognitive Behavioral Therapy for Insomnia in Euthymic Bipolar Patients: A Randomized
Controlled Trial
Mette Steinan1, 2, Karoline Krane-Gartiser1, 2, Knut Langsrud1, 2, Trond Sand1, 2, Hvard
Kallestad1, 2, Gunnar Morken1, 2.
1. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and
Technology (NTNU), Trondheim, Norway, 2. St Olavs University Hospital, Trondheim, Norway.
Background: Sleep disturbance is a core symptom of bipolar disorder, even in euthymic phases.
Insomnia in bipolar disorder may also be a mechanism for illness maintenance and relapse.
Several trials have demonstrated that cognitive behavioral therapy for insomnia (CBT-I) is an
effective treatment for primary insomnia. To our knowledge this is the first RCT with CBT-I as an
intervention in a bipolar patient group. Aims: 1) To compare CBT-I and treatment as usual
(TAU) in improving quality of sleep, stabilizing minor mood variations and preventing new mood
episodes in euthymic patients with bipolar disorder and insomnia. 2) To compare registrations of
sleep by sleep diaries, actigraphy and polysomnography in order to possibly simplify
registrations of sleep for clinical use. Method: Patients must fulfill criteria for SCID-1-verified
bipolar I or II disorder, be euthymic and fulfill a DSM-IV diagnosis of insomnia. The Insomnia
Severity Index (ISI) is the primary outcome measure. Patients first enter a 3 week run-in phase.
Patients who complete the initial phase are randomized to either CBT-I or TAU. Inclusion began
in November 2012. In this study we hope to answer the following questions: Is there an effect of
CBT-I on sleep disturbances in euthymic bipolar patients? Is there an effect of CBT-I on minor
mood variations? Is there a preventive effect of CBT-I on affective episodes? We also want to
describe the sleep architecture of euthymic bipolar patients and compare sleep diaries,
actigraphy and polysomnography as clinical tools.
Targeted Delivery of CBM to Produce a Transient Reduction in State Anxiety which
Provides Enduring Benefits
Stephanie Stevens.
University of Western Australia, Crawley, WA, Australia.
Abstract Central: Cognitive bias modification (CBM) training has been identified in previous
research as a technique that may have practical benefits in enhancing emotional functioning,
however, it has been presupposed that the real world benefits of CBM training will only be
obtained when the delivery techniques serve to produce an enduring change in emotional
vulnerability. This means that research has not addressed the impact of CBM training in
producing enduring benefits from a transient change in cognitive bias that impacts state anxiety.
The current study aimed to produce enduring benefits through targeted delivery of CBM-I at the
onset of state anxiety. High socially anxious individuals were recruited to take part in the
experiment. Participants were initially exposed to a social anxiety relevant stressor to induce a
high level of state anxiety, after which CBM-I training was completed with measures of mood

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recorded throughout. Half the participants were assigned to the training condition in which they
were trained to interpret ambiguous information as positive, and the other half were in a control
condition in which no training contingency was identified. Preliminary analyses of the current
data leads us to expect that participants in the training condition will show a tendency to
interpret ambiguous information in a positive rather than negative way, and these participants
will also have a significant decrease in anxiety levels throughout training, as compared to
participants in the no training condition. This will have great implications for the use of CBM-I
training to relieve people of anxiety symptoms at their onset in real world settings.
Development of Japanese Computer-Assisted Cognitive Behavioral Therapy Program for
Depression
Noriko Tamura1, 3, Noriko Kato1, Yuko Nakagawa2, Yoshiyo Oguchi3, Dai Mitsuda4, Yutaka
Ono1, Atsuo Nakagawa1.
1. National Center for Cognitive Behavioral Therapy and Research, National Center for
Neurology and Psychiatry, Tokyo, Japan, 2. Tokyo Medical Center, Tokyo, Japan, 3. Keio
University, Tokyo, Japan, 4. Sakuragaokakinen Hospital, Tokyo, Japan.
Background There is substantial evidence to support the use of psychotherapies, particularly
cognitive-behavioral therapy (CBT) for the treatment of depression. However, in common with
all psychotherapies, there are considerable problems in the delivery of CBT, including limited
adequately trained therapists and expense associated with service costs. Therefore CBT
delivered with less therapist involvement such as computerized CBT is assumed to have
advantages for its accessibility and convenience. In a meta-analysis, Andrews et al., (2010)
report that computerized CBT and traditional face-to-face CBT show similar effect size. We
aimed to develop a Japanese computer-assisted CBT program that will be feasible in Japanese
clinical setting. Method Based on Wrights computer-assisted CBT manual (2005), we
developed a manual for therapist using contents of pre-existing Japanese self-guided CBT
website "Kokoro-no-Skill up Training (http://www.cbtjp.net/). This websites contents have
consistency with Japanese standard manual of CBT for depression that is already shown its
usability and approved by Ministry of Health, Labour and Welfare. Thus, we intended to develop
a program that computerized CBT will be delivered over the internet with therapist support. .
Result A suggested structure of the program will be 12 sessions each lasting about 30 minutes
with therapy sessions with the clinician (the first two sessions will last for 50 min),. Content of
this program is as following: (1) making problem list and setting therapy goals, (2) behavioral
activation, (3) cognitive reconstructions (identyfing and changing automatic thoughts), (4)
problem solving, (5) relapse prevention. Usually, homework assignments and supplementary
information will be provided via the website. Conclusion We developed a Japanese computerassisted CBT program. We view this program may contribute to reduce therapists time and
service cost of CBT in Japanese clinical setting. Randomized clinical trial is underway to
evaluate clinical outcomes and cost-effectiveness.
Vulnerabilidad Cognitiva: Sintomas Depresivos y Personalidad Sociotrpica-Autonmica
Segn la Escala de Actitudes Disfuncionales
Ronald Toro.
Fundacion SERE, Bogota, Colombia.
Abstract Central: El objetivo de esta investigacin fue demostrar la relacin entre las
creencias disfuncionales sociotrpicas-autonmicas (vulnerabilidad cognitiva) y los sntomas
depresivos, de acuerdo con el modelo de dithesis-estrs (Clark, Beck & Alford, 1999; Beck,

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1983) el cual con la informacin esquemtica latente (dithesis) en Sociotropa (Personalidad


Sociotrpica), las personas activarn esquemas disfuncionales ante eventos relacionados
(estrs) como abandono, rechazo y desprecio, mientras que en personalidad Autonmica
(dominio en autonoma), se activarn esquemas depresgenos ante el fracaso, incapacidad y
prdida de la libertad e independencia, evidentes en las diferentes manifestaciones de los
sntomas depresivos, siguiendo los trabajos en torno a las hiptesis del procesamiento
congruente e hiptesis de afrontamiento diferencial. La muestra estuvo constituida por 200
participantes clasificados equitativamente por las puntuaciones bajas y altas en el BDI-II. Los
resultados arrojaron correlaciones entre las subescalas sociotrpicas y autonmicas del DAS
(Escala de Actitudes Disfuncionales), y la sintomatologa depresiva (BDI-SOC: .4; BDI-AUT:
.34). Se concluyen con los nuevos aportes acerca del procesamiento congruente en depresin
y los sntomas especficos para cada dimensin de personalidad, con resultados que sugieren
diferencias entre estas categoras de vulnerabilidad cognitiva y su posible relacin inversa en
esta patologa.
Illness Perception in Euthymic Bipolar Disorder Patients from Argentina
Fernando Torrente1, 2, Pablo Lpez1, 2, Dolores Alvarez Prado1, 2, Marcelo Cetkovich1, 2.
1. INECO (Institute of Cognitive Neurology), Buenos Aires, Argentina, 2. Institute of
Neurosciences, Favaloro University, Buenos Aires, Argentina.
Background: Efficacious psychosocial treatments for bipolar disorder involve psychoeducation
as a core intervention aimed to improve patient understanding of the illness and to develop
adequate coping strategies, which result in a better adherence to pharmacological treatment
and a healthier adjustment to the condition. Even if psychoeducation implies a cognitive work
with illness internal representation, little is known about how bipolar disorder patients
spontaneously perceive their illness prior to psychoeducation. Illness perception is a complex
cognitive construct that depends on multiple factors, such as information availability, personal
experiences and beliefs, personality and temperament, cultural and familiar influences, and also
the very course of the illness. In this poster we will present preliminary results from an ongoing
study about illness perception in euthymic bipolar disorder patients in Argentina. Methods: Forty
five patients diagnosed with Bipolar Disorder Type I or II according to DSM-IV were assessed
before the initiation of a psychoeducational program. All patients were euthymic and were
receiving mood stabilizing drugs. Patients were evaluated through a specific instrument for
exploring illness perception, the Brief Illness Perception Questionnaire (BIPQ), together with
measures of self-reported medication adherence, treatment satisfaction and affective
temperament. Results: Most patients perceive moderate to severe life consequences of the
illness, estimate timeline as prolonged, and experience moderate to severe symptoms due to
the illness. Also, most of them express moderate to high concern about the illness and
recognize a considerable emotional impact. Notwithstanding, most patients manifest to have
moderate to high control over the illness, and they rate the treatment as moderately or highly
helpful. Finally, most patients refer to have a clear understanding of the disorder. However,
almost half of them attribute the illness to environmental factors, without mentioning biological
causes. Correlations performed between the components of illness perception showed
significant positive associations between perceived symptoms and consequences, emotional
impact, and concern. Perceived symptoms were also negatively correlated with personal control
over the illness. Regarding satisfaction with pharmacological treatment, global satisfaction with
treatment was associated with both effectiveness and convenience of the treatment, but not with
side effects. In turn, effectiveness showed a negative correlation with perceived symptoms,
consequences of the illness, and emotional impact. In addition, medication non-adherence was
positively correlated with perceived symptoms and negatively correlated with convenience of

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treatment. Finally, cyclothymic temperament was correlated with more perceived symptoms ,
more emotional impact, and non-adherence; meanwhile, hyperthymic temperament was
correlated with more perceived control, effectiveness, and satisfaction with illness. Conclusion:
Preliminary results suggest that most patients show a considerable awareness of the illness,
even if they can misattribute their causes. The level of perceived symptoms and perceived
effectiveness of the drug treatment appear as central components of illness perception and
coping. Cyclothymic temperament may be related to a more difficult adjustment to illness and
hyperthymic temperament may conduce to an overestimation of control and to a minimization of
difficulties. In future, a larger sample will help to test these associations through a more powerful
statistical model.
Functional Behavioral Analysis as Strategy for the Study of Anxiety and Depression
Andromeda Valencia, Meztli Michelle Rodriguez, Carla Natalia Galvan.
Centro de Servicios Psicolgicos, UNAM, Mexico, City, Mexico.
Abstract Central: The Psychological Service Center Dr. Guillermo Davila, has the main
objective of give specialized training for the Psychology students of the UNAM. This center
annually receives over two thousand requests for psychological treatment. The main reasons for
consultation are related to depression and anxiety. Is relevant for the student training and
develop of intervention programs to analyze the epidemiological data that result from the
admission process of our patients. A high percentage of consultants have expressed more than
five years of suffering with his health condition. Mental disorders such as depression and
anxiety are highly prevalent, are a major cause of suffering and morbidity. These public health
problems are compounded by the fact that many individuals with psychiatric disorders receive
no treatment despite the availability of effective interventions. It is important to know the factors
that predispose these disorders, some of the most significant are genetic factors, referring to the
genetic predisposition of people to suffer some disease or develop a skill in life. This factor can
be inherited from our parents or previous generations and is genetically encoded in DNA,
resulting in the expression of the disorder. It is also essential to know the factors that trigger
depression and anxiety, and environmental factors that include the environment in which it
develops the individual, for example the family, the school, as well as the social circle around
him, which brings knowledge and strategies for living. This environmental factor and learning is
shaped by the experiences cognition, learning to become acquired. However it is also important
to analyze the triggers, referring to the precipitating events that act as triggers of the disorder in
the individual and thus generate particular responses to each individual situation; between these
determinants may be the death of a loved one, material losses, or disasters, among others.
These characteristics or factors are essential to know to use strategies to cope with the
condition that the patient has acquired from the mentioned factors and throughout its life. The
main objective of this study was to make a description of the principal cognitive and behavioral
triggers associated with depression and anxiety in a random sample of five hundred patients.
The patients answered a structured interview. The results are shown in terms of functional
behavioral analysis: 1) identify the problem behavior, 2) Collecting data about the problem
behavior, 3) analyze the data and 4) write the functional behavior analysis.
Predicting Potential Treatment Failure in a Cognitive Behavioral Therapy Program
Utilizing Daily Monitoring
Harry Wiegele1, Geoff Hooke1, 3, Elizabeth Newnham2, 1, Andrew Page3.
1. Perth Clinic, West Perth, WA, Australia, 2. University of Western Australia, Perth, WA,
Australia, 3. Harvard Universty, Boston, MA, USA.

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Cognitive and Behavioral Therapy (CBT) is evidence-based, but not universally effective. Thus
the present research aimed to identify those patients who might not respond as strongly to CBT
so they could be managed more effectively. We have shown that providing patients and staff
with daily feedback about treatment progress during CBT improves therapy outcomes
(Newnham et al., 2010). Specially, the benefits of feedback about progress were greatest for
patients who were not on track, relative to an expected trajectory of improvement. However, it
was not clear what characterized a not on track patient (apart from their failure to progress as
normal). Therefore, in a sample of 847 patients with depression and anxiety, characteristics of
the not on track group were studied. They comprised patients who (i) were always off track or
(ii) veered off track. These two groups of not on track patients were distinct in terms of their
gender, age, and pre-treatment symptom profile. These characteristics and final outcomes will
be discussed and treatment implications explored.
Advances in research and treatment approaches for depression
Alishia Williams1, 5, Alishia Williams1, 5, Simon Blackwell3, Emily Holmes3, Anna Mackenzie1, 5,
Gavin Andrews1, 5, Patrick Clarke2, Lies Notebaert2, Shenooka Nanthakumar2, Simon
Blackwell3, Emily Holmes3, Colin MacLeod2, Jill Newby3, 5, Timothy Dalgleish3, Willem Kuyken6,
Edward Watkins6, Barnaby Dunn6, David Richards6, Sarah Watts5, Anna Mackenzie1, 5, Cherian
Thomas5, Al Griskaitis5, Louise Mewton1, Alishia Williams1, 5, Gavin Andrews1, 5, Simon
Blackwell3, Nathaly Rius-Ottenheim4, Yvonne Schulte-van Maaren4, Ingrid Carlier4, Victor
Middelkoop4, Frans Zitman4, Philip Spinhoven4, Emily Holmes3, Erik Giltay4, Simon Blackwell3,
Simon Blackwell3.
1. University of New South Wales, Sydney, NSW, Australia, 2. University of Western Australia,
Crawley, WA, Australia, 3. MRC Cognition and Brain Sciences Unit, Cambridge, United
Kingdom, 4. Leiden University Medical Centre, Leiden, Netherlands, 5. CRUfAD, St. Vincent's
Hospital, Darlinghurst, NSW, Australia, 6. University of Exeter, Exeter, United Kingdom.
This symposium will bring together theoretical, methodological, and clinical advances in
research and treatment approaches for depression and negative affectivity. Presentations will
highlight recent advancements in treatment delivery in the form of internet-based CBT programs
and mobile applications. Research will also be presented that demonstrates potential
advancements in treatment modality through the use of imagery-based interventions that target
interpretation biases and deficits in the generation of positive mental representations. Clinical
findings will be supplemented by experimental work demonstrating proposed mechanisms of
change. Finally, the issue of comorbidity will be addressed through presentation of a novel
case-formulation-driven transdiagnostic intervention aimed at targeting the cognitive, emotional,
behavioural and interpersonal maintaining factors across depression and anxiety.
Combining imagination and reason in the treatment of depression: A randomized
controlled trial of internet-based cognitive bias modification and internet-CBT for
depression
Computerized cognitive bias modification (CBM) protocols for depression are rapidly evolving in
experimental medicine, yet might best be combined with internet-based cognitive-behavioural
therapy (iCBT). No research to date has evaluated the combined approach. The current
randomized controlled trial (RCT) aimed to evaluate the efficacy of a CBM protocol targeting
imagery and interpretation bias (CBM-I) delivered in combination with iCBT for depression via
the internet with no face-to-face patient contact. Patients diagnosed with a major depressive
episode were randomized to an 11-week intervention (CBM-I + iCBT, n = 38) or a wait-list
control (WLC, n = 31). Intent-to-treat marginal models using restricted maximum likelihood

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(REML) estimation demonstrated significant reductions in primary measures of depressive


symptoms and distress (BDI-II, PHQ9, K10), corresponding to large effect sizes (Cohens
d=1.85-2.40) and in secondary measures of disability, anxiety, and repetitive negative thinking
(WHODAS-II, STAI-T, RTQ; Cohens d = 1.33-2.00). Treatment superiority over the WLC was
also evident on all outcome measures (Hedges gs = .74 - .98). Sixty-five percent of patients
who completed the combined intervention evidenced clinically significant change. Further,
meditational analyses demonstrated that the putative causal mechanism, change in
interpretation bias (AST-D), at least partially accounted for the reduction in depression
symptoms following CBM-I. The current study provides encouraging results of the integration of
internet-based technologies into an efficacious and acceptable form of treatment delivery.
Is emotional ambiguity necessary in imagery-based interpretive bias modification?
Imagery-based interpretive bias modification (IBM) has begun to show considerable promise as
a clinical intervention for psychological problems characterised by heightened anxiety and
negative affectivity. Imagery-based IBM differs from other past interpretive bias modification
procedures (e.g. Mathews and Mackintosh, 2000) in that participants are explicitly required to
imagine ambiguous first person situations involving positive or negative outcomes and, they are
not required to generate these outcomes themselves. In the present study we sought to
examine whether the ambiguity in imagery-based IBM scenarios is necessary to elicit the
changes in interpretive bias commonly observed, or, whether the emotional content of the
imagined scenarios is sufficient to produce such changes. To achieve this we delivered an
imagery-based IBM task to participants in one of four conditions, where the valence of imagined
scenarios were either positive or negative, and the ambiguity of the scenario was either present
(until the last word/s) or the ambiguity was absent (emotional valence was evident from the
start). Results indicated that only participants exposed to scenarios where the ambiguity was
preserved came to show an interpretive bias consistent with the valence of the scenarios,
suggesting that the act of imagining positive or negative scenarios will only influence patterns of
interpretation when the emotional ambiguity is a consistent feature.
Beyond depression to resilience: Mental imagery and optimism
The ability to imagine positive events in the future is reduced in depression, and has been
suggested as a promising target for novel interventions for the disorder (Blackwell & Holmes,
2010; Lang, Blackwell, Harmer, Davison, & Holmes, 2012). Could such interventions have
applications beyond depression in promoting resilience and wellbeing? The current study
investigated whether the ability to generate vivid positive mental imagery of the future was
associated with increased levels of dispositional optimism, which is associated with a wide
range of benefits for both mental and physical health (Carver, Scheier, & Segerstrom, 2010). A
community sample of 237 participants completed a survey comprising measures of mental
imagery, optimism, health, and socio-demographic information. Vividness of positive future
imagery was significantly associated with optimism, even when controlling for sociodemographic factors and general use of imagery. This suggests that the more clearly someone
can imagine positive events in their future the more optimistic they are. Further, it opens the
possibility that novel computerised interventions that train the ability to generate vivid positive
mental imagery may be used to increase optimism. The potential of positive imagery
interventions to not only reduce depression but also to promote resilience and wellbeing via
increased optimism will be discussed.
Design, development, and case series of a novel transdiagnostic treatment for adult
unipolar mood and anxiety disorders: The Modular Protocol for Mental Health (MP:MH)
A wide range of evidence-based treatment (EBT) manuals for depression and anxiety disorders
are now available, yet most are designed to treat single Axis I diagnoses rather than comorbid

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presentations. Due to the level of complexity and comorbidity in many real-world clinical
settings, clinicians are often forced (in the absence of appropriate controlled trials) to mix-andmatch separate components from single-disorder EBT manuals to suit their clients complex
presentations and needs. To address this gap, we developed the Modular Protocol for Mental
Health (MP:MH): an individualised, case-formulation-driven transdiagnostic intervention for adult
unipolar mood and anxiety disorders. The MP:MH is theory-driven and includes both
components derived from basic science, and distils common treatment components from single
disorder EBTs that are theorised to improve symptoms (e.g., exposure). It aims to target the
shared features and underlying cognitive, emotional, behavioural and interpersonal maintaining
factors across depression and anxiety disorders. The modular format of the MP:MH allows for
flexible delivery of 10 core modules to clients on the basis of personalised goals and caseformulation (e.g., collaborative case conceptualisation, emotion awareness and tolerance, and
overcoming avoidance). This presentation will provide an overview of the theoretical framework,
content and format of the MP:MH, and the results from a small case series conducted to pilot
the MP:MH with individuals with heterogeneous comorbid depression and anxiety disorders.
The aim of the pilot study was to gain preliminary data on the efficacy, feasibility, and
acceptability of the MP:MH, and to obtain feedback from clinicians and service-users to inform
further revisions to the protocol.
Comparing delivery mode of iCBT for depression: Computer vs mobile phone
The Sadness Program (www.thiswayup.org.au/clinic) is an internet-based CBT (iCBT) program
with demonstrated clinical efficacy for depression. In order to increase accessibility to the
program we developed a version of the Sadness program to be delivered by a mobile device
and aimed to replicate efficacy of the program when delivered in this modality. In the current
RCT, 35 participants with Major Depression (77% female) were randomly allocated to access
the program via the standard computer-based program or via the new mobile application
delivered on the patients smart phone or tablet. Participants in both groups had access to 6
lessons and homework assignments, and received weekly email contact from a clinical
psychologist or psychiatrist, until completion of lesson 2. Twenty-four (69%) participants
completed all 6 lessons during the 8 week program. Marginal model analyses indicated
significant pre- to post-intervention reductions in primary measures of depression symptoms
(PHQ9; BDI-II) and psychological distress (K10), corresponding to large effect sizes (Cohens d
> .90 ). There was no difference in outcomes between the computer and mobile group,
providing preliminary support for the efficacy of a CBT program delivered using a mobile phone.
Mean therapist time spent per patient during the program was only 4 minutes. These preliminary
results suggest that delivering iCBT programs using a mobile application combined with clinical
guidance and minimal contact can result in clinically significant improvements in outcomes for
patients with depression.
Low Intensity CBT in New Zealand
Mei Wah Williams.
School of Psychology, Massey University, Auckland, New Zealand.
Abstract Central: Similar to many other developed countries, New Zealand experience high
rates of mental health problems. For many sufferers, access to mental health care is restrictive
due to the high cost or long waiting lists. Low intensity interventions is a recent innovation to
provide accessible evidence based therapy to people experiencing common mental health
problems. Without compromising empirically-based practice, the principles underlying low
intensity programs is its low utilization of resources, accessibility, high volume care, and delivery
by para-professionals. While different approaches have been developed within this paradigm, of
particular focus for this study is the guided self-help model in the management and treatment of

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mild to moderate mental health conditions. Using resources developed by Williams (2009), the
study investigated the effectiveness of the program in New Zealand. New Zealand has a
significant rural population where access to mental health facilities are not readily available,
therefore traditional and non-traditional delivery of the program, such as the use of electronic
media, was also investigated.
OCD & OCD Spectrum Disorders/ TOC y Espectro TOC/ TOC e Spectrum do TOC
Cognitive-Behavioral Therapy for Residual Obsessive-Compulsive Symptoms After Deep
Brain Stimulation in Refractory Obsessive-Compulsive Disorder
Pino Alonso1, 2, Cinto Segals1, 2, Clara Lpez-Sol1, 4, Eva Real1, 4, Gerard Planas5, Marcos
Alberto Aparicio5, Jose Menchon1, 3.
1. OCD Clinical and Research Unit. Department of Psychiatry. Hospital de Bellvitge, Barcelona,
Spain, 2. Centro de Investigacin en Red de Salud Mental. Carlos III Health Institute, Ministry of
Science and Innovation, Madrid, Spain, 3. Department of Clinical Sciences, Bellvitge Campus,
University of Barcelona, Barcelona, Spain, 4. Institut dInvestigaci Biomdica de Bellvitge
(IDIBELL), Barcelona, Spain, 5. Neurosurgery Department, Hospital de Bellvitge, Barcelona,
Spain.
Background: Despite optimal cognitive-behavioral (CBT) and pharmacological therapy,
approximattely 10% of patients suffering from Obsessive-Compulsive Disorder (OCD) remain
treatment resistant. For them, deep brain stimulation (DBS), a neurosurgical treatment involving
the implantation of electrodes that send electrical impulses to specific locations in the brain, can
constitute a therapeutical option. More than 100 patients have received DBS treatment for OCD
up to date, with results indicating an overall symptom decrease from 21 to 79%. Nevertheless,
mild to moderate OCD symptoms tend to persist after DBS, impoverishing patients functionality.
Method: We report on four treatment-refractoy OCD patients with partial response to DBS who
significantly improved after subsequent intensive CBT. Results: DBS was implemented in three
women and a man (mean age: 38.2 10.7 years; mean OCD duration: 22.0 7.8 years)
affected by severe OCD, after no response to CBT, SRIs and antipsychotics. Baseline Y-BOCS
scores decreased from 38.2 0.5 to 28.0 3.6 after six months of active stimulation (average
decrease: 26.8%). Patients were subsequently enrolled in intensive CBT consisting on 24
individual exposure sessions, conducted at patients' home, each lasting 2 hours, three times-aweek, with assignement of daily exposure (imaginal and in vivo) and ritual prevention homework
(up to 2 hours a day). After the CBT trial, Y-BOCS scores decreased to 16.0 3.6 (average
decrease: 43.1%). Conclusions: CBT is effective for reducing residual OCD symptoms after
DBS in OCD-refractory patients who have shown poor previous response to CBT. This option
should be considered to maximize the results of this new experimental therapy.
Obsessive-Compulsive spectrum disorders: common factors and treatment effects
Amparo Belloch1, Hctor Fernndez-Alvarez3, Fernando Garca3, Beatriz Gmez3, Conxa
Perpi1, Amparo Belloch1, Mara Roncero1, Pino Alonso2, Elena Cabedo4, Amparo Belloch1,
Carmen Carrio4, Conxa Perpi1, Mara Roncero1, Susana JImenez-Murcia2, Pino Alonso2,
Susana JImenez-Murcia2, Roser Granero5, Eva Penelo5, Laura Moragas2, Laurence Claes6,
Lamprini Savvidou2, Fernando Fernandez-Aranda2, Fernando Fernandez-Aranda2, Jose
Menchon2, Amparo Del Pino2, Mohammed Islam2.
1. Personalidad, Universidad de Valencia, Valencia, Spain, 2. Hospital de Bellvitge, Barcelona,
Spain, 3. Fundacin Aigl, Buenos Aires, Argentina, 4. Agencia Valenciana de Salud, Valencia,

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Spain, 5. Universitat Autnoma de Barcelona, Barcelona, Spain, 6. Faculty of Psychology and


Educational Sciences, Leuwen, Belgium.
The proposal of a spectrum of obsessive-compulsive disorders has gained increased attention
in the last two decades. This renewed interest in an ancient proposal coming from
psychoanalytic theorists, it is the result of the combined effects both of the high rates of
comorbidity observed between OCD and other disorders different than anxiety disorders, and
the advances in the understanding of psychological and biological variables underlying both
OCD and these other disorders, in which anxiety it is not the primary symptom. In fact, the
characterization of OCD as a primary anxiety disorder has been questioned (i.e., Bartz, J.A. &
Hollander, E., 2005. Is obsessive-compulsive disorder an anxiety disorder? Progress in NeuroPsychopharmacology & Biological Psychiatry 30, 338-352), and has led to the proposal of
removing OCD from the anxiety disorders category in the Fifth version of the Diagnostic and
Statistical Manual of Mental Disorders, DSM-V, thus creating a new diagnostic category, named
Obsessive Compulsive and Related Disorders (OCRDs), in which OCD seems to be the main
organizing diagnostic entity. The rationale behind this new category is to put together a set of
disorders that share phenomenological features, etiological processes, comorbidities, and
response to similar treatments. From this perspective, the DSM-V proposal includes OCD, Body
Dysmorphic Disorder, Hoarding Disorder, Trichotillomania, and Skin Picking Disorders.
Nonetheless, based on empirical studies from different approaches and methodologies (i.e.,
neurobiological, genetic, comorbidity, age of onset, family history, clinical course, metacognitive
variables, and response to similar treatments), there are other quite different proposals from
those of DSM-V about the disorders that could be clustered in an OC spectrum. The common
starting point of these so different approaches is postulate two dimensions, one related to mood
and the other one related to behaviour, along which different OCRDs might vary. The mood
dimension might fluctuate from dysphoria to euphoria, whereas the behavioural dimension might
goes from compulsivity and harm avoidance to impulsivity and need for stimulation. The
disorders that could be situated along these two dimensions are as diverse as those related to
preoccupations for bodily sensations or appearance (i.e., body dysmorphic disorder, certain
eating disorders, hypochondriasis), others usually associated with impulse control (i.e.,
pathological gambling, trichotillomania, paraphilias, substance abuse), and a third group of
neurologically based disorders (i.e., autism, Tourettes syndrome), being the OCD in the middle
point of shared characteristics with all these disorders, or nearest to the dysphoria and
compulsivity/harm avoidance ending points of the mood and behavioural dimensions,
respectively (Steketee, G. (Ed.), (2012). The Oxford Handbook of Obsessive-Compulsive and
Spectrum Disorders. New York, Oxford Univ. Press). This symposium is intended to present
and discuss evidences for an OC spectrum, with reference to OCD, eating disorders,
pathological gambling, hoarding, and treatment response to CBT. All the authors are accredited
clinicians and expertise researchers in their fields both in Spain and in Argentina.
Change processes in cognitive-behavioral therapy for obsessive-compulsive disorder.
The obsessive-compulsive disorder is characterized by recurrent obsessions and compulsions
that are time consuming and provoke marked distress and significant deterioration of quality of
life. There are currently two psychotherapeutic programs with proved efficacy for this disorder:
cognitive therapy and exposure with response prevention. However, the mechanisms through
which changes take place are still in discussion.
A description of different therapeutic change assessment modalities in patients presenting
obsessive compulsive disorder will be presented. These patients were treated with a cognitivebehavioral psychotherapy model in individual and group settings. The number of cases
considered was N=10 treated in a group setting and N1= 20 treated in an individual setting.
Possible mediating and modulating variables of therapeutic change will be proposed along with

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the therapeutic principles and cognitive processes involved. Implications for psychotherapy
treatment design will be discussed.
Pathological gambling, eating disorders and compulsive buying: Are there evidences for
the obsessive-compulsive spectrum?
Introduction: These disorders are characterized by a failure to resist an impulse, drive, or
temptation to perform an act that is harmful to the person or to others. It has been hypothesized
that they are distributed along an impulsive-compulsive spectrum and debated its potential
relationship to mood, substance abuse and obsessive-compulsive disorders. Objective: The
objective of the study was to assess the predictive value of personality profiles (temperament
and character) to classify women with pathological gambling (PG), bulimia nervosa (BN) with
and without compulsive buying, compulsive buying (CBD), and a non-psychiatric comparison
group (CG). Methods: The sample comprised 188 female patients (53 pathologic gamblers
[PG]; 50 BN without comorbid CBD [BN- CB]; 49 BN with comorbid CB [BN + CBD]; 36 with
[CBD] and 50 comparison (non-psychiatric) females. Results: The comparison between controls
and clinical subtypes showed that psychopathology levels were significantly lower for controls
than pure BN, comorbid BN and compulsive-buying patients. However, the comparison between
PG and controls did not achieve significant results for the obsessive-compulsive, anxiety and
phobic scales. When comparing with other psychological measures between diagnosis
subtypes, we observed that many scores showed a positive-growing trend and achieved
significant or quasi-significant linear trends, which confirm the presence of gradients of
affectation between the four clinical profiles. Conclusions: These disorders followed a lineal
trend both in general psychopathology and in personality traits.
UNWANTED INTRUSIVE THOUGHTS IN EATING DISORDERS: A TRANSDIAGNOSTIC
VARIABLE?
In the last 50 years, numerous studies have focused on the relationship between Eating
Disorders (ED) and Obsessive Compulsive Disorder (OCD). The evidence for the existence of a
connection stems from different arguments, including a syndromic perspective, common
personality features, and biological factors. Some of the characteristics that have been identified
as common, are rigid thoughts about thinness, concerns about body shape and ongoing
ruminations about food in case of ED. In addition, repetitive behaviors such as excessive
exercise, count calories, and food rituals are similar to the present compulsions in OCD.
The purpose of this presentation is summing up some empirical evidence of the functioning and
role of these kinds of cognitions: unwanted and repetitive intrusive thoughts, images and/or
impulses about eating-related contents, or Eating Disorder Intrusive Thoughts (EDITs). We
review the data collected through two instruments assessing intrusions about food, weight,
shape, exercise, dieting, purging, and vomiting (The Eating-related Intrusive Thoughts
Inventory; INPIAS, Perpi et al., 2011) and the part of the checklist of the Yale-Brown ScaleCornell Eating Disorders (YBC-EDS, Mazure et al., 1994), adapted from the Yale-Brown
Obsessive-Compulsive Scale (Y-BOCS) administered both in general and clinical population.
The intrusive nature and high frequency of the EDITs make them unpleasant, and individuals
could feel overwhelmed by their inability to keep them under control and by their interference in
their daily activities (Fairburn, 2008; Woolrich et al., 2008).
Taking a dimensional view of these symptoms (obsessions, intrusions, ruminations or automatic
thoughts, among others) can be considered as falling at the pathological end of normal intrusive
thoughts.
COMPULSIVE HOARDING IN OBSESSIVE-COMPULSIVE DISORDER AND OBSESSIVECOMPULSIVE SPECTRUM DISORDERS: PREVALENCE AND CLINICAL CORRELATES.

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Compulsive hoarding is a syndrome characterized by acquisition of and failure to discard a large


number of possessions; clutter that precludes activities for which living spaces were designed;
and significant distress or impairment in functioning caused by the hoarding1. Hoarding has
been classically conceptualized as a symptom of obsessive-compulsive disorder (OCD), but
recent epidemiological, clinical and neurobiological evidence indicates that hoarding may be
better classified as a distinct disorder2. DSM-V will thus probably include hoarding disorder as a
new independent diagnosis apart from OCD3. Nevertheless the relationship between hoarding
disorder and OCD and/or obsessive-compulsive spectrum disorders is still highly controversial.
Our study aimed to provide data on the prevalence and clinical correlates of hoarding disorder
in a sample of 481 subjects, including 148 patients with OCD, 99 patients with pathological
gambling, 94 patients with eating disorders, 19 patients with compulsive buying and 221 healthy
controls. All subjects completed the Saving Inventory- revised (SI-R)4 and those scoring over
the cut-off point were assessed with the Structured Interview for Hoarding Disorder (SIHD)5.
Our results will help to clarify current controversy regarding nosological location of hoarding
disorder and its relationship with obsessional and impulsivity dimensions.
1. Frost RO, Hartl TL. A cognitive-behavioural model of compulsive hoarding. Behav Res Ther
1996; 34: 341-350
2. Pertusa A, Frost RO, Fullana MA, et.al. Refining the diagnostic boundaries of compulsive
hoarding: a critical review. Clin Psychol Rev 2010;30(4): 371-86
3. Mataix-Cols D, Frost RO, Pertusa A, et al. Hoarding disorder: a new diagnosis for DSM-V?
Depress Anxiety 2010; 27 (6): 556-572
4. Mataix-Cols D, Pertusa A. Hoarding disorder: potential benfits and pitfalls of a new mental
disorder. Journal of Child Psychology and Psychiatry, 2011, 53 (5): 608-618
5. Frost RO, Steketee G, Grisham J. Measurement of compulsive hoarding: a saving inventoryrevised. Behav Res Ther. 2004 Oct;42(10):1163-82.
Unwanted intrusive cognitions in patients with Obsessive-Compulsive Disorder and
Anorexia Nervosa: commonalities and differences.
Introduction. Since the earliest descriptions of Eating Disorders (ED), and especially Anorexia
nervosa (AN), the presence of obsessive and compulsive symptoms has been noted. Recent
studies found that between 20-30% of patients with ED display clinically significant obsessions
and compulsions, not always related to eating themes, which suggest an overlap between
Obsessive-Compulsive Disorder (OCD) and ED that may reflect common neurobiological,
genetic, and/or psychological factors. Based on this, we wonder if a common psychological
factor between OCD and ED might be a heightened propensity to experience unwanted
intrusive thoughts (UIT) and appraise them dysfunctionally.
Aim. To explore the commonalities and differences between ED and OCD patients regarding
the metacognitions associated to the experience of UITs.
Participants. 34 patients with a principal Axis I diagnosis of AN and 61 patients with a principal
Axis I OCD disorder.
Results. No differences between AN and OCD patients were observed in the frequency with
which they experience UITs. The observed relationships between the most disturbing UIT and
their emotional consequences, control difficulties, evaluative appraisals, and thought
control/neutralizing strategies were comparable in the two groups.
Conclusions. The propensity to experience UIT and to appraise them in a dysfunctional way,
might be a transdiagnostic variable explaining comorbidity between OCD and AN.
Programa de Atencin Primaria del Trastorno Obsesivo-Compulsivo
Tania Borda2, Beatriz Gmez1, Amparo Belloch3, Hctor Fernndez-Alvarez1.
1. Fundacin Aigl, Buenos Aires, Argentina, 2. CONICET, Buenos Aires, Argentina, 3.
Universidad de Valencia, Valencia, Spain.

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El trastorno obsesivo-compulsivo (TOC) presenta un 2-3% de prevalencia en la poblacin. Sin


embargo, se encuentra infradiagnosticado, y se calcula que la media desde que aparece la
enfermedad hasta que se diagnostica es de 10 aos, por lo que su deteccin y abordaje precoz
resultan prioritarios. Se presenta un programa de Atencin Primaria para pacientes que
padecen Trastorno Obsesivo Compulsivo siguiendo las guas internacionales basadas en el
modelo cognitivo-comportamental. Estudios preliminares nos remiten a condiciones de
inclusin y exclusin segn niveles de severidad de la patologa, comorbilidad y caractersticas
familiares de este programa. As, describiremos el programa incluyendo la evaluacin inicial del
trastorno, las fases del tratamiento y la evaluacin de resultados, para pacientes que reciben
atencin en instituciones pblicas y privadas en la Ciudad Autnoma de Buenos Aires y en la
provincia de Buenos Aires, Argentina.
Impact of Cognitive-Behavioral Therapy for OCD: Decrease of the Levels of Obsessive
Beliefs: Randomized Clinical Trial
Cristiane Bortoncello, Juliana Gomes, Aristides Cordioli.
UFRGS, Porto Alegre, Brazil.
Introduction: Due to the Obsessive-compulsive Disorder (OCD) being a neuropsychiatric
disease, through the years, different models were designed on the study of the emergence and
maintenance of this disorder. Thus, beliefs of these patients and the impact of treatments on
reducing the obsessive-compulsive (OC) symptoms are being studied in an increasing way.
Objective: The first objective was to evaluate if the beliefs dimensions in patients with OCD,
assessed through the obsessive beliefs questionnaire (OBQ), reduce after 12 session of
cognitive-behavioral group therapy (CBGT) when compared to controls in a randomized clinical
trial. The second objective was to examine the improvement of symptoms of this disorder.
Method: Clinical trial carried out at Hospital de Clnicas of Porto Alegre, RS, Brazil. The sample
comprised 104 adult patients with OCD diagnosis recruited to participate in 12 CBGT sessions.
Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Obsessive-Compulsive Inventory Revised (OCI-R), Beck Depression (BDI) and Anxiety (BAI) Inventories were used to measure
the intensity of obsessive and compulsive, depression, and anxiety symptoms, while OBQ-44
was used to evaluate the beliefs of these patients. All instruments were applied before and after
CBGT. Results: The group in treatment had a significantly more marked improvement than the
control group in all scales used in this study, even when adjusted for basal measure, age,
number of comorbidities, and hoarding dimension of OCI-R. The treatment effect sizes in YBOCS, CGI, BAI, BDI, and OBQ-44 ranged from 0.94 to 2.56, considered of strong intensity
(Cohen, 1988). For OCI-R, effect sizes ranged from 0.69 to 1.44, considered from regular to
strong intensity. In the control group, the maximum standardized effect size was 0.39,
considered of weak intensity. Conclusion: CBGT was effective both for reducing anxiety and
depression symptoms as well as obsessive-compulsive beliefs and symptoms. This reduction
correlated with the patients having higher education level and possibly with CBGT treating
cognitive and exposition aspects in group.
Effects of Psychoeducation on Emotional, Cognitive, and Behavioural Impact of
Obsessive-Compulsive Disorder
Elena Cabedo2, Carmen Carrio2, Alexandra Barroso1, 2, Amparo Belloch1.
1. Personalidad, Universidad de Valencia, Valencia, Spain, 2. Generalitat Valenciana, Valencia,
Spain.

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INTRODUCTION: Psychoeducation about emotional, cognitive and behavioural mechanisms


involved in the development of psychological disorders is a well-established starting point for
most CBT treatment protocols. However, the impact of this module on emotions, cognitions, and
behaviours has scarcely been investigated. AIM: To examine the effects of a two-weekly
session psychoeducation module on the above-mentioned variables in a group of patients with
Obsessive-Compulsive Disorder (OCD). PARTICIPANTS: Seventeen OCD patients started
manualised CBT treatment in outpatient clinics of the public mental health system in Valencia,
Spain. 50% were women, most (72%) were married, and their average age was 35 years. The
mean duration of disorder was 8 years, 22% presented only pure obsessions, 44% a comorbid
axis I disorder and 28% a comorbid personality disorder. As a group, subjects had severe OCD
(Y-BOCS: M= 24.7). MEASURES. Among other instruments, patients completed the Obsessive
Intrusive Thoughts Inventory (INPIOS; Garca-Soriano et al., Journal of Anxiety Disorders, 2011,
25, 474-482) three times: before start CBT, after psychoeducation module, and once CBT was
finished. In the INPIOS 2nd part, subjects evaluate, using 4-point Likert scales: (a) the
emotional reactions linked to their main O-C symptom dimension (unpleasantness, anxiety,
sadness, guilt, and shame); (b) the difficulty in controlling the symptom and the interference it
produces (difficulty of controlling it, success controlling/suppressing, and interference); (c) the
dysfunctional appraisals associated with the OIT (importance of the thought, thought-action
fusion-moral, personal significance, thought-action fusion-probability, responsibility, importance
of control, over-estimation of threat, and intolerance uncertainty); and (d) frequency of use of a
list of control strategies to get rid of the symptoms (covert and overt distraction, covert and overt
compulsions, cognitive restructuring, self-reassurance, others-reassurance, reappraisal, stop
thinking, do nothing, relaxation, self-punishment, avoidance, suppression effort, worry, effort to
control). RESULTS. Decreases in emotional impact between pre-post psychoeducation were
observed (paired t= 3.508, p=0.003), and decreases in dysfunctional appraisals almost reached
significance (t=2,082, p=0.056). However, interference caused by the disorder increased (t= 2,449, p= 0.026), and no changes were observed for neutralizing strategies after
psychoeducation. To study changes considering the whole CBT process, repeated measures
ANOVAS were performed (pre-treatment, post-psychoeducation, and post-treatment, controlling
for the severity of the disorder at pre-treatment). These analyses were conducted with 11
patients who concluded the treatment at the study moment. Of them, 4 were recovered (YBOCS score <7 and decrease >6 points), and 4 had significantly improved (Y-BOCS score <12
and decrease >6 points). Decreasing changes were significant for emotional impact (F=4.294,
p=0.030) at the three study moments, whereas the decrease in interference caused by
symptoms was only significant at post-treatment. Acknowledgement. Study supported by
PSI2010-18340, MICIIN, Spain.
Depressive Symptoms and Incompleteness as Predictors of Decision-Making Difficulties
in OCD Patients
Angel Carrasco1, Clara Lpez-Sol3, 4, Amparo Belloch2, Pino Alonso3, 4.
1. Agencia Valenciana de Salud, Valencia, Spain, 2. Universidad de Valencia, Valencia, Spain,
3. Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain, 4.
CIBERSAM, Carlos III Health Institute, Madrid, Spain.
INTRODUCTION. Pathological doubt has been frequently emphasized as a central
phenomenon in OCD. Both doubt and its behavioral manifestation, indecisiveness, have been
studied from psychometric and experimental approaches during the past 50 years. However,
questions regarding the generality, specificity and causes of both phenomena still remain
unanswered. AIM. The present study, which is part of a broader research program about the
presence and causes of doubt and indecisiveness in OCD and another anxiety disorders, aims

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to explore the relationship between decision-making difficulties, pathological doubt and


psychopathology. METHOD. Participants: nineteen outpatients with a main diagnosis of DSM-IV
OCD were recruited from the OCD service at the Department of Psychiatry, University Hospital
of Bellvitge (14 women and 4 men, with a mean age of 36,5 years). Their Y-BOCS scores
ranged from 8 to 30 (mean = 21.05; SD = 5.87). No patients met criteria for current or lifetime
diagnoses of psychoactive drug use or abuse, psychotic disorders or bipolar disorder. Comorbid
non-OCD anxious or depressive disorders were not considered as exclusion criteria. Measures.
All patients completed a clinical and psychometric assessment which included measures of
obsessive (Y-BOCS), anxious (STAI-R) and depressive (BDI-II) psychopathology, and of two
constructs related to obsessional doubt: not just right experiences (NJREQ-R; Coles et al.,
2003) and incompleteness (OC-TCDQ; Summerfeldt et al., 2001). The subjects also completed
a computer-based decision-making task which presented them with 12 scenarios in which they
were asked to choose between two alternatives. Three kinds of scenarios were created: OCD
relevant, which included stimuli relevant to O-C concerns; anxiety relevant, with stimuli relevant
to other anxiety disorders, and neutral, with no threatening material. Response latency and selfreported confidence in having made the right decision were measured for each of the scenarios
and considered as its dependent variables (DVs). RESULTS. Correlational analyses showed
that DVs didnt correlate significantly to each other. Multiple regression analyses were
conducted to predict both dependent variables for each kind of scenario, with psychopathology
measures (Y-BOCS, STAI and BDI-II) entered in the first step and NJREQ-R and the
Incompleteness scale of OC-TCDQ in the second. Statistically significant predictors were only
found for OCD-relevant scenarios. BDI-II scores emerged as a significant predictor of response
latency ( = -.70; t = - 2.20; p = .04). As a predictor of confidence, incompleteness reached only
marginal significance (beta = .66; p = .076) when introduced with NJRE-Q scores in the second
step; however, further analyses revealed that it reached full significance (beta = .72; t = 2,44; p
= .029) when introduced alone. CONCLUSIONS. Our results suggests the existence of
heterogeneity among diverse measures of decision-making problems (time needed to reach a
decision vs. doubts about its appropiateness), which not only failed to substantially correlate to
each other but were also predicted by different psychological variables, i.e., depressive
symptoms and feelings of incompleteness, respectively.
Are Dysfunctional Beliefs and Thought Control Strategies Maintenance Factors for
Obsessive-Compulsive Disorder?
Carmen Carrio2, Elena Cabedo2, Amparo Belloch1.
1. Personalidad, Universidad de Valencia, Valencia, Spain, 2. Agencia Valenciana de Salud,
Valencia, Spain.
INTRODUCTION. Current cognitive approaches that view obsessions as being caused by
misinterpretations about their meanings have led to the development of cognitive therapeutic
(CT) procedures specifically designed to challenge patients dysfunctional appraisals and beliefs
about their obsessions. Nonetheless, few studies have examined the role of these dysfunctional
cognitions in the maintenance of the disorder. This study AIMS to provide information about this
topic by comparing the changes that recovered vs. non recovered (Non-REC) OCD patients
show in their adscription to these cognitions, once a specific CT protocol (i.e., without ERP) has
been completed. PARTICIPANTS: 60 OCD patients who completed a manualised CT treatment;
mean age = 34.40 (SD = 10.25) years, 53.3% women, and 38% had one or more Axis I
comorbid disorders. On average, the OCD was severe (Y-BOCS mean: 25.20, SD=5.45). After
CT, patients were classified as recovered (REC, n= 35) or not (Non-REC, n = 25) according to
these criteria: Post-treatment Y-BOCS score 7 and at least a 7-point decrease between prevs. post treatment). INSTRUMENTS: White Bear Suppression Inventory (WBSI); Thought

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Control Questionnaire (TCQ); Obsessive Beliefs Spanish Inventory (OBSI). CT: 18 sessions
over a 6-month period. RESULTS: (a) Pre-treatment: REC and Non-REC patients were
comparable on Axis I comorbidity, gender, marital and financial status, educational level,
medication, OCD age of onset, depression (BDI), worrying symptoms (PSWQ), and the YBOCS obsessions subscale. Non-REC patients presented more severe compulsions (mean YBOCS compulsions = 11.83 vs. 13.68; t=-2.62; p=.01) and a longer duration of the disorder (10
vs. 5 years, t=-2.47, p=.01). No differences were found on thought control strategies (TCQ) and
thought suppression (WBSI), or on most of the dysfunctional beliefs (responsibility, overimportance of thoughts, thought action fusion, importance of controlling thoughts and
intolerance to uncertainty). However, Non-REC scored higher on overestimation of threat (t=2.07, p=0.04) and perfectionism beliefs (t=-2.04, p=.04). (b) Post-treatment. One-way
ANCOVAS were conducted considering the post-treatment scores as dependent variables and
the pre-treatment scores as covariates. REC patients decreased more than Non-REC their
adscription to all dysfunctional beliefs: responsibility (F=30.28, p=.0001), importance of thoughts
(F=8.74, p=.005), TAF-probability (F=16.8, p=.0001), TAF-Moral (F=6.35, p=.015), thought
control (14.88, p=.000), danger (F=30.41, p=.000), intolerance to uncertainty (F=16.42, p=.000),
and perfectionism (F=10.87, p=.002). The same result was observed for the OBSI total score
(F=47.74, p=.000). Regarding thought control strategies, REC patients decreased their scores
for TCQ-worrying (F=4.16, p=.04), TCQ-punishment (F=6.92, p=.01), and WBSI (F=13.09,
p=.001) more. As expected, scores on depression and worrying were lower in REC than in NonREC patients (BDI: F=6.64, p=.01; PSWQ: F=16.17, p=.0001). CONCLUSIONS. Dysfunctional
cognitions (i.e., beliefs and thought control strategies) play an important role in the maintenance
of OCD, as posited by current cognitive models about the disorder. Acknowledgement. Study
supported by PSI2010-18340, MICIIN (Spain).
La Metfora del Neurtico Interior: nueva tcnica para el tratamiento del TOC
Jos Chertok.
Centro de Terapia Conductual, Montevideo, Uruguay.
Abstract Central: La terapia cognitivo conductual cuenta con tcnicas eficaces para el
tratamiento del TOC, pero el progreso suele ser lento y engorroso porque los pacientes no
cumplen con las consignas de suprimir los rituales y de evitar la lucha obsesiva. Esto se debe a
que poseen ideas equivocadas sobre sus propias obsesiones, como la creencia de que las
imgenes y pensamientos que evocan reflejan sus autnticos deseos, o la pretensin de
ejercer un control total sobre sus pensamientos. Tambin albergan expectativas errneas sobre
lo que pueden esperar del tratamiento, por ejemplo la creencia de que la terapia disipar sus
dudas obsesivas, eliminar su incertidumbre y les quitar la necesidad de ritualizar. Las
preguntas que plantean a su terapeuta, tales como: ser esto una obsesin o una duda
razonable? constituyen en s mismas conductas de verificacin y reaseguramiento. La
metfora del neurtico interior corrige estas expectativas y brinda herramientas para
responder en forma eficaz a las ideas y temores obsesivos. La tcnica se apoya en tres pilares
bsicos: un modelo comprensivo del trastorno que permite al sujeto convivir con sus
obsesiones sin luchar contra ellas ni entregarse a prolongados anlisis de las mismas; un
cambio en el lenguaje (pblico o privado) que emplea el paciente para referirse a sus
obsesiones, que permite tomar distanciar de las mismas; y el uso del entrenamiento asertivo
adaptado al manejo de las obsesiones y rituales. Se ilustran los distintos pasos del
procedimiento con un ejemplo clnico.

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A Global Perspective on Unwanted Obsession-Related Intrusive Thoughts: Their


Frequency, Appraisal and Control Across 13 Countries
David Clark1, David Clark1, Amparo Belloch2, Gemma Garcia-Soriano2, Guy Doron3, Danny
Derby4, Ohad Szepsenwol3, Elad Nahaloni4, Richard Moulding5, Meredith Coles6, Gillian
Alcolado8, Beatriz Gmez10, Mujgan Inozu11, Adam Radomsky8, Gillian Alcolado8, Pino Alonso9,
Guy Doron3, Gemma Garcia-Soriano2, Hctor Fernndez-Alvarez10, Adam Radomsky8, David
Clark1, Jonathan Abramowitz7, Chee Wing Wong12, Amparo Belloch2, Martine Bouvard13,
Claudio Sica14, Gregoris Simos15, Giti Shams16, Marta Ghisi17.
1. Psychology, University of New Brunswick, Fredericton, NB, Canada, 2. University of
Valencia, Valencia, Spain, 3. Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel, 4.
Cognetica- The Israeli Center for Cognitive Behavioral Therapy, Tel Aviv, Israel, 5. Deakin
University, Melbourne, VIC, Australia, 6. Binghamton University, Binghamton, NY, USA, 7. The
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 8. Concordia University,
Montreal, QC, Canada, 9. Bellvitge Hospital, Barcelona, Spain, 10. Fundacion para la
Investigacion en Ciencias Sociales, Buenos Aires, Argentina, 11. Dogus University, Istanbul,
Turkey, 12. Chinese University of Hong Kong, Hong Kong, Hong Kong, 13. University of Savoie,
Chambery, France, 14. University of Firenze, Florence, Italy, 15. University of Macedonia,
Thessaloniki, Greece, 16. Tehran University, Tehran, Islamic Republic of Iran, 17. University of
Padova, Padova, Italy.
According to cognitive behavioral theories (CBT) of OCD, unwanted intrusive thoughts and
images of contamination, harm, doubt, religion, sex, and violence occur frequently in the general
population. These unwanted cognitions give rise to clinical obsessions in vulnerable individuals
because of faulty appraisals of personal significance and futile efforts at mental control.
Numerous studies have supported or challenged this basic proposition of the CBT model but
much of this research has been based on Western samples and relied on retrospective selfreport questionnaires. Moreover it is increasingly recognized that unwanted intrusive thoughts
are a transdiagnostic phenomenon that is evident across a number of clinical disorders.
However little is known about the incidence, appraisal and control of unwanted intrusive
thoughts across diverse cultures. The present series of studies report on the incidence,
appraisal and control of unwanted intrusive thoughts in a variety of countries. The first two
studies present findings from a large structured interview of obsessive-like intrusive thoughts
conducted on 683 nonclinical individuals drawn from Argentina, Australia, Canada, France,
Greece, Hong Kong, Iran, Israel, Italy, Sierra Leone, Spain, Turkey, and the United States.
Ninety-six percent of individuals in all countries reported unwanted intrusive thoughts in the past
three months. The first paper examines the effects of cultural differences on the frequency,
appraisal and control of 7 types of intrusive thoughts reported in Western and non-Western
countries. The second presentation examines the specific relation between faulty appraisals of
individuals most distressing intrusive thought and obsessional symptoms and beliefs in 554
participants representing 11 countries where OC symptom data were collected. The third paper,
based on a Spanish OCD clinical sample, presents evidence that different types of mental
control strategies are associated with obsessions, whereas other strategies are associated with
compulsions. The final presentation introduces the concept of intimacy-related obsessions and
provides exploratory data across three studies conducted in Israel or Canada that highlights the
maladaptive nature and potential clinical utility of the construct termed relationship-centered
OCD. Together these studies provide an international perspective on intrusive thoughts and
their relation to obsessionality, as well as the possible generalizability of the CBT model of
obsessions to non-Western countries.
IInvestigating cultural differences in the beliefs, appraisals and control of intrusive
thoughts across 13 countries

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Cognitive models of Obsessive Compulsive Disorder (OCD) are based on findings that intrusive
thoughts are normal thoughts that are misinterpreted as significant, leading to negative
emotional responses and maladaptive control strategies. While individuals may experience a
variety of intrusions, individuals often report that their most important intrusions and obsessions
are often domain specific, where the person experiences their obsessions in one particular area
of life. Recent studies suggest that different intrusion domains may be linked with different
control strategies and cognitive and emotional consequences. Therefore, this paper uses
interview based data from multiple sites across the world to investigate these issues. Of the 639
participants who selected their most distressing intrusion, 50 endorsed dirt/contamination
intrusions; 76 endorsed harm intrusions; 203 doubt intrusions; 51 religious/immoral intrusions;
16 sexual intrusions; 120 victim-related intrusions; and 123 endorsed miscellaneous intrusions.
The paper examined the connections between appraisals, control strategies and the frequency,
distress and importance attributed to intrusive thoughts, and whether these relationships vary
between countries. In addition, it also examined whether the "content" matters in such
relationships - that is, whether the domains of intrusive thoughts influence these relationships.
Implications for theory and research are discussed.
Unwanted Distressing Intrusive Thoughts and their Relation to Obsessionality in a
Multilnational Sample
The cognitive behavioral model of obsessive-compulsive disorder (OCD) traces the origins of
obsessions to the faulty appraisal and control of unwanted normal intrusive thoughts, images
and impulses. Over the years numerous studies have reported that intrusive thoughts dealing
with the threatening themes of OCD occur in the general population and their faulty appraisal is
related to obsessionality. However most of this research has relied on retrospective self-report
questionnaires administered to North American and western European samples. Less is known
about intrusive thoughts and their relation to obsessionality in other parts of the world. The
present study reports on the nature of unwanted intrusive thoughts and their relation to
obsessionality in 554 nonclinical individuals from 11 countries who were administered a detailed
structured interview on intrusive thoughts as well as self-report measures of obsessive
compulsive symptoms, depression, anxiety and obsessional beliefs. Analysis revealed that 94%
reported at least one distressing intrusive thought in the past three months, the most common
being doubt, being victimized or minor annoying intrusions. There were significant differences
between countries in the frequency and appraisal of the most distressing intrusion, as well as in
obsessional symptoms and beliefs. Regression analysis revealed that frequency, distress and
appraisals of control significantly predicted obsessional symptoms even after controlling for
depression and obsessional beliefs. The findings indicate that the role of intrusive thoughts in
obsessionality may be applicable beyond the samples drawn from developing countries in
previous studies.
Controlling obsessions: Exploring the role of OCD severity and symptom dimensions
The association between OCD severity and the frequency of use of strategies to control
symptoms, as well as which are the most used strategies depending on the obsessional
content, have received, to date, little empirical attention. This study aims to examine these two
aspects. After identifying their most disturbing obsession, 61 OCD patients assessed the
frequency with which they used a set of 17 control strategies to get rid of their obsession. OCD
severity was related with higher control difficulties and lower success in controlling the
symptoms. Obsessions severity was associated with a lower use of distraction and reappraisal
strategies, whereas Compulsions severity was related to a greater use of checking, washing
and repeating and lower use of distraction. All patients used more covert (suppression, selfreassuring, cognitive avoidance, worry) than overt neutralizing strategies whatever was the

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obsessional content dimension. Only patients with contamination obsessions used also overt
control strategies related to the obsessional content (washing/ cleaning).
Dysfunctional beliefs and relationship-centered obsessive-compulsive symptoms in nonclinical and clinical samples
Background and Objectives: Dysfunctional obsessive-compulsive related beliefs such as the
excessive importance attributed to the occurrence or control of intrusive thoughts have been
shown to play a crucial role in the development and maintenance of a variety of obsessivecompulsive themes. One obsessive theme that has only recently begun to attract research
attention is obsessive concerns relating to intimate-relationships. Individuals presenting with
such concerns spend hours a day doubting their own feelings towards their partner, their
partners' feelings towards them and the "rightness" of the relationship. Such preoccupations are
commonly associated with checking (e.g., scanning one's own body), comparing (e.g., am I as
happy as them?) and reassurance seeking behaviors. Relationship-centered obsessions cause
significant personal distress, dyadic dysfunction and disability. Consistent with current cognitive
behavioral models, in the current 2 studies we have examined to association between
relationship-centered obsessive compulsive concerns and OCD-related dysfunctional. Method:
In Study 1, we compared adherence to dysfunctional obsessive beliefs in individuals from the
community scoring high on relationship-centered obsessive-compulsive symptoms (n=35; 75th
percentile) and individuals scoring low on such symptoms (n=36; 25th percentile). We also
assessed differences on dysfunctional obsessive beliefs controlling for more common
obsessive-compulsive symptoms and general worry. In Study 2, we compared individuals
presenting with Obsessive Compulsive Disorder centering on relationship concerns (ROCD;
n=13) with individuals presenting with OCD (n=15) with other obsessive themes. OCD
Diagnosis for all OCD participants was obtained using the Mini International Neuropsychiatric
Interview (MINI). Results: Study 1 supported the link between dysfunctional obsessive
compulsive beliefs and relationship-centered obsessions. This remained true after controlling for
more common obsessive-compulsive symptom and general worry. Study 2 showed that
individuals with ROCD score higher on importance/control of thoughts and
perfectionism/intolerance of uncertainty beliefs, but not inflated responsibility or overestimation
of threat beliefs than individuals presenting with OCD. Limitations: small sample size (Study 2)
and non-clinical sample (Study 1). Conclusions importance/control of thoughts and
perfectionism/intolerance of uncertainty beliefs may be particularly important to address when
dealing with relationship-centered obsessions.
Impasses Diagnstico e Interveno Cognitiva-Comportamental de um Caso Clnico de
Transtorno Sexual No-Paraflico
Mara Colombarolli, Nazar Hayasida.
Universidade Federal do Amazonas, Manaus, Brazil.
Os transtornos sexuais no-paraflicos no possuem uma classificao diagnstica prpria no
atual Manual Diagnstico e Estatstico de Transtornos Mentais (DSM-IV-TR), podendo ser
classificados como Transtorno Sexual Sem Outra Especificao (SOE). Todavia, a literatura
tem apontado para uma classe de transtornos sexuais caracterizados pela existncia de
pensamentos intrusivos sobre sexo e o engajamento contnuo em comportamentos sexuais dos
quais se pode perder o controle. Atualmente sem especificao, esses transtornos tm sido
estudados e avaliados quanto sua natureza, e dados apontam para diferentes hipteses de
classificao: um transtorno que se insere no chamado Spectrum Obsessivo-Compulsivo,
tratando-se de uma compulso sexual, ou de um transtorno de impulsivo-compulsivo, podendo
ser tambm enquadrado, na quinta edio do DSM, na categoria de vcios comportamentais.
O presente trabalho um estudo de caso que visa apresentar interveno teraputica de base

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cognitivo-comportamental realizada em paciente com transtorno sexual no-paraflico. O


paciente relatou pensamentos constantes e intrusivos de contedo sexual normativo, seguidos
da necessidade de consumao do desejo sexual atravs de relao sexual ou masturbao.
Sua queixa dizia respeito ao prejuzo pessoal e ocupacional, devido quantidade de tempo
dispendida para atender a seus desejos diariamente, diversas vezes ao dia, o que culminou no
abandono de suas atividades acadmicas e na constante evitao de exposio social. Em
avaliao psiquitrica posterior, foi diagnosticado transtorno obsessivo-compulsivo e fobia
social. As primeiras quatro sesses foram destinadas coleta dos dados da anamnese e ao
estabelecimento do foco e metas da terapia. O foco eleito pelo paciente foram os pensamentos
de contedo sexual e os comportamentos compulsivos de realizao ao desejo sexual. Nas
sesses seguintes, avaliou-se a hiptese de TOC com a Escala Yale-Brown de Sintomas
Obsessivos-Compulsivos, cujos resultados indicaram nvel extremo, e atravs do Inventrio de
Ansiedade de Padesky aferiu-se o nvel de ansiedade, tambm elevado. Diante desses
resultados, recomendou-se avaliao psiquitrica para tratamento combinado de medicao e
psicoterapia, com o objetivo de controlar o nvel de ansiedade e comprometimento
psicopatolgico do paciente. As demais sesses tiveram como foco a psicoeducao sobre os
sintomas e o tratamento proposto, bem como a investigao dos pensamentos e crenas
relacionados ao problema, identificao de distores cognitivas e tcnicas de controle da
ansiedade. O paciente descontinuou em o tratamento farmacolgico e demonstrou baixa
adeso e resistncia ao tratamento. Na 12a sesso, o paciente abandonou o tratamento. As
dificuldades diagnsticas envolvendo esse tipo de transtorno dificultam a elaborao de
estratgias de interveno apropriadas. Por isso, so necessrios mais estudos que auxiliem
no entendimento desse transtorno, com o objetivo de favorecer a elaborao de medidas
teraputicas voltadas para seu tratamento, tanto farmacolgico como psicolgico.
New Directions in Studying Obsessive-Compulsive Disorders
Reuven Dar1, Reuven Dar1, Amit Lazarov1, Nira Liberman1, Amitai Abramovitch5, 2, Sabine
Wilhelm5, 2, Sabine Wilhelm5, 2, Guy Doron3, Ohad Szepsenwol3, Einat Karp3, Netali Gal3,
Jedidiah Siev4, Jessica Rasmussen5, 2, Michelle Silverman5, 2, Sabine Wilhelm5, 2.
1. Tel Aviv University, Tel Aviv, Israel, 2. Harvard Medical School, Boston, MA, USA, 3.
Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel, 4. Nova Southeastern University, Fort
Lauderdale-Davie, FL, USA, 5. Massachusetts General Hospital, Boston, MA, USA.
Recent years have witnessed a profusion of research on OCD reflecting a wide range of
theoretical perspectives and methods, from genetics and biological psychiatry through social
and personality psychology. The present symposium will present some novel approaches to
OCD, which can significantly advance our understanding of this difficult disorder. The first two
presentations examine general hypotheses pertaining to central features of OCD, whereas the
last two examine hypotheses relevant to specific OCD subtypes.
OC tendencies appear to be associated with reduced confidence in ones own internal states,
leading to compensatory seeking and reliance on proxies that the individual perceives as more
easily discernible or less ambiguous. Amit Lazarov will present evidence that this reduced
confidence may be grounded in a real deficiency in perceiving internal states. OCD, anxious
and healthy participants were required to produce specific levels of muscle tension with and
without biofeedback. OCD participants performed relatively poorly in this task when biofeedback
was unavailable, suggesting that OC rules and rituals may function as proxies that compensate
for difficult-to-access internal signals.
Anhedonia, the inability to experience pleasure, has been extensively studied in depressive
disorders, schizophrenia and substance abuse. Amitai Abramovitch will present new evidence
of a strong relationship between Anhedonia and OCD. In a sample of 113 individuals with OCD,

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clinically significant anhedonia was found in 38% of the participants. Severity of anhedonia was
associated with greater OCD symptom severity and specifically with obsessive symptoms, even
after controlling for severity of depression. These results indicate that anhedonia may play an
important role in the psychopathology of OCD and should be considered in understanding and
treating patients with this disorder.
Common relationship concerns may become obsessive. In such cases, individuals may be
plagued by doubts and worries about their relationship and driven to repeatedly check their own
feelings, behaviors, and thoughts, and seek reassurance from others about the relationship.
Guy Doron will present two studies investigating whether the co-occurrence of attachment
anxiety and over-reliance on intimate relationships for self-worth is linked with such relationshipcentered obsessions. The results of these studies support the hypothesis that such double
relationship-vulnerability may make individuals more susceptible to the development and
maintenance of relationship-centered obsessions.
Individuals with OCD are thought to struggle with response inhibition, but previous findings have
been inconsistent. Jedidiah Siev will present a study that examined response inhibition in OCD
using a visual go/no-go task. The study found no evidence of impaired response inhibition in
individuals with either scrupulous or contamination OCD. Response inhibition did not differ by
subtype, suggesting that cognitive disinhibition is not a ubiquitous characteristic of OCD. The
results corroborate previous evidence that scrupulosity may best be understood as a category
of core fear that can be either autogenous (e.g., fears of blasphemous thoughts) or reactive
(e.g., fears of ritual contamination).
Attenuated Access to Internal States in OCD: Evidence from a Biofeedback-Aided Muscle
Tension Task
Objectives: We hypothesize that inputs from internal states in Obsessive-Compulsive Disorder
(OCD) are attenuated, so that the reduced subjective conviction characterizing OCD is
grounded in a real deficiency in perceiving and experiencing internal states. We further
hypothesize that this deficiency leads to compensatory seeking and reliance on proxies substitutes for internal states that the individual perceives as more easily discernible or less
ambiguous. We tested this hypothesis with a biofeedback-aided magnitude-production task,
which measures the ability to assess and produce specific levels of muscle tension. We
predicted that in the absence of biofeedback, OCD patients, as compared with anxiety disorder
participants and non-patients, would perform more poorly on this task. We also predicted that
when given the opportunity, OCD participants would be more inclined to request the use of the
biofeedback monitor as an aid for producing the required levels of muscle tension.
Method: OCD, anxiety disorder and non-patient participants were asked to produce specific
levels of forearm muscle tension ranging from 1 to 4 in four phases, each consisting of 12
muscle tension trials. The first three phases alternated in terms of whether the participants
viewed the biofeedback monitor, beginning with a non-viewing phase, while the fourth offered
participants the choice of whether or not to view the monitor at several time points. Our
dependent measures were participants accuracy in producing the required muscle tension
levels and the number of times participants requested to view the monitor in the final phase.
Results: In the absence of biofeedback, OCD participants, compared to anxiety and non-patient
participants, were less accurate in producing specific muscle tension levels. With the aid of the
biofeedback monitor, this deficit in performance was eliminated. In addition, OCD patients were
more likely to request the biofeedback monitor in the final phase, demonstrating their reluctance
to rely on their own judgment in regard to this particular internal state.
Conclusions: Consistent with our previous findings, this study shows that the performance of
OCD participants on a task that relies solely on internal cues is relatively deficient. These
findings support our hypothesis that OCD is associated with attenuated access to internal states
and a compensatory reliance on proxies for these states. This hypothesis may shed light on the

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development of rules and rituals, which can be seen as proxies designed to compensate for
difficult-to-access internal signals.
Anhedonia in Obsessive-Compulsive Disorder: Beyond Comorbid Depression
Background: Anhedonia, the inability to experience pleasure, is a quantifiable reliable construct
associated with impaired reward responsiveness. It may be more heritable then Obsessive
Compulsive Disorder (OCD) or depression and has been extensively researched in depressive
disorders, schizophrenia and substance abuse. Despite recent evidence of reduced ventral
striatum reactivity to positive reward, and OCDs association with negative affect and
depression, anhedonia has never been investigated in the context of OCD.
Methods: 113 participants with OCD completed a battery of questionnaires, including the
Snaith-Hamilton Pleasure Scale (SHPS), the Depression Anxiety Stress Scale (DASS), the
Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and the Obsessive Compulsive Inventory Revised (OCI-R).
Results: Clinically significant anhedonia was found in 38% of the sample. Compared to the nonanhedonic group, significantly higher Y-BOCS scores were found in the anhedonic-OCD group
(p < .0001, Cohens d effect size = .96), a finding which remained significant after controlling for
depressive symptom severity (p = .003, d = .59). Severity of anhedonia was significantly
correlated with Y-BOCS scores (r ranging from .38 to .44), as well as with all DASS subscales (r
ranging from .34 to .54). After controlling for depressive symptom severity, correlations with the
Y-BOCS scores and the OCI-R remained significant (r ranging from .26 to .29). Finally, when
controlling for depressive severity, discriminant function analysis of the OCI-R subscales
revealed that the obsessing dimension was the best discrminator for detecting the presence of
clinical anhedonia in OCD.
Conclusion: This is the first study to examine anhedonia in OCD. We found clinically significant
anhedonia in more than one third of our sample. Severity of anhedonia was associated with
greater OCD symptom severity with more pronounced association specifically with obsessive
symptoms. This association remained significant after controlling for depressive symptom
severity. In accordance with recent research demonstrating deficient reward reactivity in OCD,
our results indicate that anhedonia may play an important role in the psychopathology of OCD.
This is especially important considering that current assessment procedures, as well as
CBT/ERP protocols for OCD treatment, do not target anhedonia. There is a need for more
research on anhedonia in OCD, specifically focusing on the nature of its association with OC
symptomatology beyond depressive symptoms.
Relationship-centered obsessive compulsive symptoms: Evidence for the doublevulnerability hypothesis
Background and Objectives: Recent findings suggest that common relationship concerns may
become obsessive, leading to relationship dysfunction, distress, and disability. In such cases,
individuals are plagued by doubts and worries about their relationship - whether it is the right
relationship for them, whether they really love their partner, or whether their partner really loves
them. These individuals are then driven to repeatedly check their own feelings, behaviors, and
thoughts, and seek reassurance from others about the relationship. Consistent with recent
models implicating self and attachment insecurities in the development and maintenance of
OCD, we investigated whether the co-occurrence of fear of abandonment (i.e. attachment
anxiety) and overreliance on intimate relationships for self-worth - what we have termed a
double relationship-vulnerability - is linked with relationship-centered obsessions and behavioral
tendencies. Method: In Study 1, we assessed the correlational links between vulnerability in the
relational self-domain, attachment anxiety, and relationship-centered obsessive-compulsive
(OC) symptoms. In Study 2, we examined whether threat to the relational self-domain would
increase relationship-centered OC tendencies among individuals with high relational self-

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vulnerability and high attachment anxiety. Participants were assigned to either a control
condition or a mildly-negative feedback condition following a bogus task that was alleged to
assess competence in the maintenance of intimate relationships. Subsequently, responses to
relationship-centered OC scenarios were assessed. Results: Study 1 supported the link
between double relationship-vulnerability and relationship-centered obsessions. This remained
true after controlling for obsessive compulsive beliefs, general worry, depression, and selfesteem, suggesting a unique contribution of such double relationship-vulnerability to
relationship-centered obsessional concerns. Study 2 showed that individuals with double
relationship-vulnerability are more likely to act upon relationship-related doubts and fears when
faced with subtle threats to the relationship self-domain. Limitations: Our studies were
conducted on non-clinical samples. Conclusions: Double relationship-vulnerability may make
individuals more susceptible to the development and maintenance of relationship-centered
obsessions. Addressing self-vulnerabilities and attachment anxiety may enhance traditional
CBT treatment of relationship-centered obsessive-compulsive symptoms.
Scrupulosity and Contamination OCD Are Not Associated with Deficits in Response
Inhibition
Individuals with OCD are thought to struggle with response inhibition, the ability to suppress or
cancel learned associations and intended movements, resulting in recurrent intrusive thoughts
and compulsive behavior. However, some studies have not found deficits in inhibition (e.g.,
Moritz et al., 2010), which may vary by symptom subtype (e.g., Omori et al., 2007). Lee et al.
(2009) found deficient response inhibition in those with autogenous (e.g., sexual, aggressive,
religious) but not reactive (e.g., contamination, symmetry) obsessions using a measure that
does not assess religious obsessions. Scrupulosity is a type of OCD in which obsessional fears
are religious or moral. Scrupulous obsessions are often grouped with other autogenous
obsessions as unacceptable thoughts, but religious obsessions share cognitive features with
both autogenous and reactive obsessions (Siev et al., 2011). Therefore, response inhibition
deserves further examination in the context of scrupulosity.
We compared individuals diagnosed with scrupulous OCD (n = 19) and contamination OCD (n =
18), and healthy controls (n = 16) on response inhibition. Participants completed a visual go/nogo task, in which they detected the appearance of a square (Block 1), detected the appearance
of the square but not a cross (Block 2), and detected the appearance of the cross (i.e., previous
distracter) but not the square (i.e., previous target) (Block 3). Slower reaction time in Block 3
relative to Block 2 indicates attenuated response inhibition.
We found no evidence of impaired response inhibition in individuals with scrupulous or
contamination OCD, neither of which differed from healthy controls. Attenuated response
inhibition did not differ by group, F (2, 50) = 0.41, p = .67. Similarly, Kruskal-Wallis tests
revealed no differences in the number of errors made in any experimental block, ps > .55. Our
data further emphasize that generic cognitive disinhibition is not a ubiquitous characteristic of
OCD. Moreover, along with Siev et al. (2011), these findings provide a second piece of
evidence that religious obsessions do not conform to other autogenous obsessions in terms of
cognitive characteristics. Scrupulosity may best be understood as a category of core fear that
can be either autogenous (e.g., fears of blasphemous thoughts) or reactive (e.g., fears of ritual
contamination).
Addressing Doubt in Compulsive Hoarding : A Clinical Case Study
Marie-Eve Delorme1, 2, Magali Purcell Lalonde1, 3, Kieron O'Connor1, 3.
1. Centre de recherche Fernand-Seguin, Montreal, QC, Canada, 2. University of Quebec in
Montreal, Montreal, QC, Canada, 3. University of Montreal, Montreal, QC, Canada.

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Compulsive hoarding (CH) is currently recognized as a subtype of obsessive-compulsive


disorder (OCD). CH is characterized by the excessive acquisition of objects without value, and
by the inability or unwillingness to discard objects. It often creates clutter in the home and
prevents usual use of rooms. The disorder is associated with significant distress and
impairment, and is often the result of overvalued ideation (OI). OI creates attachment to
collected items, marked emotional distress, and avoidance behaviours. Further, obsessional
doubt is often observed in individuals with CH as it contributes to the acquisition and hoarding of
objects and creates an endless spiral of further doubt. Inference-based therapy (IBT) was
developed for individuals suffering from OCD with OI and obsessional doubt. The IBT model
has been tested on all OCD subtypes including CH. OI is common among individuals with CH
and often reinforces obsessional doubt. The present case study describes IBT for a 35-year-old
woman diagnosed with CH. Over the course of a 24-week treatment period, her hoarding
behavior and associated beliefs decreased significantly. Specifically, her Yale-Brown
Obsessive-Compulsive Scale scores were subclinical at six-month follow-up. Considerable
decreases were also observed in her scores on the Overvalued Ideas Scale, Saving InventoryRevised, Saving Cognition-Revised, Beck Depression Inventory-II, and Beck Anxiety Inventory.
Moreover, obsessional doubt was measured pre- and post-treatment, and demonstrated a
significant impact on the course of treatment. Also, it will be illustrated how the doubt or emotion
initially occurs in CH; the form it takes; the central role of doubt, ambivalence, or conflicting
emotion in CH; the role of pathological doubt in sabotaging behaviour; the role of perceived selfefficacy via resolution of the doubt; and the essential process of addressing the doubt in
therapy. Finally, the impact of the resolution of doubt or addressing of emotions is illustrated in
this case study. Also, this case study has implications for the treatment of CH and other OCDrelated disorders involving OI.
The Relation of Religious Commitment to Obsessive Belief Domains
Isabelle Drenckhan, Anne Klumparendt, Janna von Beschwitz, Fred Rist.
Clinical Psychology and Psychotherapy, University of Mnster, Mnster, Germany.
Theoretical Background: Religiosity has been suggested as a factor contributing to the
development of obsessive-compulsive disorder (OCD): certain religious rules or assumptions
(e.g. sin by thought) might cause or foster dysfunctional OCD-related beliefs like thought-action
fusion (TAF; Shafran, Thordason & Rachman; 1996). Previous studies using the TAF-scale
(Shafran et al., 1996) found a connection between religiosity and TAF, especially Moral-TAF,
which refers to the belief that unmoral thoughts are morally equivalent to corresponding actions
(Rassin & Koster 2003). However, the relation of religiosity and other obsessive-compulsive
belief domains according to the OCCWG remains unclear. The present study aimed to clarify, if
religious commitment is exclusively related to TAF or, more generally to a spectrum of
obsessive beliefs. Method: 439 Christian adults of a community sample volunteered for the
online-study including the German, slightly modified versions of the religious commitment scale
(Cohen, Malka, Rozin & Cherfas, 2006), the obsessive beliefs questionnaire (OBQ; OCCWG;
2005) and the TAF-Scale (TAF-d, Drenckhan, Andor, Glckner-Rist & Rist; 2012). Explorative
and confirmatory factor analyses were used to establish the structure of the questionnaires.
Structure equation modeling was used to evaluate the religious commitment scale as predictor
for the TAF-d and the OBQ. Results: Religious commitment predicted Moral-TAF in general
(.23), but even better Moral-TAF concerning religious contents (.42, e.g. blasphemous
thoughts). It does not predict Likelihood-TAF (e.g. thinking of a negative event makes it more
likely to occur). The relation to the OBQ factors was rather modest with little explained variance,
but significant for perfectionism and intolerance of uncertainty (-.14) and also for importance and
control of thoughts (.11). However, the latter OBQ dimension contains one item capturing Moral-

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TAF with religious content, which is especially related to religiosity (.49). Conclusion: Religious
commitment is a good predictor of Moral-TAF, especially with religious contents such as morally
judging blasphemous thoughts, but not of obsessive beliefs in general. Future studies should
examine this relationship for different religious and cultural backgrounds.
Hoarding Disorder
Lynne Drummond1, 2, Mark Boschen3, Himanshu Tyagi2, Lynne Drummond1, 2.
1. Public Health Science and Education, St George's, University of London, London, United
Kingdom, 2. OCD/BDD, South West London and St George's NHS Trust, London, United
Kingdom, 3. School of Psychology, Griffith University, Gold Coast, QLD, Australia.
It is proposed that DSM5 will have a separate category for hoarding disorder which will be
subsumed under the Obsessive-Compulsive Spectrum Disorders. It is proposed that hoarding
disorder is defined as a persistent difficulty discarding or parting with possessions, regardless of
their actual value. This difficulty is due to a perceived need to save the items and distress
associated with discarding them. The symptoms result in the accumulation of possessions that
congest and clutter active living areas and substantially compromise their intended use. If living
areas are uncluttered, it is only because of the interventions of third parties (e.g., family
members, cleaners, authorities). The hoarding causes clinically significant distress or
impairment in social, occupational, or other important areas of functioning (including maintaining
a safe environment for self and others).The hoarding is not attributable to another medical
condition This clinical round table will examine the concept of hoarding disorder. Firstly there will
be an in depth analysis of the clinical outcomes of treatment of hoarding disorder. This will
include a review of the literature on psychopharmacological treatment of hoarding. In addition a
study examining the outcome of patients with hoarding disorder treated using CBT will be
presented. Possible predictors of outcome will also be examined. Animal hoarding has been
compared and contrasted with inanimate object hoarding. This problem has recently been the
subject of global media attention. People with the condition accumulate large numbers of pets
which they are then unable to care for. They continue to live with the animals in extreme squalor
and more than half of the most severe cases have animal carcasses and faecal matter in the
living space of both animals and humans. Although this is a potential public health hazard, to
date these people have mainly been managed by the Court system having been referred by
animal protection societies. The similarities and differences between these cases and inanimate
object hoarding will be examined as well as the role of mental health services. Recent advances
in computer technology, including broadband internet access speeds and terabyte sized hard
drives have led to the possibility of a variety of hoarding focused on the acquisition and retention
of digital content such as music, films, and software. Digital hoarding shares many
characteristics with other hoarding disorders, and yet also demonstrates some specific
differences. The nature of digital hoarding will be examined in the context of existing cognitive
behavioural models of hoarding, with a focus on the similarities and differences between digital
hoarding and hoarding of other animate and inanimate objects.
Obsessive Compulsive Spectrum Disorders
Lynne Drummond1, 3, Mark Boschen2, Himanshu Tyagi3, Lynne Drummond1, 3.
1. Menatl Health, St George's, University of London, London, United Kingdom, 2. Griffith
University, Gold Coast, QLD, Australia, 3. South West London and St George's NHS Mental
Health Trust, London, United Kingdom.

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Overview Abstract :
The DSM V working party has made proposals that Obsessive-Compulsive Disorder (OCD) be
placed in a separate category from the Anxiety Disorders and included in a category of
Obsessive Compulsive and related conditions which include Obsessive-Compulsive Personality
Disorder (OCPD), Tic disorders, Hypochondriasis, Body Dysmorphic Disorder (BDD),
Trichotillomania and other grooming disorders, Eating disorders, Pathological Gambling (PG)
and other Impulse-control disorders, including alcohol and substance dependence and
Kleptomania , OCD with physical abnormality and OCD with developmental disorder.
ICD11 is still in an early planning stage but is due to be published in 2015 and is likely to also
have a separate category for Obsessive Compulsive and related disorders which is also likely to
include OCD; Tricholtillomania and Hoarding. Body Dysmorphic Disorder will be in a separate
category of bodily distress disorders.
This symposium will examine the concept of Obsessive Compulsive spectrum disorders by
describing research into the various factors and co-morbidities in OCD.
Firstly there will be an overview of research in OCD which will include the presentation of new
and recently published data as well as some unpublished work. This paper will speculate on the
proposed changes to classification of OCD and suggest there may be more than one type of
OCD with different aetiological factors and possibly variable responses to treatment.
The second presentation will examine the outcome of intervention with refractory OCD patients
and will also examine any predictors of outcome. Despite the existence of effective treatments
there are many individuals who do not respond to treatment delivered in non-specialist services.
This presentation describes the treatment approach used in a specialist OCD outpatient
treatment centre. Results indicate that when delivered by specialist clinicians, individuals who
have not responded to previous treatment demonstrate effect sizes similar to non-refractory
patients seen in non-specialist services.
The third presentation will examine the clinical presentation and symptomatology of Body
Dysmorphic Disorder (BDD) as found in a specialist clinic. Different characteristics of
presentation between the sexes as well as the differing concerns of patients will be presented.
OC Spectrum Disorders and Research - Lynne M Drummond
This paper will examine the prevalence of spectrum disorders amongst a cohort of patients
referred to a specialist unit. Research into comorbidity including anxiety disorders; depression;
sleep abnormalities and eating disorders will be presented as will data on neurological
conditions.
Data on comorbidity and spectrum disorders from a cohort of patients with OCD treated by a
Regional specialist unit will be presented. Following Different comorbidities will be examined
including the incidence of co-morbid depression and its response to treatment of OCD;
comorbid anxiety disorder and its incidence and responsiveness to OCD treatment. The
incidence of comorbid eating disorders in OCD will be presented and compared with the
incidence in a population with refractory anxiety disorders but excluding OCD and BDD. Recent
research into the incidence of antibasal ganglia antibodies in OCD will be presented to examine
the possible role of infection in the aetiology of OCD. There has been body of research
examining the role of sleep disorders particularly Delayed Sleep Phase Shift in contributing to
the morbidity of OCD. This will be examined together with recent research from a National
inpatient service for OCD.
Finally outcome data from intensive treatment will be presented including a suggestion of
different OCD syndromes.
Treatment of Severe, Refractory Obsessive-Compulsive Disorder in a Specialist
Community Setting - Mark Boschen

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Research Aims/Questions: Obsessive-compulsive disorder (OCD) is a chronic condition,


associated with significant impairment in functioning and quality of life. Despite effective
treatments such as cognitive and behaviour therapies, and antidepressant medication, there are
many individuals with OCD who do not benefit from treatment. Some individuals with OCD have
particularly severe presentations that are treatment refractory and associated with a range of
additional psychological and medical complications. We conducted a prospective treatment
study of 205 individuals referred to a specialist outpatient treatment service in the United
Kingdom, to examine the effectiveness of a specialist behavioural intervention.
Methodology: Individuals were treated with an individually tailored treatment plan focusing on
behavioural and cognitive techniques over a 24 week period.
Results: A total of 158 individuals completed treatment. Using a conservative last-observationcarried-forward intention-to-treat methodology, the treatment group demonstrated significant
reductions in both self-reported and clinician-rated measures of obsessive-compulsive
symptoms. OCD symptoms reduced during the first 12 weeks of treatment, with further
reductions after an additional 12 week period. Depression symptoms also reduced after 12 and
24 weeks. A total of 40% of individuals experienced clinically significant change in OCD
symptoms, with approximately 10% reporting recovery at the end of treatment. In addition we
will examine and review the literature on factors which predict outcomes in this group
Body Dysmorphic Disorder - Himanshu Tyagi
Introduction
Gender is unequivocally tied to self-perception of ones own body image. However, disorders of
body image usually do not have gender specific approaches to treatment, mainly due to a
relative lack of evidence for similarities and differences between genders.
This paper will report on a study performed which examined gender similarities and differences
in self reported preoccupations with various body parts in patients with Body Dysmorphic
Disorder
Method
We investigated 54 patients with a diagnosis of BDD, who were assessed between 2008 and
2011 at a specialist centre for OCD and BDD, based at Springfield University Hospital, London
UK. Routinely collected standard measures at the time of assessment i.e. Yale Brown
Obsessive Compulsive Scale (YBOCS-BDD), Body Dissatisfaction Checklist, Beck Depression
Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS), Sheehan Disability
Scale (SDS) and sociodemographic information (relationship and employment status) were
collated and analysed with respect to gender. Self report questionnaires i.e. Body
Dissatisfaction Checklist, BDI and SDS were completed by the patients prior to the assessment
interview. Assessment interviews were conducted by clinicians with specific expertise in the
treatment of BDD.
Data on the preoccupation with body parts was primarily collected from body dissatisfaction
checklist and was supplemented with information reported elsewhere in the assessment and
treatment reports.
Results
We found fewer differences than similarities between the two genders. Our data suggested that
females were more likely to present late for treatment and also not be in a stable relationship at
the time of presentation. Males were noted to be less likely to be employed. Males scored
slightly higher on all clinician rated instruments i.e. YBOCS-BDD, BDI, MADRS and SDS.
However none of these demographic or clinical factors were found to have a statistically
significant difference between the two genders. Males and females did not significantly differ in
terms of most of the variables on body dissatisfaction checklist. Statistically significant
differences were found only in preoccupation with breasts, hips, skin (face and body) and hair

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(face and body, except head).


Our results will be discussed in relation to previously reported findings.
A Comparison of Two Brief Interventions for Obsessional Thoughts: Exposure and
Acceptance
Laura Fabricant1, John Dehlin2, Jonathan Abramowitz1, Michael Twohig2.
1. University of North Carolina Chapel Hill, Chapel Hill, NC, USA, 2. Utah State University,
Logan, UT, USA.
Abstract Central: Exposure and response prevention (ERP) is currently thought to be the most
effective psychological treatment for obsessional thoughts. However, the procedures involved in
ERP are challenging, anxiety-provoking, and may contribute to refusal and drop-out (Franklin &
Foa, 1998). To address this problem, researchers have begun to evaluate alternative treatments
for obsessional thoughts, such as Acceptance and Commitment Therapy (ACT). ACT
encourages individuals to accept their obsessional thoughts and not resist or control them
(Twohig, 2009) and has shown promise for treating OCD in initial evaluations (Twohig et al.,
2010). Despite the value of both ACT and ERP, little is known about the relative impact of these
strategies. Furthermore, it is not clear whether these approaches enact change by operating on
similar or different psychological mechanisms. Understanding the processes involved in each of
these interventions will help inform recommendations for the optimal method(s) of treating OCD.
The purpose of the present study was to compare the process and outcome of a single session
of ACT and ERP for obsessional thoughts. Participants with obsessional thoughts of clinical
severity were randomly assigned to receive a brief (45-minute) intervention with the core
components of ERP (n=27), ACT (n=20), or an expressive writing control condition (n=9).
Participants obsessional symptoms were measured at pre-test and one week follow up using
(a) distress ratings during an in vivo behavioral approach task (BAT) and (b) the obsessions
subscale of the Obsessive Compulsive Inventory Revised (OCI-R; Foa et al., 2002). Process
variables were assessed at pre-test and one week follow-up using (a) participants ratings of
their willingness to experience their unwanted intrusive thought during the BAT and (b) a
measure of dysfunctional cognitions about intrusive thoughts (Interpretations of Intrusions
Inventory; III). Mixed ANOVAs were conducted to examine the effects of time and condition on
obsessional symptoms and process variables. Results showed that scores on both measures of
obsessional symptoms significantly decreased from pre-test to follow-up, but there were no
significant differences between the three conditions. Similarly, there were significant reductions
in willingness to experience intrusive thoughts and negative appraisals of intrusive thoughts
from pre-test to follow up in all conditions, but no differences were found between the
conditions. Correlational analyses were conducted to examine the relationship between
changes in process variables and changes in obsessional symptoms. We found that changes in
dysfunctional beliefs, but not in willingness to experience intrusive thoughts, were associated
with changes in obsessional symptoms in both the ACT and exposure conditions. Implications
for treatment and current conceptualizations of exposure and acceptance based treatments will
be discussed.
El Abordaje Cognitivo de las Compulsiones Mentales
Alberto Ferrer Botero.
1. Psicologa, Universidad de Antioquia, Medelln, Colombia, 2. Universidad del Norte,
Barranquilla, Colombia.
Abstract Central: El planteamiento fundamental de esta presentacin libre es mostrar que
entre Compulsiones Mentales y Pensamientos Automticos Disfuncionales pueden existir

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tantas diferencias como las establecidas por Salkovskis (1985, 1989) entre Obsesiones y
Pensamientos Automticos Disfuncionales. En esta presentacin se muestran cuatro
diferencias entre Compulsiones Mentales (CM) y Pensamientos Automticos Disfuncionales
(PAD): Las CM son una accin mental de carcter repetitivo que se ejecuta a partir de una
obsesin o con arreglo a ciertas reglas que deben cumplirse estrictamente, mientras que los
PAD son una evaluacin que el sujeto hace de un acontecimiento (interno o externo); El
objetivo de las CM es prevenir o reducir el malestar o prevenir algn acontecimiento o situacin
negativa, mientras que el objetivo de los PAD es sacar unas conclusiones sobre la situacin
vivida, sobre el sujeto que la vivi. sobre las circunstancias y sobre los otros; Las CM son una
accin mental a la cual se dedica el sujeto de forma voluntaria, aunque de manera repetitiva y
aparentemente incontrolable, mientras que los PAD son evaluaciones absolutamente
involuntarias; los sistemas de reglas que originan las CM estn relacionados con las Creencias
Intermedias Positivas, mientras los PAD estn relacionados con Creencias Intermedias y
Centrales negativas. A partir de estas 4 diferencias se trabaja en los factores que pudieran
haber influido en la formacin de las CM, en las consecuencias de la dedicacin a la CM, y en
las indicaciones que deben tenerse en cuenta para el tratamiento de las compulsiones
mentales.
Understanding the Not Just Right Experiences: OCD-Related Variables and Beyond
Gertrudis Forns, Amparo Belloch.
Personalidad, Universidad de Valencia, Valencia, Spain.
INTRODUCTION. Many patients with Obsessive Compulsive Disorder (OCD) report that their
compulsions are preceded by unpleasant sensations, feelings and/or perceptions that might be
even more disturbing than the obsessions and/or compulsions themselves. These experiences
have received different names (i.e. not just right experiences (NJREs), urge, incompleteness,
energy), although all of them refer to subjective sensory phenomena (SP). Research indicates
that SP are highly prevalent in OCD patients, and associations between incompleteness/NJREs
and obsessive personality traits, such as perfectionism and indecision, have been reported.
Nevertheless, the data are inconclusive, and no studies have examined the association
between the different proposed measures of SP and their putative relationships with non-OCD
variables, such as affective style and adult attachment. AIMS. To examine: (a) the relationships
between three measures of SP; and (b) the associations between SP and OCD-related
measures, as well as with depression, anxiety, affective style and adult attachment. METHOD.
Participants were 20 non-clinical last-year psychology students (80% women; age: M=22.95;
SD=2.76 years). Instruments: (a) SP measures: Obsessive Compulsive-Trait Core Dimensions
Questionnaire (OCTCDQ); Not Just Right Experiences-Questionnaire (NJREs-Q); Vancouver
Obsessional Compulsive Inventory-NJRE subscale; (b) OCD-related measures: Obsessive
Compulsive Inventory (OCI-R); Clark-Beck Obsessive Compulsive Inventory (C-BOCI);
Obsessive Beliefs Spanish Inventory (OBSI-R); Intolerance of Uncertainty Scale (IUS); Frost
Multidimensional Perfectionism Scale (FMPS); (c) Non-OCD measures: Affective Style
Questionnaire (ASQ); Adult Attachment Questionnaire (AAQ); Depression, Anxiety and Stress
Scale (DASS); Penn State Worry Questionnaire (PSWQ). RESULTS. Correlation analysis
showed associations between OCTCDQ-Incompleteness and VOCI-NJREs (r= .75; p<.001), but
no relationships between these two measures and NJRES-Q. The pattern of significant
associations (p .05) among the three measures of SP and the other variables was as follows:
(a) OCD measures: C-BOCI-obsessions (from r=.46 to r= .56), OCI-R-hoarding (from r=.57 to
r=.63) and order (r=.51, p<.05, to r=.58); OBSI-R responsibility (r=.47), intolerance to
uncertainty (from r=.51 to r=.68), perfectionism (from r=.57 to r=.63), and overestimation of
threat (r=.58); FMPS (from r=.53 to r=.64); (b) non-OCD measures: DASS-Stress (r=.47);

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PSWQ (r=.56); AAQ-need for approval (r=.45) and hostile conflict resolution (from r=.56 to
r=.70); ASQ-affective tolerating style (r=-.48). CONCLUSIONS. (a) The high associations found
between two measures of subjective experiences (OCTDCQ and VOCI-NJREs) indicate that
they are assessing a similar construct, whereas NJREs-Q seems to be evaluating a different
aspect of SP. (b) The SP are associated not only with some specific OCD symptoms
(obsessions, order and hoarding), OCD related dysfunctional beliefs (responsibility,
perfectionism, overestimation of threat, and intolerance to uncertainty) and general
perfectionism tendencies, but also with some aspects of adult attachment style and with a
negative affective style. Acknowledgement. Study supported by PSI2010-18340, MICIIN, Spain.
The Role of Personality in Disgust Experiences
Gertrudis Forns, Gemma Garcia-Soriano, Martha Giraldo-OMeara, Amparo Belloch.
Personalidad, Evaluacin y Tratamientos psicolgicos, Universitat de Valencia, Valencia, Spain.
Introduction. In addition to the disgust domains and disgust elicitors, some personality
dimensions have also been proposed as possible vulnerability factors to different mental
disorders (i.e., phobias, obsessive-compulsive disorder, eating disorders, or sexual
dysfunctions). However, little is known about the relationship between personality and disgust,
since only three studies have analysed the relationship between these two quite different
constructs. Results indicate that disgust is associated with neuroticism (N) and the behavioural
inhibition system (BIS). Nonetheless, these studies do not clarify the role played by other
personality dimensions, and none of the studies takes into consideration two different disgust
domains, propensity and sensitivity, and the different disgust elicitors. Aims.To examine the
relationship between personality dimensions and disgust domains and elicitors.Method. 304
non-clinical participants (mean age=33.47 (SD=13.72) years; 64.8% women)completed the
following instruments: HEXACO-Personality Inventory-Revised (100 items assessing HonestyHumility, Emotionality, eXtraversion, Agreeableness, Conscientiousness and Openness to
experience), BIS/BAS Scales (24 items, 2 scales:Behavioural Inhibition System and Behavioural
Approach System),Disgust Scale-Revised (DS-R, 27 items appraisingdifferent disgust elicitors:
core, animal reminder, and contamination-based), Disgust Propensity and Sensitivity Scale
(DPSS-R; 16 itemsassessing disgust sensitivity and propensity), and theAnxiety Sensitivity
Inventory-3.Results.Correlation analysis between disgust (DPSS; DS-R) and HEXACO
domains, revealed significant and moderate associations withEmotionality; low negative
associations withExtraversion, Agreeablenessand Openness; and low positive relationships with
Conscientiousness. Associations between disgust domains and elicitors and BIS/BAS scales
werelow and only significant with BIS. The same pattern of correlations was obtained when
controlling anxiety sensitivity. Five different regression analyses were conducted, withthe
differentdisgustsubscales as dependent variables and HEXACO and BIS/BAS as predictors.
Emotionality was the most relevant predictor of disgust, explainingbetween 21.5% (core disgust)
and 11.9% (propensity). Then, regression analyses were repeated, excluding emotionality.
Agreeableness, explaining between 6%-5% of the variance,and BIS, explaining between 8%3% of the variance, were the most significant variables in predicting the different domains and
elicitors of disgust. Conclusions.Findings support the relationship between Emotionality, BIS
and disgust elicitors. The same associations were found when distinguishing disgust sensitivity
and propensity. Moreover, low agreeableness appeared as a relevant domain explaining disgust
variance. Future studies are needed to analyse the role that emotionality, BIS, agreeableness
and disgust interactions may play in the vulnerability to developing different psychopathological
symptoms. AcknowledgementStudy supported by Grant PSI2010-18340 (Spanish Ministerio de
Ciencia y Tecnologa).

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Obsessional Contents: The Differential Role of Illness Fear, Disgust Vulnerabilities, and
Dysfunctional Beliefs
Gemma Garcia-Soriano1, Amparo Belloch1, Bonifacio Sandin2.
1. Universitat de Valencia, Valencia, Spain, 2. Universidad Nacional de Educacin a Distancia,
Madrid, Spain.
Introduction. Theoretical and research studies have analyzed the role of disgust in a range of
disorders. Regarding OCD, although studies have supported the association between disgust
and contamination OCD, there are some unsolved questions: Which is more relevant, disgust
propensity or sensitivity? Is disgust a general vulnerability OCD factor? Or is it specifically
associated with contamination OCD? Finally, what is the nature of this relationship? Is disgust
relevant because it motivates avoidance of disease? If this is the case, is illness/death fear
relevant in OCD? In order to answer to these questions, the present study aims to analyze the
relevance of disgust vulnerabilities in 6 different obsessional intrusive thought (OIT) domains,
taking into account the role played by illness fear, general (negative emotionality) and specific
OCD risk factors (obsessive beliefs). Method. 115 undergraduate participants (mean age=28.23
(SD=11.75) yr; 69.9% women) completed the following instruments: Disgust Propensity and
Sensitivity Scale-Revised (16 items, propensity and sensitivity scales); Aigle hypochondriasis
personality inventory (30 items, 5 hypochondriasis scales, only the illness/death fear scale will
be used); The Obsessional Intrusive Thoughts Inventory (48 items appraising the frequency of
six different OIT); HEXACO-Personality Inventory-Revised (100 items assessing 6 personality
domains; only the Emotionality scale will be used); Obsessive Beliefs Spanish InventoryRevised (50 items appraising 6 different obsessional beliefs). Results Correlation analyses
indicated moderate-large associations between some of the OIT contents (Contamination,
Doubt and Superstitious) and the remaining variables, and no significant associations with the
other OITs. A set of 6 different hierarchical regressions with each of the OIT dimensions as
independent variables were conducted to assess whether disgust propensity and sensitivity,
illness fear and OC beliefs significantly predict the frequency of OIT contents. Gender, age and
emotionality were controlled for by entering them as predictors in Step 1. Step 2 consisted of
disgust propensity and sensitivity and illness/ death fear, and the six OC belief domains were
entered as a final step. This final model was significant for all the OIT contents, except for Order
and Sexual/Religious OIT, explaining between 17.8% (sexual/religious OIT) and 33%
(contamination OIT) of the variance. Aggressive OITs were uniquely predicted by disgust
sensitivity and emotionality, and Doubt OITs by disgust propensity and overestimation of threat.
Contamination was predicted by illness fear, disgust propensity and over-estimation of death,
and Superstitious OITs by illness death and thought-action fusion likelihood (TAF-l). Discussion
Illness fear appeared as a relevant variable contributing to the variance of different obsessional
contents. Results confirm that disgust is relevant in the prediction of OCD symptoms,
independently of emotionality. Findings reveal that different disgust vulnerabilities may
differentially contribute to obsessional contents. Only overestimation of threat and TAF-l
contributed to the variance of different OIT contents. Acknowledgements. Study supported by
Spanish MICCIN (PSI2010-18340).
Impact of Cognitive-Behavioral Group Therapy for Patients with Obsessive-Compulsive
Disorder on Family Accommodation
Juliana Gomes, Aristides Cordioli, Elizeth Heldt.
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Introduction: Frequently family members of patients with Obsessive-compulsive disorder (OCD)
accommodate to the patients symptoms, such as cleaning and checking rituals. Previous

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studies showed that Family Accommodation (FA) predicts worst response to OCD treatment.
Objective: To examine the impact of cognitive-behavioral group therapy (CBGT) for OCD on
Family Accommodation (FA). Method: Clinical trial carried out at Hospital de Clnicas of Porto
Alegre, RS, Brazil. The sample comprised 20 patients with OCD diagnosis recruited to
participate in 12 CBGT sessions and 20 family members. Yale-Brown Obsessive-Compulsive
Scale (Y-BOCS), Obsessive-Compulsive Inventory - Revised (OCI-R), Beck Anxiety (BAI) and
Depression (BDI) Inventories were used to measure the intensity of obsessive and compulsive,
depression, and anxiety symptoms, respectively. FA was assessed by Family Accommodation
Scale (FAS-IR), translated and adapted into Brazilian-Portuguese. Instruments were applied
before and after CBGT. Results: Patients significantly reduced symptoms of OCD (before: 28.0
3.89; after: 12.7 8.86; p= <0.001), anxiety (before: 19.4 10.3; after: 11.7 13.2; p=0.001) and
depression (before: 17.5 8.62; after: 11.5 9.82; p=0.001) after CBGT, while family members
significantly reduced accommodation after intervention (before: 12.6 8.35; after: 5.70 6.28;
p=0.002). Predictors of FA reduction (Table) using of FAS and initial features of patients and
their family members were: patients with higher education level and family members with higher
scores on obsession, cleaning and OCI-R total domains. Conclusion: CBGT was effective both
for reducing the patients symptoms and FA phenomenon. This reduction correlated with the
patient having higher education level and with the family members presenting with OCD
symptoms in the treatment onset.
Tratamento Cognitivo-Comportamental em Grupo para o Transtorno ObsessivoCompulsivo
Luciana Gropo1, Lilian Pessoa1, Daniela Braga2, Moacyr Pires1.
1. Hospital Universitrio Oswaldo Cruz / C-TOC-PE, Universidade de Pernambuco, Recife,
Brazil, 2. Hospital de Clnicas de Porto Alegre, Universidade Federal do Rio Grande do Sul,
Porto Alegre, Brazil.
O Transtorno Obsessivo-Compulsivo (TOC) acomete 2 a 3% da populao geral, ocupando o
quarto lugar entre os transtornos psiquitricos mais frequentes. um transtorno aflitivo,
funcionalmente prejudicial e seus sintomas envolvem tanto os comportamentos (compulses,
evitao) e pensamentos (obsesses), quanto emoes (medo, desconforto, aflio). Por sua
gravidade, pode gerar prejuzos considerveis na qualidade de vida afetiva, social, acadmica
e profissional, tanto nas pessoas atingidas quanto em seus familiares, incapacitando seus
portadores em cerca de 10% dos casos. Apesar da possibilidade de mudanas na gravidade e
tipo de sintomas, quando no tratado, mantm-se ao longo da vida. De um tero a 50% dos
adultos iniciam seus sintomas na infncia. Apesar de fatores cognitivos, comportamentais e
familiares que interferem na etiologia e manuteno do transtorno serem diferentes no TOC
peditrico e no adulto, os sintomas do adulto so muitas vezes continuao dos sintomas
desenvolvidos na infncia. Tanto no TOC adulto como peditrico comum a participao direta
da famlia nos rituais. Esse fenmeno chamado de acomodao familiar, faz com que os
familiares assumam comportamentos inadequados, sobretudo de participao nas compulses
ou rituais, o que pode influenciar a piora ou manuteno dos sintomas. O TOC gera impacto
devastador nas famlias dos portadores, sendo elas menos saudveis em relao
comunicao, envolvimento afetivo e funcionamento geral. Atualmente, o tratamento
psicoterpico de primeira linha para o TOC a TCC que deve incluir a utilizao das tcnicas
comportamentais de exposio e preveno de resposta (EPR) e a modelao de
comportamentos adaptativos bem como as tcnicas cognitivas para a correo de
pensamentos e crenas disfuncionais para apoiar e fortalecer as estratgias comportamentais.
A dificuldade de acesso ao tratamento, sobretudo das populaes menos favorecidas, fez com
que surgisse a aplicao da tcnica sob a forma de terapia em grupo (TCCG). Essa

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modalidade alcanou 70% de resposta ao tratamento dos quais cerca de 27% com remisso
completa, alm disso pode facilitar o desenvolvimento da socializao, o compartilhamento de
informaes, equacionar a falta de adeso ao tratamento e a percepo aos pacientes de que
no so os nicos que experimentam as dificuldades. A aplicao da abordagem grupal
tambm feita crianas e adolescentes, e pode incluir ou no suas famlias como
participantes do grupo.Objetivo: Apresentar dois protocolos de tratamento cognitivocomportamental em grupo para TOC e um programa de orientao aos familiares dos
portadores. 1- Protocolo de 12 sesses de Terapia Cognitivo-Comportamental em Grupo para
adultos desenvolvido na Universidade do Rio Grande do Sul pelo professor Aristides Volpato
Cordioli ser apresentado por Daniela Tusi Braga; 2- Protocolo de 14 sesses de TCCG para
crianas e adolescentes desenvolvido para a pesquisa Smart do projeto do Instituto Nacional
de Psiquiatria do Desenvolvimento (INPD) ser apresentado por Lilian Pessoa; 3- Programa de
Orientao aos Familiares dos Portadores de TOC ser apresentado por Luciana Nagalli
Gropo desenvolvido no C-TOC/PE pela relatora.
Implicaes do Tratamento Grupal Para o Transtorno Obsessivo Compulsivo
Suely Guimaraes.
Psychology, Universidade de Brasilia, Brasilia, Brazil.
Abstract Central: O tratamento grupal de portadores de TOC foi um projeto de
pesquisa/interveno conduzido com o objetivo de investigar possveis ganhos no uso desse
formato em um intervalo de tempo definido. A tcnica utilizada foi a exposio e preveno de
resposta (ERP), aplicada nos mesmos moldes que na terapia individual. A hiptese que
motivou o trabalho foi a de que o uso do formato grupal implicaria economia de custos, tempo e
pessoal, enquanto o paciente teria um ganho importante durante o perodo definido. O trabalho
foi conduzido nas dependncias da clnica escola de psicologia da Universidade de Braslia. Os
pacientes eram recrutados por meio de chamada pela imprensa local, incluindo rdio, jornal e
televiso. Aqueles que buscavam o servio eram avaliados por uma bateria de instrumentos
que incluam o Yale Brown Obsessive Compulsive Scale e a Y-BOCS Symptom Check List. Os
pacientes admitidos no grupo haviam alcanado o mnimo de 20 pontos na YBOCS. As
sesses teraputicas aconteceram ao longo de trs anos e cada grupo, de no mximo oito
participantes, recebia atendimento por quatro meses, somando 16 sesses, com duas horas de
durao cada uma. Aps o encerramento acontecia uma sesso de seguimento ao final de seis
meses e outra ao final de 12 meses. Os resultaram confirmaram a hiptese que previa ganhos,
visto que os ndices obtidos pelos instrumentos reaplicados mostravam reduo dos sintomas e
a avaliao pessoal e annima de 100% dos pacientes mostraram ganhos relevantes e
suficientes para trazer melhor qualidade de vida. Os pontos positivos observados, especficos
do formato grupal, incluram: autoconfiana para assumir ser portador do transtorno, motivao
para usar a ERP e confiana na remisso dos sintomas ao observar os resultados dos pares, e
insight quanto ao aumento gradual da exposio, chegando a sugerir prximos passos para os
pares. Aspectos negativos no eram esperados, mas foi observado que pacientes portadores
de comorbidades demonstravam expectativa ou necessidade de trabalhar queixas que no
eram foco do tratamento, voltado exclusivamente para o TOC. Ainda assim, mesmos para
esses pacientes, os resultados foram substancialmente positivos, comparados com a
experincia clnica no formato individual.
Metamemory and Memory for Disorder Relevant Material in Checkers - Is It Real or Just
Perceived Memory Impairment?
Jana Hansmeier1, Julia Glombiewski1, Winfried Rief1, Cornelia Exner2.

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1. University of Marburg, Marburg, Germany, 2. University of Leipzig, Leipzig, Germany.


Background: Obsessive Compulsive (OC) checkers have been shown to be impaired on many
types of memory tasks, such as visual and verbal episodic memory. One factor which could
account for memory impairment in checking are metacognitions, particularly a decreased
confidence in own cognitive abilities. First studies indicate a decreased general trait cognitive
confidence in checkers, which may constitute a vulnerability factor for developing checking
behavior. However, cognitive confidence on trait level has never been investigated in relation to
memory performance of checkers. Additionally, cognitive confidence seems to be especially
decreased when using OC specific material. This study compares verbal episodic memory
performance of subjects with different levels of checking using newly developed OC specific
material. The study puts special focus on the role of trait cognitive confidence. Method: Verbal
memory performance at immediate and delayed recall was tested for 63 participants (26
patients with Obsessive Compulsive Disorder). Neutral stories (subtest Logical Memory of the
Wechsler Memory Scale) and equivalently developed OC specific stories containing checking
and washing material were applied. Checking was measured dimensionally by the Padua
Inventory. The sample was divided into high checkers and low checkers. Cognitive confidence
was measured by the Metacognitions Questionnaire (MCQ). A two (High-Checkers vs. LowCheckers) x 2 (immediate vs. delayed recall) x 2 (checking vs. washing material) ANOVA was
applied for the main analysis. Results: High checkers recalled significantly more than Low
Checkers (F (1,57) = 4.56, p = .037). However, they also forgot more over the delay period than
low checkers indicated by an interaction effect (F (1,57) = 9.99, p = .003). Additionally, a
significant interaction effect (F(1,57) = 4.07, p = .048) indicated that only checkers recalled the
checking material significantly better than the washing material at immediate recall. Differences
in rate of forgetting were mediated by decreased cognitive confidence (95 % CI 0.033 - 0.557,
B= 0.19, SE = 0.12). The results were specific to OC related material. No differences between
high and low checkers appeared in a second ANOVA with the neutral material. Discussion: Our
study indicates two mechanisms playing a role in relation to memory performance of high
checkers: There might be an attention bias for checking related stimuli that facilitates encoding
and short-term retention. However, delayed recall seems to be handicapped by low cognitive
confidence. These findings have important implications for treatment. Teaching strategies to
improve mnestic functioning could lead to a further decrease of confidence in memory, whereas
treatment including metacognitive methods might contribute to a reduction of both cognitive
impairment and OC symptoms.
Metamemory and Memory for Disorder Relevant Material in Checkers - Is it Real or Just
Perceived Memory Impairment?
Jana Hansmeier1, Julia Glombiewski1, Winfried Rief1, Cornelia Exner2.
1. University of Marburg, Marburg, Germany, 2. University of Leipzig, Leipzig, Germany.
Abstract Central: Background: Obsessive Compulsive (OC) checkers have been shown to be
impaired on many types of memory tasks, such as visual and verbal episodic memory. One
factor which could account for memory impairment in checking are metacognitions, particularly
a decreased confidence in own cognitive abilities. First studies indicate a decreased general
trait cognitive confidence in checkers, which may constitute a vulnerability factor for developing
checking behavior. However, cognitive confidence on trait level has never been investigated in
relation to memory performance of checkers. Additionally, cognitive confidence seems to be
especially decreased when using OC specific material. This study compares verbal episodic
memory performance of subjects with different levels of checking using newly developed OC
specific material. The study puts special focus on the role of trait cognitive confidence. Method:

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Verbal memory performance at immediate and delayed recall was tested for 63 participants (26
patients with Obsessive Compulsive Disorder). Neutral stories (subtest Logical Memory of the
Wechsler Memory Scale) and equivalently developed OC specific stories containing checking
and washing material were applied. Checking was measured dimensionally by the Padua
Inventory. The sample was divided into high checkers and low checkers. Cognitive confidence
was measured by the Metacognitions Questionnaire (MCQ). A two (High-Checkers vs. LowCheckers) x 2 (immediate vs. delayed recall) x 2 (checking vs. washing material) ANOVA was
applied for the main analysis. Results: High checkers recalled significantly more than Low
Checkers (F (1,57) = 4.56, p = .037). However, they also forgot more over the delay period than
low checkers indicated by an interaction effect (F (1,57) = 9.99, p = .003). Additionally, a
significant interaction effect (F(1,57) = 4.07, p = .048) indicated that only checkers recalled the
checking material significantly better than the washing material at immediate recall. Differences
in rate of forgetting were mediated by decreased cognitive confidence (95 % CI 0.033 - 0.557,
B= 0.19, SE = 0.12). The results were specific to OC related material. No differences between
high and low checkers appeared in a second ANOVA with the neutral material. Discussion: Our
study indicates two mechanisms playing a role in relation to memory performance of high
checkers: There might be an attention bias for checking related stimuli that facilitates encoding
and short-term retention. However, delayed recall seems to be handicapped by low cognitive
confidence. These findings have important implications for treatment. Teaching strategies to
improve mnestic functioning could lead to a further decrease of confidence in memory, whereas
treatment including metacognitive methods might contribute to a reduction of both cognitive
impairment and OC symptoms.
Classifying Obsessions and Compulsions with Two Dimensional System: Harm
Avoidance / Completeness and In / Out
Hiroaki Harai1, 2, Miyo Okajima1, 2.
1. Nagoya Mental Clinic, Nagoya, Japan, 2. Kikuchi National Hospital, Division of Clinical
Research, Koushi, Japan.
Abstract Central: There is increasing recognition that symptoms of obsessive-compulsive
disorder (OCD) may be associated not only with harm avoidance, but also with urge to seek
completeness. As to the former, fear of germs, contaminations or any future harm are typical
example. As to the latter, preoccupations with orderliness, perfectionism or ding things just
right are typical. Today, there is a large body of researches supporting these two independent
constructs. However, this categorization does not address who is to be harmed and when and
what is to be completed. It is well-known the fear of harm and urge to seek completeness are
related with the sense of personal responsibility. OCD patients are not preoccupied with harms
imposed on unrelated people and incompletes in uninterested area. This paper proposes
another dimension to categorize OCD; who to be harmed and when to be completed. We
propose a direction of in or out to be applied to harm avoidance and completeness, making two
by two matrixes. Harm avoidance is classified into harming oneself or other, and completeness
is into completing initiation or termination. We applied this two dimensional classification system
to eleven patients who participated in a three days intensive group behavior therapy program
(3DI). 3DI is a structured exposure and response prevention program using natural
environments and group interactions. Each patients experience in vivo and imaginal exposure
for his / her feared items. They often experience vicarious exposure through witnessing other
members exposure experiences and find other unexpected triggers of fear or urge for rituals.
For the purpose of response prevention, not only withholding hand washing for three or two
days, but also mindfulness training and habit reversals are employed. We arranged eleven
patients based on the category and made a buddy system. A patient who has a fear of harming

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others partners with another patient who has a fear of haring oneself, and the former was
encouraged to harm the latter. A patient who has rituals triggered by initiation partners with a
patient triggered by termination. The former prevents the latter to finish things completely. The
treatment results of the eleven patients suggest this treatment strategy based on the two
dimensional classification system works well to fully expose patients to fear and urge.
Theoretical and clinical implications are discussed.
Subscales of the Obsessive Compulsive Inventory-Revised and Event-Based Prospective
Memory
Lynne Harris.
School of Psychological Sciences, Australian College of Applied Psychology, Sydney, NSW,
Australia.
Abstract Central: Understanding factors maintaining obsessive compulsive disorder (OCD)
subtypes is critical for developing effective treatment. Poor prospective remembering has been
reported in subclinical samples with elevated OCD checking scores (Cuttler & Graf, 2008) and
in a clinical sample with OCD checking (Harris, Vaccarro, Jones, & Boots, 2010). It has been
argued that prospective memory problems are specific to subclinical and clinical OCD checking
and may contribute to maintaining OCD checking. In contrast, Harris and Cranney (in press)
found that a subclinical sample selected for high scores on the Obsessive-Compulsive
Inventory-Revised (OCI-R) obsessing subscale performed worse on a measure of prospective
memory than a sample selected for low scores. The purpose of the present study was to
examine the relationship between scores on the subscales of the OCI-R and performance on
matched event-based prospective memory and retrospective recognition memory tasks in a
student sample (n=108). Scores on the OCI-R obsession subscale were significantly negatively
correlated with performance on the prospective memory test, but not the retrospective memory
test. Neither OCI-R checking or OCI-R washing subscales were significantly correlated with
performance on the memory tasks. The findings are consistent with the view that the presence
of obsessions is related to poor prospective memory, regardless of the degree of concurrent
compulsive behavior. The findings have implications for theories proposing that prospective
memory deficits are causally related to OCD checking.
Superstitious Behaviour in Iceland During and After the Global Financial Crisis Simulates
the Aetiology of Obsessive-Compulsive Disorder
Fjola Dogg Helgadottir1, Ross Menzies2, Mark Jones3.
1. Department of Psychiatry, University of Oxford and AI-Therapy, Oxford, United Kingdom, 2.
University of Sydney, Sydney, NSW, Australia, 3. University of Queensland, Brisbane, QLD,
Australia.
Abstract Central: Superstitious behaviour was measured in an Icelandic undergraduate
sample in December 2007, 2008, and 2009. The first survey was conducted in the peak years of
Icelands financial prosperity. In 2008 Iceland experienced the biggest financial collapse, relative
to its size, that any country has ever experienced in what has become known as the Global
Financial Crisis (GFC). The second survey was administered shortly after the collapse and the
third survey was administered one year later. The frequency of superstitious behaviours
increased significantly during this time. The results show ecologically valid data suggesting that
a real stressor, such as the collapse of a countries economy, may increase superstitious
behaviours. This naturally occurring phenomenon in the Icelandic culture sheds light on the
aetiology of obsessive-compulsive disorder. Implications of this research will be discussed.

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Innovative Technology Recommendations for CBT with Postpartum OCD


Lisa Hoyman, Rosa Poggesi, Melissa Tamas, Robert Friedberg.
Palo Alto University, Palo Alto, CA, USA.
Obsessive-compulsive disorder is often developed during pregnancy or postpartum and
involves intrusive thoughts about harm to ones newborn (Abramowitz, Schwartz, Moore, &
Luenzmann, 2003). The evidence-based treatment approach of cognitive behavioral therapy
(CBT) is the method of choice for treating OCD in general and postpartum OCD specifically.
Recently, advances in technology such as smartphone and tablet applications (apps) have
augmented traditional CBT (Boschen, & Casey, 2008). However, applications specific to
postpartum OCD are nonexistent. Telephone and tablet apps provide an easy tool for tracking
emotions, thoughts, behaviors, and goals. Applications provide clinicians with real-time updates
of patient progress, homework assignments, and may increase motivation and consistency of
treatment. This poster suggests an outline for elements that would be helpful in the design of an
application for postpartum OCD. Modular elements of CBT treatment recommended for
inclusion are: psychoeducation, cognitive restructuring, mindfulness, and exposure and
response prevention (ERP) (Whittal, & McLean, 1999). Specific interventions and exercises
should include lists of coping strategies, access to homework assignments, behavior and
thought records, a means for tracking progress, links to pertinent information, and email
capability. The user-friendly format of the application will be implemented for smartphones and
tablets, with a home screen that offers different selections. These options will include the
following: Get the Facts (book icon), Practice Exercises (barbell icon), Progress (graph icon),
and a Settings (gear icon) feature. Get the Facts introduces psychoeducation about CBT,
provides information about newborns, postpartum, and OCD and offers links to additional
resources. An option to have these resources individually pop-up each day is suggested for
mothers who would like to remain apprised of different facts about their motherhood anxiety and
to ensure a solid understanding of the goals and process of CBT. Practice Exercises include
Train Your Brain (brain icon), Exposures (ladder icon), and Mindfulness (3-stacked stones icon)
options. Train Your Brain focuses on cognitive restructuring and includes the use of thought
records to log intrusive obsessions as well as the resulting compulsions and associated
emotions. Exposures (part of ERP) involves creating a hierarchy of distressing situations, using
a subjective units of distress (SUDS) rating scale. The ability to customize exposures is
available including the option to upload pictures or types of situations that cause distress to the
new mother. A Progress option is an important part of keeping track of success in therapy.
Graphs of SUDS ratings, mood, and the occurrence of obsessions/compulsions comprise this
module. An email feature to send progress information and completed homework is also
included in the app to be sent to the therapist. A Settings icon allows the user to customize
homework assignments, exercises, pop-up features, and privacy options, among other things.
The proposed application will be described in greater detail with preliminary sketches of the app
available.
Effects of Mindfulness Interventions in Obsessive-Compulsive Disorder
Vinicius Jobim Fischer1, Thiago Wendt Viola1, 2.
1. Faculty of Psychology, Pontifical University Catholic of Rio Grande do Sul, Porto Alegre,
Brazil, 2. Post-Graduate Program in Psychology, Centre of Studies and Research in Traumatic
Stress, Pontifical University Catholic of Rio Grande do Sul, Porto Alegre, Brazil.

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Introduction: Mindfulness can be shortly described as a process of intentionally bringing


awareness to moment-by-moment experience, without judgment thoughts that arise. The use of
mindfulness in a psychotherapeutic way has grown significantly in the last years and it has been
applied in the treatment of both affective and anxiety disorders. There are several studies
showing a significant reduction of mood and anxiety symptoms due mindfulness training
programs. However, little is known, about the potential benefits of mindfulness in the obsessivecompulsive disorder (OCD) therapeutic process. Objectives: This study aims to investigate the
effects of mindfulness interventions for patients diagnosed with OCD. Methods: A systematic
review of the literature was conducted in MEDLINE and PsycINFO to identify studies which
have proposed to verify mindfulness interventions for patients with OCD. Results: 12 studies
met the inclusion criteria and were reviewed. Data analysis is in process. Preliminary data
suggests that Mindfulness programs ought to be considered an important tool for the treatment
of OCD, complementary to psychopharmacology and psychotherapy. Studies have indicated a
relief on OCD symptomatology after intervention.
Are Obsessive Compulsive Symptoms Related to Depersonalization?: An Empirical
Evaluation
Rafael Kichic1, 2, Fernando Torrente1, 2, Pablo Lpez1, 2, Marcelo Cetkovich1, 2, Mauricio Sierra3.
1. Anxiety Clinic, Institute of Cognitive Neurology, Buenos Aires, Argentina, 2. Institute of
Neurosciences, Favaloro University, Buenos Aires, Argentina, 3. Depersonalization Disorder
Unit, Institute of Psychiatry, University of London, London, United Kingdom.
Depersonalization (DP) is a complex and poorly-understood clinical phenomenon characterized
by a constellation of symptoms other than derealization. Current views on DP, use this term to
describe symptoms, such as, anomalous body experiences (ABE), emotional numbing (EN),
anomalous subjective recall (ASR), and derealization (DR). There is ample evidence supporting
an association between DP and anxiety or panic symptoms at all levels of clinical severity. Early
observations made by clinical psychiatrists suggest that this relation is particularly noticeable
between obsessional anxiety and DP (Shorvon, 1946; Torch, 1978). Although research in OCD
samples suggests an association between checking rituals and symmetry/ordering compulsions
with DP and DR symptoms, these studies used a general measure of dissociation that do not
comprehensively assess all the variants of DP. In addition, previous studies did not explore
whether this relation can be explained for anxiety or panic symptoms. Thus, it remains unclear
the nature of this relation and if this relation can be explained by general psychopathology. The
aim of this study was to investigate the relationship between OCD symptoms and the different
variants of DP in 70 adults with anxiety disorders. DSM-IV diagnosis was established with a
semi-structured interview by an expert in anxiety disorders. Participants filled in the Cambridge
Depersonalization Scale (CDS), the Obsessive Compulsive Inventory-Revised (OCI-R), the
State Trait Anxiety Inventory, and the Body Sensations Questionnaire. Correlation and
multivariate regression analyses were used to assess the contribution of OCD symptoms to
predict the different variants of DP. Results indicated that all the OCI-R subscales were
significantly correlated to the CDS total score. The symmetry/ordering, obsessing, hoarding, and
washing subscales were significantly correlated to three of the four CDS subscales. After
controlling for panic, correlations remained unchanged. When controlling for trait anxiety
correlations between OC symptoms and DP were reduced and only a few remained significant.
Multiple linear regressions showed that the obsessing subscale, trait anxiety, and panic
symptoms predicted overall depersonalization severity. More specifically, the symmetry/ordering
subscale and panic symptoms emerged as significant predictors of ABE and ASR symptoms.
Checking rituals only predicted ASR symptoms. In addition, trait anxiety uniquely predicted CDS
numbing and CDS-DR scores. These patterns of results partially support the hypothesis that

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OCD symptoms are related to DP. Our findings suggest that trait anxiety predicts symptoms of
DP frequently found in anxiety disorders, and mediates the relation between OCD symptoms
and DP. Future studies should explore these relationships in OCD samples. In addition, future
studies should examine if more specific obsessional symptoms, such as, metaphysical
preoccupations, obsessions about fate and time commonly found in depersonalization disorder
are related to DP.
Validation of the Depressive and Obsessive Reassurance Seeking Scale (DORSS):
Results from a Clinical Sample
Hannah Levy, Adam Radomsky.
Department of Psychology, Concordia University, Montreal, QC, Canada.
Excessive reassurance seeking (ERS) is the solicitation of safety-relevant information about a
threatening object or situation, despite having already received this information. ERS was first
conceptualized in individuals with depression, but is more likely a transdiagnostic phenomenon
that is present in individuals with obsessive-compulsive disorder (OCD) and other anxiety
problems. Empirical research on the role of ERS in the onset, maintenance, and exacerbation of
OCD symptoms is in its infancy. For this reason, there is a paucity of measures available to
assess ERS in OCD. The current study aimed to validate a self-report measure of reassurance
seeking behaviour called the Depressive and Obsessive Reassurance Seeking Scale (DORSS)
in a clinical sample of individuals with anxiety disorders (N = 50), some of whom met diagnostic
criteria for OCD (n = 14). Participants completed a diagnostic interview and self-report
questionnaires including the DORSS and measures of related constructs (e.g., OCD symptoms
as assessed by the Vancouver Obsessional-Compulsive Inventory, VOCI; intolerance of
uncertainty as assessed by the Intolerance of Uncertainty Scale, IUS). Pearson correlations and
hierarchical multiple regressions were used to assess convergent validity of the DORSS with
these measures. The DORSS was positively correlated with VOCI scores (r = .44, p < .001) and
with IUS scores (r = .54, p < .001). A subsequent hierarchical multiple regression revealed that
VOCI scores contributed a significant amount of variance in DORSS scores after controlling for
scores on the Beck Anxiety Inventory (BAI; R2 = .12, F = 7.01, p = .011), suggesting that the
DORSS is a valid and reliable measure of reassurance seeking. Results will be discussed in
terms of cognitive-behavioural assessment and treatment of anxiety disorders.
Brain Regions Related to Fear Extinction in Obsessive-Compulsive Disorder and Its
Relation to Exposure Therapy Outcome: A Morphometric Study
Clara Lpez-Sol1, 2, Miquel Fullana3, 4, Narcs Cardoner1, 5, Pino Alonso1, 5, Marta Subir1,
Jesus Pujol6, Cinto Segals1, 2, Eva Real1, 2, Jose Menchon1, 5, Carles Soriano-Mas1, 2.
1. Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain, 2.
CIBERSAM, Carlos III Health Institute, Barcelona, Spain, 3. Institute of Neuropsychiatry &
Addictions (INAD), Hospital del Mar & Department of Psychiatry, Autonomous University of
Barcelona, Barcelona, Spain, 4. Kings College London, Institute of Psychiatry, London, United
Kingdom, 5. Department of Clinical Sciences, School of Medicine, University of Barcelona,
Barcelona, Spain, 6. CRC Mar, Hospital del Mar, Barcelona, Spain.
BACKGROUND The size of particular sub-regions within the ventromedial prefrontal cortex
(vmPFC) has been associated with fear extinction in humans. Exposure therapy is a form of
extinction learning widely used in the treatment of obsessive-compulsive disorder (OCD). Here
we investigated the relationship between morphometric measurements of different sub-regions
of the vmPFC and exposure therapy outcome in OCD. METHOD Seventy-four OCD patients

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and 86 healthy controls underwent Magnetic Resonance Imaging (MRI). Cortical thickness and
volumetric measurements were obtained for the rostral anterior cingulate cortex (rACC), the
medial orbital frontal cortex (mOFC) and the subcallosal cortex. After MRI acquisition, patients
were enrolled in an exposure therapy protocol, and we assessed the relationship between MRIderived measurements and treatment outcome. Baseline between-group differences for such
measurements were also assessed. RESULTS Compared to healthy controls, OCD patients
showed a thinner left mOFC (p<0.005) and a bilateral thinning of the rACC (p<0.001). Left rACC
thickness was inversely associated with exposure therapy outcome (r=-.33, p=0.005), and this
region was significantly thinner in OCD patients who responded to exposure therapy than in
those who did not (p=0.003). Analyses based on regional volumetry yielded overall nonsignificant results. CONCLUSIONS Although OCD patients showed cortical thickness
reductions in different sub-regions of the vmPFC, only those alterations located in the rACC
were related to exposure therapy outcome. The precise characterization of neuroimaging
predictors of treatment response derived from the study of the brain areas involved in fear
extinction may optimize exposure therapy planning in OCD and other anxiety disorders.
INNOVATIVE APPLICATIONS OF COGNITIVE BEHAVIOUR THERAPY IN THE
TREATMENT OF COMPULSIVE DISORDERS
Mariska Mantione, Charlotte Molenaar, Mariska Mantione, Arjan Schrder, Charlotte Molenaar.
Psychiatry- Anxiety Disorders, Academic Medical Center, Amsterdam, Netherlands.
Objective
The research program of the department of anxiety disorders of the Academic Medical Center
focuses on all facets of compulsivity and anxiety in a translational and multidisciplinary
approach. Research often leads to new approaches of existing treatments like cognitive
behavioural therapy (CBT). The objective of this symposium is to present new applications of
CBT in obsessive-compulsive disorder (OCD), misophonia and body dismorphic disorder (BDD)
and discuss the effectiveness of the treatment programs.
Methods
Innovative CBT programs for additional CBT in deep brain stimulation (DBS) for OCD as well as
for CBT in the treatment of misophonia and for CBT in the treatment for BDD in combination
with pharmacotherapy have been developed. The methodology and mechanism of action of the
treatment programs will be explained, using video demonstrations and case illustrations.
Scientific research on the clinical effectiveness of CBT will be presented for all three psychiatric
disorders.
Results
CBT can be an effective treatment as addition to DBS for OCD and as group therapy for
misophonia and BDD.
Conclusion
These studies have used innovative applications of CBT in the treatment of compulsive
disorders. The methodology of the CBT programs might have implications to the way that
clinicians recognize and treat this disorders.
CBT AS ADDITION TO DEEP BRAIN STIMULATION IN OBSESSIVE-COMPULSIVE
DISORDER
Objective
Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder that, if left untreated,
has a chronic course. At present, clinical management of OCD consists of pharmacotherapy
and cognitive behaviour therapy (CBT). Although often effective, both treatments have their
limitations: patients usually have only a partial response to medication and CBT. Besides,

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medication can have significant side effects and the exposure and response prevention in CBT
often provokes intense anxiety, resulting in a 25% drop out of patients. Eventually, 10% of
patients with OCD do not respond adequately to current treatments and remain severely
affected. In the last decade, a new treatment for therapy-refractory OCD patients has emerged:
deep brain stimulation (DBS). DBS is an adjustable, reversible, non-destructive neurosurgical
intervention using implanted electrodes to deliver electrical pulses to areas in the brain. DBS at
different brain targets has demonstrated to be an effective treatment for therapy-refractory OCD
patients. DBS certainly is a promising technique, but does not lead to remission of symptoms in
most patients. Therefore, the treatment still needs to be improved by optimizing the brain target,
the adjustment of electrode settings, the selection of patients and the post-operative
management. The aim of this presentation is to discuss additional CBT as a strategy that
augments the effectiveness of post-operative management in DBS.
Methods
The results from our own study on the effectiveness of DBS for therapy-refractory OCD and
additional CBT will be presented. During the past years we have developed a standardized CBT
program as addition to DBS treatment at our department. We will discuss the methodology of
the CBT program, which consists of cognitive therapy and exposure and response prevention,
but is adjusted on several points to suit this group of severely ill, therapy-refractory patients.
Video demonstrations will clarify the methodology and necessity of CBT. Finally, the mechanism
of action of CBT in DBS treatment will be discussed.
Results
It is our impression that CBT is needed to realize further improvement in symptoms after DBS
treatment. DBS seems to reduce anxiety and depression symptoms and CBT uniquely
obsessive-compulsive symptoms.
Conclusion
We hypothesize that DBS is not optimal as a stand-alone treatment but should be seen as a
combination of two complementary treatments: DBS as a neurosurgical treatment and CBT as a
psychiatric/ psychological treatment.
CBT IN THE TREATMENT OF MISOPHONIA
Objective
Misophonia (hatred of sound) is a condition in which people experience impulsive aggression
following specific sounds. These sounds are commonly produced by other human beings, for
example lipsmacking, sneezing or typing. The intensity of the anger causes a profound feeling
of loss of self-control. However, aggressive outbursts are rare. Patients avoidance of
misophonic situations, like dinners, results in limited social contacts and functioning. As of yet,
there is no literature on the aetiology, prevalence or incidence. However, on the internet several
misophonia newsgroups and networks exist, indicating it may occur more often. Misophonia
shares similarities with obsessive-compulsive and impulse control disorders. Recently,
diagnostic criteria have been formulated by Schrder, Vulink and Denys to distinguish it as a
separate psychiatric disorder. The aim of this presentation is to increase knowledge about this
new psychiatric disorder and to discuss CBT as a potential effective treatment.
Methods
The first results on the clinical effect of CBT for misophonia will be presented. During the past
year we have developed a special group therapy for misophonia, consisting of 8 sessions of
cognitive behavioural therapy (CBT) and psychomotor therapy (PMT). In this presentation we
will first explain the neurobiological model of misophonia. We will then show that, by using such
a model, an effective treatment can be developed, using established CBT techniques like
counter-conditioning and task concentration training. To enable counter-conditioning patients
use stimulus manipulation and create mood boards and movies of desirable associations with
their hatred sounds. By demonstrating this material we will discuss the methodology of our

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therapy program for misophonia.


Results
So far, more than 40 patients have been treated successfully. Despite a persistent hyperfocus
on sounds, feelings of anger and loss of self-control and hinder in daily life decreased
significantly after 8 sessions of group CBT.
Conclusion
Group CBT can be an effective treatment for misophonia.
A GROUP CBT MODEL FOR BODY DISMORPHIC DISORDER
Objective
Body Dysmorphic Disorder (BDD) is a chronic and severe psychiatric disorder which affects 0.7
- 2.4 % of the general population. BDD patients have egosyntonic and in some cases delusional
beliefs about imagined defects or slight anomalies in their appearance. They have extensive
rituals, like mirror checking and seeking reassurance from others, and widespread avoidance
behaviors. High rates of suicide attempts, severe impairment in psychosocial functioning and
decrease in daily functioning are very common among BDD patients. Treatment guidelines
prescribe individual Cognitive Behavioural Treatment (CBT) and/or pharmacotherapy (SSRI).
Both treatments have disadvantages and full remission rates are rarely reached. During the past
years we have developed the first CBT group therapy for BDD worldwide. The aim of this
presentation is to explore group CBT, with and without medication, as an effective treatment for
BDD.
Methods
Our CBT program is based on altering negative appraisal of body imaging and core beliefs as
well as extinction of conditioned fear. Patients receive a 16-week intensive group program,
consisting of cognitive training, exposure therapy, psychomotor therapy (PMT), mirror training
and task concentration training. The efficacy of our CBT group program with and without
pharmacotherapy has been studied in an open label study.
In this presentation we will explain the CBT model for BDD and then discuss the advantages of
group therapy over individual therapy in BDD. Using case presentations we will explain the
methodology of our therapy program and show several specific CBT techniques for BDD.
Furthermore, we will present the preliminary scientific results about the efficacy of group CBT
without pharmacotherapy and in combination with pharmacotherapy.
Results
Patients who received group CBT showed significant improvements from baseline to end of
CBT treatment on BDD symptoms. Patients who received a combination of SSRI and CBT
showed significant improvement on BDD symptoms, anxiety and depression. We found no
significant group differences between CBT and the combination of SSRI and CBT, though the
number of responders was larger in the SSRI and CBT group compared to CBT only.
Conclusion
The CBT model is an understandable and a essential part of CBT. It will subsequently lead to
involvement in and motivation for treatment-strategies in CBT. The combination of
pharmacotherapy and CBT could be preferable for mildly to severely affected BDD patients.
The Relative Impact of Cognitive Processes on Self-Report and Behavioural Indices
during a Sorting Task for Young People with OCD and Controls
Sharlene Mantz1, Maree Abbott1, Margot O'Brien2.
1. Psychology, University of Sydney, Sydney, NSW, Australia, 2. RIvendell Child, Adolescent,
and Family Services, Sydney, NSW, Australia.
Abstract Central: Background: Six belief domains are hypothesised to be key factors in the
development and maintenance of OCD. However, experimental research assessing the role of

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cognitive factors amongst children with OCD is sparse and lacks a control group or clinical
sample. This proves problematic for the appraisal model in asserting that the belief domains are
specific and important factors in the development and expansion of obsessions and compulsive
behaviour. Aims: The current study seeks to further explore the role of cognitive processes in
provoking anxiety and compulsive behaviours in young people with OCD, using an experimental
design and a control and clinical sample. Method: 30-40 young people with a primary diagnosis
of OCD and 30-40 control children meeting no Axis I diagnosis, aged 8 to 17 years, will
complete a sorting task designed to either increase or decrease anxiety. Hypotheses: It is
expected that clinical (OCD) children in the high anxiety condition will take longer to complete
the task, check and show more hesitation, report higher state anxiety, and rate higher on
cognitive appraisals compared to non-clinical participants in the high anxiety condition. It is also
expected that both threat and responsibility appraisals will explain unique variance in state
anxiety scores and time taken to complete the sorting task. Preliminary Results: OCD
participants show relatively higher mean scores on trait symptom measures, anticipatory
anxiety, and time spent completing the sorting task. Further, significant positive correlations
have been observed between threat ratings and time taken sorting. Expected Outcomes:
Completion of this study will inform the development of cognitive models of OCD in young
people and ultimately enhance therapeutic strategies to better support these individuals and
their families.
A Eficcia da TC em Comparao EPR no Tratamento do TOC
Camila Martiny, Paula Ventura, Antonio Nardi.
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract Central: A eficcia da terapia cognitiva em comparao exposio e preveno de
resposta no tratamento do transtorno obsessivo-compulsiv O transtorno obsessivo-compulsivo
(TOC) caracterizado pela presena de obsesses e compulses. A prevalncia deste
transtorno de 2,5 por cento para toda a vida, muitos indivduos portadores do TOC passam
grande parte da sua vida sem receber tratamento adequado. O objetivo deste trabalho
verificar, atravs de uma reviso bibliogrfica, a eficcia da terapia cognitiva (TC), que vem
sendo estudada como uma possibilidade para o tratamento do TOC, em comparao
exposio e preveno de resposta (EPR), cujos benefcios j so amplamente difundidos. De
acordo com os preceitos da terapia cognitiva (TC) para o TOC, certos indivduos, devido
presena de crenas preexistentes atribuem significado catastrfico e distorcido ocorrncia
de pensamentos intrusivos (obsesses normais), fazendo com que estas ganhem
caractersticas de obsesses anormais, causando sintomas fsicos e emocionais, como
ansiedade, culpa, sudorese, taquicardia, dentre outros. Determinadas crenas podem
desempenhar uma funo em tal processo, como: tendncia a superestimar a importncia dos
pensamentos, necessidade de controlar os pensamentos, tendncia a super estimar o risco,
necessidade de ter certeza, perfeccionismo, excesso de responsabilidade acerca dos fatos e
baixa tolerncia ansiedade. O objetivo da TC no TOC proporcionar ao paciente o
questionamento dos pensamentos automticos e crenas subjacentes ao transtorno, para que
este possa reestrutur-las e assim criar novas interpretaes acerca dos pensamentos
intrusivos e estratgias de enfrentamento funcionais. Embora algumas pesquisas demonstrem
que a terapia de Exposio e preveno de respostas (EPR) a mais eficaz para o tratamento
do TOC, a TC pode atuar de modo bem satisfatrio em formas particulares de sintomas, como:
obsesses sexuais, agressivas e religiosas; e rituais mentais. De uma maneira geral, ambas
abordagens so consideradas eficazes para o tratamento do TOC, o que proporcionaria um
aumento no nmero de opes teraputicas. Assim, pacientes que no aderem ou so
refratrios ao tratamento de EPR , podem ter na TC, uma chance de recuperao. Os

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indivduos que pertencem a certos subgrupos de pacientes, como: pacientes puramente


obsessivos, tambm podem beneficiar-se da TC Cognitive therapy effectiveness in comparison
to exposure and response prevention in obsessive-compulsive treatment.
An Investigation of the Perceived Acceptability and Feasibility of Time-Intensive CBT for
OCD from the Perspectives of the Service User and Therapist
Josie Millar, Paul Salkovskis.
Psychology, University of Bath, Bath, United Kingdom.
Abstract Central: Cognitive Behavioural Therapy (CBT) is an effective treatment for OCD, with
several randomised controlled trials yielding clinically significant effects in the reduction of OCD
symptomatology (Abramowitz, 1997). Despite proven effectiveness many clients remain
symptomatic following the completion of treatment (Stanley & Turner, 1995). Research indicates
that the average OCD symptom reduction across studies is 48% (Abramowitz et al., 2002). The
UK National Institute for Health and Clinical Excellence (NICE) guidelines advocate CBT as the
treatment of choice and recommend that individuals who have not responded to one or more
trials of CBT or one or more adequate trials of a Selective Serotonin Re-uptake Inhibitor (SSRI)
or Clomipramine be offered an intensive version of CBT (NICE, 2005). Thus far however there
have been no systematic studies examining the effectiveness, feasibility and acceptability of
CBT delivered in this format for clients who have not previously responded to treatment. The
perspectives of therapists regarding the feasibility and acceptability of delivering time-intensive
CBT and whether it is being delivered in practice in the UK have not been thoroughly
investigated. This paper examines the findings of two studies that have examined the perceived
acceptability and feasibility of time-intensive CBT. The first study examined this aspect from a
service user perspective. Fourteen participants took part, 7 with OCD and 7 with Panic Disorder.
Participants were 18 years and above and reported to have previously received CBT that had
not been completed or was ineffective. Participants completed a semi structured interview which
explored the reasons they believed CBT had been unsuccessful. The interview also focused on
introducing the concept of time-intensive CBT. Participants were asked about their thoughts and
feeling about time- intensive CBT, whether they viewed this as an acceptable way of receiving
treatment and if there were any benefits or obstacles that they could foresee. Thematic analysis
was used to analyse the data. Analysis revealed four main themes which were linked to two
overarching themes. The overarching themes were linked to the perceived difficulties and
benefits of this treatment format. The second study utilised a questionnaire developed to
investigate therapist beliefs about the advantages and disadvantages of delivering CBT in a
time- intensive format. The questionnaire also sought to understand how therapists perceived
various elements of this approach would work in clinical practice and to identify the number of
therapists who were actively engaged in providing time-intensive CBT and their experience of
this. One hundred qualified therapists who were involved in providing psychological therapy for
psychological problems who were 18 years and above took part in the study. Descriptive
statistics were used to examine the utilisation of time- intensive CBT in clinical practice and
which disorders it was being used for. Thematic analysis was used to analyse qualitative
responses to questions. The results of the two studies are taken together and a synthesis of the
service user and therapist perspectives was conducted to identify the perceived enablers and
obstacles to time- intensive CBT.
Processing Core Vulnerabilities in OCD and Related Spectrum Disorders

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Jordana Muroff1, Jennifer Greenberg2, Lillian Reuman2, Andrea Hartmann2, Irina Kasarskis2,
Sabine Wilhelm2, Melissa Black3, Jessica Grisham3, Jasmine Taylor4, Richard Moulding5, 4, Maja
Nedeljkovic4, Michael Kyrios4, Jordana Muroff1, Gail Steketee1, Sabine Wilhelm2.
1. SSW, Boston University, Boston, MA, USA, 2. Massachusetts General Hospital & Harvard
Medical School, Boston, MA, USA, 3. The University of New South Wales, School of
Psychology, Sydney, NSW, Australia, 4. Swinburne University of Technology, Melbourne, VIC,
Australia, 5. Deakin University, Melbourne, VIC, Australia.
Recent research has examined the role of cognitive bias, emotional factors, and other
vulnerabilities in the etiology of OCD and related disorders of (e.g., body dysmorphic disorder
[BDD], hoarding). OCD spectrum disorders have been associated with neurocognitive deficits in
attention, memory, and executive functioning as well as emotional attachment and
dysregulation. A growing number of studies are investigating the features and mechanisms
underlying symptoms associated with these disorders, utilizing survey and experimental
designs, self-report and cognitive tasks, as well as clinical and nonclinical samples. Elucidating
the role of cognitive and emotional vulnerabilities is critical to the identification, prevention, and
treatment of OCD and related disorders. The temporal relationship between the repetitive
thoughts and behaviors that characterize these disorders and the relevant constructs are
especially important given that they may be modifiable and thus, amenable to cognitive
assessment and intervention. Given recent evidence suggesting that hoarding is a separate but
related condition to OCD, current research has been focused on cognitive and emotional
processes, as well as other elements of a specialized cognitive behavioral model for this
disorder. Further research is needed to better understand core vulnerabilities and markers of
OCD spectrum disorders to enhance understanding of these psychiatric conditions and inform
treatment. This symposium will focus on studies of cognitive (e.g., attention, memory, decisionmaking) and emotional (e.g., attachment, regulation, distress tolerance) factors and other
potential vulnerabilities, as well as relevant assessment (e.g., eye tracking) and intervention
(e.g., cognitive bias modification) strategies for specific OCD spectrum disorders.
Four papers will be presented by an international team of researchers. The first paper by Dr.
Jennifer Greenberg and colleagues will present a study applying eye tracking to examine
cognitive bias (i.e., visual attention bias) in people with BDD and healthy controls. The second
paper by Melissa Black and Dr. Jessica Grisham will present two studies examining the causal
role of memory distrust in OCD checking, as well as cognitive bias modification (CBM) targeting
maladaptive beliefs related to memory distrust and intolerance of uncertainty. Next, Jasmine
Taylor and colleagues will present work examining the relationship between emotional reactivity,
emotion regulation and hoarding behaviors. The fourth paper by Dr. Jordana Muroff and Dr. Gail
Steketee examines potential vulnerabilities and core markers of hoarding in young adults based
on previous research in clinical adult samples. The Discussant for these papers will be Dr.
Sabine Wilhelm, an expert in OCD, BDD, and related disorders.
The examination of these cognitive and emotional vulnerability factors has implications for the
etiology, maintenance, prevention, cognitive behavioral models, and treatment of obsessivecompulsive and related disorders. These topics are especially timely given the new proposed
diagnostic classification of obsessive-compulsive and related disorders in the DSM-5.
Do you see what I see: An eye tracking study of attentional bias in body dysmorphic
disorder
Cognitive factors, including attention bias, have been proposed in the etiology and maintenance
of body image disorders. Eye tracking allows for examination of direct attention processes. This
approach has been used to study cognitive bias in individuals with eating disorder
symptomatology (e.g., Jansen et al., 2005; Roefs et al., 2008); these data demonstrate a
tendency toward a negative attention bias (i.e., bias toward ones own unattractive features)

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among individuals high in body dissatisfaction. The current study used eye tracking to examine
visual attention bias in individuals with body dysmorphic disorder (BDD) relative to healthy
controls.
A sample of BDD participants with primary face/head concerns (n = 19) and healthy controls (n
= 20) completed computerized tasks and questionnaires. We evaluated 1) whether BDD
participants demonstrate a negative attention bias compared to healthy controls, and 2) whether
there is an association between negative attention bias and symptom severity (BDD-YBOCS).
Eye movement data (i.e., fixations, dwell time) were recorded using the EyeLink II eye tracker
while participants viewed digital images of their own and a neutral face (selected for average
attractiveness and neutral expression). Facial stimuli were presented for 40 seconds with a 2
second break between stimuli. Participants subsequently rated subjective distress (SUDS) and
perceived most attractive and unattractive feature of their own and the neutral face using a 9point Likert scale (1 = not at all attractive, 9 = extremely attractive).
Results show that BDD participants demonstrated a negative total bias score (M(SD)fixation = 12.9 (39.3); M(SD)dwell(ms) = -5,502.7 (15,537) whereas healthy control subjects demonstrated a
positive total bias score (M(SD)fixation = 1.6 (37.2); M(SD)dwell(ms) = 2,735 (12,754). Age and
gender were found to modify the relationship. There was no significant association between
attention bias and subjective distress during the task. Results provide support for a visual
attention bias in BDD, a potential factor in the disorders etiology and maintenance. Elucidating
the role of attention bias in BDD could help to identify specific and modifiable risk and
maintenance factors in BDD. Implications for etiology, maintenance, and treatment will be
discussed.
Attenuating memory distrust in obsessive-compulsive checkers
Pathological doubting and checking is a common symptom presentation in obsessivecompulsive disorder (OCD). Previous research has established that compulsive checkers do not
display an actual memory deficit, but lack confidence in their memories regarding the
completion of tasks. Intolerance of uncertainty may also play a critical role in checking
compulsions. Past research has demonstrated that repeated checking behaviours have the
paradoxical effect of increasing memory distrust. The focus of this series of studies is on further
examining the causal role of memory distrust in compulsive checking, as well as attempting to
modify these types of beliefs. In Study 1, we collected online self-report data and laboratory
data demonstrating that beliefs about memory and checking uniquely predicted compulsive
checking symptoms. Results of this study also confirmed that high-checkers demonstrated
greater uncertainty and more negative beliefs about their memory ability in relation to common
checking scenarios compared to low-checkers, although there were no differences with respect
to memory ability, memory confidence, or urges to check on a checking relevant behavioural
measure. In Study 2, we conducted a pilot investigation of the application of cognitive bias
modification (CBM) targeting maladaptive thinking styles related to memory distrust and
intolerance of uncertainty in OCD checkers. Preliminary results provide some mixed evidence
that participants who received positive CBM training may have interpreted novel ambiguous
checking scenarios more adaptively and checked less on a behavioural measure relative to
participants in the negative CBM training condition. CBM may be useful as an adjunct to
traditional cognitive-behavioural strategies or as an online intervention to target maladaptive
beliefs in OCD.
Emotion regulation difficulties and hoarding symptoms
To date there has been little research regarding the role of emotion regulation in relation to
compulsive hoarding. Effective emotion regulation involves the awareness and understanding of
emotions, the acceptance of emotions, the ability to control impulsive behaviours and behave in
accordance with desired goals in the face of aversive emotions, and the ability to use

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situationally-appropriate emotion regulation strategies (Gratz & Roemer, 2004). The absence of
any or all of these signifies difficulties with emotion regulation, or emotion dysregulation. It is
postulated that some of the core features of compulsive hoarding, such as the strong emotional
attachment to possessions, the sense of comfort and security derived from hoarded objects,
and the emotional and behavioural avoidance evident in acquiring and saving behaviours, may
be indicative of difficulties with emotion regulation. The current research aimed to investigate
whether individuals with compulsive hoarding behaviour experience difficulty with understanding
and regulating their emotions by examining measures of emotional reactivity, emotion
regulation, and hoarding symptoms in two community samples. Quantitative analyses indicate
that hoarding symptoms are positively correlated with difficulties with emotion regulation, anxiety
sensitivity, alexithymia, and impulsivity, and negatively correlated with distress tolerance.
Implications for the cognitive-behavioural model and treatment of the disorder are discussed.
Identifying Core Vulnerabilities for Hoarding among Young Adults
Little research exists on the onset and core vulnerabilities and markers of hoarding, a
debilitating psychiatric problem with a prevalence rate of about 5%. Treatment is not typically
sought until middle-age; however, retrospective data showed that 60% of persons with hoarding
reported the onset of their hoarding symptoms by age 12 and 80% by age 18. Thus, young
adults ages 18-24 are likely to exhibit important sub-threshold and even clinical level symptoms
of hoarding and potential vulnerabilities for developing hoarding. Unfortunately, few studies
have examined hoarding in young adults. The purpose of this study is to identify potential
vulnerabilities of hoarding based on previous research in clinical samples.
We recruited 382 undergraduate young adults (50% male) who self-reported sub-clinical or
clinical hoarding (>=3 on difficulty discarding, acquiring or clutter) on the Hoarding Rating Scale
(HRS) and 382 controls, matched on gender and race/ethnicity, who reported no significant
hoarding symptoms. Forty-eight percent of this sample (174 with sub-clinical/clinical hoarding
and 181 controls) completed a web survey of hoarding-relevant questionnaires of mental health
symptoms. The sample averaged 20 years old, 54% female, 19% Hispanic/Latino, 63% White;
80% single, 81% living on campus. Of those with elevated hoarding, 6.2% met criteria for
clinical levels of hoarding.
Across both groups, hoarding symptoms (HRS) were moderately correlated with depressive,
OCD, social anxiety, indecisiveness, emotional attachment, and perfectionism symptoms, as
well as family clutter (rs>.35). Depression, OCD, indecisiveness, perfectionism, and inattention
scores were slightly elevated compared to other non-clinical samples. No gender differences in
hoarding symptoms were found. Non-whites reported slightly elevated HRS scores.
Compared to non-clinical controls those with sub-clinical hoarding reported significantly greater
OCD, social anxiety, indecisiveness, clutter, distress tolerance problems, emotional attachment
to possessions, perfectionism, and inattention symptoms (ps<.001). Depression, worry, and
family based clutter symptoms were not significantly different between groups (ps>.01).
These findings suggest that indecision, distress tolerance, emotional attachment, and
inattention may be important markers for the development of hoarding in adulthood. Identifying
such markers can facilitate better understanding of hoarding behavior as well as early detection
and prevention before saving, acquiring and clutter become problematic.
Clinical Features of Obsessive-Compulsive Disorder with Pervasive Developmental
Disorder
Akiko Nakagawa1, Kayoko Isomura1, Yoko Hiraoka2, Shinji Murakami2, Kazuko Yoshioka3.
1. Research Center for Child Mental Development, Graduate School of Medicine, Chiba
University, Chiba City, Japan, 2. Kawasaki Medical School, Kurashiki, Japan, 3. Fukuoka
Prefectural University, Tagawa, Japan.

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The presence of pervasive developmental disorder (PDD) in difficult adult cases of obsessivecompulsive disorder (OCD) has received research attention in recent years. A method for
recognizing the presence of PDD at an early stage could lead to improved treatment of the
disorder. There has been, however, little research on this matter. We have been trying to find
clinical characteristics of OCD patients with PDD at the early stage of treatment, which will be
necessary for adequate treatment for them. According to our previous research, paying
attention to the presence of hoarding and ask about its causal reasons as well as chief
complaints during initial interviews was shown to be useful. In this study, therefore, we
investigated to find more clinical characteristics of OCD patients with PDD rather than features
of OC-symptoms. The participants were 64 OCD patients (18-64 years old, 25 males, 39
females) diagnosed by SCID (Structured Clinical Interview for DSM-IIIR or IV) referred to the
CBT clinic at Kawasaki Medical School Hospital, Japan. Patients with IQ <80, total Y-BOCS
score (Yale-Brown Obsessive Compulsive Scale) <17 ,current major depression, schizophrenia,
head injury, serious medical condition, history of drug or alcohol addiction were excluded. 19 of
the patients (10 males, 9 females) were diagnosed as PDD. (2 autistic disorders, 10 Asperger
disorders, 7 PDD-Not Otherwise Specified). We investigated the difference between OCD
patients with and without PDD on demographic profiles, personality traits assessed by
PDQR(Personality Disorder Questionnare-Revised), Wechsler profiles, Hamilton and Beck
depression scale and so on rather than features of OC-symptoms that were investigated in the
previous study. The results showed the significantly higher rate was found in schizoid,
paranoid, avoidant, historionic, narccistic personality in OCD patients with PDD compared
to those without PDD. As for the Wechsler profile, the patients with PDD had significantly lower
scores of "Processing Speed". Similarities and Digital Symbol in Wechsler profiles showed
significant associations with diagnosis of PDD. Further studies with larger numbers of subjects
and with more sophisticated way of diagnosis of PDD would be warranted . Treatment for adult
patients with OCD once detected to be possible PDD need to be tailored for each patient
considering about their biological and psychological features. So, we will report the treatment
outcome of the participants and discuss about the adequate modification of CBT for OCD
patients with PDD.
The self in cognitive models of obsessive-compulsive and related disorders
Maja Nedeljkovic1, Michael Kyrios1, Claire Ahern1, Claire Ahern1, Michael Kyrios1, Frederick
Aardema3, Richard Moulding2, 1, Adam Radomsky4, Guy Doron5, Jude Allamby1, Jiaying Jiang1,
Michael Kyrios1, Imogen Rehm1, Maja Nedeljkovic1, Richard Moulding2, 1, Anna Thomas1, Kieron
OConnor3.
1. Swinburne University, Hawthorn, VIC, Australia, 2. Deakin University, Burwood, VIC,
Australia, 3. University of Montreal, Montreal, QC, Canada, 4. Concordia University, Montreal,
QC, Canada, 5. Interdisciplinary Center (IDC), Herzilya, Israel.
The symposium will present recent research on the self in Obsessive Compulsive Spectrum
Disorders (OCSDs) using experimental, quantitative and qualitative methods. While traditional
cognitive-behavioral models have focused on understanding specific beliefs about intrusive
phenomena characteristic of OCSDs, more recent research has indicated that specific aspects
of self construal also play a role in OCSDs. The symposium aims to extend current
understanding of cognitive models by incorporating notions of the self. Focusing on self
construals may extend our understanding of developmental and etiological processes and help
in the advancement of additional theory-based interventions to augment current treatments that
lead to clinically significant change in only 40% - 50% of affected individuals presenting for
treatment. The first paper investigates the role of implicit and explicit self-perceptions in OCD,

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while the second paper continues to examine OCD taking an experimental approach to the
relationship between self-perceptions and neutralization. The third paper examines a new
measure of feared-self construals and their relationship to obsessionality and cognitive
symptoms in OCD. The fourth paper examines self perceptions and moral concerns as a
possible subtype of OCD. The final paper broadens the focus to the obsessive compulsive
spectrum, examining the little understood role of cognitions and particularly views of self in
Trichotillomania, through qualitative interview data. Together, the five papers examine the role
of self-cognitions in OCD and spectrum disorders through a variety of approaches - interview
data, questionnaire data, experimental approaches, implicit and explicit measures - in order to
expand our knowledge of the disorders.
What is self ambivalence? The role of implicit and explicit self in Obsessive-Compulsive
Disorder.
While cognitive-behavioral conceptualizations of Obsessive Compulsive Disorder (OCD) have
led to effective treatments, outcomes vary and dropout/relapse rates remain high. In response,
researchers have turned to identifying factors predictive of poorer outcomes and developing
novel treatment strategies based on new theoretical approaches. Extending theoretical work by
Guidano and Lioti (1983), previous research has identified self ambivalence as a vulnerability
factor in OCD (Bhar & Kyrios, 2007). Using experimental and questionnaire-based research,
this study aimed to further our understanding of self ambivalence establishing its association
with implicit and explicit general and specific moral self construals. We found that ambivalence
was associated with the dissonance between implicit and explicit general self-esteem as
calculated by the difference between standardized scores on the Rosenberg Self Esteem Scale
(Rosenberg, 1963) and the Name-Letter Preference Task (NLPT; Nuttin, 1985), explicit
sensitivity to moral concerns (measured by the Obsessive Sensitive Self Inventory; Doron,
Moulding, Nedeljkovic, & Kyrios, 2008), and obsessional beliefs (as assessed by the
Obsessional Beliefs Questionnaire; OCCWG, 2005), but not implicit moral self construals as
measured by the Teachman et al. (2006) version of the Go No-Go Association Task (GNAT;
Nosek & Banaji, 2001). OCD severity was predicted by slef ambivalence, perceptions about the
degree of importance of the moral domain, and dissonance between implicit and explicit selfconcept, as well as obsessional beliefs. On the basis of findings about the relevance of selfbased factors, particularly relating to moral domains, we present a conceptual model of etiology
related to OCD that incorporates cognitive and self-construals.
Explicit self construals and neutralization of unwanted intrusions: An experimental
approach.
While the association between cognitive domains and compulsive phenomena has been
established consistently through correlational analysis of self-report questionnaire data, little
experimental research has been undertaken. Furthermore, virtually no research has examined
how neutralization and self construals oscillate with the experience of unwanted thoughts. This
study aimed to undertake an experimental manipulation of responses to distressing intrusive
thoughts in a combine cohort of community (n=100) and clinical OCD participants (n=20). We
found a complex set of interrelationships between explicit self-constuals and responses to
distressing OC-related situations. Consistent with previous literature, we found that an active
neutralization response to an unwanted intrusion maintained distress during a passive phase of
exposure, whereas an active refocusing response led to a decrease in distress during the
passive exposure phase. Interestingly, as distress decreased when in the active phase of
response, self-worth increased or was maintained overall, irrespective of the nature of the
response (i.e., neutralization or refocusing). During the passive phase, self-worth decreased
significantly in the neutralisation condition, but not so in the refocusing condition. In a path
analysis, as expected, we found that self vulnerability (ambivalence, discord, moral self-

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sensitivity) was associated with lower self worth & confidence during the neutralisation task
which, in turn, was associated with greater distress & urges during the task. This study
increases our understanding of the potential role that self construals play in the maintenance of
distress to unwanted thoughts. Implications for research and treatment are discussed.
People who are afraid of themselves: Development of the short Feared Self
Questionnaire and its relationship to obsessionality.
Clinically speaking, obsessions - particularly those related to causing harm - contain evaluative
dimensions about the self, reflecting a fear as to who the person might be - or might become (I
might be a murderer; I might be a sexual deviant; I might be crazy). Based on such
knowledge and following research indicating that such beliefs are relevant to OCD, and the
wider literature in social psychology regarding feared or undesired self-guides, the current
study describes the development and validation of a new questionnaire - the Feared Self
Questionnaire. This 8-item questionnaire measuring was piloted in two large non-clinical
samples (n=257; n=292), and contains items such as I often question my own sanity and I
worry about being the sort of person who might do very immoral things. Exploratory and
confirmatory factor analyses supported the unidimensionality of the measure. The questionnaire
showed a strong internal inconsistency, and good divergent and convergent validity, including
strong relationships to obsessional symptoms and with other processes implicated in cognitive
models of OCD (obsessional beliefs questionnaire, inferential confusion questionnaire). It is
hoped that the new measure finds both clinical and research utility in future studies.
Psychological features of obsessive-compulsive disorder with excessive moral concerns
Obsessive-Compulsive Disorder (OCD) is a complex mental disorder that may manifest in many
different forms, however understanding of these different subtypes are limited and current
treatments may not address specific subtype needs. According to the cognitive perspective,
most people experience intrusive and unwelcome thoughts periodically, however, people who
have excessive concerns with morality may misinterpret these intrusions as an indication that
they are immoral, which can lead to distress, and the development and maintenance of
obsessive and compulsive behaviours. This group of people who tend to make moral
misappraisals about their intrusive thoughts may represent a particular subtype of OCD. The
aim of this study is to investigate whether distinct psychological features, such as selfperception, obsessional beliefs, moral beliefs, moral perceptions, are associated with this
subtype. Preliminary results suggest that participants who are uncertain about their moral selfworth are more likely to view intrusions as reflecting an immoral aspect of themselves, and they
are also likely to perceive neutral information in the environment as having a moral theme. The
implications of this study include contributing to a better understanding of this moral-specific
subgroup; driving research impetus to investigate associated factors (e.g. genetics,
temperament, early experiences, environmental, neurobiology); and future development of more
specialized and effective treatments for this subgroup of OCD sufferers.
The role of self-beliefs in episodes of chronic hairpulling: Informing cognitivebehavioural models of Trichotillomania
Trichotillomania (TTM) is characterised by compulsive removal of ones hair, causing noticeable
hair loss typically of the scalp, eyebrows and eyelashes. The majority of phenomenological
research conducted on TTM has focused upon affective correlates of hairpulling episodes, and
considers emotion regulation to be a key maintaining factor and function of this poorly
understood disorder. Few empirical studies have investigated the role of cognitions in the onset
and maintenance of hairpulling episodes, particularly the role of self-beliefs. Thus, existing
cognitive-behavioural models of TTM, and treatments based upon these models, remain
uninformed on this phenomenological dimension. A qualitative research design was employed

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to explore the contribution of self-beliefs in hairpulling episodes as situated within the context of
other cognitive, affective, and environmental antecedent and maintaining factors. Seven women
participated in semi-structured qualitative interviews, analysed though Interpretive
Phenomenological Analysis. A prominent theme within participants interviews was a
negativistic, fractured sense of self. Rumination upon ones perceived worthlessness or low selfefficacy was a common antecedent to hairpulling episodes. Hairpulling was commonly
employed as a way to reduce associated negative affect, or to enhance a sense of mastery.
Following cessation of hairpulling however, negative-self beliefs recurred with a strong sense of
shame. These findings suggest that cognitions, including self-beliefs, play an important role in
hairpulling episodes, the implications of which ought to be considered in the conceptualisation
and treatment of TTM.
Attachment processes in Obsessive-Compulsive and Related Disorders: Their
importance and implications for cognitive theory
Maja Nedeljkovic4, Amitai Abramovitch1, 2, Guy Doron3, Ohad Szepsenwol3, Richard Moulding5,
4
, Alicia Randell4, Kate FitzGerald4, Maja Nedeljkovic4, Guy Doron3, Yaniv Efrati3, Ohad
Szepsenwol3, Michael Kyrios4.
1. Harvard Medical School, Boston, MA, USA, 2. Massachusetts General Hospital., Boston, MA,
USA, 3. Interdisciplinary Center (IDC), Herzilya, Israel, 4. Swinburne University of Technology,
Melbourne, VIC, Australia, 5. School of Psychology, Deakin University, Melbourne, VIC,
Australia.
Attachment styles are conceptualized as systematic patterns of expectations, needs, emotions,
emotion-regulation strategies, and social behavior that result from the interaction of an innate
attachment behavioral system and a history of caregiver experiences. Modern theories of
attachment have emphasized the cognitive and information processing aspects of the
attachment system, and have shown promise in providing additional explanatory power to
cognitive theories of psychopathology, as well as being implicated in more recent cognitive
therapy approaches such as Young's Schema Theory. In particular, obsessive-compulsive
disorder and related disorders show promise as an area where attachment is important,
particularly given overlap between concepts in the attachment realm and those in cognitive
theories of these disorders, including findings that attachment insecurity is associated with
elevated threat perceptions, perfectionistic tendencies, difficulty in thought suppression,
rumination, and a tendency to devaluate oneself, all aspects implicated in OCD-related
disorders. This symposium elaborates on recent developments in the study of attachment and
OCD-related symptoms. The first paper by Abramovitch and colleagues discusses the role of
attachment insecurity and self-worth in the symptoms of Body Dysmorphic Disorder. The
second by Moulding and colleagues discusses the potential role of explicit and implicit
measures of attachment in predicting the symptoms of OCD cross-sectionally and longitudinally.
The third by FitzGerald and colleagues discusses the relationship between attachment anxiety
and reassurance seeking, a hallmark of individuals with clinical OCD. The final paper by Doron
and colleagues discusses the role of attachment in being linked to scrupulosity and religious
obsessions in highly religious Jews. Overall, the papers explicate the role of attachment anxiety
in multiple symptom domains of the OCD-related disorders, and hope to contribute to an
elaboration of cognitive theories of these problems.
Self-vulnerability and attachment insecurities in body dysmorphic concerns
Background and Objectives: Recent theory and findings suggest that obsessive-compulsive
symptoms and body dysmorphic symptoms may have common developmental and maintaining
factors. Indeed, DSM 5 is intended to include Obsessive Compulsive Disorder (OCD) and Body
Dysmorphic Disorder (BDD) under a new category of Obsessive Compulsive and Related

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Disorders. Consistent with recent models implicating self and attachment insecurities in the
development and maintenance of OCD, we investigated whether the co-occurrence of fear of
abandonment (i.e. attachment anxiety) and overreliance on the appearance self-domain for selfworth is linked with body dysmorphic concerns. Method: Our sample consisted of 216
community participants who completed a battery of questionnaire examining the associations
between over-reliance on physical attractiveness for one's feelings of self-worth and attachment
insecurities. They also completed other measures aimed at controlling for possible confounding
variables. Results: Results suggested that among men body dysmorphic symptoms were
highest when both contingent self-worth on the appearance domain and attachment anxiety
were high. Among women, however, body dysmorphic symptoms were high if either attachment
anxiety or contingent self-worth on the appearance domain were high. This remained true when
controlling for obsessive compulsive dysfunctional beliefs and general self-esteem. Limitations:
Our studies were conducted on non-clinical samples. Conclusions: Cultural and biological
factors may result in different pathways for the development of body dysmorphic concerns in
men and women. Addressing contingencies of self on the appearance domain and attachment
anxiety may enhance CBT based interventions for body dysmorphic symptoms.
The Relationship Between Implicit and Explicit Adult Attachment Orientations and
Obsessive Compulsive Symptoms
This aimed to investigate the association between attachment orientations and symptoms of
Obsessive-Compulsive Disorder (OCD), using both an explicit self-report measure and implicit
task paradigm to measure adult attachment, and to examine links of attachment with changes in
symptoms of OCD longitudinally as well as cross-sectionally. The sample comprised of 213
non-clinical student respondents; 164 females (M =22.18, SD = 5.54), 49 males (M =22.57, SD
=6.77). Participants completed an online version of a battery of self-report questionnaires,
followed by the Single-Block Implicit Association Test (SB-IAT). Participants were also invited to
complete the study again four to eight weeks after their initial time of participation, 45
participants did so. The findings of the study did not show a relationship between the explicit
self-report and implicit measures of attachment insecurity. Higher levels of explicit attachment
insecurity were associated with more OCD symptoms at time 1. High levels of implicit but not
explicit attachment anxiety at time 1 were associated with increases in symptoms at time 2. The
findings provide further support for the involvement of attachment insecurity in the development
and maintenance of OCD. While future research is required, implicit paradigms show promise
as a measure of attachment insecurity in psychopathology.
The Role of Attachment in Reassurance Seeking
Reassurance seeking has been defined as the repeated solicitation of safety related
information from others about a threatening object, situation, or interpersonal characteristic
despite already having received this information (Parrish & Radomsky, 2010, p.211). Within the
context of Obsessive-Compulsive Disorder (OCD) reassurance seeking is very common;
however, little is known about its aetiology. High attachment anxiety is associated with a number
of problematic interpersonal behaviours aimed at increasing intimacy but which can push other
people away (e.g. being clingy and seeking reassurance) (Brennan, Clark & Shaver, 1998).
Attachment anxiety (and to a lesser extent attachment avoidance) have also been shown to
predict OCD-related beliefs that can lead to the development of OCD symptoms such as
reassurance seeking (Doron, Moulding, Kyrios, Nedeljkovic, & Mikulincer, 2009). Based on
these research findings the current study aimed to investigate the relationship between
attachment and reassurance seeking. The results illustrated that individuals with anxious
attachment styles but not avoidant attachment styles were more likely to seek reassurance in a
wider range of situations than those with secure attachment styles. This study has implications
for the treatment and prevention of reassurance seeking behavior.

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Scrupulosity in religious Jews is linked with attachment anxiety and over-reliance on the
morality self-domain for self-worth.
Background and Objectives: Religious obsessions and compulsions in the form scrupulosity
have recently received increasing research attention. Such obsessions often include moral
themes such as fears that one has committed sins (or will do so), intrusive mental images of a
sacrilegious or blasphemous nature, and fears that one will be punished by God or will go to
Hell. In response to such obsessions, individuals may excessively pray or seek reassurance
from clergy or loved ones about religious matters. Indeed, self-sensitivity in the moral domain
has been linked with obsessive-compulsive concerns and behaviors. Recent models also
propose implicate attachment insecurities in the development and maintenance of obsessive
symptoms and cognitions. In the current study we investigated whether the co-occurrence of
fear of abandonment (i.e. attachment anxiety) and overreliance on the morality self-domain for
self-worth is linked with obsessive preoccupation with religious concerns. Method: 195 orthodox
Jews from the community completed an online battery of questionnaires assessing the link
between over-reliance on the morality self-domain, attachment anxiety and scrupulosity
symptoms. Related factors such as obsessive-compulsive related dysfunctional beliefs, general
self-esteem and depression were also assessed. Results: Our results suggested that
attachment anxiety is positively associated with "fear of God" obsessions but only among
individuals that show high contingency of self worth on morality. This remained true after
controlling for obsessive compulsive beliefs, depression, and self-esteem, suggesting a unique
contribution of such a double vulnerability to scrupulosity concerns. Limitations: Our study was
conducted on a non-clinical sample. Conclusions: The co-occurrence of self-vulnerability in the
moral domain and dysfunctional attachment representations may make religious Jews more
vulnerable to the development of religious obsessions. Addressing over-reliance of self-worth in
the morality self-domain and attachment insecurities may reduce religious obsessivecompulsive preoccupations and behaviors and enhance current treatment interventions.
To be Perfect or Not to Be: Maladaptive Perfectionism and OCD
Richard Ohring.
Behavioral Sciences, Netanya Academic College, Netanya, Israel.
Abstract Central: Perfectionism has been found to be associated with obsessive compulsive
tendencies in several studies. However, during the past decade intense debate has emerged
over what are the features that are critically involved in the association between striving for high
standards and psychopathology. In the present study a novel cognitive behavioral
conceptualization of maladaptive perfectionism was tested in a sample of OCD patients. 20
OCD patients and 20 matched controls were administered a measure that was developed
based on this conceptualization, the Maladaptive Perfectionism Questionnaire (MPQ, and the
Beck Depression Inventory (BDI-II). The OCD group reported significantly higher levels of
maladaptive perfectionism and depressive symptoms than the controls. When controlling for
depressive symptoms, the clinical sample continued to exhibit higher levels of maladaptive
perfectionism than the controls. This study provides preliminary support for a novel cognitive
behavioral conceptualization of maladaptive perfectionism. Further examination of the MPQ in
other emotional disorders and in direct comparison to existing measures of perfectionism is
recommended.
Treating Sexual Obsessions in Obsessive-Compulsive Disorder with Therapeutic
Reframing of Ritual Function
Miyo Okajima1, 2, Hiroaki Harai1, 2.

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1. Nagoya Mental Clinic, Waraku-kai Med. Corp., Nagoya, Japan, 2. Kikuchi National Hospital,
Koushi, Japan.
Our clinic, an office based psychiatric clinic, offers a specialized treatment program for patients
with obsessive-compulsive disorder (OCD). This program accepts over 200 new referrals of
OCD patients in a year. Two behavior therapists provide behavior therapy including exposure
and ritual prevention (ERP), habit reversal, group therapy, family intervention and acceptance &
commitment therapy (ACT) based on the individual needs. The key program is the intensive
group exposure therapy, named 3DI (Three Days Intensive) which was reported in WCBCT
2010 (Harai & Okajima, 2010). 3DI is highly effective; however some of the patients, particularly
those who have sexual obsessions, often fail to participate in 3DI and their treatment outcome is
generally unsatisfactory. Sexual obsessions are common symptoms of OCD. Lifetime
prevalence of sexual obsessions is 26.3% (Williams & Farris, 2011). ERP is effective to use in
treating sexual obsessions. However, all patients with sexual obsessions struggle to understand
their occurrence and meaning. The patients are often ashamed and unwilling to tell their
typically attribute the obsession to being perverted, deviant, immoral and crazy. OCD patients
have an anxiety about homosexuality, paedophilia, sexual perversions, incest and blasphemous
thoughts combining cultural norms and sex. What if patients could tell us about their
obsessions, it will be difficult to treat them using ERP. Such patients generally have a poorer
prognosis and may require low levels of anti-psychotic medication (Gordon, 2002). Obsessions
including sexual ones are involuntary, strange, but harmless, and the opposite of patients
actual desires and values. To treat these symptoms, we have proposed reframing of ritual
function. Reframing is a general method of changing the meaning of something and thereby
changing minds, sticking in opposing and seemingly-intractable positions. Reframing can
change the valence of any thoughts exactly to the opposite side. To reframe, the therapist steps
back from what is being said and done, and considers the frame of the patients intrusive
thoughts in which this reality is being created. We modified this procedure. Instead of reframing
of obsession, we reframe ritual function. Case1: A housewife in her 30s. She was terrified of
harmful issues, for example, having thoughts about bits of glass like contact lens. Her biggest
fear is that the contact lens might get into her vagina. It was a baseless idea, but when she her
fear overwhelmed her, she went to the gynecology clinic for a check-up several times a month
and called her doctor several times a week.Her fear had started when she got married. Her
husband trash-talked her every day. He liked seeing her in a distressed condition and he did
this so effectively that she believed his joke was real. Her childish credulity seemed cute for him.
She thought if some contact lens got in her vagina, her baby might hurt when she would
become pregnant. For her treatment, we advised her to push contact lens into her vagina
deeply, whenever this idea contact in her vagina flashed in her mind. We told her, "This method
is used in order for you to feel inside your body with your finger, not to check existence or nonexistence of the contact lens. When you want to check it in that manner, it's a sign of
masturbation." After that she got well soon enough. Her rituals stopped. Perhaps her trusting
disposition and her willingness to follow our advice helped her take control of herself. The
meaning of our advice was to change her ritual function from the avoidance of fear into her
pursuit of pleasure. In this paper we report new reframed rituals that are unique treatment ideas
for another 3 cases with sexual obsessions. They could accept their behaviors as new rituals.
Reframing ritual method was better than exposing their obsession by general ERP.
Datos Preliminares de la Equivalencia de la Administracin Lpiz y Papel Vs. Internet de
la Child Version of the Obsessive Compulsive Inventory (OCI-CV) en Nios y
Adolescentes Espaoles
Jose Piqueras1, Tiscar Rodrguez-Jimnez1, Agustin Martnez-Gonzlez2, Edna Foa3.

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1. Psicologa de la Salud, Universidad Miguel Hernndez de Elche, ELCHE, Spain, 2.


Universidad de Alicante, Alicante, Spain, 3. Center for the Treatment and Study of Anxiety,
University of Pennsylvania, Philadelphia, PA, USA.
La aplicacin de cuestionarios a travs de Internet puede tener varias ventajas en la
investigacin clnica y epidemiolgica, pero no sabemos mucho acerca de si las aplicaciones
online difieren del mtodo tradicional de lpiz y papel respecto a la validez y la fiabilidad. La
administracin de cuestionarios psicolgicos a travs de internet es cada vez ms frecuente,
pero exige tener confianza para aplicar esas medidas que originalmente fueron desarrolladas
como instrumentos de lpiz y papel. Para ello es preciso documentar la equivalencia de las
versiones de lpiz y papel y online. El objetivo de este estudio es conocer la equivalencia de la
aplicacin lpiz y papel vs. online del OCI-CV (Child Version of the Obsessive Compulsive
Inventory; Foa et al., 2010) en poblacin infantil y adolescente espaola. La muestra estuvo
formada por 511 nios y adolescentes espaoles. De estos sujetos 254 cumplimentaron la
versin de lpiz y papel (edad media = 13.65; DT = 2.64; rango = 8-18) y 257 la de internet
(edad media = 11.42; DT = 2.33; rango = 8-17). La distribucin por sexo fue homognea. Tras
obtener el consentimiento informado de padres y nios se aplic a la muestra los siguientes
instrumentos: OCI-CV, el cuestionario sociodemogrfico creado para esta investigacin, el
SOCS (Short Obsessive-Compulsive Disorder Screener; Uher et al., 2007), el C-FOCI (Children
Florida Obsessive-Compulsive Inventory; Storch et al., 2009) y el RCADS (Revised Child
Anxiety and Depression Scales; Chorpita et al., 2000). Un mes despus de la primera
aplicacin se volvi a administrar el OCI-CV a una muestra aleatoria. Los resultados indicaron
que los datos de ambas modalidades de cumplimentacin del OCI-CV se ajustaron al modelo
de 6 factores (obsesin, lavado, acumulacin, comprobacin/duda, neutralizacin y orden) de
primer orden que se agrupan en un factor de segundo orden (comportamientos obsesivocompulsivos). Tambin se hall equivalencia o invarianza total entre ambas modalidades. Los
valores de consistencia interna para el grupo de lpiz y papel y online fueron: alfa de Cronbach
=.86 y .83, respectivamente. No se hallaron diferencias significativas en funcin del sexo y la
edad. Adems, ambas versiones muestran una validez convergente-discriminante adecuada.
En resumen, los datos del estudio apoyan la equivalencia de la aplicacin lpiz y papel vs.
Internet. As, el OCI-CV se muestra como un instrumento vlido y til para la evaluacin de
sintomatologa obsesivo-compulsiva en nios y adolescentes de habla hispana tanto en su
versin lpiz y papel como en la de internet.
Relationship Between Clinical Severity and Dysfunctional Beliefs in Obsessive
Compulsive Disorder
Javier Prado-Abril1, Leighna Harrison2, Sergio Snchez Reales3, Carmen Caballero Pelez4,
Sara Ben-Bouchta5, Javier Garca-Campayo1.
1. Miguel Servet University Hospital, Zaragoza, Spain, 2. Palo Alto University, Palo Alto, CA,
USA, 3. General University Hospital of Elche, Elche, Spain, 4. JM Morales Meseguer University
Hospital, Murcia, Spain, 5. La Princesa University Hospital, Madrid, Spain.
Introduction: There is no consensus on whether to opt for Cognitive Therapy (CT), Exposure
and Relapse Prevention (ERP) or a combined approach in dealing with Obsessive Compulsive
Disorder (OCD). The severity of the case may be a relevant indicator. Objectives: To explore
the relevance of dysfunctional beliefs to distinguish cases (n=18) and controls (n=12) and
analyze the relationship between the number and intensity of dysfunctional beliefs and severity
of OCD. Method: We compared in a first step the mean scores of the OCD and non-clinical
groups in the beliefs of the Obsessive Beliefs Spanish Inventory-Revised (OBSI-R) by t-test for
independent samples. In a second step, we compare four groups according to OCD severity

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scale obtained in the Y-BOCS scores with OBSI-R using ANOVA and post hoc test Tukey HSD.
Results: There are statistically significant differences between OCD and control groups in seven
of eight dysfunctional beliefs. ANOVA shows significant differences in Importance of thoughts
(F(3,15)=10.24, p<.01), Thought-action fusion likelihood (F(3,15)=11.20, p<.01) and Thoughtaction fusion morality (F(3,15)=5.02, p<.01) for the relationship between a greater severity and a
higher penetrance of dysfunctional beliefs. Post-hoc differences in the charts. Conclusions: If
OCD is of extreme severity tends to higher penetrance of dysfunctional beliefs. The results are
not conclusive because is an exploratory study but indicate the suitability of a specific cognitive
work adjunct to ERP to improve the effectiveness of psychological treatments in more serious
disorders.
Emotion Regulation and Body-Focused Repetitive Behaviours: Results of an
Experimental Study
Sarah Roberts, Frederick Aardema, Kieron O'Connor.
Fernand-Seguin Research Center, Montreal, QC, Canada.
Abstract Central: Body-focused repetitive behaviours (BRFB) include trichotillomania, skinpicking, and nail-biting. A growing body of research has provided support for an emotion
regulation model for BFRB. This model proposes that individuals with body-focused habits have
difficulty regulating certain emotions, and engage in repetitive habit behaviours to decrease
negative affect. Results from the few BFRB studies that manipulated emotions in experimental
conditions suggest that certain affective states are more likely to provoke BFRB than others.
Individuals with BFRB tend to engage in their habit during sedentary activities (e.g., reading,
studying), frustrating activities, or during activities or situations appraised as inactive or boring.
This study measured body-focused habit behaviour in experimental conditions and tested two
hypotheses: 1) that individuals with BFRB would engage in their habit more often in situations
that elicit boredom, frustration, and that 2) individuals with BFRB would have deficits in overall
emotion regulation as compared to controls. Participants with BFRB (n = 24) and control
participants (n = 23) were individually guided through experimental conditions designed to elicit
boredom or frustration, stress, and calm, respectively. Participants were filmed in each
condition. Trained raters scored the DVD recordings for BFRB to determine which condition
induced the most body-focused habit behaviour. Between-group differences in emotion
regulation and between-condition differences in habit behaviour are described. Clinical
implications are discussed.
Association Between Eating Disorders and Obsessive Compulsive Disorder: The Role of
Dysfunctional Appraisals and Thought Control Strategies in Non-Clinical Samples
Mara Roncero1, Conxa Perpi1, 2, Amparo Belloch1.
1. University of Valencia, Valencia, Spain, 2. CIBER Fisiopatologa de la obesidad y Nutricin
(CIBEROBN). I.Salud. Carlos III, Madrid, Spain.
INTRODUCTION. From a cognitive perspective of Obsessive Compulsive Disorder (OCD), both
dysfunctional appraisals and thought control strategies are pointed out as playing a central role
in the genesis and/or maintenance of the disorder. In recent years, the putative role of these
modalities of cognitive phenomena in Eating Disorders (ED) has also been investigated. AIM.
To examine to what extent dysfunctional beliefs and thought control strategies might explain the
commonalities observed between OCD and ED. To that end, differences in how intrusive
thoughts related to ED or OCD are appraised and confronted will be analyzed. PARTICIPANTS.
From a sample of 922 non-clinical individuals, three groups were extracted: a high risk of

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suffering OCD group (HR-OCD; n=92), a high risk of suffering ED group (HR-ED; n=41), and a
group with no risk of suffering OCD or ED (No-R; n=100). No differences were observed among
groups on age (F(2,230)=0.13;p>.05) or gender (2(2)=2.08;p>.05). INSTRUMENTS.
Obsessive Intrusive Thoughts Inventory (INPIOS) and Eating Intrusive Thoughts Inventory
(INPIAS). Both share the same structure and respectively evaluate first the frequency with
which 50 unwanted Obsessive/Eating Disorder -related Intrusive Thoughts, images and
impulses (EDITs/OITs) are experienced and then, dysfunctional appraisals and thought control
strategies related to the most upsetting OIT/EDIT. The Clark-Beck Obsessive-Compulsive
Inventory and the Eating Attitudes Test were used to obtain OCD and ED at-risk groups.
RESULTS. Regarding OITs (INPIOS comparisons), the HR-OCD group scored higher than the
other two groups on thought action-fusion (Moral and Likelihood; F(2,154.94)= 26.65;
p<.05;F(2,226)=18.25; p<.05), personal meaning (F(2,228)= 6.72; p<.05), and overestimation of
threat(F(2, 132.64)= 13.70; p<.05). However, no differences were obtained between the two
high-risk groups on thought importance, responsibility, importance of thought control, and
intolerance to uncertainty, whereas both groups scored higher than the No-R group on these
beliefs. As for thought control strategies, the HR-OCD used distraction (F(2, 148.63)=3.59;
p<.05) and compulsions (F(2,226)= 11.95; p<.05) more than the No-R group. The two HR
groups used anxiety control strategies and covert strategies more frequently than the No-R
group (all comparisons p< .05). Regarding EDITs (INPIAS comparisons), HR-ED group showed
higher scores on importance of thought (F(2,228)=18.72; p<.05) and intolerance to uncertainty
(F(2,133.99)= 20.79; p< .05). HR-OCD group showed higher scores on five dysfunctional
appraisals compared to No-R group, with the HR-ED subjects being between the two groups.
The two high-risk groups scored higher than the No-R on all the assessed thought control
strategies, except distraction and do nothing (all comparisons p<. 05). CONCLUSIONS. HROCD showed more dysfunctional appraisals and thought control strategies for both kinds of
unwanted intrusive thoughts, although HR-ED showed comparable results on some of them.
Nonetheless, HR-ED scored significantly higher than No-R subjects on several strategies and
appraisals, suggesting that these cognitive phenomena could play a role not only in OCD but
also in the ED psychopathology
Case Report Using Cognitive Behavior Therapy with a Female Patient Presenting with
Obsessive Compulsive Disorder
Edilaine Santos.
Clnica Existere - ITC, Bauru, Brazil.
Cognitive therapy developed by Aaron Beck, associated to specific behavioral techniques has
shown over time its effectiveness in treating patients with obsessive compulsive disorder. This
summary describes the outcomes of care of a female patient, aged 24, a receptionist. Only child
of divorced parents, resides with her mother. The main complaint relates to the fear of stealing
and doing something harmful to children, the elderly or other person considered weaker than
her. She had thoughts of inappropriate sexual content, religious, blasphemous and catastrophic,
doubts, fear of failure and the need to make checks. Had already presented to delegate to
believe that the arrest by assaulting the child. He worked with the patient for 24 sessions of 50
minutes, and their initial scores were: BDI: 15, BAI: 12, BHS: 02. The areas focused in the
treatment were social, professional and leiasure. The latter being due to the urgent suffering of
the patient having to deal with money every day at work. Later intervene in the health field
goals. It was observed that their problems stemmed from activation schemes vulnerability,
inadequacy and not estimates, and its compensatory strategies were avoidance, and
perfectionism verification. Understanding the patient about his problem brought much relief and
hope. The challenge distorted thoughts, as well as the identification of cognitive errors allowed

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the relaxation of ideas catastrophizing, overgeneralization, personalization, mind reading and


thinking all or nothing, and even contributed to the belief in alternative and more adaptive
thoughts. In addition, the patient understood their basic beliefs, which reduced ideas of
perfectionism. She learned how to manage symptoms, was consequently stabilizing mood and
subsequently restructuring themselves cognitively. Today, the patient copes well with the money
and does checks. Is approaching children, picking up baby in her lap. Final scores on scales of
Beck; BDI: 0, BAI: 01, BHS 01. Cognitive therapy is significant modality treatment of obsessive
compulsive disorder, since the cognitive interventions provide the individual identify and flexible
dysfunctional beliefs and thereby rescue the ability of problem solving and coping to deal with
life.
Scrupulosity is Associated with Higher Rates of OCPD and Schizotypal Traits than
Contamination OCD
Jedidiah Siev1, Jessica Rasmussen2, Joseph Slimowicz1, Michelle Silverman2, Natalie
Matheny2, Sabine Wilhelm2.
1. Nova Southeastern University, Fort Lauderdale, FL, USA, 2. Massachusetts General Hospital
and Harvard Medical School, Boston, MA, USA.
Abstract Central: Background: Scrupulosity is a manifestation of obsessive-compulsive
disorder (OCD) in which obsessional fears are religious or moral. Scrupulosity is associated with
poor treatment outcome in several studies (e.g., Alonso et al., 2001; Ferrao et al., 2006; MataixCols et al., 2002; Rufer et al., 2005). Personality disorders are also associated with poor
treatment outcome for OCD, including comorbid obsessive-compulsive personality disorder
(OCPD) (Pinto et al., 2011) and features of schizotypal personality disorder (SPD) (e.g.,
Minichiello et al., 1987; Moritz et al., 2004). Interestingly, although personality features of
scrupulosity have not been well characterized, there is reason to suspect that scrupulosity is
associated with both OCPD and SPD. Regarding the former, diagnostic criteria for OCPD
include excessive preoccupation with rules and rigidity related to issues of ethics and morality.
Regarding the latter, Tolin and colleagues (2001) found that individuals with primary religious
obsessions had more magical thinking and perceptual distortions than did individuals with other
types of obsessions. The aim of this study was to examine OCPD and features of SPD in
individuals with scrupulous versus contamination-focused OCD. Method: Adults diagnosed with
scrupulous OCD (n = 23) or contamination OCD (n = 20), and controls without any current Axis I
disorder (n = 15), were recruited as part of a study on attentional processes in OCD.
Participants were administered structured clinical interviews (SCID-I and the OCPD module
from SCID-II) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by a doctoral-level
clinician. They also completed the Schizotypal Personality Questionnaire - Brief (SPQ-B).
Scrupulous participants primary obsessional fears were religious or moral; contaminationfocused participants had primary obsessions about contamination and no religious or moral
obsessions in their three most distressing areas of concern. Results: A greater proportion of
individuals with scrupulosity (41%) than contamination OCD (15%) or healthy controls (0%) met
criteria for OCPD, 2 (2) = 9.66, p = .008. Pair-wise comparisons demonstrated that the
scrupulous group was more likely to have OCPD than both other groups (p = .06 and .004),
which did not differ from each other (p = .12). On all three SPQ-B scales, there was a large and
significant effect of group, and in all cases pair-wise LSD comparisons revealed that the
scrupulous participants had significantly more SPD traits than both other groups, and that the
contamination group had more traits than the control group. On the Cognitive-Perceptual scale,
F (2) = 8.12, p = .001, 2 = .23; on the Interpersonal scale, F (2) = 10.66, p < .001, 2 = .28; on
the Disorganized scale, F (2) = 20.45, p < .001, 2 = .43. Discussion: These data demonstrate
that scrupulosity is associated with higher rates of OCPD and more schizotypal personality traits

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than contamination OCD. Considering that OCPD and schizotypal traits both predict poor
treatment outcome, these features may account for why scrupulosity is also associated with less
improvement following treatment. Scrupulous individuals may benefit from attention to these
personality characteristics in the context of standard treatment for OCD.
Symptom Severity and Delusionality in Individuals with Scrupulous and Contamination
OCD
Jedidiah Siev1, Jessica Rasmussen2, Joseph Slimowicz1, Michelle Silverman2, Natalie
Matheny2, Sabine Wilhelm2.
1. Nova Southeastern University, Fort Lauderdale, FL, USA, 2. Massachusetts General Hospital
and Harvard Medical School, Boston, MA, USA.
Background: Several studies demonstrate that poor insight is associated with worse treatment
outcome in cognitive-behavioral and pharmacological treatments for obsessive-compulsive
disorder (OCD) (e.g., Foa et al., 1999; Himle et al., 2006; Neziroglu et al., 2004; Tolin et al.,
2004). There is also evidence that individuals with certain OCD symptom manifestations are
most likely to have fixed beliefs. Tolin and colleagues (2001) found that OCD patients with
primary religious obsessions had more fixed beliefs than did those with several other types of
obsessional content. However, in that study, degree of fixidity did not predict symptom severity
across patients with all obsessional types. Hence, although religious symptoms may be
associated with less insight, degree of insight may not indicate greater symptom severity. In
light of these findings, we examined the relationship between insight and symptom severity in
individuals with scrupulous (religious or moral obsessional fears) or contamination-focused
OCD. We predicted that OCD symptom severity would be more strongly associated with poor
insight in patients with scrupulous OCD compared to contamination OCD. Method: Adults
diagnosed with scrupulous OCD (n = 24) or contamination OCD (n = 20) were recruited as part
of a study on attentional processes in OCD. All participants were administered a structured
clinical interview (Structured Clinical Interview for DSM-IV-TR Axis I Disorders), Yale-Brown
Obsessive Compulsive Scale (Y-BOCS), and Brown Assessment of Beliefs Scale (BABS) by a
doctoral-level clinician. Higher scores on the BABS indicate poorer insight or greater
delusionality. All participants met criteria for OCD and had a minimal score of 16 on the YBOCS. Scrupulous participants primary obsessional fears were religious or moral;
contamination-focused participants had primary obsessions about contamination and no
religious or moral obsessions in their three most distressing areas of concern. Results: The
magnitude of the relationship between symptom severity and delusionality was twice as large in
the scrupulous group as in the contamination group. Among individuals with scrupulosity, YBOCS and BABS scores were strongly correlated, r = .59, p = .002. The association was
moderate in the contamination group, r = .31, and non-significant in a sample of this size, p =
.19. The difference in correlation coefficients was not statistically significant (using Fishers r-toz transformation), p = .27. Discussion: The results of this investigation are consistent with the
prediction that scrupulosity is more strongly characterized by lack of insight than contaminationfocused OCD. However, although the effect sizes are suggestive, the magnitude of the
association did not differ significantly in this relatively small sample (N = 44). Nevertheless,
considering that lack of insight is associated with poor treatment outcome, if replicated in a
larger sample, these results could elucidate one reason clinicians struggle with scrupulous
patients. Scrupulous individuals may particularly benefit from techniques designed to increase
insight.

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Handling Comorbidity, Varieties of Symptom Presentation, and Parental Involvement in


the Treatment of Youth with Obsessive-Compulsive Disorder
Eric Storch1, Stephen Whiteside2, Dean McKay3, Caleb Lack4, Throstur Bjorgvinsson5, Gary
Geffken6, Bradley Riemann7.
1. Pediatrics, University of South Florida, St. Petersburg, FL, USA, 2. Psychiatry, Mayo Clinic,
Rochester, MN, USA, 3. Psychology, Fordham University, Bronx, NY, USA, 4. Psychology,
Central Oklahoma University, Edmund, OK, USA, 5. Houston OCD Program, Houston, TX,
USA, 6. University of Florida, Gainesville, FL, USA, 7. Rogers Memorial Hospital, Oconomowoc,
WI, USA.
Recent research has demonstrated convincingly that child and adult OCD is amenable to
cognitive-behavioral treatment. However, much of this research focuses on children who have
few additional diagnoses or complications that might interfere with treatment. Yet, in everyday
clinical practice there are numerous additional considerations that lead to poorer treatment
response than would be implied by the published research literature. The aim of this panel is to
discuss methods for addressing some of the major factors that contribute to attenuated
outcomes with the goal of providing clinically useful information for the practicing clinician. The
major domains that will be discussed are as follows: comorbid presentations (including
internalizing and externalizing disorders); complex symptom presentations, such as atypical
symptoms; treatment noncompliance; and utilizing effective parental involvement in treatment.
Dr. Eric Storch will serve as moderator of this panel. Each panelist brings a wealth of clinical
and research experience to this panel, from a variety of diverse settings including outpatient
specialty clinics, intensive outpatient programs, and residential facilities. Panelists will be
queried on their thoughts and/or approach to responding to each problem domain, with
approximately 15 minutes allocated to each topic. Discussions will be geared towards how to
address these domains in a pragmatic clinical fashion.
RECENT ADVANCES IN PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER
Eric Storch1, Caleb Lack2, Sandra Mendlowitz3, Gary Geffken4, Stephen Whiteside5, Bradley
Riemann6.
1. Pediatrics, University of South Florida, St. Petersburg, FL, USA, 2. University of Central
Oklahoma, Edmund, OK, USA, 3. University of Toronto, Toronto, ON, Canada, 4. University of
Florida, Gainesvill, FL, USA, 5. Mayo Clinic, Rochester, MN, USA, 6. Rogers Memorial Hospital,
Oconomowoc, WI, USA.
Pediatric obsessive-compulsive disorder (OCD) is a chronic and debilitating disorder that has a
prevalence rate of up to 2% in children and adolescents. Pediatric OCD is associated with
substantial psychosocial impairment and, without treatment runs a chronic course into
adulthood. Given this, it is necessary to have a better understanding of both the impact of the
disorder during childhood and the effective interventions that are available for this population.
Fortunately, the last decade has seen a great expansion in the realms of treatment,
assessment, and phenomenology of pediatric OCD. With such advances in mind, the proposed
symposium highlights each of these domains in a series of talks by a collection of leading
international researchers. First, Dr. Eric Storch and colleagues will discuss recent translational
findings regarding the efficacy of d-cycloserine augmentation of cognitive behavioral therapy in
youth with OCD. This study represents a major translational success by targeting neural
mechanisms through a safe and acceptable non-psychotropic medication to improve treatment
outcome. Second, Dr. Caleb Lack and colleagues present data regarding rage attacks in youth
with OCD, and its association with clinical presentation. Clinical experience indicates that the
presence of rage can significantly exacerbate clinical presentation and complicate treatment

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outcome. Third, Dr. Sandra Mendlowitz and colleagues will present findings examining the
difference between a protocol-driven treatment in group versus individual modalities, and the
role of outcome predictors. Understanding which treatment works best for which person has
marked implications for improving outcomes. In the fourth presentation, Dr. Gary Geffken will
discuss the role of family accommodation in pediatric OCD, highlighting recent empirical
findings. Finally, Dr. Stephen Whiteside presents on the development and preliminary outcomes
associated with a truncated version of cognitive-behavioral therapy. This study is particularly
innovative given the issues that many families have in accessing appropriate cognitivebehavioral treatment. Dr. Bradley Riemann, a respected OCD researcher and clinician will
provide commentary on the papers and their implications for research, practice and treatment.
Pediatric obsessive-compulsive disorder (OCD)
Pediatric obsessive-compulsive disorder (OCD) is a chronic and debilitating disorder that has a
prevalence rate of up to 2% in children and adolescents. Pediatric OCD is associated with
substantial psychosocial impairment and, without treatment runs a chronic course into
adulthood. Given this, it is necessary to have a better understanding of both the impact of the
disorder during childhood and the effective interventions that are available for this population.
Fortunately, the last decade has seen a great expansion in the realms of treatment,
assessment, and phenomenology of pediatric OCD. With such advances in mind, the proposed
symposium highlights each of these domains in a series of talks by a collection of leading
international researchers. First, Dr. Eric Storch and colleagues will discuss recent translational
findings regarding the efficacy of d-cycloserine augmentation of cognitive behavioral therapy in
youth with OCD. This study represents a major translational success by targeting neural
mechanisms through a safe and acceptable non-psychotropic medication to improve treatment
outcome. Second, Dr. Caleb Lack and colleagues present data regarding rage attacks in youth
with OCD, and its association with clinical presentation. Clinical experience indicates that the
presence of rage can significantly exacerbate clinical presentation and complicate treatment
outcome. Third, Dr. Sandra Mendlowitz and colleagues will present findings examining the
difference between a protocol-driven treatment in group versus individual modalities, and the
role of outcome predictors. Understanding which treatment works best for which person has
marked implications for improving outcomes. In the fourth presentation, Dr. Gary Geffken will
discuss the role of family accommodation in pediatric OCD, highlighting recent empirical
findings. Finally, Dr. Stephen Whiteside presents on the development and preliminary outcomes
associated with a truncated version of cognitive-behavioral therapy. This study is particularly
innovative given the issues that many families have in accessing appropriate cognitivebehavioral treatment. Dr. Bradley Riemann, a respected OCD researcher and clinician will
provide commentary on the papers and their implications for research, practice and treatment.
RAGE ATTACKS IN YOUTH WITH OBSESSIVE-COMPULSIVE DISORDER:
PHENOMENOLOGY AND CLINICAL CORRELATES
Rage attacks have been documented in youth with varied psychiatric disorders, but few data
have been reported on the clinical characteristics and correlates of rage episodes among
children with obsessive-compulsive disorder (OCD). Participants were 86 children (ages 6-16
years) with a primary diagnosis of OCD. Patients and their primary caregiver were administered
clinician-rated measures of obsessive-compulsive severity and rage severity. Children
completed the Center for Epidemiologic Studies Depression Scale and the Child Sheehan
Disability Scale-Child, while parents completed the Rage Attacks Questionnaire, Aberrant
Behavior ChecklistIrritability Scale, Childrens Affective Lability Scale, and Child Sheehan
Disability Scale-Parent. Rage was common among youth with OCD and associated with varied
clinical characteristics. Rage severity accounted for functional impairment beyond the influence
of obsessive-compulsive symptom severity; however, these relations were explained by the

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impact of family accommodation. These data suggest that rage attacks are relatively common,
negatively impact illness presentation, and contribute to functional impairment above and
beyond obsessive-compulsive symptom severity. Rage may contribute to family accommodation
of symptoms, which may further impact obsessive-compulsive symptom severity and
impairment.
COGNITIVE-BEHAVIORAL THERAPY FOR PEDIATRIC OBSESSIVE-COMPULSIVE
DISORDER: GROUP VERSUS INDIVIDUAL TREATMENT AND PREDICTORS OF
OUTCOME
Obsessive-compulsive disorder (OCD) affects between 1.9% to 3.6% of children and
adolescents. Research supports the efficacy of cognitive behaviour therapy (CBT) with family
involvement as the treatment of choice for paediatric obsessive compulsive disorder (OCD).
Comparison studies identified CBT as highly significant treatment across a multitude of studies,
with larger effect sizes than pharmacotherapy trials (Watson & Rees, 2008). The current study
addresses the difference between a protocol-driven treatment in group versus individual
modalities, and the role of outcome predictors. While group treatment appears to provide
several advantages, individual treatment may provide more focused or tailored care to the
individual and their family. This study used a sample of 81 children between Grade 2 and Grade
11 diagnosed with OCD. Subjects participated in either a group or individual 12-week
manualized CBT program. All sessions included parent interventions, matched for each session
of either group or individual session. The sample contains 43.2% of boys and 56.8% of girls. All
children in this sample had treatment: 42% individual and 58% group. Gender distribution of the
two treatment groups was similar. Average change in CYBOCS, MASC, and CDI subscales
across the four time points (pre-treatment, post-treatment, 6-months follow-up and 1-year
follow-up) was examined by means of repeated-measures ANOVA with measurements at the
four time-points as a within-factor and treatment (individual vs. group) as a between-factor. This
analysis also allowed exploring whether the change (if any) differs between the two treatment
groups. The results of the repeated-measures ANOVAs indicate that CYBOCS, MASC, and CDI
scores significantly decline over time in both treatment groups and that this change is the same
for both groups. Child and parent perceptions of the family environment differed in terms of
family expressiveness, with children perceiving their family as being distressed. Post treatment,
children perceived their families as being more cohesive. Although girls and boys had similar
perceptions of their family environment, girls perceptions were more in agreement with their
parents than boys. Results were consistent with previous research; however, different
characteristics were found to predict treatment response for boys and girls, with girls having
more predictors than boys. The treatment protocol was an effective intervention for pediatric
OCD. There was no significant difference between group versus individual treatment and gains
were maintained at one-year follow-up. Results emphasize the importance that families have in
the treatment of OCD and in our attempt to find predictors, as well as the continued need to
examine boys and girls separately.
FAMILY ACCOMMODATION IN PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER
Obsessive-compulsive disorder (OCD) among children and adolescents is a debilitating and
chronic psychiatric condition with prevalence rates ranging of approximately 2%. Despite the
importance of the family in the treatment of pediatric obsessive-compulsive disorder (OCD),
relatively little empirical attention has been directed to family accommodation of symptoms. This
study examined the relations among family accommodation, OCD symptom severity, functional
impairment, and internalizing and externalizing behavior problems in a sample of 57 youth with
OCD. Family accommodation was a frequent event across families. Correlational analyses
showed that family accommodation was positively related to symptom severity, parent-rated
functional impairment (but not child-rated impairment), and externalizing and internalizing

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behavior problems. Finally, family accommodation mediated the relationship between symptom
severity and parent-rated functional impairment. Recognizing the role of family accommodation
in symptom expression has significant implications for assessment and modifying existing
psychotherapeutic treatment.
ADVANCES IN INTENSIVE COGNITIVE-BEHAVIORAL THERAPY: THE EFFICACY OF A
FIVE-DAY TREATMENT FOR PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER
Although exposure and response prevention (ERP) is the most effective intervention for
pediatric obsessive-compulsive disorder (OCD), many children do not receive ERP due, in part,
to the lack of trained providers and geographic barriers (e.g., distance to such providers). To
increase the availability of ERP, intensive protocols that compress treatment into daily sessions
over a short period of time have been developed. This presentation reviews advances in the
research on intensive ERP for pediatric OCD focusing on the development and study of a 5-day
treatment protocol. To begin with, the structure, applications, and patient populations for which
the protocol is appropriate will be described with an emphasis on adaptations necessary for
intensive treatment (i.e., parent involvement). During the implementation of ERP parents receive
hands on training in coaching exposure to enhance generalizability to the home environment.
Data examining the effectiveness of the 5-day intensive treatment from a recently completed
multi-site baseline comparison study will be presented. In summary, data collected from 25
children with OCD that received a week-long intensive treatment indicate reductions in scores
on the Childrens Yale-Brown Obsessive-Compulsive Scale comparable to more traditional
approaches to treatment. Moreover, symptoms continued to improve after the families returned
home suggesting that parents could successfully learn to be exposure coaches. Finally, issues
involved in researching intensive OCD treatments and directions for further development will be
discussed.
Innovations in the Treatment of OCD and Associated Disorders
Kiara Timpano1, Gail Steketee3, Eric Storch7, Regina Bussing7, Gary Geffken7, Brent Small7,
Joseph McNamara7, Omar Rahman7, Jane Mutch7, Dana Mason7, Adam Lewin7, Cynthia
Garvan7, Wayne Goodman8, Tanya Murphy7, Sabine Wilhelm6, Jennifer Greenberg6, Irina
Kasarskis6, Lillian Reuman6, Kiara Timpano1, Jonathan Abramowitz4, Norman Schmidt5, Jessica
Grisham2, Lauren Becker2, Alexis Whitton2, Alishia Williams2.
1. Department of Psychology, Univ Miami, Coral Gables, FL, USA, 2. The University of New
South Wales, Sydney, NSW, Australia, 3. Boston University, Boston, MA, USA, 4. University of
North Carolina, Chapel Hill, NC, USA, 5. Florida State University, Tallahassee, FL, USA, 6.
Massachusetts General Hospital, Boston, MA, USA, 7. University of South Florida, Tampa, FL,
USA, 8. Mt. Sinai Hospital, New York, NY, USA.
One of the changes proposed for the DSM-5 is the inclusion of a new diagnostic categorythe
Obsessive-Compulsive (OC) and Related Disorders category. Disorders identified as falling
within the OC spectrum are linked by high comorbidities, common etiological factors, and similar
phenomenological features. Despite our growing understanding of the nature of these disorders,
treating patients with OC spectrum conditions is still a significant challenge and there remains
much room for improvement. The current symposium will bring together a diverse group of
international experts to present new data on some of the most pressing questions facing the
field: prevention, predictors of treatment outcome, combined treatments, provision of services to
pediatric patients, and the development of innovative new intervention modalities.
Eric Storch from the University of South Florida will present results from a randomized, placebocontrolled trial comparing cognitive-behavioral therapy to a combination of cognitive-behavioral
therapy and sertraline for pediatric OCD. Next, Sabine Wilhelm from Massachusetts General
Hospital will discuss the development of a cognitive-behavioral therapy for adolescent Body

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Dysmorphic Disorder, along with initial outcome data. Kiara Timpano from the University of
Miami will examine a range of factors that could predict and/or influence the outcome of a
cognitive-behavioral prevention program for postpartum OCD. The fourth talk in this symposium
will be presented by Jessica Grisham from the University of New South Wales, who will discuss
the development of an innovative computerized cognitive bias modification paradigm to target
responsibility biases, which are commonly associated with OCD.
Gail Stektee, as discussant, will have the opportunity to synthesize common themes across the
presentations with a focus on the implications of the findings for the dissemination of evidencebased approaches. Consideration will be given to common themes between the various OCspectrum disorders and their treatment. Future avenues of research will also be addressed.
Randomized, Placebo-Controlled Trial of Cognitive-Behavioral Therapy Alone or
Combined with Sertraline in the Treatment of Pediatric Obsessive-Compulsive Disorder
Objective: To examine the efficacy of sequential sertraline and cognitive-behavioral therapy
(CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents
with obsessive-compulsive disorder (OCD).
Method: Forty-seven children and adolescents with OCD (Range = 7-17 years) were
randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing +
CBT (RegSert+CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the
maximally tolerated daily dose + CBT (SloSert+CBT); or 3) pill placebo + CBT (PBO+CBT).
Assessments were conducted at screening, baseline, weeks 1-9, 13, and 17, and posttreatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status.
Primary outcomes included the Children's Yale-Brown Obsessive-Compulsive Scale (CYBOCS), and response and remission status. Secondary outcomes included the Child Obsessive
Compulsive Impact Scale-Parent/Child, Children's Depression Rating Scale-Revised,
Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.
Results: All groups exhibited large within-group effects across outcomes. There was no group
by time interaction across all outcomes suggesting that group changes over time were
comparable. Sertraline and CBT were well-tolerated.
Conclusions: Among youth with OCD, there was no evidence that sequentially provided
sertraline with CBT differed from those receiving placebo with CBT. Possible explanations for
these findings are discussed.
Development and Testing of Cognitive-Behavioral Therapy for Adolescents with Body
Dysmorphic Disoder
Body dysmorphic disorder (BDD) is defined as a distressing or impairing preoccupation with a
perceived defect in physical appearance. BDD is a common disorder but often goes
unrecognized in clinical settings, and research on treatment outcome in BDD is limited.
Cognitive-behavioral therapy (CBT) has shown promise in adults but research on CBT in
children is scarce. This presentation will review the development and early stages of testing of a
new cognitive-behavioral treatment for adolescents with BDD and will present initial treatment
outcome data.
We tested feasibility, acceptability, and treatment outcome in a sample of 8 (7 females)
adolescents [mean age 15.3 years (SD=0.9)] with primary BDD. Participants primary
appearance concerns included face (ugly ; n=2), nose (n=2), body build (n=1), eyes (n=1),
shoulders (n=1), and skin (n=1). At baseline, most participants reported avoidance of social
interactions (n=7) and school refusal (n=7). Commonly reported rituals included
checking/inspecting body part (n=8), seeking reassurance (n=8), touching body part (n=7),
mirror checking (n=7), comparing appearance to others (n=7), grooming activities (n=5),
avoiding intimate/close contact (n=5), camouflaging (n=4), and using topical treatments (n=3).
Treatment was delivered in weekly individual sessions over 20 weeks. Two patients dropped out

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of treatment, two were withdrawn due to worsening of preexisting comorbid conditions, and two
patients are currently in treatment.
Preliminary analyses show that mean symptom severity measured with the BDD-Yale Brown
Obsessive Compulsive Scale (BDD-YBOCS-Adolescent Version) dropped from the severe
range at pre-treatment to the moderate range in the intent to treat (ITT) sample [38.3 (SD=2.6)
to 25.4 (SD=10.2) and to the mild range in completers [37.0 (SD=4.2) to 10.0 (SD=1.4)] at posttreatment. Insight (Brown Assessment of Beliefs Scale) dropped from 20.3 (SD=2.6) to 17.3
(SD=6.1) in ITT and from 17.5 (SD=0.7) to 12.0 (SD=7.1) in completers. Depression (Childrens
Depression Inventory) dropped from 22.5 (SD= 10.7) to 19.3 (SD=9.8) in ITT and from 10.5
(SD= 9.2) to 9.0 (SD=11.3) in completers. Results will be analyzed after 12 patients have
completed therapy. To our knowledge, this represents the largest study of a psychosocial
treatment for adolescent BDD.
Predictors and Moderators of Response to a Postpartum OCD Prevention Program
There has been a recent rise in research on maternal psychological conditions during the
perinatal period. Although the majority of investigations have examined postpartum depression,
there is a growing appreciation for the deleterious consequences of perinatal anxiety. Obsessive
Compulsive Disorder (OCD), in particular, has emerged as a desirable target for intervention.
We recently presented the results from a randomized controlled trial (RCT) of an indicated,
CBT-based prevention program for postpartum obsessive compulsive symptoms (OCS). Briefly,
study findings revealed that at 1, 3 and 6 months postpartum, the prevention program was
associated with significantly lower levels of OCS compared to the control group. Having
established the potential utility of an OCS prevention program, we can now consider different
outcome predictors (i.e., baseline characteristics that have a main effect on outcome) and
moderators (i.e., baseline characteristics that interact with treatment condition to predict
outcome). A better understanding of these variables could help identify modification points that
would render the intervention more effective, and also potentially help in tailoring the treatment
towards specific subgroups of individuals.
The aim of the present study was to examine a range of factors as potential predictors and
moderators of 1-month postpartum OCS, within the context of the above mentioned RCT.
Participants included at-risk women in their 2nd or 3rd trimester and their partners, who were
randomized into either a treatment (N=78) or control (N=66) group. Using linear regression
models, we considered the following factors as potential predictors and moderators. (1) OCDspecific factors, including: baseline OCS severity, obsessive beliefs, and levels of thought-action
fusion; and (2) more general factors associated with anxiety, including: distress tolerance,
anxiety sensitivity, and relationship adjustment. Significant predictors of 1-month postpartum
OCS were baseline levels of OCS (= 0.44, p <.001), thought-action fusion (= 0.31, p <.001),
and distress tolerance (= -0.35, p <.001). Significant moderators included baseline OCS (=
0.22, p <.01), obsessive beliefs (= 0.28, p <.05), distress tolerance (= -0.17, p <.05), and
relationship adjustment (= -0.22, p <.05). The interaction between these variables and
condition was such that the prevention program was particularly effective for individuals who
had poorer functioning at baseline. Results will be discussed with respect to implications for
future intervention research on postpartum OCS.
Cognitive Bias Modification for Compulsive Checking: A Novel Computerized
Intervention Targeting Responsibility Biases
Inflated responsibility biases appear to play a unique causal role in pathological doubting and
checking, a common obsessive-compulsive disorder (OCD) symptom dimension. Compulsive
checking therefore presents an ideal opportunity to apply cognitive bias modification (CBM), a
computerized intervention targeting attentional or interpretative biases. In the current study, we
developed and tested a novel CBM training program targeting inflated responsibility. This study

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served as an initial investigation of the application of CBM to compulsive checking, as well as a


direct test of the etiological role of responsibility biases. Undergraduate participants with high
levels of compulsive checking symptoms (N = 80) were randomly assigned to either a positive
(decrease responsibility) or negative (increase responsibility) CBM condition. Following training,
participants completed an implicit measure of interpretive bias in which they interpreted novel
ambiguous scenarios, as well as a questionnaire measure of responsibility beliefs. They also
engaged in a behavioral stressor task designed to activate responsibility beliefs. In this task, the
experimenter asked participants to sort candies in order to remove those that might harm a
subsequent participant with a nut allergy. As expected, positive CBM training resulted in
training-congruent changes in the interpretation of novel ambiguous scenarios related to
responsibility, as well reduced scores on an explicit measure of responsibility beliefs. Contrary
to predictions, negative CBM training did not result in training-congruent changes in subsequent
interpretations of ambiguity or on a measure of responsibility beliefs. Finally, CBM training
condition did not differentially impact participants behavior or emotional response with respect
to the candy sorting stressor task. Present findings provide support for the further evaluation of
CBM paradigms targeting inflated responsibility with clinical OCD samples.
Recent advances in understanding the obsessive compulsive spectrum
Kiara Timpano1, Eric Storch2, Alexis Whitton3, Jessica Grisham3, Julie Henry3, Peter Rendell4,
Sheila Woody5, Kirstie Kellman-McFarlane5, Alison Welsted5, Kiara Timpano1, Jesse Cougle6,
Priscila Chacon7, Elisa Bernardes7, Marcelo Batistuzzo7, Euripedes Miguel7, Roseli Shavitt7,
Guilherme Polanczyk7.
1. Department of Psychology, Univ Miami, Coral Gables, FL, USA, 2. University of South
Florida, Tampa, FL, USA, 3. The University of New South Wales, Sydney, NSW, Australia, 4.
Australian Catholic University, Melbourne, VIC, Australia, 5. University of British Columbia,
Vancouver, BC, Canada, 6. Florida State University, Tallahassee, FL, USA, 7. Institute &
Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Obsessive compulsive disorder (OCD) is a chronic and disabling condition that affects about 23% of the population worldwide. Increasingly, scientists are acknowledging that OCD may fall
within a spectrum of disorders (i.e., the OC spectrum), which are linked by common etiological
and phenomenological features. Despite our growing understanding, treating patients with OC
spectrum disorders is still a significant challenge and much remains to be learned about the
maintenance and etiology of these disorders. This symposium will summarize and discuss
recent advances in our understanding of several OC spectrum disorders. Four international
researchers from Australia, Canada, Brazil and the United States will present original research
findings. Speakers will highlight findings on cognitive, emotional, and information processing
correlates. In particular, psychopathology research will be discussed that could directly translate
into and inform future investigations on the best clinical practices for the OC spectrum.
Alexis Whitton from the University of New South Wales will discuss results from a series of three
studies that examined clinical, cognitive and emotional correlates of moral rigidity within OCD.
Next, Sheila Woody from the University of British Columbia will examine categorization deficits
using a behavioral task in hoarding. Kiara Timpano from the University of Miami will present on
the relationship between emotional tolerance and hoarding symptoms. The fourth talk,
presented by Priscila Chacon from University of So Paulo School of Medicine, will present data
on obsessive compulsive symptoms in children with a first degree relative diagnosed with OCD
research on the exploration of information processing deficits in hoarders, including
categorization, attention, and decision-making.
Eric Storch from the University of South Florida will serve as discussant for the symposium. The
implications of the presented psychopathology research on the development and investigation
of treatment interventions will be discussed, along with a consideration of common themes that

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link the various presentations and OC spectrum conditions together. Future avenues of
research, with a particular focus on vulnerability models and potential mechanisms of change,
will also be addressed.
Clinical, cognitive and emotional correlates of moral rigidity in obsessive-compulsive
disorder
Individuals with obsessive-compulsive disorder (OCD) frequently experience obsessions that
centre on the moral themes of violence, sex and blasphemy. The disorder is also often
associated with extreme moral rigidity, resulting in an existential paradox that leads to marked
distress and pathological guilt.
Moral rigidity in OCD poses a particular challenge for the cognitive-behavioural therapist.
Staunch moral beliefs are often accompanied by a lack of insight into the dysfunctional nature of
obsessional fears, moral rules are especially resistant to cognitive challenge, and exposure to
moral transgression is difficult to facilitate.
There is a paucity of research into the factors that contribute to moral rigidity in OCD, and it
seems especially important to elucidate the processes underpinning this cognitive style given
that it impedes treatment and causes marked distress to the sufferer. Therefore, the aim of the
current research was to determine, through a series of experiments, the factors that underpin
moral rigidity in OCD. Using analogue and clinical OCD samples, the emotional, cognitive,
clinical and psychophysiological correlates of moral rigidity were examined.
Study 1 assessed the relationship between obsessive-compulsive (OC) symptom dimensions,
emotion and moral reasoning in an analogue sample of individuals high (n = 30) and low (n =
30) in OC symptoms. Self-reported emotional responses to moral transgressions were
supplemented by a psychophysiological index of emotion, facial electromyography (EMG).
Study 2 sought to clarify the findings of Study 1 in a second analogue sample of individuals high
(n = 30) and low (n = 30) in OC symptoms through the added assessment of negative affect.
Study 3 assessed the relationship between domains of obsessive beliefs, and emotional and
psychophysiological responses to moral transgressions in a sample of individuals with clinical
OCD (n = 25), relative to individuals with non-OCD anxiety disorders (n = 21) and healthy
controls (n = 24).
The results of the current research extend previous self-report-based findings by showing that
individuals with OC symptoms exhibit heightened psychophysiological responses to moral
transgressions. Furthermore our findings indicate that greater moral rigidity may be driven by
emotional factors such as heightened disgust sensitivity, and cognitive factors such as
perfectionism and beliefs about the over importance of thoughts. These findings will be
discussed with reference to current theoretical models of emotional and cognitive processes in
OCD.
Categorization in Hoarding
Current theories of compulsive hoarding propose executive functioning deficits may underlie
some of the symptoms of this problem. For example, individuals who hoard are hypothesized to
prioritize the unique features of an object relative to common features shared by objects, which
would interfere with categorization. Because fewer redundancies are perceived with other
objects, parting with any object is more difficult, and the home environment becomes quite
cluttered. Categorization difficulties would also help account for the disorganization evident in
many hoarded homes. Several studies have used unstructured sorting tasks to examine
whether hoarding is associated with categorization deficits. Some studies have found hoarding
clients create more categories, take longer to complete the sorting task, and report more anxiety
during the task. Other studies report no differences on these indices between hoarding and
healthy comparison groups or clients with mood or anxiety disorders. The contradictory results
may be due to methodological differences in sampling (subclinical vs. clinical hoarding) or

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stimulus characteristics (e.g., everyday nonpersonal items vs. personal items vs. names of
personal items written on cue cards).
In an effort to clarify the results of these studies, we compared participants with a range of
severity of problems with clutter and difficulty discarding, and used several unstructured sorting
tasks of the types used in previous studies. The aim was to bridge the prior studies to clarify the
discrepant findings. We recruited 90 participants for three groups: clinically significant hoarding,
subclinical clutter (e.g., mild-moderate clutter and difficulty discarding with little impairment or
distress), and healthy controls who reported no features of hoarding. Each participant sorted
three sets of 20 items: (a) trivial low cost items (e.g., rubber ball, birthday candle), (b) typically
hoarded objects (e.g., newspaper, deodorant), and (c) a standardized set of objects participants
were asked to bring from home (e.g., mug, pen). Dependent variables were number of
categories generated, latency to complete the sorting, and subjective distress during each task.
Results will be discussed in relation to previously published findings as well as implications for
treatment approaches that include training in categorizing and organizing alongside more
traditional cognitive and behavioural approaches.
The Relationship between Emotional Intolerance and Hoarding
Hoarding Disorder is slated for inclusion as a discrete syndrome in DSM-5 and is increasingly
recognized as a substantial public health burden. Despite the magnitude of impairment
associated with this phenomenon, empirical research is still in the nascent stages and many
facets of the phenomenology, including an understanding of the underlying risk factors, are as
of yet unknown. The cognitive behavioral model of hoarding hypothesizes that saving and
acquiring behaviors are reinforced via emotionally-driven feedback loops. Despite the central
role emotional processes seem to play in maintaining hoarding, few studies have examined this
topic. Thus far, hoarding has been associated with several facets of emotional intolerance: high
anxiety sensitivity, low distress tolerance (DT), and avoiding negative emotions. Yet, all previous
research has used self-report methodology. The purpose of this investigation was to expand on
past research by conducting a multi-method investigation of the relationship between hoarding
and emotional processes.
In Study 1 a large unselected sample of young adults (N=213) completed questionnaires and
behavioral tasks, which assessed DT and the appraisal of emotions. Ratings of emotional
intensity and tolerance were also collected following a series of mood inductions for sadness,
fear, disgust, and anger. Greater hoarding severity was associated with lower self-reported DT
(r = -.19, p < .05) and more threatening appraisals of and difficulty tolerating negative emotions.
Individuals high in hoarding symptoms also experienced more intense emotions than individuals
low in hoarding symptoms (F = 8.38, p < .01). We extended these findings in Study 2 by
examining levels of distress tolerance and anxiety sensitivity in a clinical sample (N=45),
comparing participants with clinical hoarding to those with social anxiety disorder. Results
revealed that the hoarding group had significantly lower levels of DT (t = -2.2, p < .01) and
higher levels of anxiety sensitivity (t = 2.3, p < .05). This is the first investigation to use a multimethod approach to examine how emotional processes relate to hoarding. Across Studies 1
and 2 Hoarding was consistently associated with problems experiencing and tolerating negative
emotions. Our results offer initial support for the important role of emotional processes in the
cognitive-behavioral model of hoarding. A better understanding of these processes may play a
crucial role in developing more effective treatments for hoarding.
Obsessive Compulsive symptoms in children with first degree relatives diagnosed with
obsessive compulsive disorder
Background: Obsessive compulsive disorder (OCD) is a neuropsychiatric disorder with a life
time prevalence of about 2% with most of the cases with an onset before age 18. The early
identification of obsessive compulsive symptoms (OCS) and associated clinical features can

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contribute with a better understanding of early risk factors involved in the trajectory of the
development of the full blown of the disorder. The first goal of this study was to investigate
whether children who had a first degree relative (parent or sibling) diagnosed with OCD would
have OCS. The second goal was to explore clinical and demographic characteristics of these
children and relatives. Methods: Children were identified by screening patients with OCD from
two studies. The first study is the Brazilian obsessive-compulsive consortium (Miguel, Ferro et
al., 2008), and the second one is an ongoing clinical trial of children with OCD (Miguel,
Mercadante et al., 2009).
From 231 OCD patients from Sao Paulo, 102 were contacted and 53 had eligible
siblings/offspring. A total of 66 children 3-17 were evaluated through a phone screening
interview that assessed OCS, any other behavioral problem and coercive behavior. Children
with reported diagnosis autistic spectrum disorders, schizophrenia, organic mental disorder or
intellectual disability were excluded. Results: First degree relatives who responded to the
screening about their children or had a parent (or other caregiver) were younger than nonresponders (p=0,011), had a higher YBOCS score (0,019) and had more
cleaning/contamination symptoms.Three children (4,5%) had OCD diagnoses and an additional
26 (39,4%) had OCS. There was an association between lower socioeconomic status and
presence of OCS in children with a first degree relative with full blown OCD (p=0,008). Children
with OCS had more externalizing symptoms and coercive behaviors than children without OCS
(p=0,008). Children/siblings of OCD patients who had cleaning/contaminations symptoms were
at higher risk for presenting with OCS (p=0,04; OR=9,47) compared to children whose first
degree relatives had other dimensions. Conclusion: OCS run in families and seem to be
associated to coercive behaviors and externalizing symptoms. Contamination/cleaning
symptoms in the proband are a risk factor for the manifestation of OCS in another first degree
relative. Future studies should take these variables together, to assess their relationship to the
development and maintenance of OCD.
Body Dysmorphic Disorder - An evidence based summary of the key challenges
Himanshu Tyagi1, 2, Lynne Drummond2, 3, Rupal Patel2, Himanshu Tyagi1, 2, Pratima Singh4.
1. Sobell Department, University College London, London, United Kingdom, 2. National
OCD/BDD Service, London, United Kingdom, 3. St Georges University of London, London,
United Kingdom, 4. South London and Maudsley NHS Trust, London, United Kingdom.
Body dysmorphic disorder is a highly distressing and impairing disorder characterized by a
preoccupation with imagined or slight physical defects in appearance. The perceived flaws in
their appearance lead to obsession and they are convinced their body is imperfect when they
actually look completely normal. Sufferers think about their perceived defect for many hours per
day and engage in time-consuming repetitive behaviours such as comparing, mirror-checking,
camouflaging, excessive grooming or reassurance-seeking (Phillips 1991; 1993). It is also
marked by the presence of an extreme social avoidance leading to substantial social isolation,
including being housebound for years. Despite such challenges, it remains as one of the most
under-researched disorders in mental health sciences. Effective treatment, although available,
is often delayed or not accepted by the clients. This thought provoking symposium would try to
focus and explore the key issues leading to this disorder being under-researched, underdiagnosed and generally inadequately managed worldwide. Our several years of experience in
treatment of a range of body dysmorphic disorder patients in both outpatient and inpatient
settings in a specialist national service for BDD has led us to believe that the reasons for above
challenges can be reduced to three key obstacles, which are:
1. Evolving definition and ever-changing place of BDD in diagnostic classification systems
2. Relatively poor understanding of the phenomenology which prevents further development
and refinement of psychological and pharmacological therapeutic strategies.

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3. A general lack of understanding of illness related risk in BDD.


This symposium would try to generate useful discussion by exploring each of the above key
obstacles with a highly relevant clinical or academic paper produced by each of the presenter.
From Dysmorphophobia to BDD, a never ending journey of a disorder amongst
diagnostic classification systems
Aim
To highlight the various diagnostic challenges and discrepancies that has made it difficult for
this disorder to be researched and treated in a standardised fashion over the last century.
Method
This paper would present a literature review illustrated by well researched anecdotes and
relevant cases and images that mark the history of BDD and its journey through the various
classification systems including ICD-10 and various editions of DSM with special attention on
DSM-5 which is scheduled to release in May 2013. It would trace the journey of BDD from the
point when it was identified as Dysmorphophobia by the Italian psychiatrist Morselli in 1886 to
DSM-V proposals. Historical and ongoing arguments for and against it being a phobia vs.
cognitive disorder, somatoform disorder vs. non-somatoform disorder, manifestation of
psychosis vs. mono-symptomatic delusional disorder, overvalued ideation vs. irrational
conviction, OCD subtype vs. obsessive-compulsive spectrum disorder, heterogeneous vs.
homogenous etc. would be included. How specific cultural aspects and manifestations make the
classification and diagnosis difficult would also be explored.
Conclusions
We believe that by understanding the historical journey of BDD amongst various diagnostic
systems helps a clinician to take a long view of the remaining challenges and puts them in
context.
Gender Differences in Body Dysmorphic Disorder
Aim
Gender is unequivocally tied to self-perception of ones own body image. However, disorders of
body image usually do not have gender specific approaches to treatment, mainly due to a
relative lack of evidence for similarities and differences between genders. This study
investigated gender similarities and differences in self-reported preoccupations with various
body parts in patients with Body Dysmorphic Disorder.
Method
We investigated 54 patients with a diagnosis of BDD, who were assessed between 2008 and
2011 at a specialist centre for OCD and BDD, based at Springfield University Hospital, London
UK. Routinely collected standard measures at the time of assessment i.e. Yale Brown
Obsessive Compulsive Scale (YBOCS-BDD), Body Dissatisfaction Checklist, Beck Depression
Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS), Sheehan Disability
Scale (SDS) and sociodemographic information (relationship and employment status) were
collated and analysed with respect to gender. Self-report questionnaires i.e. Body
Dissatisfaction Checklist, BDI and SDS were completed by the patients prior to the assessment
interview. Assessment interviews were conducted by clinicians with specific expertise in the
treatment of BDD. Data on the preoccupation with body parts was primarily collected from body
dissatisfaction checklist and was supplemented with information reported elsewhere in the
assessment and treatment reports.
Results
This study found fewer differences than similarities between the two genders. The data
suggested that females were more likely to present late for treatment and also not be in a stable
relationship at the time of presentation. Males were noted to be less likely to be employed.

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Males scored slightly higher on all clinician rated instruments i.e. YBOCS- BDD, BDI, MADRS
and SDS. However none of these demographic or clinical factors were found to have a
statistically significant difference between the two genders. Males and females did not
significantly differ in terms of most of the variables on body dissatisfaction checklist. Statistically
significant differences were found only in preoccupation with breasts, hips, skin (face and body)
and hair (face and body, except head). Our results are similar to previously reported findings in
the literature (Phillips 1997).
Conclusions
We believe that the above findings can potentially inform new gender specific strategies for
successfully treatment body dysmorphic disorder.
Suicidality & other risks in Body Dysmorphic Disorder
Aim
Over 75% of people with BDD feel suicidal at some point, with 25% having already attempted to
take their own life. This paper would present a literature review on Suicidality and other risks in
BDD and would highlight the recent published work by Philips et al in this area.
Method
This presentation would focus on the acquired capability of suicide of BDD patients in terms of
physical pain tolerance and reduced fear of death according to Joiner's (2005) interpersonal
psychological suicide theories. A recently demonstrated link between limited food intake or
excessive dieting and a rise in suicide attempts in those suffering from BDD will be discussed.
Investigations of the link between attempted suicides with physically painful BDD-related
behaviours will also be covered i.e.
1. Excessive exercise
2. Physical self-mutilation
3. BDD-related cosmetic surgery
4. Compulsive skin picking
Prevalence data on the suicidal ideation and impact of treatment on them would also focus in
this session. Other implicit and explicit risks like harm to the professional, poor engagement,
poor insight, dis-inclination of the patient to see a mental health professional and the evidence
based methods to mitigate these risks would be covered in this talk.
Conclusions
We believe that a better understanding of the implicit and explicit risk in BDD by policy makers
and clinicians would lead to development and provision of better services for this underdiagnosed and under-treated but common illness.
Remote Treatment of Obsessive-Compulsive Disorder: Results from 3 Trials
Demonstrating the Efficacy of Guided and Self-Guided Administration
Bethany Wootton, Nick Titov, Blake Dear, Luke Johnston.
Macquarie University, Sydney, NSW, Australia.
Abstract Central: Background: Effective treatments for OCD exist, however there are many
barriers to accessing these treatments. An innovative way to reduce many of these barriers is to
provide treatment remotely. The OCD Course is an 8-week cognitive and behavioural treatment
program that can be delivered remotely. Three studies will be presented which investigated the
efficacy of both guided and self-guided delivery of the OCD Course. Methods: Study 1: 21
participants with OCD were treated online with the OCD Course in a clinician-guided format
using an open trial design. Study 2: 56 participants with OCD were allocated to receive clinicianassisted online treatment, clinician-assisted bibliotherapy treatment, or waitlist control, using a
RCT design. Study 3: 19 participants with OCD received self-guided online treatment with
automatic email reminders using an open trial design. Results: Study 1: Participants improved

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significantly on the Yale-Brown Obsessive Compulsive Scale (YBOCS) with a within-group


effect size (Cohens d) of 1.5 at post-treatment. Participants rated the program as highly
acceptable. Study 2: Participants in both active treatment groups improved significantly
compared to the waitlist control group. Within group effects sizes on the YBOCS at posttreatment was 1.2 for the bibliotherapy group, 1.1 for the internet group and 0.10 for the waitlist
control group. There were no significant differences between the treatment groups in
acceptability to participants. Study 3: Participants improved significantly on the YBOCS with a
within-group effect size for those who completed the treatment of 1.2. Participants found the
course acceptable. Conclusions: The results of these 3 studies demonstrate the efficacy of both
guided and self-guided administration of remote treatment for OCD. These findings have
important implications for public policy administrators as remote treatment is more cost effective
and overcomes many of the barriers associated with face-to-face treatment.
How Specific Are Obsessive Beliefs for Obsessive-Compulsive Disorder?
Janna von Beschwitz, Anne Klumparendt, Fred Rist, Isabelle Drenckhan.
Clinical Psychology and Psychotherapy, University of Mnster, Mnster, Germany.
Theoretical Background: Cognitive-behavioral theories of obsessive-compulsive disorders
(OCD) emphasize the role of dysfunctional beliefs in the development and maintenance of OCD
(Rachman, 1998; Salkovskis, 1985). The Obsessive Compulsive Cognitions Working Group
(OCCWG) postulated six cognitive domains to be central to OCD: responsibility, overestimation
of threat, importance and control of thoughts, perfectionism and intolerance of uncertainty.
Some of these domains apply also to other disorders, i.e. depression or anxiety disorders (i.e.
OCCWG, 2003). However, all these obsessive belief domains are highly intercorrelated. Thus,
by only examining correlational patterns, the specific predictive quality of each obsessive belief
for non-obsessional disorders remains unclear. In our study we intend a) to validate and
improve the German version of the Obsessive Beliefs Questionnaire (OBQ; OCCWG, 2005) and
b) to test the differential predictive validity of the OBQ for symptoms of OCD and of depression.
Method: In an internet-based survey a community sample of 1061 participants filled out a
slightly modified German version of the OBQ, the Obsessive Compulsive Inventory - Revised
(OCI-R, Foa et al., 2002), and the depression module of the Patient Health Questionnaire
(PHQ-9, Spitzer, Kroenke, & Williams, 1999). The dimensional structure of the questionnaires
was established via explorative and confirmatory factor analyses. In structural equation models
the obsessive belief domains were tested as predictors for obsession and depression
symptoms. Results: Exploratory factor analysis revealed four factors for the German OBQ:
Overestimation of threat, responsibility, intolerance of uncertainty/perfectionism and
importance/control of thoughts. Two strong associations of the OBQ dimensions and the OCI-R
emerged: a) Threat overestimation predicted all six facets of OCD assessed with the OCI-R (.29
- .51). b) Importance/control of thoughts predicted obsessional thoughts (.40). Only moderate
associations with OCI-R scores were found for Perfectionism/intolerance of uncertainty and
responsibility. All obsessive belief dimensions except for importance/control of thoughts are
significantly related to depression, with threat estimation (.62) as the most important predictor.
Conclusion: Among the beliefs postulated to influence the development and maintenance of
OCD, only perceived importance and the striving to control ones thoughts are specific to this
disorder. A particular strong predictor of symptoms of both depression and OCD is the
overestimation of threat. These results help to ascertain the concurrent and the discriminant
validity of the OBQ and should be considered in cognitive-behavioral models of OCD.
Personality Disorders/ Trastornos de la Personalidad/ Transtornos da Personalidade

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Psicologia como Ao Preventiva para a Violncia Escolar: Um Relation de Experincia


Carmen Amorim-Gaudncio, Lucas F. Braz, Jessica Oliveira, Nilse Chiapetti.
Universidade Federal da Paraba, Joo Pessoa, Brazil.
A violncia hoje uma das principais preocupaes da sociedade. Ela atinge a vida e a
integridade fsica das pessoas. um produto de modelos de desenvolvimento que tem suas
razes na histria. A definio de violncia se faz necessria para uma maior compreenso da
violncia escolar. uma transgresso da ordem e das regras da vida em sociedade. o
atentado direto, fsico ou no, contra a pessoa cuja vida, sade e integridade fsica ou liberdade
individual correm perigo a partir da ao de outra pessoa. A violncia escolar diz respeito a
todos os comportamentos agressivos e antissociais, incluindo os conflitos interpessoais, danos
ao patrimnio e atos criminosos, que envolvem alunos, professores e demais pessoas que
esto envolvidas no mbito escolar. Muitas dessas situaes dependem de fatores externos,
cujas intervenes podem estar alm da competncia e capacidade das entidades de ensino e
de seus funcionrios. O comportamento violento, que causa tanta preocupao e temor, resulta
da interao entre o desenvolvimento individual e os contextos sociais, como a famlia, a escola
e a comunidade. Mais especificamente, a delinquncia um dos problemas sociais que mais
reconhece a necessidade e utilidade da Psicologia e suas diversos mtodos de interveno. O
aumento da delinquncia juvenil observado de forma alarmante mediante os estudos
cientficos realizados sobre o problema e atravs dos diferentes meios de comunicao. O
objetivo do presente projeto (piloto) foi colaborar na preveno da conduta violenta na escola,
desenvolvendo uma interveno com os jovens estudantes da rede pblica do Estado da
Paraba. Os estudos prvios com amostras de estudantes paraibanos revelam uma forte
relao entre condutas antissociais ou delitivas e determinados valores (emoo, sexual e
prazer). Para efetivao do referido projeto, foram realizadas reunies para preparao,
anteriores a ida a campo e a cada tarefa a ser cumprida. O projeto foi realizado em trs etapas,
iniciando-se com a procura pelas escolas, entrevista com diretores, autorizao para o
desenvolvimento do projeto na etapa de escolha da escola, seguida pela etapa de contato com
os alunos, englobando aqui a redao do termo de consentimento livre e esclarecido e a
preparao para a aplicao dos questionrios. A ltima etapa foi a de interveno
propriamente dita, com a formulao de palestras e a formulao das sesses para a
interveno e o fechamento do Projeto. A escolha dos alunos para participarem da interveno
foi feita a partir das pontuaes dos participantes na escala de condutas antissociais e delitivas.
A partir desse projeto pode-se observar a real necessidade de interveno no que diz respeito
violncia no contexto escolar pblico atravs de tcnicas de cunho comportamental. Diante
disso, importante que o pensamento e a prtica caminhem juntos para que um
comportamento ajustado possa ser produzido, e a educao seja fruto do prprio sujeito que
pode ser capaz de decidir as questes da sua prpria vida sem interferir de maneira negativa
no direito ou na vida do outro.
Schizoaffective Disorder Diagnostic and Complications
Amasa Carvalho, Lucivania Souza, Izaura A. cardoso, Cileuma Mara Linhares, Maria Assis,
Luiz Vieira.
IESPES, Santarem, Brazil.
Abstract Central: A complexidade das doenas mentais, afeta no apenas os pacientes, mas
tambm seus familiares, causando prejuzos durante todo o curso da doena. A instabilidade
dessas condies e a impreviso quanto aos perodos de crise alternados aos perodos de
estabilidade, dificultam qualquer resoluo do quadro clnico. E, tendo em vista a semelhana

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existente entre os transtornos, esta pesquisa tem como objetivo geral identificar as diferenas
diagnsticas existentes entre a Esquizofrenia e o Transtorno Esquizoafetivo. E os objetivos
especficos foram: investigar as caractersticas da Esquizofrenia, do Transtorno Esquizoafetivo
e do Transtorno Bipolar; analisar as diferenas de tratamento e o curso da doena e dos
transtornos. Para o DSM IV, a Esquizofrenia uma doena mental que se distingue por uma
desorganizao ampla dos processos mentais, apresentando um quadro complexo de sinais e
sintomas no contexto que envolve a conscincia, as percepes e emoes. Para Quarantine
(2005), as atuais evidncias relativas s causas da esquizofrenia so um mosaico: a nica
coisa clara a constituio multifatorial da esquizofrenia. Isso inclui mudanas na qumica
cerebral, fatores genticos e alteraes estruturais. A origem viral e traumas enceflicos no
so descartadas. A esquizofrenia , provavelmente, um grupo de doenas relacionadas,
causadas por algum fator ou por muitos fatores. Entretanto, o Transtorno Esquizoafetivo, de
acordo com a Classificao de Transtornos Mentais e de Comportamento da CID-10, no
apresenta causas, ele episdico, no qual, ambos os sintomas, afetivos e esquizofrnicos, so
proeminentes dentro do mesmo episdio de doena, preferivelmente de forma simultnea ou,
pelo menos, distanciam-se poucos dias uns dos outros. Para Zanetti (2006), no Transtorno
Esquizoafetivo tipo depressivo h sintomas como retardo, a perda de energia, de apetite,
reduo dos interesses normais, comprometimento de ateno, a culpa e o sentimentos de
desesperana alm de recorrentes pensamentos suicidas. De acordo com Angst (2002), o tipo
manaco tende a durar mais e o prognstico menos favorvel. A metodologia aplicada foi um
estudo de caso com enfoque qualitativo e descritivo tendo um individuo diagnosticado como
esquizoafetivo tipo manaco. O instrumento de levantamento e tratamento de dados foi o
questionrio semi-estruturado seguindo o protocolo de Barlow (1999). Como aspectos ticos foi
seguido o anonimato e a assinatura do Termo de Consentimento Livre e Esclarecido. A
alterao de elementos cognitivos e o tempo levado at o diagnstico trouxeram ao individuo
muitos conflitos familiares, sociais e profissionais. Acredita-se que a dificuldade diagnostica
seja reflexo de um problema mais amplo de validade dos sistemas (CID-10 e DSM-IV) e suas
respectivas categorias diagnsticas. Visto que possvel que existam vrias formas
intermedirias de psicose com sintomas de humor ou que os dois diagnsticos clssicos de
esquizofrenia e transtorno de humor bipolar representem questes da mesma doena.
Entretanto, para qualquer afirmao dessa natureza primordial que sejam realizadas mais
pesquisas referentes a casos que geram dvidas diagnsticas e sejam feitas revises
peridicas, para levar mais qualidade de vida a esses indivduos.
Estilos de Personalidad en Profesionales de la Salud Que Ingresan a la Salud Pblica de
la Provincia de San Luis
Maria Correche, Mariela Lucero, Gomez Maria Alejandra.
San Luis (capital), Universidad Nacional de San Luis, San Luis, Argentina.
El objetivo de la presente investigacin fue describir los estilos de personalidad en los
profesionales que ingresan a la Salud pblica de la provincia de San Luis. La muestra estuvo
conformada por 50 profesionales ( mdicos, obstetras, psiclogos, enfermeros, radilogos y
bioqumicos) todos los que ingresaran a la carrera sanitaria de dicha provincia. Se aplico el
Inventario de estilos de personalidad MIPS . El cual esta compuesto por 180 tems. Los
resultados encontrados revelan que los puntajes ms elevados son: Apertura (PP 63),
Modificacin(PP 57), Sensacin (PP 689, firmeza (PP 58), Control (PP58). Los profesionales de
la salud son optimista con respecto a las posibilidades que les ofrece el futuro, se hacen cargo
de las situaciones a resolver, confan en las experiencias directas: Tienden a creer que son
ms competentes y talentosos que los dems. Palabras claves: Estilos de personalidadProfesionales Salud

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Dialectical Behavior Therapy for Adolescents an Alternative to Treat and Prevent Non
Suicidal Behaviors
Vinicius Dornelles1, 2, Diego Alano1, 2, Guilherme Ebert1, 2.
1. INFAPA, Porto Alegre, Brazil, 2. INFAPA, Porto Alegre, Brazil.
Non-suicidal behaviors are acts issued intentionally causing great harm himself. We can include
behaviors such as cutting themselves, burning, head banging, self aggression and scratching
until the appearance of wounds. In Borderline disorder this particular behaviors can happen
without intent to die. However, the non-suicidal acts are the biggest factor for subsequent
suicide. The non-suicidal behavior is also diagnostic criteria for Major Depressive Disorder and
Borderline Personality Disorder. As for the diagnosis of BPD adolescents is still controversial,
however the current Developmental Psychopathology proposes an alternative conceptualization
to this behaviors, promoting greater differentiation of etiologic MDD and TPB in relation to DSMIV. The biosocial model developed by Linehan, the diagnosis of BPD passes through five
stages, namely: poor impulse control, emotional deregulation, biological vulnerability x
environmental interactions of risk, and behavioral reactions triggered exacerbated by poor
emotional regulation triggered by interpersonal relationships. For many years the behavioral
therapy was the main model for treating self harm behaviors, yet in recent years the Dialectical
Behavioral Therapy has proven effective results for these behaviors. The TCD for adolescents
differs in TCD for adults. The main differences are more individual assistance weekly, family
care and group skills with a family. So while the TCD is hired at least one year, TCD-A will be 16
weeks with two weekly meetings in individual therapy. Thus is enhanced adaptive behaviors
that adolescents present throughout the process, taught problem solving strategies, exposure
and response prevention, strategies for acceptance and recognition and modulation of
emotions. The BPD is a disorder that comes from a poor care environment and may have gone
through negligent situations and physical abuse, psychological and sexual. Because of this care
with the adolescent has a strong focus on primary support group, believing that many of the
conflicts that arise patient passes through this alliance poor. In this sense it is necessary the
family support group weekly. This form of group - therapy will last for two hours, being
recommended to attend a family with five patients each. Mindfullness techniques will be
covered, effective relationship skills, frustration tolerance, emotional regulation and program
middle walking the path. So help facilitate conflict with a particular family member, to handle
family crises and guide members to improve treatment. Like TCD, the TCD-A requires that the
therapist is always present dialectic, has strong and positive interpersonal relationships and
help promote the freedom and self-control teenager. Emphasizing the importance of the
therapist make supervision meetings systematically, TCD as in adults. The TCD-A has a
dropout rate therapy less than 25%, a significant remission to the non suicidal behaviors four
weeks after the end of treatment.
Tratamento Cognitivo-Comportamental de um Paciente com Transtorno da
Personalidade Esquiva
Jssica Gubolin1, Luciana Bernardes da Rosa1, 2.
1. Instituto de Psicoterapia Cognitivo-Comportamental - IPC, So Jos do Rio Preto, Brazil, 2.
Universidade Paulista - UNIP, So Jos do Rio Preto, Brazil.
Abstract Central: finalidade desse trabalho demonstrar o atendimento de um paciente com
Transtorno da Personalidade Esquiva atendido em terapia cognitiva e discutir intervenes e
desafios. Foi sujeito desse relato um paciente do sexo masculino, homossexual, de 44 anos,

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solteiro, carpinteiro e escolaridade de nvel tcnico (Curso Tcnico em Produo Moveleira). A


queixa inicial foram sintomas depressivos e de ansiedade (Episdio Depressivo Maior
Recorrente) e dificuldades nos relacionamentos interpessoais, com a famlia e ainda
dificuldades em definir sua identidade profissional. O paciente apresentou sintomas
caractersticos Transtorno da Personalidade Esquiva. Foram realizadas 49 sesses at o ms
de abril de 2012, totalizando trs faltas neste perodo. Durante o processo teraputico os
sintomas depressivos sofreram alteraes constantes, relacionadas aos eventos estressores,
porm houve reduo dos sintomas de ansiedade, indicando que o paciente passou a lidar de
forma mais adequada com a ansiedade. Apresentou dificuldades em lidar com as exigncias da
vida profissional, optando por um novo curso superior e desistindo dele no segundo ms de
aula. As dificuldades nos relacionamentos interpessoais se tornaram persistentes, uma vez que
o paciente repete de forma rgida o padro de relacionar-se com homens pouco disponveis, o
que gera rejeies e abandonos que contribui para o aumento dos sintomas de depresso.
Apresentou aumento de comportamento pr-sociais e assim foi possvel diminuir o
comportamento de isolamento que o tornava mais suscetvel ao desenvolvimento da
depresso. De forma geral o processo teraputico mostrou-se positivo no sentido de auxiliar o
paciente a compreender seu padro de comportamento e diminuir a ansiedade, contudo,
permanecem os sintomas depressivos como emoo predominante diante das situaes
estressoras e o comportamento de esquiva como principal estratgia de enfrentamento para
lidar com as demandas no ambiente profissional, familiar e amoroso.
Resistncia No Processo Terapeutico em Pacientes com Transtornos da Personalidade:
Relato de Experincia e Propostas de Atuao
Jssica Gubolin1, Luciana Bernardes da Rosa1, 2.
1. Instituto de Psicoterapia Cognitivo-Comportamental - IPC, So Jos do Rio Preto, Brazil, 2.
Universidade Paulista, So Jos do Rio Preto, Brazil.
Abstract Central: O objetivo desse trabalho foi discutir sobre as resistncias e dificuldades
encontradas nos processos teraputicos de pacientes com transtornos da personalidade, sob a
perspectiva da terapia cognitivo-comportamental. Foram analisados 5 casos clnicos de
pacientes com diagnstico do Eixo II sendo respectivamente: Transtorno da Personalidade
Obsessiva-Compulsiva, Transtorno da Personalidade Histrinica, Transtorno da Personalidade
Narcisista, Transtorno da Personalidade Esquiva e Transtorno da Personalidade PassivoAgressiva. Foram sujeitos desse relato trs pacientes do sexo masculino e duas pacientes do
sexo feminino. Quatro destes pacientes buscaram a terapia, em funo de sintomas
depressivos e de ansiedade importantes, portanto apresentando comorbidade com
diagnsticos do Eixo I (transtorno depressivo Maior e Transtorno de Ansiedade sem outra
especificao). Apenas um paciente procura atendimento sem queixa especfica. Os pacientes
ainda permanecem em terapia e os processos teraputicos tm em mdia a durao de 20
meses, a exceo do paciente com personalidade Narcisista que interrompeu o tratamento
aps cinco meses de atendimento. Em todos os atendimentos, os pacientes apresentaram
resistncia em discutir suas dificuldades de relacionamento interpessoal, profissional e familiar.
Alm disso, os processos inicialmente foram marcados por reaes sinalizando a
indisponibilidade em aderir ao tratamento como dificuldades em estruturar focos e objetivos
para a terapia, dificuldades em seguir a estrutura da sesso, fazer tarefa, propor e discutir uma
agenda. Os pacientes de forma geral apresentaram padres rgidos de comportamento e de
estratgias de enfrentamento, com dificuldades importantes de compreender seu papel na
origem dos problemas vividos. Portanto vrios foram os desafios no atendimento a esses
pacientes, como estabelecer objetivos, lidar com a frustrao da lentido da melhora dos
sintomas clnicos, a necessidade em lidar constantemente com processos transferenciais

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(esquemas de no ser amado, ser incompreendido, ser muito exigido) e processos


contratransferncias (esquemas de ser uma terapeuta incompetente e no ser boa o
suficiente). Conclui-se que a permanncia dos pacientes em terapia e o sucesso em atingir
algumas metas, deveu-se a disponibilidade da terapeuta em lidar com suas crenas, o
estabelecimento de um vnculo emptico genuno (relao teraputica positiva) e a superviso
constante dos casos, que tornam-se aqui pontos relevantes para o andamento do processo
teraputico com pacientes resistentes.
Tratamento Cognitivo-Comportamental de um Paciente com Transtorno de
Personalidade Narcisista
Jssica Gubolin1, Luciana Bernardes da Rosa1, 2.
1. Instituto de Psicoterapia Cognitivo-Comportamental - IPC, So Jos do Rio Preto, Brazil, 2.
Universidade Paulista, So Jos do Rio Preto, Brazil.
Abstract Central: O objetivo desse trabalho foi demonstrar o atendimento de um paciente com
Transtorno de Personalidade Narcisista com base na terapia cognitiva e discutir intervenes e
desafios. Foi sujeito desse relato um paciente do sexo masculino, de 21 anos, solteiro,
empregado como caixa de um estabelecimento comercial e estudante do terceiro ano de
psicologia. O paciente o filho mais velho e tem um irmo, revela dificuldades importantes de
relacionamento com o pai, que no compreende sua escolha sexual e acredita que ele quer
coisas que esto alm do que pode alcanar e portanto o critica constantemente. A figura
materna submissa, mas afetiva, porm o paciente no se sente pertencente ao ncleo
familiar, o que o levou a sair de casa e buscar um emprego em uma cidade prxima a sua, mas
um centro maior, com mais possibilidades. O paciente busca terapia sem queixa especfica,
declarando desejar fazer terapia na abordagem Cognitiva, afim de conhecer o procedimento
teraputico e tambm porque sua terapeuta anterior, havia parado de clinicar, o que gerou
ento a necessidade de buscar outra terapeuta. Foram realizadas 22 sesses at o ms de
maro de 2012, totalizando oito faltas neste perodo, portanto foram realizadas 14 sesses de
atendimento. Durante o atendimento o paciente apresentou resistncia em discutir suas
dificuldades de relacionamento interpessoal, profissional e familiar. Alm disso, o processo foi
marcado por reaes negativas e desafiadoras direcionadas terapeuta, todas as vezes que
eram sinalizados comportamentos caractersticos do seu padro de funcionamento. Ele
apresentou constantemente o comportamento de testar os conhecimentos da terapeuta em
psicologia, de exigir tratamento diferenciado (horrios, sala, temas de agenda, disponibilidade
da terapeuta) e negar suas dificuldades de relacionamento. O paciente desistiu do processo
teraputico logo que admitiu sua dificuldade em lidar com as pessoas e a tendncia a
supervalorizar suas qualidades. Revelou que esta idia sobre si mesmo surgiu como forma de
lidar com as intensas crticas oferecidas pelo pai. Portanto possvel considerar que o insight
sobre suas caractersticas de personalidade podem ter sido teis, porm no foram o suficiente
para provocar mudana do repertrio e to pouco para manter o paciente aderindo ao processo
teraputico.
Intervenciones Eficaces en Pacientes Multiproblemticos Desde una Perspectiva
Cognitiva de Tercera Generacin
Guillermo Lencioni.
1. Beam Up psicologa para el cambio, Buenos Aires, Argentina, 2. Universidad de Buenos
Aires, Buenos Aires, Argentina.

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Abstract Central: El presente trabajo se propone mostrar y explicar la relacin entre la


desregulacin emocional de algunos pacientes multiproblemticos que se nos presentan en
la prctica clnica y la conveniencia de indicar el entrenamiento para el desarrollo de diferentes
habilidades en bsqueda de la disminucin efectiva de la desregulacin emocional. Sobre ello,
la definicin de paciente multiproblemtico no se realiza con fines diagnsticos ni de
nomenclatura y su sentido, en esta oportunidad, ser distinguir un repertorio de caractersticas
que no indican cuadros particulares y que se observan en ciertos pacientes cuya caracterstica
fundamental y distintiva es la desregulacin emocional. El contexto de reflexin que nos
proponemos radica en el creciente inters por el entrenamiento en habilidades -sociales,
cognitivas y emocionales- dirigido a pacientes multiproblemticos, en tanto ha demostrado ser
un componente fundamental para el aumento de la eficacia teraputica con los mismos. En
este sentido, una relacin no siempre evidenciada es la que existe entre la prctica o el
desarrollo de la habilidad mindfulness con habilidades de mentalizacin, metacognicin y el
entrenamiento en habilidades en el marco de la clnica psicolgica. En esta ocasin se pondr
de relieve los puntos de contacto y las diferencias entre las habilidades sociales y cognitivas
como tradicionalmente fueron entendidas y las integradas en los nuevos paradigmas como
mindfulness, metacognicion y mentalizacin, indicando cules son sus ventajas y los aspectos
novedosos que agregan valor para la eficacia teraputica.
Transculturizacin del Reggaetn y su Influencia en la Conducta de los Estudiantes de
5to Ao de la U.E.N
Norkys Lpez.
Centro de Investigaciones Psiquitricas Psicolgicas y Sexolgicas de Venezuela (CIPPSV),
Caracas, Venezuela.
La presente investigacin en desarrollo, tiene como objetivo general Describir la
Transculturizacin del Reggaetn y su Influencia en la Conducta de los Estudiantes de 5to ao
de la U.E.N. 28 de Marzo Edo Miranda ao 20122013. La transculturacin se refiere a la
situacin en la cual dos culturas que tienen contacto se influyen mutuamente y sobreviven.
Citado por Zevallos (2006). El Gnero Musical Reggaetn es una de las culturas que
actualmente es adoptada por los jvenes de diferentes pases incluyendo Venezuela; en donde
se ha observado el modelaje de conductas socialmente rechazadas; ya que el reggaetn es
uno de los gneros musicales que por sus contenidos sexuales, hablan sobre droga,
menosprecian a la mujer y en alguno de los casos es vista como objeto sexual. La presente
investigacin se sustentar en los postulados de Bandura (1998), quien en su teora del
Aprendizaje Social seala que el modelo no solo es un vehculo para la difusin de ideas,
valores y estilos de conductas dentro de una sociedad sino que tambin posee una influencia
generalizada en los cambios transculturales (p.133). En la motivacin, el porqu de una
conducta ha de tener connotaciones funcionales y adaptativas: tiene que haber buenas razones
para la ocurrencia de esa conducta del modo en el que se produce y en las situaciones en las
que ocurre (Alcock, 1998). Es una investigacin de campo enmarcado en un diseo descriptivo;
la poblacin est constituida por 220 estudiantes de 5to ao, distribuidos en 6 secciones. Es
importante sealar que se va a incluir a tres (3) expertos en el rea de cultura y/o msica, a
objeto de obtener mayor informacin en el anlisis de estudio, se va a aplicar un muestro
probabilstico estratificado, en cuanto a las tcnicas para recolectar la informacin, se va a
disear un cuestionario tipo escala de estimacin y una entrevista las cuales sern abordadas
por la estadstica descriptiva; como la investigacin est actualmente en desarrollo los
resultados estn en proceso as como tambin las conclusiones del mismo.

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Outcome Evaluation of a Brief Group Intervention for Avoidant Personality Disorder


Chris Mackey, Megan Henderson, Suzanna Copp.
Chris Mackey and Associates, Geelong West, VIC, Australia.
Abstract Central: This paper reports on the effectiveness of a brief cognitive-behavioural group
therapy intervention for over 50 clients who met DSM-IV criteria for Avoidant Personality
Disorder. All clients had initially been offered at least three individual therapy sessions prior to
joining a Taking a Step Forward Group which typically varied between six and ten therapy
sessions. The group strongly focused on exposure to challenging situations related to social
anxiety and avoidance. Measures used at the commencement and conclusion of the group
intervention included the Social Avoidance and Distress Scale, the Fear of Negative Evaluation
Scale, the Social Phobia Scale, the Social Interaction and Anxiety Scale, SUDS and selfefficacy ratings of a challenging target situation, the Beck Anxiety Inventory and the Beck
Depression Inventory. Based on outcome data, qualitative feedback from clients and clinical
observations, this paper highlights the potential utility of such a group intervention for Avoidant
Personality Disorder, including key strategies available in a group intervention relative to
individual therapy interventions.
Desregulacin Conductual en una Muestra de Pacientes Puertorriqueos/as
Diagnosticados/as con el Trastorno de Personalidad Limtrofe en Terapia Dialctica
Conductual
Domingo Marqus1, 2, Kathleen Kelly2, Elizabeth Guadalupe1, Jomaly Guilbe1, Jennifer
Caussade1, Alianis Santos1, Alixida Ramos Pibernus1, Eliut Rivera Segarra1.
1. Ponce School of Medicine and Health Sciences, Ponce, USA, 2. Red Metropolitana de
Psicologa, Santurce, USA.
Una de las facetas principales del trastorno de personalidad limtrofe (TPL) es la desregulacin
conductual, una gama de conductas impulsivas difciles de controlar y dainas para el
individuo. El propsito de este estudio es explorar la asociacin entre el TPL y una variedad de
conductas desreguladas, algunas de las cuales han recibido poca atencin emprica. Usando
una muestra de 100 pacientes, 50 diagnosticados con TPL y que participan de la Terapia
Dialctica Conductual (DBT) y 50 de un grupo de comparacin de estudiantes graduados. Se
registraron las conductas con la Entrevista de Desregulacin Conductual y se llev a cabo un
anlisis utilizando estadsticas descriptivas. Variables como edad de comienzo, regulacin de
emociones, y sensacin de control se consideraron. Los resultados sugieren la presencia
frecuente en TPL de sobredosis y abuso de drogas ilegales, conductas sexuales de riesgo,
pegarle a alguien/romper cosas, manejo negligente del automvil, abuso de alcohol, provocar
peleas/discusiones, atracones, robar, y cortarse. Estas conductas se presentan en menor
frecuencia en la muestra del grupo comparativo de estudiantes. Los resultados de este estudio
proveen evidencia novel sobre el papel de las conductas impulsivas potencialmente dainas en
la poblacin puertorriquea que vive con TPL. Dichos datos impactan el manejo del tratamiento
DBT.
Narcissism: Is Parenting Style to Blame, or is there X-Chromosome Involvement?
Gabrielle Miles, Andrew Francis.
RMIT University, Bundoora, VIC, Australia.
Narcissism is a stable, dimensional personality trait with relevance to problematic interpersonal
relationships. While etiology is unclear, parenting has long been implicated in its development.

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Recently Lootens (2011) found perceived maternal and paternal authoritarian parenting to be
associated with offspring narcissism. However, twin studies have consistently demonstrated
considerable narcissism heritability (Vernon et al., 2008). Therefore, the present study aimed to
investigate both parenting and genetic factors, including possible mode of inheritance, in
offspring narcissism. One hundred and forty-nine community participants belonging to thirtyseven biological family groups comprising: mother, father, sons and daughters, completed
questionnaires assessing parental and offspring narcissism, and perceptions of parenting style.
Results found a significant father-daughter correlation for levels of narcissism with a close to
large effect size (r = .48, p = .012), but close to zero correlations for the other parent-offspring
dyads, indicating a genetic basis with possible X-chromosome involvement. Associations
between parenting styles and offspring narcissism across the gender and generation groups
were few and inconsistent: (a) For the offspring generation, a moderate positive correlation was
found between overall offspring narcissism levels and perceived authoritarian fathers, r(65) =
.37, p = .003; but not between overall offspring narcissism and perceived authoritarian mothers.
(b) For the parent generation, a moderate positive correlation was found for females between
levels of narcissism and perceived permissive fathers, r(44) = .35, p = .019; but not for males.
No relationship was found between levels of offspring narcissism and the mothers perceived
parenting style. (c) For the combined generations, a small positive correlation was found
between overall offspring narcissism levels and perceived authoritarian fathers, r(149) = .17, p =
.034; but no correlation was found with perceived authoritarian mothers. Therefore it was
concluded that: (i) parenting style contributes little to the behaviour, and (ii) the unique finding of
a significant father-daughter correlation supports the hypothesis of an X-linked genetic basis for
levels of NPI narcissism. Larger scale biological family groups studies assessing narcissism and
including DNA testing are suggested to further explore the hypothesis of X-chromosome
involvement, outcomes of which could provide important information for the development of
treatment approaches for narcissism and NPD.
Structure of Personality and Object Relations in Borderline Personality Disorder
Tilottama Mukherjee.
Psychology, University of Calcutta, Kolkata, India.
Abstract Central: Kernbergs object relations theory, particularly his exploration of the
borderline personality organization, has been widely influential within the psychological and
psychiatric community during the past several decades. Kernberg asserts that early
interpersonal experiences determine basic psychological structure and give rise to the drive
systems. It is, therefore, essential to examine the internalization process whereby these
experiences form the foundation of the individuals psychic make-up.This study attempted to
explore the structure of the personality and personality dynamics of a group of Borderline
Personality Disorder patients and the results were compared with a matched non-clinical
group.Rorschach Inkblot Test following Exner(4th edition) scoring system and Thematic
Apperception Test( Murray & Morgan, 1935) were administered on 12 subjects.Data was
analysed both quantitatively and qualitatively.Wilcoxons Signed Ranks Test and Spearman
Rank Order Correlation were computed using the data of both groups on each of the selected
variables.Findings suggested that the two groups differed significantly on the domains of
personality structure like Suicidal potential, depression,coping deficit index, perceptual- thinking,
current stress tolerance capabilities in Rorschach protocol.TAT stories were analysed with
respect to a representation of self,object and affec.Findings indicated that the clinical group
perceived themselves as inadequate, anguished and lonely, environment as hostile and
mistrustful .Love and belongingness needs were prominently present and significant conflict

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was internalised /externalised aggression .Prominent defences used were rationalisation,


projection ,projective identification and splitting
Effectiveness of Cognitive-Interpersonal Therapy in Personality Disorders: Two Singles
Cases Analysed
Javier Prado-Abril1, Javier Garca-Campayo1, Leighna Harrison2.
1. Mental Health, Miguel Servet University Hospital, Zaragoza, Spain, 2. Palo Alto University,
Palo Alto, CA, USA.
Introduction: The literature suggests that the core dysfunctions of Personality Disorders (PDs)
consist of those related to the self and chronic and inflexible interpersonal patterns. The design
of treatments for PDs requires a high degree of complexity, the use of different interventions
and a special attention to the therapeutic alliance. In this regard, treatments have proven
effective in different orientations. Objectives: To show the effectiveness of cognitiveinterpersonal therapy in achieving certain symptomatic changes critical in the early stages of
PDs treatment. Method: Two single cases of PD were analyzed each with the following
presentations. Patient 1, 54 year old, caucasian male with DSM-IV-TR diagnoses: Axis I =
296.33 Major Depressive Disorder, Recurrent; Axis II = 301.4 Obsessive-Compulsive
Personality Disorder and 301.82 Avoidant Personality Disorder. Patient 2, 25 year old,
caucasian female with DSM-IV-TR diagnoses: Axis I = 296.23 Major Depressive Disorder; Axis
II = 301.83 Borderline Personality Disorder. Process assessment was measured in sessions 1,
5 and 10 with the Working Alliance Inventory (WAI). Outcome assessment was evaluated in
sessions 1 and 10 with the Clinical Outcomes in Routine Evaluation-Outcome Measure (COREOM) and the Symptom Checklist 90 Revised (SCL-90-R). Results: The data reflect the first 10
sessions of treatment in each respective case. The WAI shows a significant increase in patient
scores, while there is a significant decrease in the CORE-OM and SCL-90-R scores.
Conclusions: The results support the effectiveness of cognitive-interpersonal therapy in
achieving significant changes from the first sessions. The role of therapeutic alliance in the
change process is discussed.
Schema Therapy: An Innovative Approach to Challenging Diagnostic Populations
Neele Reiss1, Heather Fretwell4, Arnoud Arntz2, Lisa Hernandez6, Carlos Rojas6, Eelco Muste3,
Heather Fretwell4, Neele Reiss1, Heather Fretwell4, Ida Shaw5, Joan Farrell5.
1. Psychology, Goethe University Frankfurt, Frankfurt, Germany, 2. Maastricht University,
Maastricht, Netherlands, 3. Center of Psychotherapy De Viersprong, Halsteren, Netherlands, 4.
Midtown Community Mental Health Center, Indianapolis, IN, USA, 5. Schema Therapy Institute
Midwest, Indianapolis, IN, USA, 6. Schema Therapy Institute New Jersey, Springfield, NJ, USA.
Schema Therapy (ST) is an evidence-based psychotherapy approach for the treatment of
personality disorders and an increasing number of Axis I disorders. The goals of ST reach
beyond teaching behavioral skills to include the fundamental work of personality change. ST
combines cognitive, behavioral and experiential treatment techniques with a specific limited
reparenting format of the therapeutic relationship. This series of presentations by world-class
experts will start with an overview of the ST model and current research evidence by Arnoud
Arntz, a professor of psychology at the University of Maastricht, The Netherlands, who
specializes in psychotherapy research and is the permanent scientific advisor to the
International Society of Schema Therapy (ISST). Besides describing the ST model and its
specific treatment components in detail, he will present landmark studies in the growing
evidence base for ST, including some of the newest investigations on ST for personality

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disorders other than BPD. Lisa Hernandez and Carlos Rojas have specialized on treatment
implications for patients of Latino backgrounds with a focus on maladaptive schemas as they
relate to the concepts of machismo and marianismo. Their presentation summarizes the origins
of machismo and marianismo as an integral part of gender roles in Latino cultures and presents
ST treatment strategies. Eelco Muste represents the prestigious Deviersprong Institute in The
Netherlands, which is a key center for personality disorder research in Europe. He will describe
the results of ST multidisciplinary team intervention for combined cluster B and C personality
disorders in both inpatient and intensive outpatient formats. Heather Fretwell is a currently
implementing a team-based ST treatment approach for Dissociative Disorders in a mental
health center in Indianapolis, USA, and will present the ST treatment program for this
population. The last presentation is given by Neele Reiss, an active researcher and lecturer
from Germany, in the use of the group format to deliver ST and will describe different treatment
strategies within this approach and its proven effectiveness in both the inpatient and the
outpatient setting.
The Schema Therapy model - overview and current research evidence
Schema Therapy (ST) is an integrative treatment with roots in cognitive Therapy,
psychodynamic psychotherapy, gestalt therapy, learning theory, and developmental psychology;
and is based on a unifying theory with a structured and systematic approach. This approach
involves decreasing the intensity of maladaptive schemas, a psychological construct including
beliefs about ourselves, the world, and other people, which result from interactions of unmet
core childhood needs, innate temperament, and early environment. When schemas are
triggered, intense states occur that are described in ST as modes. Mode activation and
flipping from one mode to another can result in dissociative experiences, and accounts for
some of the emotional reactivity and unstable relationships seen in many patients with
personality disorders (PD). Schema therapy addresses and seeks to correct the underlying
schemas by utilizing cognitive, behavioral pattern-breaking and experiential strategies such as
imagery rescripting. These strategies are used by a highly active therapist taking a limited
reparenting stance. The goal of ST is to change schemas and modes so that patients can
change dysfunctional life patterns and get their core needs met in an adaptive manner outside
of therapy.
So far, ST has demonstrated effectiveness and cost-effectiveness in treating borderline PD
(BPD) in the group and individual outpatient setting (Farrell et al, 2009; Giesen-Bloo et al.,
2006) and in other than BPD PD (Arntz et al., submitted), but trials for other populations such as
cluster C PDs and forensic patients are under way.
Furthermore pilot studies on BPD patients have demonstrated that a combination of individual
and group ST may be effective in the inpatient setting for patients who cannot be maintained
safely in the community (Reiss et al, submitted). In the future, dismantling studies will be
needed to understand the active ingredients of ST as well as the mechanisms of change
underlying the used techniques. The dosage needed to elicit change needs to be determined for
different disorders and severity levels. Finally, if a limited reparenting therapeutic relationship
proves to be important, future studies will have to research why this element is crucial in
working with patients with difficult interpersonal patterns.
Machismo, Marianismo and Schema Therapy. A perspective on Treatment.
The concept of machismo and marianismo has been discussed in popular culture and has been
the subject of many academic and literary articles. Their possible implications on the schema
therapy model however, have not been an area of focus. In particular, the implications in
treatment for patients of Latino backgrounds. Schema Therapy combines proven cognitive
behavioral therapy techniques with elements of interpersonal, experiential, and psychodynamic
therapies in order to help work with patients. Schema Therapy recognizes a set of universal

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emotional needs. The concept of schemas refers to patterns imposed on reality or experience to
help individuals explain it, to mediate perception, and guide their responses. A schema is an
abstract representation of the distinctive characteristics of an event.
This presentation examines the implications of the concept of machismo and marianismo as it
applies to the model of schema therapy. We pay specific attention to treatment implications to
patients from Latino cultures and focus on maladaptive schemas as they relate to machismo
and marianismo. The presentation summarizes the origins of machismo and marianismo as an
integral part of gender roles in Latino cultures, as well their negative and positive qualities. We
examine concepts and their implications on the schema therapy model as they appear to be
central concepts in discussions of the roles, status, rights, responsibilities, influences and moral
positions of men and women of Latino cultures.
Schema Therapy for Cluster B and C Personality Disorders
This presentation describes the Schema Therapy (ST) Program at De Viersprong Halsteren in
the Netherlands, a psychotherapy center for the treatment of personality disorders, and its
preliminary evaluation. The program adapted the ST model developed for outpatient individual
psychotherapy for use with groups in an inpatient and day hospital setting implemented by a
multidisciplinary therapy team (psychotherapists, nonverbal creative therapists - drama, art, and
psychomotor, and sociotherapists) (Muste et al, 2009). Combining cognitive, emotional, and
nonverbal interventions in a safe therapeutic milieu provides many opportunities to deepen
personality change, especially for patients with severe personality problems. Furthermore,
multiple therapist interactions broaden the opportunities for ST limited reparenting, which
provides corrective emotional experiences. Healthy interactions that are absent in patients
home environments can be fostered in therapy groups. This intensive group program provides
many opportunities for maladaptive schemas and modes to be identified, their triggers
understood and healthier modes developed. Patients have Cluster C (severe) or cluster B (mild)
personality disorders. This mix of personality disorders requires integrating schema and mode
oriented approaches. Anumber of open-trial pilot studies demonstrate significant treatment
effects in reduced psychiatric symptoms at treatment and maintained at one-year follow-up
(Timman et al, 2006).
Schema Therapy for Dissociative Disorders
Dissociative disorders, such as DDNOS, Depersonalization Disorder, and DID, are frequent
comorbidities when treating populations who have experienced trauma, and represent
complicating factors for treatment and recovery. Schema therapy theory provides excellent
descriptors and provides direction in treating these disorders. Three of the five core symptoms
of dissociation - amnesia, depersonalization, and derealization - are represented as extremes of
Detached Protector variants, and the remaining two core symptoms - identity confusion and
identity alteration - can be represented as extremes of other maladaptive schema modes such
as Abandoned Child, Angry Child, and Punitive Parent. Identifying dissociative disorders, when
present, is critical in order to focus specific, additional attention on the strong DP modes that
can otherwise interfere with treatment. Specific strategies include a variety of sensory based
grounding strategies for physical and emotional awareness, matching distress reduction
techniques to underlying unmet needs in order to reduce the patient's need for dissociative
defenses, and careful limited reparenting of the extreme mode states. A team-based model of
treatment will be described.
Group Schema Therapy: Catalyzing the Treatment of Personality Disorders
This presentation describes Group Schema Therapy (GST) for the treatment of Personality
Disorder patients. The GST model demonstrated positive treatment effects on symptoms and
overall functioning for patients with Borderline Personality Disorder in a randomized- controlled

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trial and pilot studies in outpatient and inpatient settings. GST integrates cognitive, experiential,
and behavioral pattern-breaking interventions in a cohesive group culture, which is a close
analogue to the family of origin. Group acceptance and validation can correct a schema of
defectiveness and shame that developed in critical and rejecting family environments or
childhood peer group. Group therapeutic factors, like cohesiveness and corrective emotional
experiences, are activated strategically to change early maladaptive schemas and modes at the
emotional level. Group imagery rescripting and mode role plays are powerful interventions for
filling gaps in emotional learning and healing residual effects of childhood unmet needs and
trauma. Empathic confrontation from peers regarding maladaptive coping modes effects
motivate change and corrections can be practiced in group. Different intervention components
will be described and the integration of GST emotion-focused and experiential interventions into
cognitive and behavioral groups as well as the strategic use of the group process are discussed
as ways to increase positive treatment effect sizes.
Etiology of Borderline Personality Disorder
Cristina Sayago1, 2, Julia Schfer1, 2, Sabrina Fuhr1, 2, Vinicius Dornelles1, 2.
1. GEP.PERSONALIDADE, Instituto da Famlia (INFAPA), Porto Alegre, Brazil, 2. INFAPA,
Porto Alegre, Brazil.
Borderline Personality Disorder (BPD) is a devastating condition characterized by pervasive
patterns of instability on affect regulation, impulse control,interpersonal relationships and selfimage. Moreover, individuals with BPD present real or imaginary fear of abandonment, deep
feelings of emptiness, and suicide ideation and/or attempts. Some studies assure that BPD
predictors can be observed since the age of six, what makes us believe that its etiology lies in
the childhood years, pointing out to the necessity of early preventive interventions, and actions.
Since BPD is a highly dysfunctional disorder that brings much harm to these individuals, it is
extremely important to comprehend its etiology, due to the necessity of understanding its
precursors, and developmental mechanisms to enable the elaboration of preventive strategies,
and to promote health. Understanding BPD through a developmental psychopathology
perspective implies that many environmental and biological, or genetic factors interact making
some individuals more prone, and vulnerable to the development of the disorder. Even though,
there is no definite etiological path to BPD, and there is no certainty to the amount of influence
of these aspects to the establishment of a borderline personality, there already are solid, and
concrete evidences regarding some etiological factors of BPD. According to some data found in
the current literature, the etiological factors involved in the development of BPD are biological,
or genetic, and environmental, including mechanisms of attachment and separation, family
environments, and traumatic and adverse experiences in childhood years. Regarding traumatic
experiences during childhood, experiences of abuse and neglect are emphasized. Moreover,
these factors, and their interaction are believed to contribute to failures throughout the
development of the individual, characterizing some central aspects of BPD. There are
evidences that support the idea that temperament, as an inborn tendency to a certain pattern of
personality, impulsivity, and aggressiveness are among the biological factors in the etiology of
BPD.About the environmental etiological factors mentioned before, it is known that the age of
the child when a separation occurs, and its nature must be observed to understand the
influences it might have on the child. In case of abuse, it is known that experiences of recurrent
sexual abuse during the childhood yearstend to discriminate borderline individuals from
individuals presenting other personality disorder. However, it is important to remember that in an
environment where sexual abuse is present, it is possible that some other variations of abuse
may be present as well. Besides, to understand the effects of any abuse experience, the age of
the child, the gravity of the experienced abuse, and the frequency of it must be assessed,
considering that the configuration of abusive situations may regulate the intensity of BPD.

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Regarding family environment, it is already understood that it is in early childhood years that the
children develop the foundations to the ability of responding properly to relationships. Therefore,
if the development occurs in an invalidating environment, the individual may develop a fragile
inner representation of theses interactions, making the establishment of satisfactory
relationships in the future difficult. In short, the presence of the mentioned biological, or genetic
factors in an individual growing up in a dysfunctional family environment, marked by
experiences of abuse, neglect, and/or traumatic experiences that contribute to de development
of insecure attachment mechanisms, set this individual at risk of developing, and establishing
BPD.
Aplicacin de la Terapia Dialctico Comportamental (DBT) en pacientes de habla Hispana
German Teti1, 2, Pablo Gagliesi1, Juan Pablo Boggiano1, Juan Pablo Coletti1, Paula Quintero1,
Mariano Etenberg1.
1. Fundacin Foro, Palermo, Buenos Aires, Argentina, 2. Hospital "Braulio A Moyano", Capital
Federal, Argentina.
Objetivos Educacionales Fundamentos: La Terapia Dialctico Comportamental -DBT- es una
tecnologa de psicoterapia multicomponente desarrollada por Marsha Linehan. Este modelo de
trabajo es el que tiene mayor evidencia emprica para el tratamiento de los consultantes
suicidas, parasuicidas y con Desorden Lmite de la Personalidad. Actualmente este modelo
tiene validacin para trastornos por abuso de sustancias, trastornos alimentarios, impulsividad y
depresiones resistentes. Las bases tericas en las que se sustenta provienen de las terapias
conductuales contemporneas o de tercera generacin y en la tradicin del Mindfulness o
Conciencia Plena. Contenidos Principios bsicos del DBT: Teora del aprendizaje
(Condicionamiento Operante) y Principios de la Psicologa Zen. Teora Biosocial: La
construccin de un modelo que aporte una explicacin razonable y experiencial al consultante,
su familia y a los profesionales. Este modelo es resultado de la interaccin entre el Ambiente
Invalidante y la Desregulacin Emocional. Herramientas para las Crisis: Aportar al tratamiento
herramientas validadas que permitan asistir las crisis con consultantes graves y que puedan ser
usadas en otros contextos o nuevas crisis. Luego se integran como modo de terapia de la
Desregulacin Emocional. Formulacin de Casos: La construccin de un modelo diagnstico
que explique la experiencia de los consultantes y formalice objetivos del tratamiento
jerrquicamente. La formulacin debe ser definida en trminos conductuales, organizada y
secuenciada. Integra la informacin recabada en la Historia Clnica y la procesa a partir de la
Teora Biosocial. Modos de Tratamiento: Los modos de tratamientos con Consultantes,
familiares y allegados son: Psicoterapia Individual, Asistencia Telefnica de Pacientes Graves,
Taller de Habilidades Conductuales (sociales, regulacin de emociones, flexibilidad, principios
del aprendizaje, mindfulness, manejo de crisis), Entrenamiento para Familiares y Allegados,
Consultas Psiquitricas.
Transtorno de Personalidade em Pacientes Que Buscam Atendimento Psicoterpico
Todesco
Carina Todesco1, Luciana Bernardes da Rosa1, 2.
1. Instituto de Psicoterapia Cognitivo-Comportamental - IPC, So Jos do Rio Preto, Brazil, 2.
UNIVERSIDADE PAULISTA - UNIP, So Jos do Rio Preto, Brazil.
Abstract Central: O presente estudo teve como objetivo investigar a presena de esquemas
disfuncionais de personalidade em pacientes em tratamento psicoterpico. Trata-se de um
estudo documental e, para tanto, foram avaliados 10 pronturios de pacientes, com idades a

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partir de 20 anos, de ambos os sexos, submetidos ao processo psicoteraputico em um


Instituto de Psicoterapia do interior de So Paulo. Foram analisados para avaliao a ficha de
identificao do paciente, ficha de triagem, Inventrio Beck de Depresso (BDI) e Ansiedade
(BAI), o Questionrio de crenas pessoais e o Termo de Consentimento Informado. Os
resultados apontaram que os sujeitos da amostra apresentaram em mdia trs queixas
(problemas), sendo que a maioria estava relacionada dificuldade no relacionamento familiar
ou interpessoal. Os Transtornos de Personalidade (Eixo II) foram diagnosticados em metade da
amostra (50%), possuindo comorbidades com algum Transtorno Clnico (Transtorno
Depressivo Maior, Transtorno Conversivo, Tricotilomania e Fobia Social). Houve a incidncia
de crenas disfuncionais dos Transtornos de Personalidade Dependente, Passivo-Agressivo e
Obesessivo-Compulsivo. Houve reduo significativa dos escores de ansiedade e depresso,
aps os sujeitos iniciarem acompanhamento psicoterpico. Foi possvel identificar a presena
de Transtorno de Personalidade em metade da amostra, o que implica em pacientes que se
constituem em desafios clnicos. Contudo, pode-se considerar a Terapia CognitivoComportamental um tratamento efetivo, considerando a melhora de sintomas de ansiedade e
depressivos.
Psicoterapia e Terceiro Setor: Um Estudo de Caso Envolvendo Hbitos de Piromania
Rodrigo Vieira1, Carmen Andrade2, Emiliana Braz1.
1. ONG Psicologia e Integrao Social, Marlia, Brazil, 2. Unimar - Universidade de Marlia,
Marlia, Brazil.
Desde o final da dcada de 90, o Brasil tem experimentado um expressivo envolvimento da
sociedade civil com polticas pblicas, e das muitas formas de trabalho as organizaes no
governamentais tm sido um caminho para a atuao acadmica de professores e alunos.
Inseridas nessa realidade, uma ONG e uma universidade do municpio de Marlia, do interior de
So Paulo, tm proporcionado desde o ano de 2008 a insero de alunos de Psicologia em um
contexto de favela. Dessa parceria, estudantes do terceiro ao quinto ano da graduao tm
experimentado, atravs de atendimentos individuais e em grupo - supervisionados por
psiclogos da faculdade e de campo -, a unio entre teoria e prtica, uma possibilidade de
oferecer e receber de populaes em situao de risco um crescimento pessoal e coletivo.
Partindo dessa vivncia, o artigo traz, como procedimento metodolgico, um estudo de caso
envolvendo o Transtorno da Personalidade e do Comportamento Adulto: com base em uma
abordagem focada no esquema, a aplicao e adaptao de tcnicas da Terapia Cognitiva aos
hbitos e impulsos de piromania.
Associative Network Destabilization as a Predictor of Change in Cognitive Therapy for
Personality Disorders
Carly Yasinski, Adele Hayes.
University of Delaware, Newark, DE, USA.
Personality disorders are characterized by enduring and inflexible patterns of thoughts, feelings,
and behaviors. These patterns, or associative networks, are functionally maladaptive. Recent
developments in the treatment of personality disorders have focused on the disruption of these
pathological associative networks as a route to symptom relief (Lynch & Cheavens, 2008;
Young & Lindemann, 2002), however few studies have attempted to directly measure this
process. The current study addresses this gap in the literature by examining the dynamics of
these pathological networks of cognitions, emotions, behaviors, and somatic functioning over
time, as well as the development of more positive, adaptive networks. Participants (N = 27)

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were adults diagnosed with Obsessive Compulsive Personality Disorder (OCPD) and/or
Avoidant Personality Disorder (APD), who were enrolled in an open trial of cognitive therapy for
personality disorders (Beck et al., 1990). Therapy sessions were coded using a coding system
that captures therapy processes (CHANGE; Hayes, Feldman & Goldfried, 2006). Cognitive,
affective, behavioral, and somatic functioning were coded and then used to create pathological
and positive network variables. A state space grid methodology (Lamey, Hollenstein, Lewis, &
Granic, 2004) was used to capture the breadth, strength, and destabilization of these networks.
Cognitive emotional processing , which has been identified as a central mechanism of change in
therapy for depression and anxiety disorders, was also coded (Foa, Huppert & Cahill, 2006;
Hayes, Beevers, Feldman, Laurenceau & Perlman, 2005; Teasdale, 1999). Results indicated
that network destabilization was significantly associated with more cognitive emotional
processing and with positive network strength, but not with pathological network strength.
Further analyses indicated that both network destabilization and cognitive emotional processing
predicted lower personality disorder severity and lower levels of depression at post-treatment.
When entered simultaneously as predictors of outcome in a hierarchical regression analysis,
more network destabilization remained a significant predictor, whereas processing did not.
Overall, results suggest an important role of destabilizing associative networks as a potential
mechanism of change in the treatment of personality disorders. Implications for the
development and refinement of treatments for personality disorders are discussed.
A Aprendizagem no Transtorno de Personalidade Borderline: Um Estudo de Caso
Josiane de Moura.
ICTC, Florianpolis, Brazil.
O que um Transtorno de Personalidade, se no a manifestao de um padro de
aprendizagens disfuncionais e arraigadas ao longo da vida de uma pessoa? Ao partir da idia
de que crenas disfuncionais so aprendidas, o foco do trabalho psicoteraputico pode estar,
justamente, na mediao da aprendizagem de crenas adaptativas e alternativas s
disfuncionais, gerando assim, mais alternativas ao indivduo para olhar o mundo e a si
mesmo. Nesse sentido, o presente estudo de caso teve por objetivo apresentar um caso de
Transtorno de Personalidade Borderline e refletir seu processo de aprendizagem, por meio da
Terapia Cognitivo-Comportamental. No incio do processo psicoteraputico foram aplicados os
Inventrios Beck, para os quais a paciente apresentou depresso em nvel grave, ansiedade
em nvel moderado, desesperana em nvel grave e Ideao Suicida moderada. Os objetivos
centrais da terapia foram de preveno de suicdio, re-estabelecer ciclo circadiano, diminuir
comportamentos compulsivos, modificar padro de envolvimento com homens, diminuir a
ansiedade social, diminuir sintomas depressivos, desenvolver comportamento controlado e no
impulsivo, por meio da mediao da aprendizagem na reestruturao de suas crenas
aprendidas. O tratamento at o presente momento pode ser dividido em 2 fases principais: 1Formao de vnculo e Preveno do suicdio e 2 - Aprendizagens significativas: Identificao
de crenas disfuncionais aprendidas, reestruturao cognitiva e simultneo planejamento de
estabelecimento de cuidados gerais com a sade e bem estar. As principais tcnicas utilizadas
foram dirio de terapia, a lista de combinaes, psicoeducao sobre os afetos que causam
estresse, tcnica comportamental de relaxamento rpido, reestruturao cognitiva,
levantamento de hipteses, pensamento dicotmico, deslocamento do self, exerccios de
imaginao guiada, identificao de modos de esquema de Young, role play, revivncia de
experincias da infncia e treinamento de habilidades sociais. Os principais resultados
alcanados at a trigsima quinta sesso so de ideao suicida prximo a zero h 4 meses e
uma mdia de ansiedade de 65% a 75%, sendo inicialmente, entre 90 e 100%. Seus
comportamentos de ingesto compulsiva de bebida praticamente extintos, diminuio

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significativa do consumo de cigarros e dos atos compulsivos de cortar o cabelo e de fazer


compras. Alm disso, a paciente conseguiu assumir em seu emprego, uma funo muito
desafiadora para seus esquemas, na qual precisa orientar pessoas diante de grupos e tambm,
j fez viagens trabalho acompanhada de colegas. Durante seu processo teraputico, teve
dois afastamentos do trabalho, sendo que o ltimo terminou h 4 meses. Diminuiu a busca
impulsiva por homens. Tem manifestado esperana para viver, sonho de ter um relacionamento
feliz. Consegue identificar quando est no modo de esquema de criana
vulnervel/abandonada ou impulsiva. Tem apresentado maior flexibilidade dos pensamentos
dicotmicos, passando a acreditar progressivamente em idias alternativas s j arraigadas.
Palavras-chave: transtorno de personalidade borderline, aprendizagem, crenas.
Positive Psychology/ Psicologa Positiva/ Psicologia Positiva
Efectos de la Tcnicas de Atencin Plena (MBSR) en los Niveles de Relajacin,
Afectividad Positiva y Comunicacin Interpersonal
Alberto Amutio-Kareaga, Cristina Martnez-Taboada.
Social Psychology, University of the Basque Country, Donostia-San Sebastian, Spain.
OBJETIVO: Presentar los resultados de un programa de intervencin grupal psicoeducativa
basado en las tcnicas de Atencin Plena - Mindfulness - (Krasner y cols, 2010; Kabat-Zinn,
2004) en mdicos de diversas especialidades interesados en la mejora de su bienestar
psicolgico y de las relaciones interpersonales, incluida la relacin mdico-paciente. MTODO:
La muestra total se compuso de 42 profesionales mdicos en activo del Pas Vasco (Espaa).
El grupo experimental (N=21) particip en el programa de intervencin durante 8 semanas con
una sesin semanal de dos horas y media de duracin (Fase 1). Cada sesin del curso se
compona bsicamente de dos mdulos: uno de Dinmica Grupal en donde se analizaban
diferentes aspectos relacionados con la profesin de mdico, y un segundo mdulo en donde
se practicaban las tcnicas de Atencin Plena o Mindfulness. Se realiz una evaluacin
sistematizada a travs de varios instrumentos cuantitativos, entre ellos: FFMQ (Baer, y cols.,
2006) para evaluar los niveles de mindfulness, el Inventario de Estados de Relajacin (SRSI-3 Smith, 2005),el cuestionario PANAS ( Watson, Clark & Tellegen, 1998) para evaluar los niveles
de afectividad positiva y negativa, as como un instrumento cualitativo para realizar una
evaluacin del programa y de su efectividad en la mejora de las relaciones interpersonales y en
la comprensin de los pacientes. Al cabo de las 8 semanas, se puso en marcha una fase de
mantenimiento (Fase 2) por un periodo de 10 meses, en donde se realizaban sesiones
mensuales de dos horas y media de duracin. El grupo control (N=21) se qued en lista de
espera. RESULTADOS: Al cabo de 8 semanas de entrenamiento, los resultados revelaron: Aumentos significativos en los niveles de atencin plena (mindfulness) - Aumentos
significativos en las puntuaciones obtenidas en los estados de relajacin (SRSI-3), los cuales
hacen referencia principalmente a afecto positivo. - La asociacin de las tcnicas de
mindfulness y la dinmica grupal fortalece significativamente el impacto del programa para la
mejora de los niveles de afectividad positiva y relajacin en los profesionales mdicos. - La
prctica de las tcnicas de atencin plena (mindfulness) se asocia a una mejora en las
relaciones interpersonales en general y a la comunicacin y comprensin de los pacientes en
particular. - Los resultados obtenidos se mantienen, e incluso mejoran, en la fase de
mantenimiento, despus de 10 meses desde la finalizacin de la primera fase. - Consideramos
estos resultados muy relevantes, dado que las tcnicas de dinmica de grupo pueden potenciar
la eficacia de las tcnicas de atencin plena, y a la inversa. - No se encontraron variaciones
significativas en el grupo control. CONCLUSIONES: Consideramos estos resultados relevantes
dado que las tcnicas de dinmica grupal pueden potenciar la eficacia de los ejercicios

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basados en mindfulness, y a la inversa. Adems, hay que tener en cuenta la brevedad de la


intervencin y lo econmico del formato de grupo.
Psicologia Positiva, TCC e Filosofia: possvel ensinar Felicidade?
Gildo Angelotti, Marcelo Carvalho, Marilia Pereira, Benria Donato.
Ambulatrio de Ansiedade, Universidade de So Paulo, So Paulo, Brazil.
A TCC e principalmente a Psicologia Positiva, acreditam ser possvel ensinar uma vida mais
funcional e feliz ao paciente, j a viso concreta sobre a vida atravs da Filosofia, mostra
descrena sobre essa possibilidade. Como engajar o paciente sobre os aspectos de controle
de seus pensamentos, comportamentos de maneira realista e um olhar crtico existencial.
Como lidar com as dificuldades inerentes a vida sem banalizar a ideia de felicidade?
Predicting Life Satisfaction, Depression, and Anxiety from Self-Compassion and SelfEsteem: The Mediating Role of Positive Automatic Thoughts
Kohki Arimitsu.
Psychology, Komazawa University, Setagaya, Japan.
Studies suggest that self-compassion is related to happiness, optimism, and life satisfaction but
the mediating role of automatic thoughts has been unrevealed. The current study examined the
relationship between self-compassion, and positive automatic thoughts, subjective well-being,
depression, and anxiety in Japanese people. The Self-compassion Scale (SCS), the Rosenberg
Self-esteem Scale (RSS), the Positive Automatic Thoughts Questionnaire (ATQ-P), the
Satisfaction With Life Scale(SWLS), the State Trait Anxiety Inventory-Trait version (STAI-T),
and the Beck Depression Inventory (BDI) were administered to Japanese university students (n
= 192). As expected, the SCS score had a significant negative correlation with STAI-T and BDI
scores, and a significant positive correlation with RSS, ATQ-P, and SWLS scores. Structural
equation modeling (SEM) was conducted to examine the causal relationship between selfcompassion, self-esteem, automatic thoughts, and mental health measures. Results indicated:
(1) both self-compassion and self-esteem increased positive automatic thoughts and reduced
trait anxiety whereas only self-esteem increased life satisfaction and reduced depression
directly; (2) positive automatic thoughts increased life satisfaction and reduced depression and
trait anxiety; and (3) positive automatic thoughts played a mediating role between selfcompassion, self-esteem, and mental health. These findings provide evidence of the mediating
role of positive automatic thoughts between self-compassion, self-esteem and mental health in
Japanese people. SEM revealed that self-compassion had direct and indirect effects on trait
anxiety, even after controlling for the effects of self-esteem, suggesting that self-compassion
has adaptive functions that are independent of self-esteem. In terms of the link between
depression and self-compassion, people with high levels of self-compassion adopt a mindful
perspective and such a cognitive style could increase positive thoughts and reduce depression.
Those with high self-esteem, however, tend to have behavioral skills that may also be directly
contributing to their lessened depression. This issue should be examined in future research.
Community Integration and Shame of Mental Health Problems, in a Group of Psychiatric
Patients from the Azores, Portugal
Joana Cabral, Clia Barreto Carvalho.
Cincias da Educao, Universidade dos Aores, Ponta Delgada, Portugal.

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A recuperao de pessoas com doena mental envolve, no s factores internos mas, tambm,
factores externos, como a interaco com o ambiente. Ao longo de muitos anos ignorou-se a
importncia da vida social dos indivduos com doena mental, mantendo-os em instituies ou
ambientes protegidos. Actualmente comea-se a valorizar a importncia e os benefcios da
integrao comunitria de pessoas com doena mental, embora se reconhea que esta poder
ser condicionada pela vergonha e estigma associado aos problemas psiquitricos (Moldovan,
2007 and Pauline, Kruzich & Gordon, 2008).Este estudo estabelece uma comparao entre os
nveis de integrao e a percepo de vergonha e estigma relacionado doena mental, de um
grupo de doentes psiquitricos da Regio Autnoma dos Aores, Portugal. No presente estudo,
foi aplicada a Escala de Integrao Comunitria - Perturbaes Psiquitricas (EIC_PP) (Barreto
Carvalho & Cabral, 2012) e a Escala de Atitudes sobre Problemas de Sade Mental (Guilbert,
et al 2007) que mede os nveis de vergonha / estigma consciente; vergonha Interna e vergonha
reflectida associada com doena mental. Os resultados obtidos permitiram tirar concluses
sobre a influncia que a vergonha tem na integrao comunitria de indivduos com transtornos
psiquitricos.
Anlisis de la Relacin de la Afectividad en la Relacin del Optimismo con la Salud
Karem Celis Atenas1, Pablo Vera - Villarroel1, Jaime Silva2, Paula Pavez1.
1. Universidad de Santiago de Chile, USACH, Santiago, Chile, 2. Universidad de la Frontera,
Temuco, Chile.
Abstract Central: La investigacin de los recursos psicolgicos que favorecen las conductas
de salud y el bienestar ha experimentado un aumento considerable, evidenciando una
tendencia al anlisis de variables positivas y la promocin de conductas saludables en lugar de
aspectos negativos y patolgicos en el comportamiento individual como grupal (Psicologa
Positiva). Diversos estudios muestran variados beneficios que producen la conducta emocional
y afectos positivos, como tambin evidencia de las ventajas del optimismo y el bienestar, entre
otros estados positivos sobre la salud fsica y psicolgica. A partir de sta evidencia, el
propsito de este estudio es evaluar la mediacin de la afectividad en la relacin Optimismo Salud auto informada (fsica y mental). Se realiz un estudio de tipo no experimental,
transeccional y correlacional, se aplic un conjunto de encuestas a personas entre 18 y 60
aos (n = 900 casos). A partir de ellos se verific un modelo predictivo del optimismo y sus
consecuencias en los comportamientos de salud. Se concluye entorno al rol del optimismo en
la Salud. The research of psychological resources that favors the health and well being behavior
had experimented an important raise, showing a tendency to the positive variables analysis and
the healthy behavior promotion instead of negative and pathological aspects in the individual
behavior as group (Positive psychology). Many studies shows different benefits that emotional
behavior produce. Also shows the advantages of optimism and well being, among other positive
status over mental and psychological health. From this evidence, the purpose of this study is to
evaluate the mediation of affective in the relationship Optimism-Health self informed (physical
and mental) was realized a non-experimental study, trans-sectional and correlational. A group of
inquires was applied over people between 18 and 60 years old (n = 900 cases). From this an
optimism predictive model of optimism and its consequences in health behaviors. Is concluded
around the role of optimism in Health. This study was a part of the project FONDECYT N
1110520.
A Aplicao da Psicologia Positiva em um Estudo de Caso de Depresso
Patricia Desco, rica Liberato.
Curso de Psicologia, UNIMAR - Universidade de Marlia, Marlia, Brazil.

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De acordo com a Organizao Mundial da Sade - OMS, a depresso afeta cerca de 340
milhes de pessoas em todo o mundo sendo que a estimativa que, at 2020, ser a principal
causa de incapacitao em todo o mundo. Em decorrncia deste fato, vrias tcnicas e novas
reas esto sendo desenvolvidas no ramo da Psicologia, entre elas se destaca a Psicologia
Positiva, postulada pelo norte-americano Martin Seligman no final da dcada de 80 que visa
potencializar as virtudes que habilitam os indivduos, os grupos e as sociedades a viverem de
maneira saudvel. Constitui-se como um ramo da cincia psicolgica baseado na crena de
que possvel identificar, compreender, desenvolver, promover e cultivar os mecanismos
necessrios para viver-se de maneira significativa e satisfatria. Em um estudo de caso de
depresso leve, atendido em 2012 na Clnica Escola de uma Universidade do Interior Paulista,
tcnicas para o tratamento de depresso da linha cognitivo-comportamental foram utilizadas
com sucesso e, aps a estabilizao do caso, novas tcnicas de Psicologia Positiva como A
carta de agradecimento si prprio, Trs coisas boas, Os cinco pontos fortes e Visita de
gratido foram aplicadas. Como resultado observou-se que nos trs meses de aplicao do
mtodo no houve episdios de recada, havendo ainda o aumento na qualidade de vida no
somente da paciente, mas tambm do seu ciclo familiar. Conclui-se que a Psicologia Positiva
ter melhores resultados no tratamento da depresso quando aplicada aps a estabilizao do
quadro depressivo por meio de tcnicas da Teoria Cognitivo - Comportamental, uma vez que
os indivduos depressivos no percebem aspectos positivos em sua trade cognitiva antes de
compreenderem seus esquemas, e que este novo ramo da Psicologia tem se mostrado eficaz
na manuteno de um quadro saudvel ps terapia, onde as recadas so menos constantes e
postergadas.
Making Mindfulness Based Stress Reduction Work
Susan Evans1, Amelia Aldao2, Anna Edwards3.
1. Weill Cornell Medical College, New York, NY, USA, 2. Ohio State University, Columbus, OH,
USA, 3. New York Anxiety Treatment Center, New York, NY, USA.
The past decade has seen an increased interest in the incorporation of mindfulness techniques
in the treatment of anxiety disorders (e.g., Hofmann et al., 2010; Roemer et al., 2008). Of
particular interest, mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982) is an easy to
disseminate 8-week group-based class facilitated by use of audio materials and daily homework
practice. We examined the implementation of MBSR groups in a community sample of 94
participants completed a questionnaire at the end of the course. We used participant feedback,
review of the academic literature, anecdotal experience and expert opinion to delineate the
barriers to the effective delivery of a mindfulness based treatment program to the community
and outline useful strategies to target these challenges. Following the course, participants rated
perceived usefulness of course components (11-point scale) and improvements in their daily
functioning (4-point scale). A repeated measures MANOVAs indicated significant differences in
perceived usefulness of each component, F (10, 48) = 20.52, p < .01; 2= .81. Post-hoc
analyses revealed that awareness of the breath and personality of the teacher were the most
useful components, whereas body scan with no tape was least useful component. A second
repeated measures MANOVAs suggested significant differences in the perceived improvements
in functioning following participation, F [9, 81] = 8.48, p < .01; 2= .49. Post-hoc analyses
indicated that participants reported greatest improvement in their ability to take better care of
themselves, their awareness of stress when it happens, and their ability to handle stressful
situations; conversely participants indicated less improvement in terms of their self-confidence,
assertiveness, and ability to correct negative habits. These findings underscore the importance
of dismantling MBSR in our understanding of the mechanisms by which mindfulness practice

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can exert its beneficial outcomes. We identify and offer strategies for resolution of five
challenges to implementing MBSR: 1) misconceptions about mindfulness; 2) difficulties
maintaining a regular practice; 3) potential interference of medical conditions on practice; 4) the
role of comorbid psychiatric disorders; and 5) complex group dynamics. In order to maximize on
program utility, we encourage the setting of realistic expectations prior to starting the course by
running an orientation that includes a course description, mindfulness practice, and reading
recommendations, and emphasis on the time commitment requisite for the course and the
openness to experience useful to reap its full benefits. We discuss ways of tailoring the program
to fit the needs of the participants with physical limitations. We also suggest techniques for
managing group dynamics.
Operantes Verbales Positivas
Fernando Fergusson.
Psicologa Positiva, Sociedad Colombiana de Psicologa, Bogot, Colombia.
Abstract Central: Se abordaran las formas de conductas, que marcan la mayor diferencia
cuantitativa entre el comportamiento verbal y otros comportamientos fsicos. Hablar y pensar
positivamente son dos procesos tan ntimamente relacionados que en algunos casos podemos
estar hablando del mismo tipo de respuesta verbal positiva pero a frecuencias diferentes. El
tema se inicia con los conceptos ms relevantes del anlisis funcional realizado por B.F Skinner
en la conducta verbal. El trabajo presenta tanto la delimitacin y la definicin del
comportamiento de pensar positivamente, como su adquisicin y efecto prctico. Se
considerara una conducta verbal positiva, cuando es reforzada por consecuencias que
requieren de mediacin de otras personas entrenadas para ello. El episodio verbal es la unidad
de anlisis de la interaccin entre el hablante y el oyente. El estimulo verbal positivo dispara al
respuesta verbal positiva del hablante, que es escuchada por un oyente capaz de emitir la
misma conducta verbal. Es decir un estimulo se considera verbal positivo cuando los
repertorios del hablante y del oyente se combinan para controlar la conducta verbal positiva.
Will address the forms of behavior, marking the largest quantitative difference between verbal
behavior and other physical behaviors. Speak and think positively two processes are so closely
related that in some cases we may be talking about the same kind of positive verbal response
but at different frequencies. The issue begins with the most relevant concepts of functional
analysis conducted by BF Skinner on verbal behavior. The paper presents both the definition
and the definition of the behavior of positive thinking, as the acquisition and practical effect.
Verbal behavior was considered positive if it is reinforced by requiring mediation consequences
of others trained for it. The verbal episode is the unit of analysis of the interaction between
speaker and listener. The positive verbal stimulus triggers the positive verbal response of the
speaker, which is heard by a listener able to emit the same verbal behavior. Ie a verbal stimulus
is considered positive when the repertoires of the speaker and the listener are combined to
control positive verbal behavior.
Factores Psicosociales de la Salud Ocupacional en Maestros de Lima, Per
Jos Fernndez, Marisut Guimet.
Universidad de San Martn de Porres, Lima, Peru.
Abstract Central: La presente investigacin estudia la relacin entre las variables
psicosociales de Burnout, Engagement y Areas de la Vida Laboral (carga de trabajo, control,
recompensa, comunidad, justicia y valores) en profesores de primaria y secundaria en la zona
metropolitana de la Ciudad de Lima, Per. Material y Mtodos: La muestra fue de 146

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profesores, 89 mujeres y 57 hombres; 40 solteros, 86 casados, 20 en unin libre, divorciados o


viudos. Los instrumentos utilizados fueron el Utrech Work Engagement Scale - UWES (Schaufeli and Bakker, 2003), el Maslach Burnout Inventory - MBI-GS (Maslach and Leiter,
1999), y el Areas of Worklife Scale - AWS - Leiter y Maslach, 2003). Resultados: Relaciones
significativas se encontraron entre todas las variables bajo estudio, aunque los predictores
principales de agotamiento fueron el vigor y la carga de trabajo. Conclusiones: Se discuten los
hallazgos de acuerdo a la revisin de la literatura y los objetivos de la investigacin, enfatizando
la intervencin desde la psicologa positiva.
Formulacin de Casos Clnicos y Psicologa Positiva Como Herramientas Teraputicas
Araceli Flores1, Andromeda Valencia2, 1.
1. Sepimex, Mexico d.f., Mexico, 2. SEPIMEX, MEXICO, Mexico.
Abstract Central: La formulacin de casos clnicos ha recibido gran atencin por parte de la
psicologa clnica y la psicoterapia en las ltimas dcadas (Eells, 2001). El papel central de la
formulacin de casos est relacionado con la importancia que tienen para la psicologa clnica
el anlisis y la organizacin de la informacin obtenida durante el proceso de evaluacin e
intervencin. Virues-Ortega y Haynes (2005) sealan que la formulacin de caso tiene
implicaciones el desarrollo de planes de intervencin que respondan a las variables causales
identificadas para el logro de objetivos teraputicos y para el desarrollo de modelos que
permitan presentar una visin organizada de la informacin del paciente, la identificacin de
variables causales relevantes y modificables, y adicionalmente la disminucin de sesgos en el
juicio clnico. Desde la visin de la Psicologa Positiva la psicoterapia favorece en el usuario no
solo la disminucin de sus sntomas o patologa, sino la posibilidad de desarrollar habilidades
interpersonales, optimismo, honestidad, perseverancia, realismo, capacidad para el placer,
para poner los problemas en perspectiva, para encontrar propsito y orientacin al futuro.
Peterson y Seligman (2004) desarrollaron una Clasificacin de Fortalezas y Virtudes Humanas
(Character Strengths and Virtues). En este sentido una fortaleza se considera un rasgo cuando
muestra cierto grado de generalidad en las situaciones y estabilidad a travs del tiempo. Las
fortalezas se agrupan en seis reas: sabidura y conocimiento, coraje, humanidad, justicia,
moderacin y trascendencia. El objetivo de la presente investigacin fue evaluar el proceso de
formulacin de casos clnicos en 50 terapeutas cognitivo-conductuales. Se emple el diseo de
formulacin de casos propuesto por Nezu (2008). La metodologa aplicada consisti en la
integracin de los datos a travs de la descripcin grfica de las de las variables hipotticas
que contribuyeron al surgimiento y mantenimiento de las dificultades del usuario, para lo cual
se realiz el Mapa Clnico de Patognesis (MCP). Esta estrategia permiti especificar las
relaciones funcionales entre las variables distantes, variables antecedentes, variables
organsmicas, variables de respuesta, y las consecuencias a corto y largo plazo. El Mapa
Clnico de Patognesis desarrollado dio paso a la integracin del Mapa de Alcance de Metas,
una representacin grfica que coadyuva a la elaboracin de un plan de tratamiento general
que apoya el logro de las metas del paciente, as como la identificacin de los componentes y
mtodos del tratamiento necesarios para una aplicacin ptima del plan de tratamiento,
incluyendo las estrategias potenciales de la intervencin, las variables instrumentales de
resultados y las metas de resultados finales. Asimismo, se revisaron los mapas de fortalezas de
cada caso considerando la Clasificacin de Fortalezas y Virtudes Humanas propuesta por
Peterson y Seligman (2004). Las fortalezas se agrupan en seis reas: sabidura y
conocimiento, coraje, humanidad, justicia, moderacin y trascendencia. Los resultados
muestran una revisin integral de los contenidos para la formulacin de casos clnicos y el logro
de los objetivos teraputicos.

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Testing the Theory of Ecological Self: Relationships between Connection with Nature,
Spirituality, and Wellbeing
Andrew Francis1, Jasmine Trigwell1, Kathleen Bagot2.
1. Psychology, RMIT University, Bundoora, VIC, Australia, 2. University of Queensland,
Brisbane, QLD, Australia.
Abstract Central: Ecological-self theory proposes that the wellbeing of humans and nature are
interwoven, whereby wellbeing is experienced through a spiritual interconnectedness with all
things. Framed within ecological-self theory, this study aimed to (1) explore the relationships
between nature connectedness, spirituality, and six dimensions of eudaimonic wellbeing, and
(2) examine the role of spirituality as a potential mediator of the relationship between nature
connection and wellbeing. 155 females and 61 males aged between 18 and 77 years (M =
35.32, SD = 13.09) completed a battery of self-report questionnaires including: (1) Ryffs Scales
of Psychological Wellbeing, (2) the Connectedness to Nature Scale, and (3) the Mysticism
Scale. All variables were significantly positively associated. Greater connectedness to nature
was associated with better wellbeing across all dimensions, as was higher levels of reported
spirituality (Mysticism). Connection to nature and spirituality were also positively related. Five
out of six mediation models were confirmed whereby spirituality mediated the relationship
between nature connectedness and the wellbeing dimensions of personal growth, selfacceptance, purpose in life, autonomy, and positive relations with others, but not environmental
mastery. Findings are consistent with ecological-self theory and offer a unique insight into the
positive relationship between humans and nature. Implications are discussed within the context
of psychological interventions, healthy living, and social planning strategies.
The Effectiveness of Training Spirituality on Marital Happiness on Couples in Iran
Amir Ghamarani1, Mohammad bagher Kajbaf2, Mahnaz Shirani3.
1. Univerdity of Isfahan, Isfahan, Islamic Republic of Iran, 2. Univerdity of Isfahan, Isfahan,
Islamic Republic of Iran, 3. Univerdity of Isfahan, Isfahan, Islamic Republic of Iran.
This study investigated the effectiveness of training Spirituality on Marital happiness on
Couples. .The research study was Quasi-experimental research methods with pretest- posttest
control group.Population include all Couples in Iran that from community, sample of 50 Pair (25
Pair the experimental group, and 25 Pair control group).questionnaire in this study was Marital
happiness(MHS). For respond to question the methods of inferential statistic( such as
multivariate analysis of covariance and T test).The result showed that in all experimental groups
Spirituality intervention had significant effect on Marital happiness(p=0/0001).The total score of
expectancy, marital happiness of its components can be predicted to be significant. . Results
with previous studies and discuss the practical suggestions offered.
The Effectiveness of Training Spirituality on Optimism and Hope on Couples in Iran
Amir Ghamarani1, Mohammad bagher Kajbaf2, Mahnaz Shirani3.
1. Univerdity of Isfahan, Isfahan, Islamic Republic of Iran, 2. Univerdity of Isfahan, Isfahan,
Islamic Republic of Iran, 3. Univerdity of Isfahan, Isfahan, Islamic Republic of Iran.
This study investigated the effectiveness of training Spirituality on Optimism and hope on
Couples. .The research study was Quasi-experimental research methods with pretest- posttest
control group.Population include all Couples in Iran that from community, sample of 50 Pair (25
Pair the experimental group, and 25 Pair control group).questionnaire in this study was
Optimism (Shyyr et al, 1985) and hope scale(Snyder et al, 1991). For respond to question the

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methods of inferential statistic( such as multivariate analysis of covariance and T test).The result
showed that in all experimental groups Spirituality intervention had significant effect on
Optimism(p=0/0001) and hope(p=0/0001).The total score of expectancy, Optimism and hope of
its components can be predicted to be significant. . Results with previous studies and discuss
the practical suggestions offered. Key words: Spirituality , Optimism, hope, Couples
Measuring Cognitive Social Capital Among University Students Social Capital, Mental
Health, and QOL
Michimasa Haga1, Keisuke Takano2, 1, Shinji Sakamoto3.
1. Graduate School of Literature and Social Sciences, Nihon University, Tokyo, Japan, 2. Japan
Society for the Promotion of Science, Tokyo, Japan, 3. College of Humanities and Sciences,
Nihon University, Tokyo, Japan.
[Introduction & Objective] Cognitive social capital is conceptualized as the amount of resources
available for the cognition of social group members. Cognitive social capital is the basis of social
ties and is believed to enhance mental health and quality of life (Kawachi, 2008; de Silva, 2006).
However, social capital and healths researches about the detail of high risk groups seem to do
slightly because there is no consistency of the indicators among these studies. According to the
social structural perspective, people who perceive themselves to have no social ties
nevertheless belong to social networks (called structural social capital). Therefore, it is
possible that these people simply do not have cognitive resources from their social networks.
Thus, studies on social capital may need to analyze these resources as cognitive social capital
derived from structural social capital. This explanation may help explain the problem of truancy
faced by Japanese universities. Therefore, it is important to prevent students from perceiving
low cognitive social capital in order to fight the problem of truancy. This study developed a scale
that measures cognitive social capital. We also examined the relationship between cognitive
social capital and mental health and quality of life in university students. [Methods] We collected
data from 313 university students in Japan in July 2012 and analyzed data from 256 students
(men: 134, women: 122). The measurements used were (1) the Cognitive Social Capital scale
to measure cognitive social capital (CSC) (Haga, Takano, & Sakamoto, 2012; 3 categories
(fellows, schoolmates, and teachers) 12 items, 5 points); (2) Mental Health-K6 (Kessler, 2002;
6 items, 5 points); (3) the Satisfaction With Life Scale (Diener, Emmons, Larsen & Griffin, 1985;
5 items, 7 points) to measure quality of life (QOL); and (4) a question on whether students
participated in clubs (0 = No, 1 = Yes) to measure structural social capital (SSC). [Results] The
results of Pearsons partial correlation analysis showed the relationships between the three
CSC categories (fellows, schoolmates, and teachers) and mental health and QOL. Cluster
analysis of CSC revealed 5 clusters (Wards methods). Mental health and QOL tended to be
different between the 5 clusters of CSC. On the other hand, the participation rates in clubs for
each cluster shows that groups at high risk for mental health problems or have low QOL tended
to have low CSC but SSC was not necessarily low. [Discussion] This study found that groups
with high risk for mental health problems or low QOL have low CSC. Schoolmates are more
important in the development of horizontal SC, which depends on individuals horizontal social
networks and have high voluntary participation. Therefore, it may be more important to build
horizontal SC than vertical SC in university. This point should be kept in mind when supporting
the students, and designing the university environment.
Panorama de las Intervenciones Psicolgicas Basadas en las Tecnicas de Meditacion
Oriental
Maria Hernandez-Pozo1, 2, Lucia Cervantes2.

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1. Universidad Nacional Autonoma de Mexico, CRIM, Cuernavaca, Mexico, 2. Universidad


Nacional Autonoma de Mexico, Tlalnepantla, Mexico.
Abstract Central: Los efectos clnicos de la meditacin Zen se encuentran documentados en
la literatura, se ha encontrado que disminuye la ansiedad y el estrs de manera tan efectiva
como la relajacin y otras tcnicas cognitivo conductuales. En diversas intervenciones se ha
comprobado que reduce una variedad de trastornos fsicos y emocionales. La meditacin
puede conceptualizarse, en trminos cognitivo-conductuales, se constituye, adicionalmente, en
una tcnica de autocontrol, autorregulacin, autoobservacin, control de estmulos y de
monitoreo del pensar. Sus efectos sobre la calidad de vida no se restringen a los pacientes,
sino tambin a los terapeutas, que son susceptibles al desgaste profesional (burnout). En la
actualidad el individuo ha perdido el contacto con la capacidad de sentirse bien y es necesario
regularizar el modo de vida enfocndose en la dimensin natural (funcionamiento del cuerpo),
la dimensin intelectual y afectiva para lograr la un estado emocional armonioso y balanceado,
poco vulnerable a los elementos adversos impredecibles del entorno. Este estudio ofrece un
anlisis cienciomtrico de la literatura publicada en espaol y en ingls sobre el tema, para
proveer una imagen del estado de la investigacin documentada en revistas cientficas
especializadas en las ltimas tres dcadas. A partir de ese anlisis se identifican las redes de
autores, los principales problemas de salud que se han abordado con esa metodologa y el
nivel de xito reportado. A manera de conclusin se sealan algunas fortalezas y debilidades
de ese tipo de metodologa cognitiva conductual, as como algunas reas de aplicacin an no
exploradas.
Organizational Benefits of Alternate Mindsets: How Meditative Techniques Enhance WellBeing and Creative Production Amongst Employees
Marie Holm.
Strategy, HR & Organisation, ESCP Europe School of Business, Paris, France.
In contrast to the traditional mindset (TMS) the conscious awareness, controlled mental
processes, and analytical-logical manipulation of symbolsan alternative mindset (AMS) is
viewed as the pre-conscious mental processes (i.e. associative, imaginative, intuitive) and
holistic thinking. Since Plato, the West has considered TMS as the hallmark of intelligence and
simply of any cognition. Yet, in recent decades various research explored complementary
and/or alternative to analytical-logical cognition mental systems. The alternative mindsetan
array of such systemswas primarily explored for its individual benefits, while our research
focuses on organizational benefits. To do this, we used a bi-weekly meditative practice to
induce an AMS in organizational actors. We hypothesized that following the shift from TMS to
AMS, organizational actors will experience enhanced well-being and creative production.
Empirical experiments were conducted with 144 self-selected participants within two
organizationsa business and a municipal governmentin Canada (measuring levels of wellbeing and creativity) and one in Francea business school administration(measuring levels
of well-being), consisting of eight bi-weekly 20 minute sessions of guided meditation; for the
control group a placebo technique of relaxation. Statistical analysis, using the fixed effects
model, showed significant increase in well-being and creativity for the experimental groups
compared to the control groups for all three locations after six sessions. In addition,
mindfulnessnot being a dependent variablealso increased significantly after six sessions.
Future possibilities for research involve replicating the experiments at additionalbusiness
and/or not-for-profitorganizations, measuring either: (1) the same individual benefits of ASM,
in order to strengthen the ecological validity of results and be able to have sufficient numbers of
participants to make demographic comparisons such as we were not able to yet achieve. For

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instance, this research could explore how ASM cultivation varies with age, gender, job role
(managerial versus front-line, various hierarchical levels) or venue (such as in an educational or
health-care institutions or non-profit organizations), or (2) additional ASM benefits, either at the
individual (such as level and duration of concentration, level of fulfillment or work engagement),
team (such as group cohesiveness, team productivity or extent of synergy) or organizational
level (such as corporate citizenship, turnover levels, absenteeism levels or productivity) , or a
combination of these. As AMS organizational benefits span from enhanced well-being and
creative production, to higher employee engagement, improved health and greater relaxation,
introducing AMS-inducing techniques into organizations could potentially aid in minimizing
stress levels and thus reducing negative impacts of stress. Furthermore, applying AMS-inducing
techniques could benefit organizations in ways beyond stress reduction, such as higher
profitability, enhanced concentration, lower absenteeism and greater awareness.
La integracin de la Terapia Cognitivo Conductual y la Psicoterapia Positiva en el
Desarrollo de la Resiliencia Familiar y de Pareja y la Esperanza en el Crecimiento y el
Flourishing ('Florecimiento') luego de Crisis, Trauma y Adversidad
Jacinto Inbar.
Bar Ilan University, Jerusalem, Israel.
Abstract Central: En nuestro acercamiento cognitivo conductual y de la psicoterapia cognitiva,
la pareja y la familia no son solamente vistas desde el contexto sistmico para el crecimiento
individual, sino tambin como la unidad social central que crece, cambia y se "re-inventa" a si
misma a travs de la identificacin, reclutamiento e implementacin de los recursos personales
y sistmicos. Ambos acercamientos, en la resiliencia de pareja y familia, crecimiento y
florecimiento como constructos psicolgicos, no son relacionados para prevenir psicopatologas
sino para la promocin de la salud mental, la calidad de vida y el mejoramiento de la Esperanza
y la felicidad. La resiliencia, en nuestro acercamiento positivo, esta tambin relacionada con la
prevencin pro-activa de la depresin en parejas y en el sistema familiar, y la habilidad de
"rebotar" luego de un evento crtico, incluyendo infidelidad, engao, traicin o abuso, o de
diversos momentos de adversidad y continuar con el proceso de crecimiento, buscando
significado vlido y un Propsito. En la comunicacion libre incluiremos aspectos y
conceptualizaciones tericas relevantes, y sern presentados modelos de crecimiento postcrisis y post trauma basados en evidencias cientficas. La ponencia enfatizar la centralidad de
la Terapia Cognitiva Conductual integrada con el acercamiento de la Psicoterapia Positiva, y la
Terapia de Aceptacin y Compromiso. Estar enfocada en las Emociones en el desarrollo de la
resiliencia familiar y de pareja, crecimiento y florecimiento, y consistir en: a. Modelos de
resiliencia familiar y de pareja, crecimiento y florecimiento luego de la crisis, del trauma y de la
adversidad, desde una perspectiva cognitivo conductual y positiva integrativa y multimodal. b.
La identificacin de los recursos de afrontamiento familiar y de pareja y las fortalezas
relevantes en la resiliencia, la Esperanza y el crecimiento. c. La descripcin de estrategias
cognitivas, positivas y pro-activas, intervenciones y tcnicas con familias y parejas. d. Principios
para disear un plan idiosincrtico familiar y de pareja con el objetivo de fomentar la resiliencia,
el crecimiento, el flourishing, la Esperanza, el optimismo y el "reinventar" la vida de manera
constructiva.
Measurement of Positive Factors for Long-Term Mental Health: Perspectives on Albert
Elliss Theory
Hiroe Kondo1, Kazumi Nakagawa2.

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1. Sompo Japan Healthcare Services Inc., Shinjuku, Tokyo, Japan, 2. Department of Child
Studies, Seitoku University, Matsudo, Chiba, Japan.
INTRODUCTION: Ellis states that emotion or behavior has minimal influence on affirmative
belief or the philosophy of life, and hence the stress of daily life does not influence or alter such
beliefs. On the other hand, an irrational belief negatively affects mental health. Most mental
health scales measure the relatively recent health status and assess negative factors such as
stressors or symptoms. Moreover, prediction of long-term health using such scales is difficult.
OBJECTIVE: To define factors that positively influence mental health and to develop a scale to
assess mental strength and health in the long term by using the theory of rational emotive
behavior therapy advocated by Ellis. METHOD: A 36-item questionnaire covering six categories
(social interest, self-acceptance, commitment, tolerance, realistic thinking, and self-sustenance)
was developed. Each category comprised six questions that were compiled from the initial pool
of items mentioned in Elliss studies on health. A survey that included a new scale, the 28-item
General Health Questionnaire (GHQ28; Japanese version) (Nakagawa & Daibo, 1985) and the
Maslow self-fulfilling scale (Yamazaki, 2000, in Japanese, MSL scale), was administered to 434
employees (valid response rate 85.7%, 219 males, 153 females; average age 38.4 9.4 years).
All participants gave their consent to the study. Survey results were analyzed by factor and
regression analysis. RESULT: The items of the new scale conformed to a five-factor structure
(commitment, realistic thinking, fairness, acceptance and social interest) with high internal
consistency. A negative correlation was observed between the subscales of GHQ28 and four
factors (commitment, realistic thinking, fairness, and acceptance). Results revealed that
realistic thinking negatively correlated with all GHQ28 subscales. A positive correlation was
observed between MSL subscales and three factors (commitment, realistic thinking, and
acceptance). No correlation was observed between social interest or fairness factors and
both GHQ28 and MSL scales. CONCLUSION: We believe social interest and fairness are
important factors for maintaining long-term mental health, considering the results of correlation
based on Elliss theory reflecting long-term mental health and the correlation between selffulfillment and health reflecting short-term health.
Promoting Resilience Against Future Adversities and Stressors: A Systematic Review
Tnia Macedo, Livia Wilheim, Raquel Gonalves, Alessandra Lopes, Helga Rodrigues, Evandro
da Silva Freire Coutinho, Ivan Figueira, Paula Ventura.
UFRJ, Rio de Janeiro, Brazil.
Os eventos traumticos no so raros. A maior parte das pessoas exposta ao longo de sua
vida a pelo menos um evento grave o suficiente para ser caracterizado como trauma
psicolgico. Apesar disso, observa-se acentuada variabilidade de adaptao para estes
eventos e natural heterogeneidade da resposta humana ao estresse. A resilincia, entre os
resultados possveis aps eventos potencialmente traumticos, o padro de resposta mais
comum. A maior parte das definies refere-se resilincia como um processo dinmico que
engloba adaptao positiva no contexto de uma adversidade significativa. A resilincia
distinta do processo de recuperao e pode potencialmente ser alcanada por uma variedade
de vias diferentes. Quando nos referimos adversidade significativa, devemos considerar os
eventos estressores da vida diria, que no se encaixam na definio de eventos
potencialmente traumticos, mas que podem levar ao desencadeamento de transtornos e
doenas. Comeou a ser estudado o desenvolvimento de estratgias de preveno ou
diminuio dos efeitos negativos de situaes adversas na sade mental. O objetivo deste
trabalho foi realizar uma reviso sistemtica de artigos que avaliem a eficcia da promoo de
resilincia (ou constructos relacionados) em adultos, visando fortalecer o indivduo frente a

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estressores ou situaes adversas futuras. Buscas eletrnicas foram realizadas nas bases de
dados ISI/Web of Science, PsycINFO/PsychLit e Pubmed, incluindo todas as lnguas e todos os
anos at setembro de 2012. Foram includos estudos controlados randomizados, controlados
no randomizados ou ensaios abertos que avaliaram a eficcia de programas de treinamento
em resilincia com o objetivo de preparar o indivduo para o enfrentamento de eventos
adversos futuros. Foram excludos artigos de reviso, captulos de livros, dissertaes e teses,
estudos sem medida padronizada de eficcia antes e aps a interveno, estudos de caso e
estudos cuja interveno no era preveno primria. Nossa busca identificou 3225 artigos.
Destes, selecionamos 15 para compor a reviso, sendo 8 randomizados controlados, 6
controlados no randomizados e 1 ensaio aberto. Somente um estudo (controlado no
randomizado) no apresentou diferenas significativas nos resultados antes e aps a
interveno, sugerindo a eficcia destes programas de treinamento na promoo da resilincia.
Entretanto, algumas limitaes foram observadas. Oito estudos no apresentaram resultados
de follow-up, o que seria um dado importante ao avaliar a resilincia. As intervenes foram
heterognias quanto s tcnicas utilizadas, tempo de treinamento, durao e formato das
sesses. No houve uniformidade entre os estudos quanto s escalas utilizadas, o que dificulta
a comparao entre os mesmos. Nossos resultados apontam para a necessidade de unificao
no campo quanto ao conceito de resilincia e quanto s medidas utilizadas para que a aferio
da eficcia destes programas seja realizada de forma mais objetiva e, portanto, mais replicvel.
So necessrios mais estudos controlados randomizados avaliando a eficcia de treinamentos
de resilincia e avaliaes de follow-up mais longas, at mesmo para aferir se estes
treinamentos trazem algum prejuzo para os participantes.
La Importancia de la Calidez en la Familia en el Contexto de un Trastorno Mental Grave
Cristina Medina-Pradas1, 2, Jordi E. Obiols2.
1. Universidad Autnoma de Madrid, Madrid, Spain, 2. Universidad Autnoma de Barcelona,
Barcelona, Spain.
Abstract Central: Se rescata la importancia del afecto positivo (calidez) en el contexto familiar,
aspecto dejado de lado la mayora de las veces en las investigaciones basadas en el
constructo de la Emocin Expresada (EE). Estudios preliminares comienzan a apuntar su poder
protector, entre ellos los trabajos de Medina-Pradas y su equipo con familias con un miembro
con esquizofrenia o un trastorno de la conducta alimentaria. Se presentarn dichos resultados y
se discutirn sus implicaciones clnicas. El hecho de que las emociones positivas no estn
incluidas en la definicin de EE no significa que no sean importantes. Empezamos a saber
bastante acerca de cmo la EE alta (es decir, crtica, hostilidad y/o sobreimplicacin emocional)
se desarrolla y acta sobre el curso de diferentes enfermedades; sin embargo, se sabe mucho
menos acerca de cmo los aspectos positivos (calidez, fundamentalmente) actan en la
asociacin entre la EE familiar y los trastornos psiquitricos. Empiezan a asumirse los efectos
de apoyo de las emociones positivas en el contexto de la EE, su condicin de factores de
proteccin de recada, y su poder predictivo de mejora en los sntomas y el funcionamiento
social. Por tanto, no slo sera deseable en las familias la EE baja (es decir, la ausencia de
emociones negativas), sino tambin la presencia de actitudes positivas y de apoyo hacia los
pacientes. Los modelos predominantes de la asociacin EE-recada conceptualizan la EE como
una forma de estrs para los pacientes, fundamentalmente en base al modelo de
vulnerabilidad-estrs. Tal vez sea el momento de centrarnos en los aspectos positivos e
integrar los puntos de vista predominantes con modelos ms actualizados sobre la base de la
psicologa positiva.

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Unconditional love and Forgiveness


Seema Mehta.
Greenlawns High School, Mumbai, India.
Abstract Central: Unconditional love is an active, moving transpersonal energy which opens
the heart center. It is an impersonal love expressed in decisions and actions. Forgiveness is
something that happens within us. To forgive is to cancel all demands, conditions and
expectations held in our mind that block the Attitude of Love. It does not depend on any external
circumstances. Forgiveness is a willingness to move forward, be more comfortable and suffer
less. It is a decision not to punish ourselves for the wrongs of others or other circumstances. To
forgive is to be willing to get back into the flow of life - to be willing to allow love from the Source
of life, or God, to flow into us and out to that other person we need to forgive, for our own
health's sake. It is a decision to re-enter the flow of love and life.
Quality of Life and Communication Skills of Portuguese University Students and
Teachers
Rute Meneses1, Cristina Miyazaki2, Jos Pais-Ribeiro3.
1. Universidade Fernando Pessoa, Porto, Portugal, 2. Faculdade de Medicina de So Jos do
Rio Preto, So Jos do Rio Preto, Brazil, 3. Universidade do Porto, Porto, Portugal.
Abstract Central: The Dublin descriptors for first, second, and third cycle qualifications have
made university students and teachers very aware of the need to assess/proove to master
communication skills. Nevertheless, some debate still remains regarding the true value both
students and teacher attribute to communication skills and its training. In this context, the aim of
the present study was to explore the relationship between university students' and teachers'
quality of life and: the importance they give to a set of communication skills and the degree of
satisfaction they report regarding these same communication skills. To do so, the WHOQOLBref and the Communication Skills Questionnaire (CSQ) were administered to 79 Portuguese
university teachers and 251 university students, between 17-82 years of age (M=27.42;
SD=10.59), mostly female (73.3%), single (73.6%) and without health problems (self-report;
74.5%). The existing health problems had a duration between 0.06 and 35 years (M=10.34;
SD=8.60). The results showed that only 5 of the 26 items of the CSQ Importance Subscale had
no statistically significant correlation with at least one of the quality of life domains. There was
no item of the CSQ Satisfaction Subscale without a statistically significant correlation with at
least one of the quality of life domains assessed. These results suggest that communications
skills have a considerable role in the (quality of) life of university students and teachers, not
limited to academic/working contexts.
Gratitud Disposicional y Satisfaccin con la Vida: El Rol del Gnero en el Potencial
Salugnico de la Gratitud
Natalia Moyano1, 2, Hyo Mi Chang1, Mnica Altamirano2, Ricardo Hernandez2.
1. Gelzwork Salud Ocupacional, Cordoba, Argentina, 2. Universidad Nacional de Crdoba,
Crdoba, Argentina.
La finalidad del presente estudio es analizar la relacin entre el gnero, la gratitud disposicional
y la satisfaccin con la vida. Son escasos los estudios en cuanto a la relacin del gnero y la
gratitud, mientras que la asociacin entre sta y el bienestar ha sido informada como positiva y
relevante, razn por la que se considera a la gratitud en su variante disposicional como un
factor salugnico. Se considera relevante el estudio sobre la influencia del gnero en esta

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relacin debido a las implicancias para el trabajo clnico. Sobre una muestra de 200 casos, el
63% femenino, entre 18 y 63 aos, con una media de 24.15, residentes de Crdoba Capital,
Argentina, se calcul la diferencia de media entre gratitud y satisfaccin vital entre hombres y
mujeres; y la correlacin entre la gratitud y la satisfaccin vital, tanto para el total de la muestra
como para el subgrupo femenino y masculino a travs del coeficiente de Pearson. Se obtiene
un nivel de significacin de la prueba t de ,519 en la gratitud y de ,537 en satisfaccin vital,
indicando que la diferencia entre hombres y mujeres no es estadsticamente significativa para
ambas variables; se obtiene un r de ,452 p. 0001 para la muestra global, un r de ,462 p. 0001
para el subgrupo femenino y un r de ,421 p. 0001 para el subgrupo masculino, mostrando una
asociacin positiva y moderada con una pequea diferencia entre los subgrupos femenino y
masculino. Se puede concluir que, si bien las mujeres poseen niveles de gratitud mayor y
niveles de satisfaccin vital menor que los hombres, y que la gratitud y la satisfaccin vital se
presentan asociadas, el gnero no resulta relevante en la relacin entre la gratitud disposicional
y la satisfaccin con la vida.
La Orientacin Cognitivo Conductual: Una Propuesta para la Prevencin
Marco Muoz.
1. Cursos Bsicos, Universidad de Oriente, Barcelona, Venezuela, 2. Centro de Investigaciones
Psiquiatricas Psicologicas y Sexologicas de Venezuela, Barcelona, Venezuela.
Abstract Central: Han sido diversas las concepciones que se han formulado en relacin con la
orientacin; algunos de los autores que han abordado la temtica la asumen como un proceso
de asesoramiento, otros la conciben como una relacin de ayuda entre un especialista en este
campo y el cliente, otros como la asistencia que se debe brindar para promover cambios, bien
sea desde el punto de vista cognitivo, como desde el mbito conductual en quien solicita el
apoyo de un profesional ligado con esta rea. Atendiendo a ello, el objetivo de la ponencia es
asumir la orientacin como una relacin entre un cliente, que puede ser una persona, un grupo,
una familia, quien recibe asistencia, para efectuar cambios en sus cogniciones y en su
conducta, pues ello, a mediano o largo plazo, pudiera generar errores de concepto, conductas
desadaptadas o inadecuadas que obstaculicen el normal funcionamiento personal o grupal. En
s, es una estrategia que emplean los profesionales ligados con el campo de la orientacin
como medida para prevenir displacer psicolgico e inadecuada adaptacin al medio
sociocultural del cual forma parte el cliente; por tanto, se asume que la orientacin cognitivo conductual es una estrategia de prevencin. Atendiendo a lo dicho, el objetivo de la prevencin
en materia de la orientacin como proceso de ayuda sera propiciar el desarrollo de la
competencia funcional y social de la persona, su capacidad para afrontar situaciones y su
fortalecimiento interior (empowerment). Have been different conceptions that have been made
in relation to the guidance, some of the authors who have addressed the issue assume it as a
counseling process, others conceived as a helping relationship between a specialist in this field
and the customer, other as assistance that should be provided to promote change, either from
the cognitive point of view, and from the behavioral level who is seeking the support of a
professional linked to this area. On this basis, the aim of the presentation is to take counseling
as a relationship between a client, which can be a person, a group, a family who receives
assistance, to make changes in their cognitions and behavior as this, medium to long term,
could generate misconceptions, maladaptive or inappropriate behaviors that impede the normal
personal or group performance. In itself, it is a strategy used by professionals related to the field
of counseling as a measure to prevent psychological displeasure and inadequate sociocultural
adaptation to the environment which is part the client, so it is assumed that the orientation
cognitive - behavior is a strategy prevention. Considering the above, the goal of preventative
counseling as aid process would encourage the development of social and functional

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competence of the person, their ability to deal with situations and internal strengthening
(empowerment).
Evaluacin de Factores de Riesgo y Protectores de la Depresin: Anlisis de la Felicidad,
Afecto Positivo, Optimismo y Factores Cognitivos
Paula Pavez1, Karem Celis Atenas1, Jaime Silva2, Pablo Vera - Villarroel1.
1. Universidad de Santiago de Chile, USACH, Santiago, Chile, 2. Universidad de la Frontera,
Temuco, Chile.
Abstract Central: El objetivo de este estudio fue evaluar factores protectores y de riesgo para
la depresin, especficamente de las variables afecto positivo - negativo, de personalidad,
felicidad y optimismo. En la actualidad existe evidencia que la consideracin de variables
positivas y negativas colaboran en la comprensin y delimitacin de fenmenos clnicos como
la depresin, descentrndose as de la visin tradicional que ha surgido desde la observacin
de cogniciones negativas.La evidencia muestra que este fenmeno se definira a partir de la
presencia de emociones negativas y la ausencia de emociones positivas. Los participantes
fueron 818 participantes con edades entre 18 y 77 aos, quienes tras aceptar consentimiento
informado respondieron los cuestionarios de afecto positivo - negativo (PANAS), inventario Big
Five (BFI), Cuestionario de felicidad y cuestionario de Orientacin Vital (LOT). En base a
anlisis de regresin logstica se encontr que las variables felicidad, optimismo y afecto
positivo son protectoras de depresin; y neuroticismo, afecto negativo y apertura a la
experiencia seran factores de riesgo. Se concluye entorno a la consideracin de estos factores
para la comprensin y tratamiento de los estilos de afrontamiento y conductas que influyen en
la depresin. The main purpose of this study is to evaluate protectors and risk factors for
depression. Specifically of the positive-negative affect of personality, happiness, and optimism
variables. Today there is evidence that the consideration of positive and negative variables
helps to the understanding and delimitation of clinical phenomenon such as depression, moving
forward of the traditional view that emerges from observation of negative cognitions. The
evidence shows that this phenomenon could be defined from the presence of negative emotions
and the absence of positive emotions. The participants where 818 participants from 18 to 77
years old. Whom after agree with the informed consent, responded the of positive-negative
affect questionnaire (PANAS), Big Five Inventory (BFI), happiness Questionnaire and Life
Orientation Test (LOT). Base on an Analysis of Logistic Regression was found that the
happiness, optimism and positive affect variables are predictors of Depression, and neuroticism
Negative Affect and Open to Experience will be risk factors. Is concluded around the use of this
factors to the understanding and treatment of coping styles and behaviors that depression
influence. This study was a part of the project FONDECYT N 1110520
Efectos de un Programa de Resiliencia en los Niveles de Salud Mental Positive de un
Grupo Estudiantes de Grado Sexto
Adriana Perugache, Sara Guerrero Caicedo, Mayra Guerrero Rosero.
Psicologa, Universidad de Nario, San Juan de Pasto, Colombia.
Abstract Central: El presente proyecto permite determinar los efectos de un programa de
Resiliencia en los niveles de Salud Mental Positiva de un grupo de estudiantes de grado sexto,
de la Institucin Educativa Municipal Nuestra Seora de Guadalupe del Corregimiento de
Catambuco. La investigacin realizada es de tipo explicativo, ya que se encarga de buscar el
porqu de los hechos mediante el establecimiento de relaciones causa - efecto. Tiene un
diseo cuasi experimental, lo que significa que no existe ningn tipo de aleatorizacin, en la

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asignacin de los sujetos a los grupos, por lo que no hay manera de asegurar la equivalencia
inicial de los grupos experimental y control. Inicialmente se evala el nivel de la variable
dependiente, en el grupo control y experimental, a travs de la prueba estandarizada y
validada, Escala Salud Mental Positiva de Lluch (1999), posteriormente se aplica la
intervencin en Resiliencia al grupo experimental, desde una perspectiva de recursos y
fortalezas humanas, para la promocin de la salud positiva y bienestar integral. Finalmente se
aplica el pos-test en los dos grupos, y se realiza el anlisis estadstico, utilizando las pruebas T
de Student y Wilcoxon, para muestras independientes, las cuales permiten determinar las
diferencias estadsticas en los niveles en los niveles de Salud Mental Positiva entre los grupos,
las cuales arrojan la existencia de diferencias estadsticamente significativas, de esta manera
se confirma la hiptesis de trabajo que plantea que el programa en Resiliencia incrementa los
niveles de Salud Mental Positiva en los estudiantes. Lo anterior permite reconocer los recursos
en la historia personal y colectiva para afrontar la adversidad y alcanzar bienestar integral,
mejorando la calidad de vida de los participantes del proceso de intervencin.
EMOCIONANDO: Efectos de un Programa de Educacin Emocional, Sobre la
Satisfaccin con la Vida Percibida en un Grupo de Adultos Mayores
Adriana Perugache, Ana Caicedo, Karen Barn.
Psicologa, Universidad de Nario, San Juan de Pasto, Colombia.
Abstract Central: Las perspectiva de vida en aumento, las condiciones socio demogrficas
que se ven permeadas por esta situacin, el escaso abordaje de la parte emocional del adulto
mayor y el reto de las nuevas ciencias en abordar estos fenmenos, son los principales
justificantes de este trabajo, que tuvo como objetivo determinar el efecto del programa de
Educacin Emocional EMOCIONANDO, sobre la satisfaccin con la vida percibida en un
grupo de adultos mayores, mediante la utilizacin de un diseo experimental pre prueba, pos
prueba con grupo control y experimental, cuyos participantes fueron 40 adultos mayores de la
Fundacin Tercera Edad San Antonio FUNTESA. El instrumento utilizado fue el ndice de
Satisfaccin Vital-A que mide la satisfaccin vital en cinco dimensiones: Congruencia,
Entusiasmo, Autoconcepto, Tono emocional, Resolucin y fortaleza. El programa contempl
cinco mdulos que corresponden a las habilidades emocionales de autoconciencia, regulacin
emocional, auto concepto, habilidades de vida y bienestar e inteligencia interpersonal y se gui
bajo el paradigma de Salud Mental Positiva. Los resultados obtenidos muestran que el
programa de Educacin Emocional, mejoro significativamente los niveles de satisfaccin con la
vida en el grupo experimental, mientras que en el grupo control no se presentaron cambios.
Estos resultados se atribuyen al hecho de que la las dimensiones que conforman la satisfaccin
con la vida estn contempladas en cualquier programa de educacin emocional, lo cual sugiere
la importancia de las emociones en los procesos vitales y para este caso especfico de la vejez.
Asimismo, el programa les permiti descubrir nuevas formas de asumir la vejez de manera ms
positiva, adems de afrontar las situaciones de la vida de una manera ms adecuada
(Bisquerra, 2003 y Ribes, Fillela y Aguill (2005). El estudio es concluyente en la indiscutible
importancia que posee el conocimiento y manejo de las emociones propias y las de los dems,
en virtud de la satisfaccin personal y el xito en la vida (Urrutia y Villagra, 2010). Bisquerra, R.
(2003). Educacin Emocional y competencias bsicas para la vida. Revista de investigacin
educativa, 21 (1), 7-43. Recuperado el 14 de enero de 2012, de
http://dialnet.uniroja.es/servlet/articulo?codigo=649432. Filella, G; Soldevila, a., Cabello, E.,
Franco, L., Morell, A. & Farr, N. (2008). Diseo, aplicacin y evaluacin de un programa de
Educacin Emocional en un centro penitenciario. Revista Electrnica de Investigacin
Psicoeducativa, 6 (2), 383-400. Recuperado el 20 de enero de

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http://stel.ub.edu/grop(files/Art_15_243.pdf. Urrutia, N. & Villarraga, C. (2010). Una vejez


emocionalmente inteligente [versi electrnica], de la base de datos eumed.
O Uso da Empatia nas Intervenes para a Promoo do Perdo Interpessoal
Vanessa Pinho, Eliane Falcone.
UERJ, Rio de Janeiro, Brazil.
Abstract Central: Os psiclogos clnicos comearam a utilizar tratamentos para promover o
perdo nos anos 80. Como um tema de estudos complexo e novo, ainda h falta de consenso
sobre o que o perdo. H certa concordncia, entretanto, acerca da transformao na
valncia dos afetos, motivaes, pensamentos e comportamentos que acompanham o perdo,
que mudam de negativa para positiva. O interesse dos psicoterapeutas em desenvolver
estratgias para a promoo do perdo interpessoal est atrelado aos efeitos debilitantes da
raiva e da mgoa, como dificuldades nas relaes interpessoais, danos para a sade fsica,
para o bem-estar psicolgico e para a qualidade de vida em geral. Muitos estudos tm
ressaltado a importncia da empatia na promoo do perdo. As evidncias provm de
pesquisas de neuroimagem, ou com medidas de autorrelato ou de interveno. A empatia pode
ser compreendida como uma habilidade social, com elementos cognitivos, afetivos e
comportamentais. Em termos cognitivos, envolve a capacidade de entender a perspectiva do
outro com acuidade. Em termos afetivos, denota a capacidade de se sensibilizar e de se
importar genuinamente com o bem-estar alheio. O componente comportamental diz respeito
capacidade de expressar, por meio de comportamentos verbais, no verbais e paralingusticos,
o entendimento acerca da situao do outro. O objetivo do presente trabalho foi estudar se e
como a empatia tem sido empregada nos programas de promoo do perdo interpessoal.
Para isso, foi feita uma reviso sistemtica da literatura em quatro bases de dados, na seguinte
ordem: Pepsic, Lilacs, PubMed e PsicInfo. Foram utilizados como descritores: perdo e
interveno e perdo e terapia. Como critrios de incluso, as produes bibliogrficas
deveriam ser: artigos, disponveis na ntegra no portal da Capes; pesquisas com desenho
experimental; os descritores deveriam estar presentes no ttulo e/ou no resumo. Foram
excludos estudos de caso e terapia de casal. No foram encontrados artigos sobre interveno
para promoo do perdo nos peridicos indexados nas bases Pepsic e Lilacs, o que indica
uma carncia de pesquisas sobre o tema nos pases latinoamericanos. Mais de 100 artigos
foram obtidos nas demais bases; 32 foram selecionados; destes, 20 foram recuperados e lidos
na ntegra. As intervenes para a promoo do perdo se basearam principalmente em dois
modelos: o Modelo do Processo de Perdo (50%) e o Mtodo REACH para o Perdo (35%). A
Terapia Focada na Emoo, uma terapia focada em reestruturao cognitiva e o Treino da
Motivao social aparecerem cada uma em um artigo. Verificou-se que a empatia s no foi
empregada na terapia focada na reestruturao cognitiva e no treino de motivao social. Nas
demais intervenes, a empatia apareceu em diferentes etapas do processo de promoo do
perdo interpessoal: no acolhimento do terapeuta em relao dor dos clientes; no
desenvolvimento da capacidade de tomar a perspectiva do ofensor; e no estmulo vivncia de
compaixo em relao ao ofensor. Conclui-se que a empatia est sendo amplamente
empregada nas estratgias para o desenvolvimento do perdo interpessoal e enfatiza-se a
necessidade de que investigaes desse tipo sejam realizadas na Amrica Latina.
Diseo y Evaluacin de un Programa de Potenciacin de la Resiliencia para Pacientes
con Diagnstico de Artritis Reumatoide
Japcy Quiceno1, Eduardo Remor2, Stefano Vinaccia3.

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1. CES, Medelln, Colombia, 2. Universidad Autnoma de Madrid, Madrid, Spain, 3. San


Buenaventura, Bogot, Colombia.
Abstract Central: Japcy Margarita Quiceno Eduardo Remor Stefano Vinaccia El objetivo de
este estudio fue disear, ejecutar y evaluar un programa para la potenciacin de la resiliencia
(Fortaleza) para pacientes con diagnstico de artritis reumatoide. Participaron en la
investigacin un total de 76 pacientes (71 mujeres y 5 hombres), quienes fueron asignados a
dos grupos cuasi-experimentales (piloto y rplica) y dos cuasi-controles (piloto y rplica). Se
utilizaron como instrumentos de medida para las variables dependientes el cuestionario de
Salud MOS SF-36, el cuestionario Breve de Percepcin de Enfermedad IPQ-B, la escala de
Autotrascendencia (STS), el cuestionario de Resiliencia (RS), la percepcin de apoyo social se
midi a travs de dos preguntas, y el estado emocional fue medido con una Escala Visual
Analgica antes y despus de cada sesin del programa. El programa Fortaleza es un
programa multimodal de bajo costo que estuvo compuesto por un conjunto de tcnicas de
intervencin psicolgicas derivadas de la psicologa positiva y la terapia cognitivo-conductual
donde se trabaj la resiliencia a travs de tres pilares: autoestima, autoeficacia y autocontrol.
La estructura del programa fue diseada para que los pacientes pensaran en positivo. El
programa estuvo compuesto adems por seis sesiones de dos horas y media de duracin que
se desarrollaron en seis das consecutivos. Para evaluar los resultados se emple un diseo
tipo antes y despus con un grupo cuasi-control y seguimiento al grupo intervenido al cabo de
tres meses de finalizado el programa. Los resultados mostraron en ambos estudios un aumento
significativo de la resiliencia en comparacin con un grupo cuasi-control y al cabo de tres
meses. La autotrascendencia fue significativa slo en el estudio rplica a nivel de post test
respecto a un grupo cuasi-control y en el seguimiento. Se presentaron cambios en el estado
emocional al final de cada sesin respecto a la medicin inicial en los grupos intervenidos de
ambos estudios. La calidad de vida en ambos grupos intervenidos (piloto y rplica) mejora
mucho ms en la medicin de seguimiento. El control personal del IPQ-B y la percepcin del
nmero de personas con las que se puede contar aparecen significativos en ambos estudios al
cabo de tres meses. Conclusin: en este estudio se pudo ver que programas de intervencin
focalizados en resiliencia pueden potenciarla y producir cambios importantes en variables
psicosociales asociados con la artritis reumatoide.
Felicidade e Suas Determinantes Empricas
Ctia Rodrigues-Cmara.
Universidade Presbiteriana Mackenzie, So Paulo, Brazil.
Abstract Central: O problema ao qual esta pesquisa se dedica estudar quais fatores
determinam empiricamente a felicidade humana, bem como investigar se e de quais modos
possvel estimular e otimizar o estado de bem estar subjetivo para o ser humano. Partimos da
considerao aristotlica de que a Felicidade a finalidade da vida humana - finalidade esta
que est limitada para efetivar-se na condio existencial Moderna, seja pelos interditos sociais
(como economia), seja pelos fundamentais, como a liberdade, dada a tica de consumo que
orienta a conduta nesta cultura. Sendo assim, por meio de levantamento bibliogrfico, o
presente estudo tem como objetivos: 1) investigar as determinantes empricas para o estado de
felicidade humana; 2) compreender as variveis da felicidade a fim de construir e propor
mtodos eficazes de promoo de bem estar subjetivo atravs do enfrentamento, elaborao e
superao de emoes e sentimentos negativos em relao s experincias de vida. Valendose de clssicos como Aristteles, Freud e Selligman, e de autores contemporneos nacionais,
como Corbi et alli, Gianetti, Passareli et alli e Scorsolini-Comin, a contribuio deste texto para

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a Psicologia a realizao de uma compilao panormica sobre a finalidade da ao humana,


que pode colaborar prtica clnica na superao das desordens psquicas.
Bem Estar Subjetivo em Grandes Centros Urbanos: Um Estudo de Campo em So Paulo
Ctia Rodrigues-Cmara.
Universidade Presbiteriana Mackenzie, So Paulo, Brazil.
Abstract Central: Este trabalho apresenta os resultados de pesquisa de campo realizada com
50 paulistanos aleatoriamente selecionados em pontos centrais da cidade de So Paulo, que
investigou os aspectos relacionados felicidade sentida (ou no) em suas vidas, bem como as
correlaes entre o estado de bem estar subjetivo vivenciados entre os sujeitos e condies
cotidianas da vida urbana moderna. Tivemos como objetivos 1) investigar as determinantes
empricas para o estado de felicidade humana no indivduo urbano contemporneo, bem como
sua relao com o desenvolvimento espiritual do sujeito; 2) discutir cientificamente sobre o
carter e a virtude humana, conferindo a autenticidade das emoes positivas como fontes da
felicidade. Com a fundamentao de dados a partir de clssicos como Aristteles, Freud e
Selligman, e de autores contemporneos nacionais, como Corbi et alli, Gianetti, Passareli et alli
e Scorsolini-Comin, a interpretao dos dados obtidos nesta amostra indicam correlaes
diretas entre o estado de felicidade pessoal e a condio familiar, a espiritualidade, a sade
pessoal e de familiares, mas no diretamente com o status ou condio financeira.
Effect of the ABCDE Model on the Languishing Physically Active People
Marei Salama-Younes.
1. Helwan University, Cairo, EGYPT, Egypt, 2. CREAD and CRPCC, Rennes, France.
Abstract Central: Background: The multidimensional model of mental health includes
emotional, social and psychological well-being. The factor structure of the Mental Health
Continuum Short Form (MHC-SF), designed to measure these three factors, has been
confirmed with a sample of French physically active people (Ismail & Salama-Younes, 2009).
Scale is able to categorize sample into three categories of mental health (i.e. flourishing,
moderately healthy and languishing). Method: Using MHC-SF, 33 languishing persons (14
Mister and 19 Mrs.) were classified. They aged from 58 to 64 years (M= 63, SD= 1.96). In this
study, as using a pre-post test design, ABCDE model was applied. A = Adverse event or
situation; B = Beliefs about that event; C = Consequences of those beliefs; D = Disputation and
Distraction ; E = Energization. Following the physical activity session, the ABCDE model was
applied for three times per week during 11 weeks. Findings and conclusion: score of MHC-SF
for languishing people is significantly changed. It means that score is modified and there are
almost oriented to be moderately mental health people. Probably, The ABCDE model has an
effect to modify the well-being perception. As a result, the effect of ABCDE model will be
evaluate on the 24th and on the 36th weeks.
Effect of the ABCDE Model on the Pessimistic Explanatory Style for French Children
Marei Salama-Younes.
1. Helwan University, Cairo, EGYPT, Egypt, 2. CREAD- IUFM de Brittagne, Rennes, France.
Abstract Central: Objective: Meta-analytic studies of the relationship between explanatory style
and depression symptoms have confirmed a strong association between unipolar depression
and pessimistic explanation of negative events (Mezulis, Abramson, Hyde, & Hankin, 2004). In

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different cultures, these findings have been confirmed (Satterfield, Folkman & Acree, 2002;
Purandare, 2012). Otherwise, for adults as well children, optimistic persons have better physical
and psychological health than pessimistic ones (Peterson, 2000; Yates, 1998; Salama-Younes
et al., 2005). However, using the ABCDE model, optimistic style could be learned (Seligman,
2003). Method: The French version of the Childrens Attributional Style Questionnaire (CASQ)
has been used in order to evaluate the explanatory style for 192 children. They were students in
public schools in Rennes city, France. Only 42 children, aged from 10 to 12 years (M=10.62;
SD= 13.13), have been classified as pessimistic, and were selected for this study. For 12
weeks, two sessions per week, the ABCDE model was applied. The explanatory style was reevaluated in the 12th, 24th and 33rd weeks. Results and discussion: Results show that
pessimistic participants explanatory style has been modified. As a result their pessimistic style
could be changed to be more optimistic. The effect is significant for the three assessments (12,
24 and 33 weeks). The ABCDE model has an effect to change the pessimistic style. Once
negative event identified, beliefs that don't make sense can be disputed or changed. Then,
better results and feelings are possible.
Behavioral Cognitive Intervention and Positive Psychology Therapy for Children with
Health and Behavioral Problems: The Optimistic Game
Andromeda Valencia.
Centro de Servicios Psicolgicos, UNAM, Mexico, City, Mexico.
Abstract Central: Children with chronic diseases or misbehavior present different psychological
responses that have an impact in the childrens and families adjustment, another important
factor is the attributions that children and their parents have about the disease or behavioral
problem. Seligman and Csikszentmihalyi (2000) postulate that the type of attribution that is
made for negative events in life has a direct impact in the cognitions, this situation changes the
behavioral patterns, taking a person into a pessimistic or optimistic. This style has an effect on
health and quality of life, and influence the behavior that is related to the maintenance of
physical wellbeing (therapeutic adherence). In Mexico is important to develop psychological
treatment that provides to the children and their families abilities to adjust the children health or
behavioral situation. The object was to design and promote a cognitive-behavioral intervention
program based on principles of the positive psychotherapy (PPT). The Optimistic Game
(Valencia, 2007), is a program that rest on the hypothesis that the reduction of the negative
symptoms is important but is also necessary to build positive emotions, character strengths and
well-being components as goals of a psychological intervention program for children and their
families. Intervention Handbooks were made to encourage the replication of the therapeutic
model; and describe the instructions and exercises for each session. The Intervention was an
experimental design of single case type AB with 10 replications. We show the data from 10
families with children with chronic diseases or behavioral problems. We used the Therapeutic
Contract, Adherence Carnet, Behavioral Interview, Family Environment Scale (FES-Moos,
1980; adapted by Ayala), Children`s Depression Inventory (CDI- Kovacs, 1992), Children
Attributional Style Questionnaire and the CAVE Technique (Seligman, 1986), Parental Stress
Index (Abidin, 1979,1990; adapted by Ayala) and the Social Satisfaction Questionnaire
(Valencia, 2002). The Optimistic Game gives cognitive and behavioral skills to the children and
their families to improve their quality of life and the adherence to medical treatment. The
intervention was divided into evaluation and social validity and treatment (7 modules for parents
and 6 for children-siblings). We found significant statistical changes in the treatment adherence
behavior, increase in the quality of live and the perceived level of self-efficacy. The families
showed changes in their attributional style and they were able to complete the behavioral
products of each module. The results show that the Optimistic Game is an effective intervention

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to give cognitive, emotional and behavioral skills, and had social validity. Finally, we have
significant clinical change in all cases.
Optimismo: Una Propuesta de Investigacin Psicofisiolgica para la Comprensin del
Bienestar y la Conducta de Salud
Pablo Vera - Villarroel1, Jaime Silva2, Karem Celis Atenas1, Paula Pavez1.
1. Universidad de Santiago de Chile, USACH, Santiago, Chile, 2. Universidad de la Frontera,
Temuco, Chile.
Abstract Central: La diversidad de estudios existentes en relacin a variables positivas,
muestran los beneficios de las variables positivas (felicidad, optimismo, afecto positivo) en la
promocin de conductas de salud de forma independiente. An existe poca informacin de los
mecanismos y variables relacionadas en los procesos subyacentes a estas, adems de escaso
consenso acerca de los mecanismos psicolgicos y/o fisiolgicos que expliquen su relacin.
Por tanto este estudio propone evaluar el rol del optimismo en la comprensin del bienestar y la
conducta de salud desde una perspectiva psicofisiolgica. Para ello se prob tarea
experimental que evala las diferencias de la respuesta conductual y fisiolgica ante el
reforzamiento frente a un estresor agudo en personas con alto optimismo versus personas con
bajo optimismo (n = 140 casos). Se espera confirmar la hiptesis que las personas con alto
nivel de optimismo mostrarn una respuesta fisiolgica disminuida frente a un estresor agudo
en comparacin con las personas con bajo optimismo, as como una mejor performance (mejor
tiempo de reaccin y tasa de respuesta correctas). The diversity of existing studies regarding
positive variables, show the benefits of positive variables (happiness, optimism, positive affect)
in the promotion of health behaviors independently. There is still little information on the
mechanisms and related variables in the processes underlying these, plus little consensus
about the psychological and / or physiological explain their relationship. Therefore, this study
aims to assess the role of optimism in the understanding of the well being and health behavior
psychophysiological perspective. This task was tested experimentally evaluating the differences
of behavioral and physiological responses to the reinforcement against an acute stressor
optimism in people with high versus low optimism persons (n = 140 cases). It is expected to
confirm the hypothesis that people with high levels of optimism show a diminished physiological
response against an acute stressor compared to those with low optimism, and better
performance (better reaction time and correct response rate). This study was a part of the
project FONDECYT N 1110520, granted to the first author.
Resiliencia, Percepcin de Enfermedad, Creencias y Afrontamiento Espiritual-Religioso
en Relacin con la Calidad de Vida Relacionada con la Salud en Enfermos Crnicos
Stefano Vinaccia Alpi1, Eduardo Remor2, Japcy Quiceno3.
1. Unversidad San Buenaventura, Bogot, Colombia, 2. Universidad Autnoma de Madrid,
Madrid, Spain, 3. CES, Medelln, Colombia.
Abstract Central: Stefano Vinaccia Alpi Eduardo Remor Japcy Margarita Quiceno El propsito
de este estudio fue relacionar la Resiliencia, la Percepcin de enfermedad, las Creencias y
afrontamiento espiritual-religioso sobre la Calidad de vida relacionada con la salud en 121
sujetos con una edad promedio 59 aos, hombres y mujeres residentes en la ciudad de
Medelln, Colombia, quienes tenan diagnstico de Insuficiencia Renal Crnica (n=40), Artritis
Reumatoide (n=41) y Enfermedad Pulmonar Obstructiva Crnica (n=40). El diseo del estudio
fue Exploratorio, Transversal, Comparativo, Ex-post-facto Correlacional, mediante una
metodologa tipo encuesta. Insrumentos: Escala de Resiliencia (RS), la escala de resiliencia

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breve CD-RISC2, el Cuestionario Breve de Percepcin de Enfermedad (IPQ-B), el Inventario de


Sistema de Creencias (SBI-15R), la Escala de Estrategias de Afrontamiento Espirituales (SCS)
y el Cuestionario de Salud MOS SF-36. Respecto a los resultados a nivel descriptivo se
encontr en los tres grupos estudiados altos niveles de Resiliencia, conviccin religiosa, de
apoyo social religioso y el uso frecuente de la religin como estrategias de afrontamiento. Por
otro lado, se evidenci que la percepcin de enfermedad y la Calidad de vida varan
significativamente entre cada tipo de enfermedad. El grupo de pacientes con Enfermedad
Pulmonar Obstructiva Crnica (EPOC) es el que tuvo los resultados ms diversos. Respecto al
anlisis correlacional en los tres grupos se encontr que las variables psicolgicas como
resiliencia y percepcin de enfermedad se relacionan positiva y negativamente con algunas
dimensiones de la calidad de vida menos las variables asociadas a creencias y afrontamiento
espiritual-religioso, sin embargo la dimensin de afrontamiento no religioso tiene un
comportamiento diferencial entre grupos especialmente en los pacientes de AR donde hubo
relaciones de esta dimensin con la resiliencia, con las creencias y afrontamiento espiritualreligioso y con calidad de vida y en los pacientes de EPOC con las dimensiones de los
instrumentos que miden creencias y afrontamiento espiritual-religioso. De acuerdo al anlisis de
regresin lineal mltiple se encontr por tipo de enfermedad que los pacientes de IRC y AR
predijo positivamente ms la resiliencia sobre el ndice sumario mental (MOS SF-36). De
acuerdo a la percepcin de enfermedad (IPQ-B) es en los pacientes de IRC y AR donde predijo
negativamente ms la dimensin de consecuencias sobre el ndice sumario fsico (MOS SF-36)
mientras que en el grupo de EPOC lo fue sobre el ndice sumario mental, de igual modo la
dimensin control personal en el grupo de EPOC predijo sobre este ndice positivamente. Con
relacin a algunas caractersticas sociodemogrficas y clnicas es slo en el grupo de AR
donde hubo incidencia de estas sobre los ndices sumario fsico y mental (estrato
socioeconmico y recibe tratamiento farmacolgico). En conclusin, la CVRS se ve ms
afectada por las consecuencias de la enfermedad, mientras que los aos de estudios, el tener
mayor tiempo de diagnstico de la enfermedad y ms edad la favorecen. Finalmente las
creencias/prcticas y el afrontamiento espiritual-religioso no parecen tener ningn peso sobre la
CVRS en los pacientes de esta investigacin.
Promoo de Sade Mental para combater o estresse em militares da Fora Area
Brasileira
Lvia dos Santos.
1. Fora Area Brasileira, Anpolis, Brazil, 2. Base Area de Anpolis, Anpolis, Brazil.
Os mecanismos do estresse no funcionamento humano tm recebido ateno de vrios
estudiosos, uma vez que ele pode contribuir para o incio e manuteno de doenas fsicas e
mentais 1. No Brasil, as pesquisas na rea incluem o estudo dos efeitos negativos do estresse
no que diz respeito profisso, como em policiais militares2, professores3, profissionais da
sade4, juzes1. No que diz respeito s Foras Armadas, os estudos na rea concentram-se no
Transtorno de Estresse Ps-Traumtico e envolvem principalmente estudos americanos.No
caso da atividade area militar, o nvel de estresse ainda maior, devido natureza da
atividade, que envolve risco vida, adaptao constante a novos desafios e resposta rpida.
Nem sempre possvel afastar o estmulo estressor, por isso importante aprender o que
pode ser feito para melhorar a qualidade de vida. O presente trabalho aborda um projeto
realizado pelo servio de Psicologia de uma Base Area, que abriga duas unidades areas,
alm de outros esquadres de apoio, totalizando um efetivo de 1500 militares. O projeto de
promoo de sade foi idealizado a partir do momento em que se percebeu a recorrncia de
sintomas ansiosos e de estresse nos pacientes que procuravam atendimento. O projeto
consiste na realizao de palestras sobre estresse e visa ensinar estratgias para combat-lo,

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baseado em conceitos da psicologia positiva, como resilincia e estratgias de enfrentamento.


A proposta foi encaminhada para os comandantes dos esquadres e, a partir do interesse e
disponibilidade de tempo, realizou-se a palestra, com durao de uma hora. Elas foram
ministradas entre os meses de agosto e novembro de 2012. Na palestra, expusemos o que o
estresse, os sinais, caractersticas humanas que contribuem para o surgimento e manuteno
e caratersticas humanas que funcionam como fatores de proteo e desenvolvimento de
resilincia, como manter uma viso positiva de si e do mundo, buscar identificar pensamentos e
sentimentos, praticar atividades fsicas, etc. A plateia era composta por pilotos, mecnicos e
outros aeronavegantes. No total, foram realizadas sete palestras. Na prtica, observou-se que
aps os encontros houve um aumento na conscientizao dos militares quanto importncia
de modificar pequenos hbitos dirios, como acrescentar atividade fsica sua rotina e realizar
atividades prazerosas. Eles aprenderam a identificar cognies distorcidas a fim de diminuir o
risco de estresse emocional. Essa experincia profissional revela a importncia de se realizar
aes que promovam sade mental e qualidade de vida. Referncias: 1.Stress e qualidade de
vida em magistrados da Justia do Trabalho: diferenas entre homens e mulheres. MEN Lipp,
MS Tanganelli - Psicologia: Reflexo e Crtica, 2002. 2.Costa M, Accioly Jr H, Oliveira J, Maia
E. Estresse: diagnstico dos policiais militares em uma cidade brasileira. Rev Panam Salud
Publica. 2007;21(4):217-22. 3.Carlotto MS, Palazzo LS. Sndrome de burnout e fatores
associados: um estudo epidemiolgico com professores. Cad. Sade Pblica, Rio de Janeiro,
22(5):1017-1026, mai, 2006. 4.CARVALHO, Liliane de; MALAGRIS, Lucia Emmanoel Novaes.
Avaliao do nvel de stress em profissionais de sade. Estud. pesqui. psicol., Rio de Janeiro,
v. 7, n. 3, dez. 2007.
Professional Issues/ Asuntos Profesionales/ Assuntos Profissionais
Formacin de Psiclogos en Psicoterapias Basadas en la Evidencia Cientfica: Un
Proyecto Piloto en Paraguay
Maria Celeste Airaldi.
Sensorium, Hernandarias, Paraguay.
Abstract Central: Desde que la psicologa emplea la metodologa experimental se han
realizado notorios avances en el campo de la salud mental, los cuales han permitido mejorar la
calidad de vida de las personas que acuden a nuestros servicios. Parte de esos avances se
apoy en el establecimiento de abordajes psicoteraputicos que han sido probados como
eficaces para tratar diferentes trastornos mentales. Adems, diariamente se producen nuevos
conocimientos, lo cual demuestra la necesidad de que el psiclogo tenga permanente
actualizacin para asegurar la calidad profesional y cimentar la prctica sobre una base
cientfica. En el informe de 1998 de la Asociacin de Psicologa Americana (APA), 85% de los
tratamientos incluidos se basaban en el paradigma cognitivo conductual (Chambless & Hollon,
1998). En el informe del 2005, la APA incluy 32 nuevos tratamientos, de los cuales el 72% son
cognitivos, conductuales o cognitivo-conductuales (American Psychological Association, 2006).
No es en vano, que la terapia cognitivo conductual (TCC) es la ms empleada en el mundo
(Sparrow-Leiva, 2008). Teniendo esto en mente, resulta coherente que los profesionales de la
psicologa estn formados en mtodos diagnsticos y teraputicos con efectividad
comprobada, como lo es la TCC. No obstante, se evidencia la deficitaria formacin cientfica de
los profesionales de la psicologa (Berke et al., 2011; Gallo & Barlow, 2012; Kendall, Settipani &
Cummings, 2012; Stewart, Stirman & Chambless, 2012; Woody, Weisz & McLean, 2004),
asociada a la pluralidad de abordajes psicoteraputicos (Kazdin, 1986) y al dogmatismo. Con el
objetivo de acortar la brecha existente entre la ciencia y la prctica clnica, hemos desarrollado
un entrenamiento de posgrado en psicoterapias basadas en la evidencia cientfica. Consta de 8

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mdulos a travs de los cuales los participantes conocen los protocolos recomendados por la
APA y son entrenados en la manera de ponerlos en prctica. Este trabajo ejemplificar un
modelo de formacin para psiclogos orientado a aplicar psicoterapias basadas en la evidencia
cientfica, de acuerdo a un proyecto piloto implementado en Paraguay en el ao 2012, con la
certificacin de la Asociacin Latinoamericana de Anlisis, Modificacin de Conducta y
Terapias Cognitivo Comportamentales (ALAMOC).
Uma Anlise Funcional do Comportamento nas Organizaes: Manejando
Consequncias para Satisfazer Colaboradores, Patres e Clientes
Yanne Azevedo.
Universidade Ceuma, So Lus, Brazil.
Abstract Central: Apesar das constantes mudanas nas exigncias do mercado de trabalho e
do investimento massivo em novas tecnologias, nota-se ainda grande dificuldade de se
desenvolver comportamentos mais funcionais na rea organizacional. Fazendo uma anlise do
comportamento de trabalhar nas organizaes sob o enfoque do Behaviorismo Radical e
utilizando como unidade de anlise a trplice contingncia, notam-se pelo menos dois
constantes equvocos: 1- A utilizao constante do controle aversivo como forma de obter o
comportamento esperado no trabalho; e 2- A pouca nfase na anlise das conseqncias que
deveriam manter o comportamento de trabalhar. O presente trabalho pretende discutir as
implicaes dos equvocos citados acima em relao ao desenvolvimento de comportamentos
mais funcionais na rea do trabalho, bem como para a satisfao e qualidade de vida de
patres, colaboradores e clientes. Alm disso, pretende tambm propor formas mais eficazes
de anlise e interveno na rea organizacional, visando a maior satisfao de todos os
envolvidos nessas relaes. Desta forma, ser apresentada uma pesquisa desenvolvida por
Machado (2005) na qual foi pesquisada uma empresa de So Lus (Ma), visando analisar como
a coero tem sido praticada no ambiente trabalhista, como os coagidos tm reagido e quais os
efeitos que esse controle tem deixado para os dois plos da relao coercitiva - o que coage e
o que coagido. Uma anlise funcional permitiu a descoberta de quais condies aversivas de
trabalho (como levar faltas injustas ou no receber alguma resposta da liderana quanto a um
pedido ou reclamao que fez) esto controlando, dentre outros comportamentos, as respostas
de fuga e esquiva (como isolar-se e procurar outro emprego) e certas estimulaes privadas
(como sentimentos de revolta e injustia). Buscou-se ainda apresentar uma anlise funcional
do comportamento de trabalhar, identificando estmulos antecedentes, comportamentos e
consequncias. Nota-se que, na maioria das vezes, as intervenes nessa rea, envolvem o
manejo de antecedentes (seleo, regras, treinamentos, etc), enquanto que as consequncias,
que deveriam manter o comportamento adequado no trabalho, so negligenciadas. Por outro
lado, quando ocorre a manipulao de conseqncias, normalmente envolvem a utilizao do
controle aversivo do comportamento (ameaas e punies). Como forma de ilustrar e
demonstrar as vantagens da nfase e interveno sobre as consequncias do comportamento
de trabalhar, bem como da maior utilizao do reforamento positivo ao invs da coero, ser
apresentado um relato de experincia envolvendo uma empresa em So Lus do Maranho.
Session Summary Structured: Report on a CBT Teaching Tool
Janana Barletta.
Universidade Federal de Sergipe, Braslia, Brazil.
Abstract Central: One of the features of Cognitive Behavioral Therapy (CBT) is a
psychotherapeutic intervention structured. Thus, the structure of the session becomes an

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important factor in the teaching of CBT but it has been touted as one of the great difficulties by
beginning therapists. In order to improve the adherence of the structure and increase its seizure
by the beginners as well as facilitate the description of important data for understanding the
process, we designed a session summary that follows the same format of the intervention. The
structured summary is composed of data to identifying the student therapist, patient and session
number. Other questions follow this sequence: 1) chief complaint; 2) rapport and cognitive
model, which the student must describe how was the explanation of the therapeutic model in the
first session and how he/she checked the patient understanding; 3) assessment of mood and
tool used; 4) bridge with the previous session; 5) setting the agenda, including the topics and
who suggested it; 6) home work, where it should be described if the therapist checked it and if
the patient has done it. If he has not done, must be described if the difficulties of task execution
were raised and whether it was made during the session; 7) session development; 8) new home
work; 9) summarization of the session, which must be described who did it, what was said, and
if it was related to the objectives of short and long duration of therapy; 10) feedback, which
describes whether the therapist made and received it anytime during the intervention. In the
end, there is a space also structured for analysis session, which it should be described: a
cognitive conceptualization, the working hypotheses, planning the next session and the
therapist's comments. This summary has been used for three years with seven groups of
psychology undergraduate students (40 students) and with two groups of post graduating
students in CBT(11 students) currently. At the end of the learning stage, was asked to all
students about the advantages and disadvantages of the session summary structured. As
advantages, all students indicated that this tool facilitates the learning of CBT, as it increases
the understanding of the structure, its occurrence in a more natural way during intervention and
self-confidence of the therapist. Thus, decreases the major concern in maintaining the format of
the session, which in turn generated a sense of mechanic behavior of the therapist and
insecurity, as well as decrease the attention of the customer and their needs by the student.
Other advantages listed were: highlights the session problems (37); helps in detailing the case
analysis of case (35); increases the training of specific techniques (30), as the diary of
automatic thoughts and cognitive conceptualization; helps to list the most important (22);
maintains the therapeutic focus (20) and facilitates the planning of the following intervention
(16). The disadvantage indicated by 100% was related to filling time, although some students
still believe that it is compensated (8). We believe that it may be an important tool in teaching
the CBT structure.
Reflections on Tools for Teaching Cognitive Behavioral Psychotherapy to Beginning
Therapists
Janana Barletta1, Ana Lucia Fonseca2.
1. Universidade Federal de Sergipe, Aracaju, Brazil, 2. Universidade Federal do Vale do So
Francisco, Petrolina, Brazil.
Abstract Central: Supervision of clinical stage is a critical time for the development of
psychotherapeutic skills. However, there is little systematic in this process and a preference for
the case report as a single strategy of education. This presentation aims to reflect the inclusion
of some teaching tools in the clinical supervised process of cognitive behavioral therapy. Among
these stand out structured supervision, summary session structured, recording and transcription
of clinical intervention, the observation by the mirror unilateral room, formative activities and
process evaluations. Without intending to exhaust the discussion, it is believed that these tools
contribute to developing the skills needed to perform well in practice, as well as facilitate the
systematization of the supervised process.

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Curriculum and Pedagogy in the Clinical Supervision


Hamer Bastidas-Bilbao.
Universidad de los Andes, Bogot, Colombia.
Abstract Central: Behavioral and cognitive therapies are rich in techniques designed to
facilitate learning of new skills and complex behavioral repertoires. In addition, these very same
techniques are frequently used by supervisors with trainees enrolled in practicums or
internships in order to facilitate acquisition of the clinical skills they need to successfully manage
their caseload and complete their training programs. Nevertheless, this paper will present key
aspects from the fields of curriculum and pedagogy that might contribute towards the
development of innovative clinical supervision practices that place a focus on the identification
of trainees educational needs, development of contextually relevant learning experiences, and
design of formative and summative methods for student evaluation as well. Therefore, this
proposal integrates evidence-based clinical supervision, curricular notions and pedagogical
tools, resulting in a new perspective for developing cooperative, critical and autonomous
learning in the trainees.
La Clnica Psicolgica en las Publicaciones Latinoamericanas
Claudia Bregman.
Fundacion Aigle - ALAPCO, Ciudad Autonoma de Buenos Aires, Argentina.
El objetivo de este poster es presentar las tendencias de los artculos cientficos sobre el
campo de la clnica psicolgica publicados por las revistas latinoamericanas en espaol con
factor de impacto (Revista Argentina de Clnica Psicolgica, Revista Latinoamericana de
Psicologa, Revista Mexicana de Psicologa, Terapia Psicolgica, Salud Mental, Universitas
Psychologica) de acuerdo a la base del Social Sciences Citation Index. Se expondr un estudio
bibliomtrico de dichas publicaciones que abarca el perodo 2009-2012. Se contemplaran las
siguientes variables: nmero de artculos publicados, tipo de artculo, nacionalidad de los
autores, tipo de colaboracin los autores, referencias bibliogrficas, indice de autora, temtica
de los artculos. Para esto ltimo se clasificar la produccin cientfica de acuerdo a los
siguientes descriptores: psicopatologa, enfoque teraputico, formacin, entrenamiento,
supervisin.
Innovacin Acelerada por la Multitud y Psicoterapia: Oportunidades y Desafos
Juan Ccahuana.
1. RCursos, Lima, Peru, 2. ALAMOC, Lima, Peru.
Abstract Central: Internet est cambiando nuestras vidas. Este proceso es inevitable y est
ocurriendo con mayor velocidad, extensin y profundidad. Este trabajo analiza cmo Internet
est transformando la educacin, la salud, los negocios, el desarrollo de software y el gobierno,
y describe las oportunidades y desafos al adaptar lo que funciona en estos campos e
industrias para mejorar la psicoterapia. El concepto de Innovacin Acelerada por la Multitud es
utilizado para resumir el poder sinrgico de la colaboracin masiva que puede enriquecer la
teora y prctica de la psicoterapia. Al ofrecer en cdigo abierto las teoras y mtodos de
psicoterapia, con plataformas que incorporen la colaboracin abierta utilizada por los
desarrolladores de software y con el uso de repositorios de datos internacionales, la difusin y
la variacin sistemtica de los tratamientos y de sus componentes pueden realizarse de forma
ms rpida y productiva. Con el aporte de una amplia gama de personas, que provienen de
diferentes contextos, orgenes y profesiones, puede ser ms fcil identificar puntos ciegos y

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sintetizar y probar nuevas ideas. Porque cada oportunidad tiene sus propios desafos, el
posible impacto de estos nuevos enfoques en relacin con la privacidad, los derechos de autor
y la tica en general sern discutidos.
tica del Proceso de Investigacion y Difusin en Psicologia en la Era de: InvestigarPublicar o Perecer: Papel de los Comits de tica
Norma Coppari.
1. Psicologia, Universidad Catlica, Asuncion, Paraguay, 2. Conacyt Paraguay, Asuncion,
Paraguay.
Abstract Central: Posiblemente para muchos este sea un tema trillado, y que mayormente no
amerita una presentacin, discrepamos en tanto, en la acelerada poca que nos toca vivir a los
cientficos del comportamiento, la formula investigar-publicar o perecer se ha vuelto una
espada de Damocles. Los psiclogos se han vuelto, en la ltima dcada, protagonistas de una
carrera desenfrenada de alta productividad pero con serios riesgos para la calidad y tica
aplicada al proceso de investigar y difundir, casi de inmediato, los resultados de sus estudios so
pena de obsolescencia. Esta verdadera mana se ha tornado una prioridad estimulada
constantemente por las exigencias acadmicas de los concursos de meritos, los ranking
bibliomtricos de popularidad de las publicaciones, el ndice de impacto, el crecimiento
exponencial de invitaciones a publicar, la cantidad de nuevas revistas en temticas diversas de
la Psicologia, que podra verse solo, positivamente, como un elevado crecimiento cientfico de
nuestra ciencia, disciplina y profesin, o tambin en su faceta contraria. En este contexto
propongo recordar y debatir cual es el papel que toca a los Comits de tica en el proceso de
valorar los trabajos que se presentan a publicacin, la importancia del cumplimiento de los tres
principios fundamentales reconocidos en todos los Cdigos y reglamentos que rigen el proceso
de investigacion con seres humanos y la publicacin cientfica: el principio de Beneficencia, que
justifica una valoracin objetiva de los riesgos y beneficios, el principio de la Autonoma que se
trata de respaldar por el consentimiento informado de los participantes o sus apoderados, y el
de Justicia sustentado en una adecuada seleccin de los participantes. Idealmente el proceso
de publicacin cientfica pasa por la labor de los Comits de Aspectos Formales, Metodolgicos
y ticos. Se subraya el papel de los comits de tica en una lista de chequeo que revisa:
consentimiento informado y por escrito, investigacin en pases en desarrollo, proteccin de
poblaciones vulnerables, distribucin de riesgos y beneficios, investigadores calificados,
diseos de investigacin apropiados, participantes por autoseleccin, bienestar de los
participantes versus los intereses de la ciencia y de la sociedad, precaucin en casos de
dependencia del participante del investigador, empleo de placebos, mayor acceso a los
beneficios, etc. Palabras Claves: cdigos de tica, papel de comit de tica, publicar o perecer.
Caracterizao da Clientela Atendida, Identificao de Queixa e rea de Atendimento na
Clnica-Escola de Psicologia da Universidade Paulista
Giedre Costa2, 1, Camila Belentani2, Rosana Garcia2, 1, Camila Chaves2, Thais Remondi2.
1. INSTITUTO DE PSICOTERAPIA COGNITIVO-COMPORTAMENTAL - IPC, So Jos do Rio
Preto, Brazil, 2. UNIVERSIDADE PAULISTA - UNIP, So Jos do Rio Preto, Brazil.
Abstract Central: O presente estudo objetivou caracterizar a clientela que buscou atendimento
psicolgico na clnica-escola da Universidade Paulista (UNIP) - Campus de So Jos do Rio
Preto, So Paulo, Brasil, durante o ano de 2012, em funo de variveis como: gnero, idade,
estado civil, queixas apresentadas, reas de atendimento psicolgico, instrumentos utilizados,
freqncia de avaliao do humor e adeso ao tratamento. Foram avaliados os dados de 187

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pronturios utilizando metodologia retrospectiva documental. De acordo com os resultados


obtidos, buscaram atendimento predominantemente indivduos do sexo feminino (61,5%), idade
mdia de 30 anos, estado civil solteiro (56,7%). Entre as queixas mais relatadas pelos
pacientes estavam Medo/Ansiedade (25,1%); Dificuldade na Relao Familiar (22,5%);
Dificuldade no Relacionamento Amoroso (16,0%); Tristeza/Depresso (12,3%) e Dificuldade de
Aprendizado (9,1%). Quanto rea de atendimento psicolgico, houve alto ndice de
atendimentos realizados no Planto Psicolgico (54,1%), seguido por Terapia Cognitiva
(19,0%), Psicodiagnstico infantil (14,4%), Psicanlise (10,1%) e Terapia Familiar - Sistmica
(9,1%). Em relao aos instrumentos utilizados, os mais prevalentes foram Desenho Livre
(11,7%), Hora Ldica (10,7%), Anamnese (9,1%) e HTP (7,5%). No que se refere avaliao
do humor, interveno teraputica esta realizada somente pela abordagem da Terapia
Cognitiva, 10,7% dos pacientes tiveram seu humor verificado semanalmente e 7,5% realizou
verificao de humor com freqncia quinzenal. Quanto adeso ao tratamento, 39,0% dos
casos foram concludos e 13,4% esto em andamento, entretanto, pde-se verificar tambm
alta taxa de desistncia/abandono do tratamento, equivalente a 45,4%. Ao analisarmos a taxa
de desistncia encontrada neste estudo e comparar com os ndices de dados da literatura este
resultado compatvel e esperado. Esta anlise, portanto, permitiu uma maior visibilidade do
perfil clnico e sociodemogrfico da clientela atendida neste servio de ateno psicolgica, o
que possibilitou uma reflexo ampliada no que se refere formao dos futuros profissionais
da rea da psicologia assim como sobre a demanda dos pacientes atendidos nesta instituio,
fornecendo subsdios para tornar este tipo de atendimento ainda mais eficaz e adequado
populao que o solicita.
As Habilidades Sociais dos Adolescentes para o Mercado de Trabalho: Estudo e
Treinamento
Richardison Costa.
Faculdade Anhanguera, Jundia, Brazil.
A pesquisa foi desenvolvida na rea de Psicologia Social, no Programa de Extenso
Comunitria (PEC) - Capacitando da Faculdade Anhanguera de Jundia, que tem como objetivo
o atendimento de capacitao de adolescentes da comunidade do municpio de Jundia - SP
Brasil, de forma educacional e profissional, visando cidadania, bem estar social e qualidade
de vida. Os participantes do projeto foram 92 adolescentes, de ambos os sexos, na faixa etria
entre 14 e 18 anos, inseridos no Ensino Fundamental (8 srie) e Ensino Mdio de escolas
pblicas e residentes nas comunidades carentes do municpio de Jundia. As habilidades
sociais referem-se as habilidades de comunicao, cooperao, resoluo de problemas nas
relaes pessoais e profissionais que podem ser herdadas ou adquiridas, nessa pesquisa
buscou-se verificar o grau em que se encontravam os adolescentes do programa e por meio de
treinamentos e tcnicas cognitivo comportamentais aumentar as suas habilidades.
Presentacion de la Guia de Referencia Rpida de Tratamientos Psicolgicos con Apoyo
Emprico de la Universidad Complutense de Madrid
Maria Crespo, Mnica Bernaldo de Quirs, M. Mar Gmez, Alfonso Roa.
Clinical Psychology, Complutense University, Madrid, Spain.
Abstract Central: El objetivo es dar a conocer esta Gua de Referencia Rpida (GRR), un
proyecto que se enmarca en la Psicologa Clnica basada en la evidencia y que pretende
proporcionar una herramienta que permita una bsqueda sencilla (organizada en funcin de
trastornos) de las recomendaciones de las principales guas de tratamientos psicolgicos con

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apoyo emprico y posibilitando con ello tambin el contraste de las diversas recomendaciones.
Esta herramienta, elaborada en castellano, es de libre acceso a travs de Internet (publicada
en 2012 en la web de la Universidad Complutense de Madrid y accesible en el siguiente enlace
http://www.ucm.es/info/psclinic/guiareftrat/index.php). En la presente comunicacin se
describirn las bases y el proceso de creacin de la GRR, y se har una presentacin
interactiva de sus contenidos y posibilidades, incluyendo los siguientes mdulos o apartados: 1.
Presentacin: breve introduccin a la gua con especificaciones de sus objetivos, de la
informacin contenida en ella, y de su proceso de elaboracin. 2. Equipo del proyecto 3.
Niveles de evidencia: se recogen datos de los niveles de evidencia utilizados en las cuatro
guas de referencia generales que sirven de base a la presente, a saber: la de la Sociedad de
Psicologa Clnica de la Divisin 12 de la APA, la del National Institute for Health and Clinical
Excellence (NICE), las Guas de Prctica Clnica del Sistema Nacional de Salud de Espaa, y
el Registro Nacional de Programas y Prcticas Basados en la Evidencia (NREPP) de Estados
Unidos. 4. Guas de referencia rpida: incluye las guas para los distintos trastornos
psicopatolgico en adultos (en el momento de redaccin del presente resumen 13, todos ellos
en adultos), incluyendo, para cada uno de ellos, los siguientes materiales: a) Criterios
diagnsticos (DSM-IV-TR y CIE-10) b) Recomendaciones de la Sociedad de Psicologa Clnica
(APA) c) Recomendaciones del NICE d) Recomendaciones de las Guas de Prctica Clnica
(GPC) del Sistema Nacional de Salud (SNS) e) Recomendaciones del NREPP f)
Recomendaciones de otros organismos g) Informacin adicional h) Resumen de
recomendaciones i) Referencias y enlaces 5. Material y enlaces de carcter general sobre la
temtica del proyecto 6. Contacto As mismo, se describir la difusin de la GRR hasta el
momento de su presentacin en el congreso y se proporcionar a los asistentes informacin
detallada para su utilizacin y aplicacin en la toma de decisiones sobre tratamientos.
From Um. to What were you thinking when.?: Teaching Graduate Students CBT
Skills
Rene Drumm, Stanley Stevenson, Lorri Merchant.
Social Work, Southern Adventist University, Collegedale, TN, USA.
Abstract Central: While many books have been written for therapists on how to develop CBT
skills, beginning therapists often require formal, guided training to demonstrate initial therapeutic
skills. In addition, research notes that most therapists do not exhibit measurably improved
outcomes much beyond that which they have achieved in graduate school (Duncan and Miller,
1999). For these reasons, it is imperative that graduate schools and communities who are
passionate about clinical excellence develop programs that encourage and enhance initial CBT
skills. If we are to offer a better quality of life for clients needing to change cognitions and
behavior, it is important to cultivate quality CBT training using a systematic process with
measurable outcomes. Southern Adventist Universitys school of social work has developed a
system of training beginning therapists in the Beck approach to CBT that demonstrates
measurable improvement over a 15-week course. This improvement ranges from 50 to 100
percent increase in therapist skill. This presentation will offer a proven plan for professors and/or
community mentors to follow as they systematically engage students or mentees in learning
CBT skills. The presentation will feature before and after video clips of students engaging in
CBT as a way to help the audience see the profound difference that skills-training produces. In
addition, the presentation will feature assignments, exercises, and measurement tools for
training the next generation of CBT therapists.
La Formacin de Terapeutas Cognitivos en Colombia

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Alberto Ferrer Botero.


1. Psicologa, Universidad de Antioquia, Medelln, Colombia, 2. Universidad del Norte,
Barranquilla, Colombia.
Abstract Central: El objetivo fundamental del trabajo es mostrar que en Colombia han existido
dos tipos diferentes de tradicin en Psicoterapia con aproximacin cognitiva: la derivada de una
tradicin de las teoras del procesamiento de la informacin (propiamente "cognitiva") y la
derivada de una tradicin conductista ( que podra llamarse "conductual-cognoscitiva"). El
objetivo del trabajo es mostrar que esas dos tradiciones tienen races epistemolgicas
diferentes, y tienen, igualmente un origen regional diferente. El trabajo muestra que el enfoque
cognitivo derivado de las teoras del procesamiento de la informacin, se desarroll
fundamentalmente en Medelln en torno al Centro de Investigacin y Terapia de la Conducta
FORMAR y gravit en torno al liderazgo de Walter Riso. El enfoque "conductual-cognoscitivo"
se desarroll fundamentalmente en Cali y en Bogot. esta tradicin no surgi en torno a un
centro de investigacin, como la anterior, sino en el seno de distintas Universidaddes. Este
enfoque terico es producto de la ampliacin de los modelos cajanenegristas a modelos ms
mediacionales . El trabajo muestra cmo se ha dado la formacin de Terapeutas cognitivos y
cognitivo-conductuales (o para ser ms exactos conductuales-cognitivos) en Colombia desde
estos dos modelos, seala la diferencia bsica que hay en la formacin de estos terapeutas y
muestra los aportes cada uno ha hecho a la psicoterapia.
Self-Compassion for Trainee Therapists: An Open Trial of a Web-Based Self-Compassion
Training Program amongst Post-Graduate Psychology Trainees
Amy Finlay-Jones, Clare Rees, Robert Kane.
Curtin University, Perth, WA, Australia.
Abstract Central: Psychotherapists tend to report higher levels of work-related stress- and
burnout- spectrum conditions than many other occupational groups. In particular, it has been
argued that therapists who are younger and who have more recently entered the profession
report elevated levels of professional stress, and that the dual demands of the profession and
the academic culture may lead trainee therapists to experience overwhelming feelings of
anxiety, negative self-evaluation, and feelings of inadequacy. Work-related stress has serious
implications for the mental and physical well-being of psychotherapists, and may lead to
professional impairment, thus compromising the provision of care. As a result, researchers have
highlighted the importance of identifying variables that (a) enhance psychotherapists
psychological wellbeing and resilience to stress; and (b) are capable of development through
training. Given the elevated levels of stress amongst trainee psychologists, it has been argued
that the development of programs to improve resilience and psychological health amongst this
subgroup is of particular importance. A variable attracting recent interest in terms of its ability to
promote psychological health and well-functioning among psychotherapists is self-compassion.
A growing body of literature supports the proposition that self-compassion is a skill that is
capable of being developed in a number of ways, amongst a variety of populations. However,
the utility of an intervention to increase self-compassion amongst trainee therapists has not
previously been examined. The current study sought to evaluate the effectiveness and feasibility
of using a web-based program to facilitate the development of self-compassion amongst trainee
psychologists. The use of a web-based program is a novel form of delivery amongst selfcompassion intervention research, and has the potential to enhance well-being and resilience to
stress amongst this population in a way that is cost-effective, flexible, accessible, and
sustainable. The current study follows on from our previous findings which indicated that selfcompassion was negatively correlated with stress and emotion regulation difficulties, and

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positively correlated with happiness amongst Australian psychotherapists (including trainee


psychologists). The aim of this study was to develop, trial, and evaluate a novel web-based
intervention designed to enhance the psychological health of therapists in training through the
cultivation of self-compassion. A six-week online program (Self-Compassion Online; SCO) was
developed and delivered to participants via a website. A pre-experimental repeated-measures
design was used to collect change data on measures of self-compassion, happiness, emotion
regulation and stress. Qualitative data regarding participants subjective experiences of the SCO
program was also collected, to facilitate understanding of the feasibility of the program. A
convenience sample of 39 post-graduate psychology trainees from around Australia took part in
the study. Of these, 20 (51%) completed post-test measures. Three-month follow-up data is
currently being collected.
Self-Compassion for Psychotherapists: An Examination of the Relationship Between
Self-Compassion, Emotion Regulation, Happiness, and Stress amongst Practising
Psychotherapists and Post-Graduate Psychology Trainees
Amy Finlay-Jones, Clare Rees, Robert Kane.
Curtin University, Perth, WA, Australia.
Abstract Central: Psychotherapists tend to report higher levels of work-related stress than
many other occupational groups, with work-related stress potentially leading to a range of
deleterious outcomes, including compassion fatigue, burnout, and compromised provision of
care. Research suggests that therapists who are younger and less experienced report elevated
levels of professional stress, and may experience overwhelming feelings of anxiety, negative
self-evaluation, and feelings of inadequacy. Consequently, it has been argued that the pursuit of
professional well-functioning and resilience to stress amongst psychotherapists (particularly
trainees) is an ethical imperative. A variable attracting recent interest in terms of its ability to
promote psychological health and well-functioning among psychotherapists is self-compassion.
Previous research suggests that self-compassion is a skill that can be developed in a number of
ways, amongst a variety of populations. Despite this, there is a dearth of research examining
the relationship between self-compassion and health-related outcomes amongst this
occupational group. This research sought to address this gap by investigating the relationship
between self-compassion and stress amongst psychotherapists (including trainees), and to
examine the utility of broaden-and-build theory and emotion regulation theory in accounting for
the mechanisms underlying this relationship. This study utilised a cross-sectional, correlational
design to examine the relationship between self-compassion, emotion regulation difficulties,
happiness, and stress amongst psychotherapists, including trainees undertaking clinical work.
An online survey was used to collect data from a convenience sample of psychotherapists and
post-graduate psychology trainees throughout Australia (n= 289). Preliminary analyses indicate
significant positive relationships between self-compassion and happiness, and significant
negative relationships between self-compassion and emotion regulation difficulties and stress.
Structural Equation Modelling will be used to further explore the relationship between selfcompassion and stress, and to examine the potential mediating role of happiness and emotion
regulation difficulties in this relationship.
Constructing Strategies of Social Education in Health Professionals using TCC
Ana Lucia Fonseca1, Janana Barletta2.
1. Colegiado de Psicologia, Universidade Federal do Vale do so Francisco, Juazeiro, Brazil, 2.
Universidade Federal de Sergipe, Aracaju, Brazil.

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Abstract Central: Ana Lucia Barreto da Fonseca Janaina Bianca Barletta The Brazilian Unified
Health System institutionalization,at the beginning of the 90s of last century, had as guiding
principle the public health equality, universality and equity. These actions support demands
identification, interventions requests and building knowledge about each community sociocultural reality. The proposal is to reconstruct healthy cultural practices in the social actors,
being essential to know the rules that selected and maintained the reinforcing contingencies for
each behavior in a certain verbal community. The development of new behavioral patterns
involves the finding of the interweaving of contingent and the need to breaks away them to
insert other contingencies in order to compose other cultural practices. So it is necessary make
them experts of the cultural practices of each social group. The objective is to make the health
professionals knowledgeable of the cultural practices of their own social group to reflect about
the social education limits and possibilities. In a group of health professionals - psychologists,
nurses, and pharmacists - of the postgraduate program in Family Health, were applied
presupposed of CBT. The prospect was teaching them the nuances that constitute the cultural
practices of a given community from the basic beliefs recognition, historically constructed and
which is reproduced and endorsed by the contingencies of reinforcement present in the verbal
community. The first task was to identify their basic beliefs around various topics breastfeeding, physical activity, personal care, garbage collection - supported in cultural
practices, distinguishing knowledge socially constructed those installed by science as from their
life histories, the daily habits and beliefs expressed by familiar actors. The cultural practices
beliefs and composition of each family group and the verbal community contingencies of
reinforcement in front of each issue expressed provided a basis on identifing cultural practices,
beliefs and verbal reinforcements, and set goals besides on changing some of participants and
their immediate families behavioral patterns. Most goals was aimed on dietary practices richer in
nutrients and the withdrawal of sugars and sodium, as well as daily physical activities. In order
to achieve the goals, was proposed simplest intervention actions until the most complex ones,
entering diet novelties and involving daily physical activities with participants and their family.
Everything was daily recorded, to whom he addressed, in particular, the difficulties faced,
strategies for problem solving, and progress. These records were analyzed and discussed by
the professional group during the academic meetings. At the end of two months it was noted
that progresses were reinforcing, while the difficulties in greater number felt as threat were
reinforced by cultural practices of the verbal community. This exercise has enabled the
professionals reflect on the dimensions that limit social education, making them able to create
alternatives that made possible to have a broader view of preventive education in different
communities.
Understanding cognitive behavioral supervision through global lenses: Fidelity and
flexibility in three countries
Robert Friedberg1, Dean McKay5, Cory Newman2, Robert Friedberg1, Lisa Hoyman1, Nathan
Chow1, Micaela Thordarson1, Niel Mclachlan3, Elena Rasskazova4.
1. Center for the Study and Treatment of Anxious Youth at PAU, Palo Alto, CA, USA, 2.
University of Pennsylvania School of Medicine, Philadelphia, PA, USA, 3. North CAMHS,
Peterborough, United Kingdom, 4. Moscow State University, Moscow, Russian Federation, 5.
Fordham University, Bronx, NY, USA.
Kendall and colleagues (Kendall, Gosch, Furr, & Snood, 2008) sounded the contemporary call
for "flexibility within fidelity" in cognitive behavioral therapy (CBT). Remaining faithful to the
philosophical, theoretical, and procedural foundations in the cognitive brand of psychotherapy is
assured by competent supervision. Moreover, innovations are promoted by flexible application
of traditional clinical practices. Good supervision spawns creative clinical practices. Accordingly,

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this symposium speaks to both the faithful and flexible cognitive behavioral therapist.
The presentation offers four unique perspectives on CBT supervision. Newman sets the table
with his paper detailing a graduate course on meta-supervision. The six essential modules
germane to this course are explained along with their multi-modal training components. Further,
the process of meta-supervision is introduced. Newman's discussion is augmented by a case
example.
Friedberg, Hoyman, Chow, and Thordarson tackle neglected areas in supervision of CBT with
youth. Teaching supervisees to properly demonstrate therapeutic presence, work with
immediacy in session, and maximize experiential learning in their sessions with young patients
is delineated. Finally, creative training methods and case examples punctuate the presentation.
McLachlan offers his perspective on CBT training based on his work with the National Health
Service Child and Adolescent Mental Health Clinic in the United Kingdom. He discusses the
way supervision often mirrors the clinical practice of CBT. More specifically, correct use of
feedback within an appreciation of the interpersonal context is emphasized. Finally, McClachlan
pays special attention to common questions raised by trainees during CBT supervision.
Rasskazova provides a glimpse into the cutting edge of CBT training being conducted in the
Russian Federation. The Russian Federation's unique cultural context is explained and the
ways training need to match this context is discussed. Helping supervisees learn to work with
patients' fear of deception and uncertainty are main foci. Finally, placing therapy within the
socio-economic context which contributes to many adults living with their parents is explained.
McKay, in his role as discussant, responds to these presentations and offers his perspectives
on the topics.
Training in CBT supervision: A graduate course and "meta-supervison"
Drawing on recent findings from evidence-based programs of CBT supervision, this
presentation highlights the contents and processes of a graduate training course in CBT
supervision involving didactics, readings, and experiential exercises. The six major modules of
this seminar will be described: (1) The supervisory relationship, (2) The chief responsibilities
and teaching methods of a CBT supervisor, (3) Promoting ethical behavior and cross-cultural
sensitivity in supervisees, (4) Facilitating and assessing supervisee competency in CBT, (5)
Managing the administrative tasks of documentation, feedback, and formal evaluation in a
timely, constructive manner, and (6) Helping supervisees manage high-risk clinical situations.
Multi-modal aspects of the training methods are highlighted, including the use of lectures,
readings, audio-visual recordings, role-modeling, and role-playing. Additionally, the concept of
meta-supervision is explicated, involving the ongoing monitoring of the activities of new CBT
supervisors as they work with trainees of their own. A specific case of meta-supervision
involving a North American meta-supervisor and a supervisor-supervisee training dyad from
Asia is reviewed as an illustration of the impact of cross-cultural factors in the international
training of CBT supervisors.
Supervision of CBT with youth: Attending to neglected areas
Shaping the practice patterns of a new generation of cognitive behavioral therapists is an
awesome professional privilege and responsibility. CBT is housed within a theoretically robust
home and enjoys an strong empirical foundation. The scientific base is so sturdy that March
(2009) predicted that CBT will find a place within neuroscience medicine. Moreover, CBT is a
front-line treatment applied by a multitude of practitioners for a variety of childhood disorders.
Proper training prepares supervisees to deliver an empirically supported approach in a flexible
manner. This presentation provides attendees with a rubric for training and various
recommendations for dealing with complex training issues.
The presentation focuses on several pivotal yet often neglected issues in training therapists in
CBT with youth (Friedberg & Poggesi, 2012). First, the importance of creating therapeutic

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presence in session is specifically emphasized. Presence in CBT is defined and several


guidelines for transparently communicating to young patients are outlined. Second, methods for
effectively and efficiently working with immediacy in session are delineated. Third, training
supervisees to embrace the role of experiential learning by properly implementing exposures
and behavioral experiments are described. Various creative methods for developing cognitive
behavioral competencies (Newman, 2012) are explained. Finally, numerous case examples
amplify the salient points.
Supervising Cognitive Therapists in a community outpatient clinic in the United Kingdom
The outpatient clinic referred to in this discussion is situated within the context of a National
Health Service (NHS) Child and Adolescent Mental Health (CAMH) setting. Clinical
Psychology/Cognitive Therapy (CT) forms part of a Multi-Disciplinary Team (MDT), including
Child and Adolescent Psychiatry, Mental Health Nursing and Family Therapy. Children and
young people with a range of mental health-related difficulties including anxiety disorders, mood
disorders, and eating disorders are referred to the service. Following an initial assessment,
children and young people meeting referral criteria are referred to Routine Treatment or a
Specific Treatment Waiting List (Family Therapy or Cognitive Therapy). Presentations for which
CT is the treatment of choice, based on research evidence and National Institute for Clinical
Excellence (NICE) Guidelines, are referred to the CT specific treatment pathway. Consequently,
competent supervision is necessary to facilitate proper treatment.
The fact that CT supervision often mirrors treatment is emphasized in this presentation. . Taking
this into account, CT Supervision meetings, as practiced in this CAMC follows the structure
below to replicate CT therapy sessions incorporating an agreed time and place for weekly
meetings, an agenda agreed between supervisor and supervisee, feedback, and
homework tasks. A specific focus in this part of the discussion is the provision of feedback to the
supervisee. Feedback is not only essential in developing competence, but also in the
maintenance of an effective working relationship between supervisor and supervisee. It is,
therefore, important to negotiate the process of feedback and to make it predictable and
respectful to ensure that the supervisee feels safe receiving it. The interpersonal context of
supervision in CT is also emphasized Just as the relationship between therapist and patient is
considered important to the outcome of therapy, the relationship between supervisor and
supervisee is central to learning.
Various supervisory procedures are explained. These methods include case discussions, role
plays, and the use of audio/video material to assess competence using standardised scales
Finally, the process of developing supervisees skills in their child-focused CT practice is
illustrated by means of frequently asked questions within the supervision process. Typical
questions raised by supervisees (e.g. how to involve parents in therapy, how to include
developmental and systemic considerations within the case conceptualization process, and how
to ask questions which will engage children and young people in eliciting relevant cognitive
content) are discussed.
Training and CBT in Russia: Opportunities and limitations
Effective CBT training should be dependent on cultural and social contexts. First, there are
differences in legislation, kinds of psychotherapy that are spread in the country and cultural
beliefs about it. These factors lead to specific expectations held by trainees. Second, social
reality makes some complaints in psychotherapy very frequent. Context-specific training
programs should take into account trainees' beliefs and expectations about psychotherapy and
emphasize ways to work on problems typical for the population.
The aim of this presentation is to describe opportunities and limitations of the training in CBT in
Russia. It is based on my experience of providing basic training in CBT for psychology students.
First, in Russia there is no legislation base for the psychotherapy in private practice and

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education. Psychoanalysis, gestalt-therapy, psychodrama and CBT seem to be the most


common approaches but only trainings in gestalt-therapy and psychodrama match world
standards. In the public health sector only medical doctors after completing a brief course on
psychology and psychotherapy could work with clients. Lack of knowledge leads to the image of
psychotherapy as "magic" which is based on intuition, should help immediately and demands
hard work from neither therapist nor client. The other consequences of the lack of legislation are
fear of deception as well as uncertainty experienced by clients. Emphasis on techniques that
reduce anxiety (session structure, continuum techniques etc.) becomes very helpful. A great
proportion of clients come to the therapy only when having pronounced clinical symptoms so
basic knowledge on psychiatry and clinical psychology is necessary.
Second, an unstable economic situation leads to fears and negative thoughts about the future.
Living with parents increases family-related complaints in youth and parents. Students' own
experience could be a basis for understanding of clients.
In general, features of CBT training in Russia seem to have much in common with other
developing countries. There are limitations related to lack of legislation, skills and knowledge.
However, taking into account social context gives CBT training great opportunity to transform
lack of motivation and unrealistic expectations to strengths
Estado de la Conflictividad en Establecimientos Educacionales de Alta Vulnerabilidad
Social de la Provincia de Concepcin, Chile
Patricia Garreton.
Facultad Humanidades y Educacin, Universidad Andrs Bello, Concepcin, Chile.
Este trabajo presenta los resultados de un estudio sobre el estado de la convivencia y la
conflictividad realizado en una muestra intencionada de ocho establecimientos de educacin
primaria de la provincia de Concepcin, Octava regin, Chile, cuya caracterstica comn se
relaciona con el alto ndice de vulnerabilidad escolar, la cual es medida a travs del ndice de
vulnerabilidad escolar (IVE), indicador de la condicin socioeconmica de los estudiantes y sus
familias. Algunos de los aspectos que este considera, se encuentra el nivel ocupacional del jefe
de hogar, la escolaridad de los padres, el acceso del estudiante a servicios de salud, el nivel de
hacinamiento del alumno, el estado de salud bucal del alumno. Por medio de este ndice la
definicin de vulnerabilidad no queda supeditada slo por las condiciones socioeconmicas
actuales, sino que logra adems relevar el peso de la herencia sociocultural que los
estudiantes traen al incorporarse al sistema de educacin. El estudio se realiz en alumnos de
cursos del 2 ciclo bsico considerando la opinin de la totalidad de los actores pertenecientes
a este colectivo: 85 docentes 1.385 estudiantes y 686 familiares. Los resultados sealan que en
los tres colectivos hay una visin positiva de la convivencia, asumiendo la existencia de
algunos conflictos que se identifican en un nmero reducido de estudiantes, los cuales, sin
embargo, presentan conductas que afectan el clima de aula, alterando la convivencia en los
centros estudiados. Estos resultados, permiten abordar adecuadamente la convivencia escolar,
partiendo de las evidencias aportadas por los tres colectivos estudiados, para, desde ah,
adoptar medidas que permitan mejorar el clima escolar y las relaciones interpersonales. La
convivencia escolar es uno de los principales desafos que enfrentan los establecimientos
educacionales, ya que se ha ido evidenciando a nivel mundial, un cambio que se manifiesta en
situaciones de conflicto entre los alumnos que daan de manera decisiva los objetivos
educativos que la escuela procura. En Chile, el Ministerio de Educacin, ha desarrollado un
esfuerzo sostenido en pro de mejorar la convivencia escolar. As, desde comienzos de los 90,
seala que la calidad de la convivencia en un centro educativo es un antecedente decisivo que
contribuye a configurar la calidad de la formacin ciudadana, en cuanto la comunidad educativa
constituye un espacio privilegiado de convivencia interpersonal, social y organizacional que

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sirve de modelo y que da sentido a los estilos de relacin entre los nios, nias y jvenes,
futuros ciudadanos del pas.
Casos Clnicos Desafiadores
Luiz Guilherme Guerra1, Marcela Ferraretto1, 2, Maria Rossi1, 2, Mariangela Savoia1, 2.
1. Conscientia - Ncleo de Estudos de Comportamento e Sade Mental, So Paulo, Brazil, 2.
AMBAN - Instituto de Psiquiatria da USP, So Paulo, Brazil.
Certos casos clnicos podem revelar-se particularmente desafiadores devido a condies que
os distanciam dos cnones usuais da prtica psicoteraputica. As habilidades do terapeuta, se
no forem constantemente atualizadas nos quesitos tericos, tcnicos e multidisciplinares,
podem ser insuficientes para um bem-sucedido manejo clnico. Os esforos do terapeuta
comportamental para resolver seu caso clnico podem, por exemplo, envolver prticas de
outras abordagens psicolgicas, ou ao menos prticas no tradicionais de sua prpria
abordagem. Nesse caso, o desafio o de manter-se teoricamente fiel abordagem, evitando
que a prxis possa ser considerada um excesso de liberalidade. Pode-se tambm encontrar um
desafio quando as tcnicas teraputicas consagradas em livros e artigos no do conta da
melhora do estado de sade do paciente. Aqui, a criatividade e experincia do terapeuta
podem levar a uma adaptao das tcnicas ou a um alargamento das possibilidades de
tratamento de determinado transtorno. Os desafios podem se dever a entraves causados por
um amplo repertrio de esquiva do paciente, padro este que exige, do terapeuta, conhecer e
saber aplicar, a qualquer tempo, todo o arcabouo de conceitos que possibilitem driblar cada
forma que a esquiva assuma. Por fim, h casos clnicos que no avanam se o psicoterapeuta
no tiver um bom conhecimento de reas afins da sade - sem tal conhecimento de interface,
pode-se no desconfiar, por exemplo, que um distrbio neurolgico esteja na gnese de uma
sintomatologia tpica de transtorno de personalidade. Neste proposto trabalho, pretende-se
enfim debater o necessrio engajamento em habilidades e conhecimentos complexos - e s
vezes atpicos da abordagem comportamental - para a adequada conduo de determinados
casos clnicos. Para tanto, quatro relatos de caso sero apresentados, cada um oferecendo um
tipo diferente de desafio habilidade do terapeuta.
Clinician Health thyself
Derek Indoe.
The Bath Clinic, Bath, United Kingdom.
The paper aims to stimulate thinking around the application of CBT to the dealings between
patients, professionals and the families of patients. In a climate of increasing pressure on
mental Health resources, professionals would do well to look closely at the use they make of
cognitive behavioural methods to themselves and how they ignore its applications in their
dealings with others except when providing therapy to patients. The importance of 'physician
heal thyself' and stress management are issues which are often swept under the carpet. If CBT
is the healthy way to live why is it so confined in its application. This paper seeks to contribute to
the debate that health is a matter of mind and body. it also draws on recent developments in
CBT such as compassionate focused therapy and ACT.
Co-therapy with a Challenging Asian American Patient: Lessons Learned in the Crucibles
of Clinical Practice and Supervision
Marisa Keller, Micaela Thordarson, Rosa Poggesi, Robert Friedberg.

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Center for the Study and Treatment of Anxious Youth at Palo Alto University, Palo Alto, CA,
USA.
Learning to do Cognitive Behavior Therapy (CBT) is a challenging task. There are declarative,
procedural, and self-reflective skills that must be acquired and applied (Bennett-Levy, 2006).
Additionally, psychotherapy requires becoming mindful about therapeutic structure, process and
content (Friedberg & McClure, 2002). Frequently, the necessary multi-tasking becomes
overwhelming especially for beginning trainees. Moreover, learning basic CBT skills becomes
even more daunting when trainees are confronted with challenging patients. This poster
presents an innovative case of co-therapy with beginning trainees who worked with a young
Asian-American male experiencing complex symptoms. The poster includes a description of the
key lessons learned by the supervisees during the course of treatment. Five specific clinical
lessons are presented. Each trainee was assigned to either intervene at the process or content
level in each session. By assigning one supervisee to either content or process, trainees
learned to strategically intervene. Conducting co-therapy with this individual facilitated
considerable pre-planning for each session which promoted a heightened therapeutic focus.
Moreover, the co-therapy made explicit commununication of therapeutic goals and direction
essential. Coordination between the therapists was key so efforts were not duplicated. Having
two therapists in the room with one patient complicated the therapeutic alliance. However, cotherapy seemed to simplify the process of alliance repair by increasing supervisees' comfort in
managing therapeutic ruptures. Finally, this patient induced considerable anxiety in one trainee
due to fears of the patients' anger. Co- therapy enabled the non-anxious trainee to model
appropriate responses for the fearful trainee. In ths way, the patient's negative beliefs could be
better addressed clinically and the trainees' educational needs could be served. The poster
presents a summary of the clinicial crucibles encountered in the case and the various
procedures used to resolve these crucibles. Managing the case with co-therapists working with
an individual patient is given special emphasis. The supervisees' reactions to collaborating on
the case and supervisory techniques to foster the co-therapy are illustrated.
Pilot Survey of Cognitive Behavioral Psychotherapy (CBT) Supervisors to Determine
their Supervisory Practice and Learning Needs
Diana Kljenak.
Psychiatry, University of Toronto, Toronto, ON, Canada.
Background: Substantial empirical support for cognitive behavioral therapy (CBT) effectiveness
in treatment of various psychiatric disorders has been demonstrated. Adequate training in CBT
results in improved therapist competence and patient outcomes. Effective clinical supervision is
an essential part of the training in CBT. However, we do not have a complete and accurate
understanding of how supervisors themselves acquire competence in CBT or of the methods of
CBT supervision they use. The need for training of supervisors is widely accepted and there is
evidence that it can be effective. Methods: We piloted an anonymous self-administered
questionnaire survey to CBT supervisors who have attended a supervisory peer support group.
The survey included questions on kind of training CBT supervisors have had both in CBT and in
CBT supervision, supervisory methods they currently use and their perceived educational
needs. Summary of results: 12 supervisors were invited to participate, and 7 responded (58 %
response rate). Most (86%) trained CBT by attending various workshops. 57% received their
training during residency in psychiatry. Only 43% have attended a formal teaching/supervision
course. Modeling of the structure of CBT session during the supervision was done always or
often by 57% of respondents. More then 50% of responders never or rarely observed trainees
therapy session either through direct, video or audiotape observation. 100% of the respondents

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were interested in receiving further training in CBT supervision with 86% of the respondents
believing that this training should be done through a formal course. Conclusion and Discussion:
This pilot survey has provided a baseline analysis of CBT supervisors supervisory practice and
educational needs. Surveyed CBT supervisors have expressed a strong need to receive further
training in CBT supervision through a formal course. The needs assessment will serve as a
platform for the development of a faculty development program for CBT supervisors. By
addressing psychotherapy supervisors learning needs more successful psychotherapy
supervision outcomes are likely which may positively influence therapy outcomes.
O Significado e o Sentido do Trabalho de Concluso de Curso para os Alunos de
Psicologia
Aline Magnani.
1. Psicologia, UNiversidade So Judas Tadeu, So Paulo, Brazil, 2. Universidade So Marcos,
So Paulo, Brazil.
Abstract Central: O presente estudo teve como objetivo investigar qual o significado do
Trabalho de Concluso de Curso (TCC) para o aluno da graduao em Psicologia e que
sentido este o atribui. Fundamentada na Psicologia Scio-Histrica, que concebe o homem um
ser social que se desenvolve a partir das relaes que estabelece com o meio sendo construto
e construtor deste, esta pesquisa teve como participantes quatro alunos que haviam concludo
o TCC. De natureza qualitativa a coleta dos dados foi obtida por meio de entrevistas
semidirigidas que foram gravadas e transcritas para posterior anlise. A organizao dos dados
foi realizada de acordo com os contedos encontrados nas entrevistas seguindo as sugestes
de Aguiar e Ozella (2005). Os resultados mostraram que os alunos conhecem o significado do
Trabalho de Concluso de Curso tal como instrudo pelos professores e Planos de Ensino da
Instituio. Constatou tambm que o sentido construdo e atribudo pelo aluno ao TCC,
singular, sendo conseqncia das relaes e enlaces que o homem estabelece com o meio e
que nos apresentaram indicadores da subjetividade de cada um.
Dificuldades de Aprendizagem Baseadas em Crenas: A Atuao do Psiclogo Cognitivo
Aline Magnani, Aline dos Santos, Aline Sousa.
Psicologia, UNiversidade So Judas Tadeu, So Paulo, Brazil.
Abstract Central: Definir o termo aprendizagem parece ser fcil num primeiro momento por
ser empregado diariamente pelas pessoas em diversos contextos. Boch, Furtado e Teixeira
(2002) apontam que existem diversas possibilidades de aprendizagem e que a Psicologia
transforma a aprendizagem em um processo a ser investigado. Piaget apud Sisto e Martinelli
(2008) considera o aspecto scio-afetivo uma das reas em que qualquer aprendizagem gira e
destaca a importncia dos fatores sociais para o desenvolvimento cognitivo, sendo interao
social condio para o desenvolvimento. Podemos dizer que assim como os fatores sociais
esto diretamente relacionados s condies para a aprendizagem, eles tambm podem estar
relacionados s dificuldades de aprendizagem. Para Sternberg e Grigorenko (2003), cada
indivduo apresenta dificuldade de aprendizagem em alguma coisa, pois as aptides so
muitas, assim como a estrutura de cada aptido, por isso distinguveis umas das outras. Os
fatores afetivos contribuam para o incio das dificuldades, pois quando o aluno no tem o
desempenho esperado, a tendncia ter baixas expectativas em relao realizao pessoal,
no persistindo diante das tarefas escolares, e, por fim, desenvolvendo uma baixa autoestima
de si prprio (Sisto e Martinelli, 2008). A autoestima parte integrante do desempenho infantil e
se expressa em suas atitudes e crenas, suas expectativas de sucesso ou insucesso, sua

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capacidade de despender esforos, enfrentamento das dificuldades, reagir s prprias


experincias. Assim, a criana se comportar frente s dificuldades de acordo com o que
aprendeu em sua relao com o meio, e seu xito ou fracasso obtido nessa relao refletir
em suas atitudes consigo mesma. Segundo Reinecke, Dattilio e Freeman (2009), a terapia
cognitiva fundamenta-se a partir do pressuposto de que o comportamento adaptativo e que
existe uma interao entre os pensamentos, sentimentos e comportamentos do indivduo.
Assim, pensamentos distorcidos ou disfuncionais interferem diretamente na maneira como a
pessoa se comporta e levanta a hiptese de que as emoes e comportamentos so
influenciados por sua percepo dos eventos. Na infncia as pessoas desenvolvem
determinadas crenas sobre si mesmas. A terapia cognitiva se utiliza de tcnicas para
identificar os pensamentos distorcidos e/ou disfuncionais que envolvem essas crenas. O
trabalho com crianas, na identificao e mudanas das crenas que envolvem as dificuldades
de aprendizagem, deve ser feito por intermdio de brincadeiras e atividades ldicas. Como
descrito por Valle (n. d.), a criana se sente segura para realizar atividades, como jogos e
brincadeiras, que talvez possuam o mesmo grau de dificuldade que uma tarefa escolar, porm,
no segundo caso, a criana no se sente segura para obter um bom desempenho, pois
considerada por ela como algo valorizado pelas pessoas que lhe importam. Nos jogos e
brincadeiras possvel trabalhar com a criana aspectos como cooperao, assertividade,
responsabilidade, empatia e autocontrole, que tambm esto presentes nas atividades
escolares e demais situaes de aprendizagem. Conforme a criana vai percebendo que
capaz de desempenhar certas atividades, sua autoestima tambm vai sendo trabalhada.
Dislexia: Anlise Qualitativa do filme Como Estrelas na Terra: Toda Criana Especial
Aline Magnani, Brbara Naddeo.
Psicologia, UNiversidade So Judas Tadeu, So Paulo, Brazil.
Abstract Central: O presente trabalho explicita, primeiramente, os conceitos de transtornos de
aprendizagem com o intuito de contribuir para o conhecimento a respeito da temtica, pois a
falta de informao resulta em diagnsticos errneos e, consequentemente, rotulaes de
crianas com problemas escolares. Neste sentido, dentre os distrbios de aprendizagem,
optou-se por pesquisar sobre a dislexia, pois trata-se de um dos transtornos mais comentados
atualmente em mdias, congressos, escolas e pesquisas. Este distrbio pode ser encontrado
em crianas com capacidade intelectual normal ou acima da mdia, com boas oportunidades
de escolarizao, estimulaes adequadas e rgos sensoriais intactos, no entanto
apresentam extrema dificuldade para se apropriar da aprendizagem da leitura e escrita. Para
poder discutir acerca das vivncias de uma criana dislxica, este trabalho foi dividido em:
Introduo (o primeiro captulo sobre Transtornos de Aprendizagem, o segundo a respeito da
Dislexia e o terceiro quanto Pesquisa Qualitativa); Objetivo (analisar qualitativamente o filme
Como estrelas na terra: toda criana especial e discutir aspectos da trajetria do
personagem principal); Mtodo (em que envolve todo o processo de execuo da pesquisa);
Resultados e Discusso (aps a seleo e descrio das cenas da obra cinematogrfica,
realizou-se uma anlise qualitativa das cenas do filme) e; Consideraes Finais. A partir da
anlise qualitativa realizada pode-se entender que fundamental que o diagnstico da dislexia
seja realizado de maneira multidisciplinar e que tanto a famlia, quanto a escola como um todo
ofeream todo o apoio e suporte necessrio para que a aprendizagem seja alcanada.
La Psicoterapia Cognitiva en Argentina: Una Aproximacin Histrica Sobre el Suelo Psi
que Caracteriz su Recepcin
Gustavo Manzo.

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Psicologa, Facultad de Psicologa de la Universidad Nacional de Mar del Plata, Mar del Plata,
Argentina.
Abstract Central: A partir de la segunda mitad del siglo XX, la revolucin tecnolgica impact
radicalmente en el campo de los desarrollos cientfico-tecnolgicos. Los avances en
Informtica, Ciberntica, Inteligencia Artificial dieron lugar al nacimiento de las Ciencias
Cognitivas. La Psicologa Cognitiva forma parte de estos desarrollos y sienta las bases para el
surgimiento en Estados Unidos de la Psicoterapia Cognitiva durante la dcada del 60. En la
Argentina, el inters inicial por esta corriente teraputica se da a fines de los aos 70.
Entendiendo la recepcin como una apropiacin activa y transformadora, el surgimiento y
afianzamiento de la Psicoterapia Cognitiva en dicho pas no pudo haberse producido sobre un
terreno vaco. De hecho, tradicionalmente se ha caracterizado a la psicologa en Argentina
como asistencialista, clinicista, mono-terica, psicoanaltica. El objetivo de este trabajo es dar
cuenta de las caractersticas distinguibles de la psicologa argentina y su vinculacin con la
emergencia de una Psicoterapia Cognitiva verncula.
Modelo Teoricos Unificados o Dominantes en Psicologia
Jose Martinez.
1. Universidad Nacional Federico Villarreal, Lima, Peru, 2. Universidad de san Martin de Porres,
LIma, Peru.
Abstract Central: En el presente trabajo tratamos de dar respuesta a dos de las preguntas que
con mucha frecuencia nos hacemos los que estudiamos el comportamiento de los organismos,
stas son: Es posible hacer de la psicologa una ciencia?; De ser esto posible, esta
disciplina cientfica tendra un modelo terico que, de alguna forma, unos conceptos y teoras
de los ya existentes (modelo unificador) o sera una disciplina con un modelo con teoras y
conceptos propios (modelo dominante)? Desde nuestro punto de vista, sera ingenuo
considerar la posibilidad de unir definiciones, teoras, conceptos, tcnicas y objetos de estudio
de modelos ya existentes porque stos poseen teoras, epistemologas, metodologas,
ontologas y lenguaje que son incompatibles entre s. Consideramos ms razonable que un
modelo cientfico en psicologa se desarrolle con base en un paradigma dominante con su
propia epistemologa, metodologa, ontologa y con un lenguaje coherente con la naturaleza
que describe. Afirmamos, en este ensayo, que este modelo o paradigma (desde una
perspectiva Kuhniana) ya existe y es el modelo conductual.
CBT Training in Latin America: Challenges and Opportunities
Ana Maria Martins Serra1, Fernando Torrente2, Mario Laborda3, Arturo Heman4, Maria Clara
Cuevas Jaramillio5, Sophia Behrens6, Frank Dattilio7.
1. Instituto de Terapia Cognitiva, So Paulo, Brazil, 2. Favaloro Universidad, Buenos Aires,
Argentina, 3. Universidad Catolica de Chile, Santiago, Chile, 4. Cognitive Behavior Therapy
Institute de Mexico, Mexico City, Mexico, 5. Universidad Central de Venezuela, Caracas,
Venezuela, 6. Pontificia Universidad Javeriana- Cali, Cali, Colombia, 7. Harvard University,
Boston, MA, USA.
In 1996, J.S.Beck published an article titled Who is a Cognitive Therapist, delineating the
criteria which would allow psychotherapists to identify themselves as cognitive-behavioral
therapists. In addition, Dr. Beck himself, in his seminal book Cognitive Therapy of Depression
(1979), had already recommended formal and extensive training for new therapists and for
those that had previously been trained in another psychotherapeutic approach. It is readily

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obvious that a prescriptive and structured model, such as the CBT model, require formal
training. However, in Latin American countries, there is a generalized preoccupation about the
scarcity of authorized training centers for proper training of professionals on CBT, as well as
about professionals who, although identifying themselves as cognitive-behavioral therapists, do
not follow the basic tenets of the cognitive-behavioral psychotherapy model. This situation lends
the present Symposium a very opportune and relevant aspect. This presentation will cover CBT
training in Latin America, emphasizing the models recent evolution in the Continent, the
institutions which offer CBT training programs in each of the presenting countries, at the
undergraduate and graduate level, as well as aspects that suggest opportunities and challenges
that presently confront the field. The Symposium is proposed, most specially, as an opportunity
for information and exchange of experiences among all, participants and presenters, aiming at
the further development of the field in Latin America. So as to make the Symposium
representative, five international experts were invited, from five different countries, who enjoy
great recognition for the training of professionals on CBT, in each of their respective countries
and in all of Latin America and the world, in order to present data about their experiences. I am
honored to be able to count on the participation of the following specialists: 1. from Buenos
Aires, Argentina, Dr. Fernando Torrente, Director of the Psychology Dept. and Professor of
Cognitive Behavioral Psychotherapy, Universidad Favaloro, presenting Factors in CBT Training
in Argentina; 2. from Chile, Dr. Mario A. Laborda (with Valeria V. Gonzalez y Vanetza E.
Quezada), of the Department of Psychology, FACSO, Universidad de Chile, presenting The
Cognitive-Behavioral Approach in Chile: Historical aspects and current state; 3. from Colombia,
Dr. Maria Clara Cuevas Jaramillo, Professor and Researcher, Departament of Social Sciences,
Pontificia Universidad Javeriana - Cali, presenting The Present State of CBT Training in
Colombia; 4. from Mexico, Dr. Arturo Hernan Contreras, General Director of the Instituto de
Terapia Cognitivo-Conductual, presenting Cognitive Behavioral Therapy in Mexico; y 5. from
Caracas, Venezuela, Dr. Sophia Behrens, Professor at Universidad Central de Venezuela,
presenting CBT Training in Venezuela. In addition, it is a great honor and pleasure to have the
participation of an internationally recognized expert in CBT, Dr. Frank Dattilio, Professor at the
School of Medicine of Harvard University, USA. Dr. Dattilio has dedicated himself, for over 30
years, to the training of professionals on CBT all over the world, notably in Latin America. His
broad experience with training in many countries places him in a unique position, concerning the
training of Latin American professionals, and for the role of Discussant in this Symposium.
Finally, I, as this Symposiums Chair, will very briefly comment on the consistencies and
unconsistencies between the presenters experiences in their own countries, and my own
present and historical experience regarding CBT training in my country, Brazil.
Factors in CBT Training Argentina
Training in cognitive-behavioral therapy (CBT) is a rapidly expanding phenomenon in Argentina.
Therefore, the first part of the presentation will display an overview of the process of
dissemination of CBT in a country traditionally oriented to psychodynamic-psychoanalytic
therapies. The factors promoting this change will be discussed, as well as the obstacles
encountered and still unresolved. In particular, a differentiation will be made between CBT
training for therapists with previous training in other psychotherapeutic schools, compared to
professionals without prior training. The second part of the presentation will be focused on the
experience of undergraduate education at the Favaloro University, inspired by the scientistpractitioner model and evidence-based psychotherapy. Finally, future challenges and possible
strategies for developing the training and dissemination of CBT in the context of Argentina will
be addressed.
The cognitive behavioral approach in Chile: Historical notes and current status

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A brief history of Cognitive Behavioral Therapy (CBT) in Chile is presented, reviewing CBTs
principal milestones since its introduction in 1969 by Dr. Sergio Yulis (e.g., Dorna, 1982;
Quezada, Verges, & Laborda, en prensa; Montesinos & Ugalde, 1983; Vera-Villarroel,
Montesinos, & Prieto, 2006, 2010). Critical historical moments to the area are presented and its
consequences in the current status of CBT in Chile are discussed. Several sources are
considered to discuss the present of CBT in the country. In terms of training in CBT, the training
programs taught in the principal higher education institutions (universities with accredited
psychology programs and professional institutes) at an undergraduate and graduate level are
reviewed. In terms of research concerning CBT, the Grant funds allocated to research in the
area (e.g., FONDECYT), the articles by Chilean authors published in the main Chilean journals
of psychology (e.g., Terapia Psicolgica [Sociedad Chilena de Psicologa Clnica], Psykhe
[Universidad Catlica de Chile], Revista de Psicologa [Universidad de Chile]), and the articles
by Chilean authors published in the main international journal of the area (e.g., Behavioral
Research and Therapy, Behavior Therapy) are reviewed.
Finally, all data reported are discussed critically evaluating the current status of CBT in Chile in
reference to other clinical models present in the country and also evaluating how certain
milestones of our history continue determining the contemporary training in CBT.
Cognitive Behavior Therapy in Mexico
The development of cognitive behavioral therapy in Mexico can be recognized from various
basic events: (1) the increased incidence of mental health problems: personality disorders,
mood disorders and psycho-emotional problems in populations of adolescents and young
adults. (2) The poor empirical evidence of the effectiveness and efficiency of therapeutic
procedures based on traditional psychodynamic models. (3) The formalization of an update in
teaching from the advances and new developments in global research and treatment programs
grounded in empirical evidence. (4) Expansion and decentralization of vocational education of
clinical training. Private institutions offer clinical training in CBT. (5) The survey and certification
under the guidance of cognitive behavioral health professionals abroad. (6) The addition of
cognitive behavioral model and areas of interest include neuroscience,
psychoneuroimmunology, Psychoneurology in psycho-emotional problems and personality and
mood disorders. (7) The increased development of basic and applied research in various higher
education institutions and research institutes of CBT in order to find and strengthen an identity
in the country. For 2012 we have in Mexico City three institutes that offer CBT, and a Cognitive
Therapists Association which is meant to preserve and protect the clinical activity of cognitive
behavioral therapists and professional ethical standards. In Mexico, the growth of interest in
CBT from the year 2000, has been downright chaotic and messy. The emergence of CBT
institutions and centers, run by psychologists and psychiatrists without formal training, has led to
mishandled and biased opinion of CBT therapists. A process of massification of CBT education
has emerged, as well as the expansion of fraudulent institutions and centers. But those
recognized institutions may be mentioned, in that the training of health professionals in CBT
have focused primarily on key areas:
- Systematic CBT clinical training.
- The expertise in the description and diagnosis of DSM-IV disorders
- Development of Clinical Intervention programs, for the management, treatment and mental
problem solving
- Supervision of clinical cases.
- The gestation of evidence-based research has increased significantly in universities, institutes
and centers for mental health care.
- International certifications by CBT institutes are recognized.
CBT Training in Venezuela

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This presentation will center on CBT training in Venezuela, informing of the most important
courses which are presently offered in the country. The University Simon Bolivar used to offer a
post-graduate degree in Cognitive-Behavior Modification, which is now under the Department of
Psychology. Health psychology is one of the areas of this degree and it uses the CBT model
and techniques.
Since the 90s, the Rafael Urdaneta University, in Maracaibo, offers a Masters degree in
Psychology, with CBT orientation. Moreover, the post-graduate degree in Psychiatry and
Clinical Psychology from the Universidad Central de Venezuela, at the Psychiatric Hospital in
Caracas, offers CBT in its curriculum, which lasts two four-month periods for the second-year
Residents. The Department of Psychiatry, at the Jose Maria Vargas Hospital, offers one
trimester of CBT. Other post-graduate degrees, such as the one at the Hospital Clinico
Universitario and Sebucan, frequently invite experts on CBT, so that their students get to know
the model.
Universities at the States of Bolivar, UDO, Merida, ULA, Lara, LA, frequently gather a group of
health professionals, who are offered training for emotional and personality disorder modules in
CBT.
At the undergraduate level, UNIMET offers a Diploma on CBT, as an elective subject, with one
trimester of duration. At other Universities, students are informed about the model, but do not
received training on the models techniques.
At the private training sector in Venezuela, there are three cognitive behavioral therapy (CBT)
centers following Dr. Becks model, which have, as their fundamental goals, clinical intervention
for patients, training on cognitive therapy and research in the mental health area. These centers
are: UCOSEX, led by Dr. R. Aponte, TRIADA, led by Dr. S. Behrens, and Psicotrauma, led by
Dr. M. A. Lpez. Every year, these centers train many professionals from different States of the
country in Dr. Becks model of CBT.
Presently, in Venezuela, the CBT model is of the most referred to by health professionals for the
treatment of different emotional disorders, personality disorders, addictions, etc. The Colegio
Venezolano de Neuropsicofarmacologa , one of the most renowned scientific institutions in the
country, recommends CBT as a model to follow and organizes, approximately every two years,
conferences in Venezuela on CBT, as part of their schedule of scientific congresses.
CBT training in Colombia
CBT training in Colombia is offered under three modalities: undergraduate Psychology
programs, graduate programs and continuing education courses. Undergraduate programs in
Psychology generally include some level of training in the cognitive behavioral (CBT) model,
with significant differences in the emphasis given to CBT. Very few programs in the country
have exclusive training in CBT, and the trend is shared training with psychodynamic and
humanistic clinical approaches. Some programs, additionally, offer basic levels of theoretical
training, but also offer the option of training in therapeutic procedures. The offer of training is
relatively diverse in different regions in the country, including graduate programs in CBT, but still
insufficient for the needs of teachers and qualified clinical professionals. There is a large
number of specializations, for one year, focused primarily on Health Psychology and on
Children and Adolescents. Master's programs are scarce, and are also offered in the
universities of the capital cities, both private and public. They last one year, a few focus
exclusively on the CBT approach, and the training is shared with other models, in the initial
phase, with the possibility of advanced seminars, supervised clinical practice, and research
papers in only one of them. Doctoral programs in Psychology have started to be offered for no
more than seven years, being that their total number does not reach 10 in the country. They do
not focus exclusively on CBT either, being the reason why psychologists, in the country, with
doctoral training in CBT, have studied mainly in the U.S. and Europe (Spain, England and
Germany). In continuing education there is a large and permanent offer, provided by

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undergraduate and graduate programs in Psychology and scientific societies, such as the
Colombian Association of Behavior Analysis and Therapy, the American Association of
Cognitive Therapies, the Colombian Association for the Advancement of Behavioural Science,
Latin American Psychological Association, the Spanish Association of Behavioral Psychology,
and the Latin American Association of Behavior Analysis and Modification, among others.
Gradually, the more visible courses are those which emphasize training on third generation
behavioral therapies and empirically validated therapies.
Terapias de Tercera Generacin en Argentina. Experiencias y desarrollos locales
Fabin Olaz1, Pablo Gagliesi2, Juan Coletti2, Adrin Fantini1.
1. Centro Integral de Psicoterapias Cognitivas, Crdoba, Argentina, 2. Fundacin Foro, Buenos
Aires, Argentina.
En los ltimos aos, las denominadas Terapias de Tercera Generacin estn cobrando cada
vez mayor importancia dentro de los enfoques Cognitivos Comportamentales. Esta tercera
generacin de terapias de conducta se centra en el anlisis funcional de la conducta clnica, a
partir de un replanteo contextual de la problemtica del paciente en donde el objetivo de la
terapia es el abandono de la lucha contra los sntomas y en su lugar la reorientacin de la vida.
En estas terapias se enfatiza la importancia del contexto y las relaciones funcionales de los
eventos psicolgicos como as tambin la utilizacin de estrategias de cambio contextual y
vivencial. Desde esta perspectiva, se considera a la flexibilidad como criterio de salud mental y
se utiliza a la relacin teraputica como herramienta principal de cambio teraputico. Si bien
estas propuestas gozan de cada vez mayor prestigio a nivel internacional, en nuestro pas su
utilizacin y difusin es an incipiente. Por esto, en esta mesa se desarrollarn experiencias
clnicas surgidas del trabajo en el marco de las ms importantes terapias contextuales,
presentando en forma resumida el estado actual de cada uno de estos abordajes a nivel local,
como as tambin perspectivas futuras de trabajo. En el primer trabajo, se exponen las bases
fundamentales del Mindfullnes, se discute la utilidad clnica del enfoque mediante la exposicin
de resultados observados en la experiencia clnica. Se intenta dejar en claro que Conciencia
Plena no constituye la respuesta a todos los problemas de la vida, sino ms bien es un modo
de ver la vida, y los problemas que hay en ella, con mayor nitidez a travs de una mente clara.
En la segunda exposicin, se presentan algunas experiencias clnicas en el marco del trabajo
con esquizofrenia utilizando Terapia de Aceptacin y Compromiso, uno de los desarrollos ms
recientes de la Terapia de conducta. Se presentan algunas herramientas clnicas en casos con
sintomatologa delirante abordados mediante ACT, en los cuales queda evidenciada la
hiptesis de que esta sintomatologa constituye una forma de Evitacin Experiencial. En el
tercer trabajo, se exponen un caso de tratamiento mediante Terapia Analtico Funcional, de un
paciente con Trastorno obsesivo compulsivo de la personalidad con dificultades en el manejo
asertivo de la ira. FAP est basada en principios bien establecidos empricamente emergentes
de la investigacin bsica en condicionamiento operante. Este modelo de psicoterapia est
demostrando eficacia en el tratamiento de cuadros en los que la problemtica interpersonal
cobra mayor relieve. Se har una revisin de los fragmentos ms relevantes de la vieta y se
discutirn posibles aplicaciones del modelo en distintos contextos. En la ltima exposicin, se
presentaran algunas experiencias y fundamentos de trabajo con la Terapia Dialctico
Comportamental -DBT- tecnologa de psicoterapia multicomponente desarrollada por Marsha
Linehan (1993). Este modelo de trabajo es el que tiene mayor evidencia emprica para el
tratamiento de los consultantes suicidas, parasuicidas y con Desorden Lmite de la
Personalidad. Actualmente este modelo tiene validacin para trastornos por abuso de
sustancias, trastornos alimentarios, impulsividad y depresiones resistentes.

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Psicologia Ambiental: Um Estudo Sobre a Degradao No Ambiente de Trabalho


Mary Oliveira, Carmen Andrade.
Universidade de Marlia, Marlia, Brazil.
OLIVEIRA, Mary Elizabeth Sampaio de. ANDRADE, Crmen Valria. H algumas dcadas,
com o surgimento dos estudos ambientais, criou-se o conceito de meio ambiente, o qual se
limitava a se relacionar apenas s condies naturais, assim um dos principais assuntos
atualmente so os problemas ambientais: a poluio do ar e da gua, a destruio do ambiente
natural e entre outros, que so divulgados em todos meios eletrnicos e de comunicao,
assim a conscincia pblica dos problemas ambientais resultou-se em vrias leis. Mas aps
algumas conferncias sobre o Meio Ambiente, o fator humano passou a integr-lo, de tal forma
que os psiclogos ambientais dividem o ambiente fsico em dois tipos: o construdo pelo
homem ou o modificado pelo homem e o natural. Passou-se a entender tambm que o meio
ambiente amplia sua rea no ambiente do trabalho, o qual objeto deste trabalho. Tem-se
como objetivo investigar as formas em que o trabalhador consegue usufruir de uma melhor
qualidade de vida no ambiente trabalhista, apontando as problemticas que esse ambiente
pode estar influenciando no comportamento do ser humano, assim como o assdio moral. Esse
trabalho atravs de uma metodologia qualitativa e tem como base alguns referenciais tericos
envolvendo trs reas interdisciplinares: Direito Ambiental, Psicologia Organizacional e
Psicologia Jurdica. Com esse trabalho foi possvel determinar que a degradao no ambiente
de trabalho tem propiciado conseqncias problemticas na sade mental do trabalhador.
Relacin Entre Factores Personales y Satisfaccin de Compasin, Burnout y Estrs
Traumtico Secundario en Profesionales que Trabajan con Personas Vctimas o
Infractoras de Ley
Marcela Ossio.
Universidad de Santiago, Santiago, Chile.
Las polticas pblicas en Chile en torno a la atencin de vctimas de delitos y la intervencin
con infractores de ley han incrementado la creacin de programas psicosociales especializados
que se hagan cargo de estas tareas en los ltimos 13 aos. Esta necesidad se ha hecho
manifiesta tambin en el Plan de Seguridad Pblica Chile Seguro 2010 - 2014 ejecutado en la
actualidad. El trabajo de los psiclogos y los trabajadores sociales ya resulta desafiante en el
trato permanente con otras personas, y en este caso, se suma la variable de las temticas que
se abordan debido a los usuarios atendidos, las que suelen ser da a da asuntos muy crudos y
potentes en lo emocional. Este estudio examin la relacin entre factores personales (sexo,
edad, aos de experiencia, profesin y poblacin atendida) y tres variables: Satisfaccin de
Compasin, Burnout y Estrs Traumtico Secundario, las cuales tambin se relacionaron entre
s, en una muestra de 35 profesionales psicosociales chilenos que trabajan en la atencin de
vctimas o infractores de ley. Los encuestados completaron la escala Professional Quality of
Life (ProQOL - IV). Entre los hallazgos, la Satisfaccin de Compasin tiene una asociacin
inversa y significativa con el Burnout y tambin con el Estrs Traumtico Secundario, en tanto
el Burnout tiene una correlacin directa con el Estrs Traumtico Secundario. Cuando los
tramos de aos de experiencia se analizaron, se determin una correlacin positiva con la
Satisfaccin de Compasin. Sexo, edad, profesin y tipo de usuarios atendidos no se asocian
significativamente con ninguna de las variables. Al finalizar, se revisan las limitaciones de este
estudio y se hacen sugerencias para investigaciones futuras en el rea. Palabras clave:
Burnout, Estrs Traumtico Secundario, Satisfaccin de Compasin, Calidad de Vida
Profesional (ProQOL)

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Las Plataformas Educativas (LMS) como Auxiliares en el Proceso Formativo de


Terapeutas Conductuales
Antonia Rentera-Rodrguez, Jos Manuel Snchez-Sordo, Alejandro Martnez-Silva, Mara
Angeles MartnezPazarn, Deyanira Jazmn De-Jess.
Universidad Nacional Autnoma de Mxico, Mxico, Mexico.
El empleo de las nuevas tecnologas en la educacin superior ha tenido un auge inusitado. Se
estima que actualmente un gran porcentaje de universidades o centros de educacin superior
cuentan con sistemas de enseanza abiertos, a distancia donde desarrollan e-learning o
despliegan el llamado aprendizaje mixto (b-learning). Actualmente el CUVED (plataforma de
aprendizaje tipo Moodle) oferta diversos cursos para la carrera de Psicologa de la FES Iztacala
UNAM en reas como educacin especial, psicologa educativa, experimental, social, mtodos
cuantitativos y metodologa. La enseanza de la psicologa clnica en sus componentes
tericos y aplicados representa un ejercicio docente que incluye el know what hasta al know
how. En este estudio se presenta una estrategia de b&m learning, es decir, los estudiantes se
involucraron en un proceso de aprendizaje presencial en aula junto a actividades de
aprendizaje mediante tecnologas mviles y todo esto dentro del marco de una plataforma
educativa. Los participantes fueron 30 estudiantes de sexto Sem. de la carrera de psicologa
quienes llevaron a cabo su curso semestral de la asignatura Psicologa Clnica Terica II como
parte de sus estudios de licenciatura en psicologa. En esta presentacin se describen toda la
secuencia de actividades de aprendizaje realizadas en el aula, las ejecutadas mediante
dispositivos tecnolgicos mviles como telfonos, tabletas y netbooks y las realizadas dentro
de la plataforma educativa. Al final del curso los estudiantes evaluaron su aprendizaje as como
esta experiencia educativa.
Cmo Intervenir en los Casos de Sndrome de Burnout?
Karina Reyes-Jarqun1, Mara del Roco Hernndez-Pozo1, 2, Ana Luisa Gonzlez-CelisRangel1.
1. UNAM, FES Iztacala, Tlalnepantla, Estado de Mxico, Mexico, 2. CRIM-UNAM, Cuernavaca,
Morelos, Mexico.
Abstract Central: En los trabajadores que constantemente tienen contacto con personas se
puede desencadenar el fenmeno denominado desgaste laboral o sndrome burnout. La
descripcin de este fenmeno surgi en Estados Unidos, en el ao de 1974, dnde
Freudenberguer lo acu para dar una explicacin al proceso de deterioro en los cuidados y
atencin profesional a los usuarios de las organizaciones de servicios, seala que el sndrome
burnout hace alusin a la experiencia de agotamiento, decepcin y prdida de inters por la
actividad laboral que surge en los profesionales que trabajan en contacto directo con personas
en la prestacin de servicios como consecuencia de ese contacto diario con su trabajo. Este
fenmeno, trae consecuencias negativas para los trabajadores en distintos niveles: salud,
trabajo, familia, entre otros; pero adems tambin conlleva repercusiones sobre la sociedad en
general y sobre todo en aquellos a quienes asisten. Actualmente es de suma importancia
contar con evidencia emprica de las intervenciones ms efectivas para disminuir el sndrome
burnout e implementarlas en distintos contextos. Es por lo anterior que el objetivo del presente
trabajo fue realizar una revisin de los estudios que evalan el efecto de programas de
intervencin para el sndrome burnout en los ltimos 5 aos a nivel mundial, empleando la
bsqueda avanzada de la base de datos Pubmed, con los combinaciones de los siguientes
descriptores: terapia, psicoterapia y burnout en el idioma ingls. La muestra inicial fue de 53
artculos, aplicando los criterios de exclusin, la muestra final fue de 17 artculos. Los
resultados confirman la falta de investigacin emprica en relacin con el sndrome burnout, ya

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que solo el 32% de las publicaciones evaluaron el efecto de algn tipo de intervencin a favor
de los trabajadores con alguno de los sntomas propios del sndrome burnout. Entre las
intervenciones empleadas podemos mencionar las terapias cognitivo-conductual,
psicodinmica, espiritual, musicoterapia, arte-terapia, psicoeducativa y dirigida a la
organizacin. En esta investigacin, la terapia que demostr mejores resultados en la
disminucin de sintomatologa del sndrome burnout, es la cognitiva conductual; sin embargo,
solo el 5.6% de los artculos revisados apoyan este dictamen. Se concluye que es necesario
llevar a cabo mayor investigacin poniendo a prueba la eficacia de diversas tcnicas de la
terapia cognitivo-conductual evaluando los efectos no slo en los trabajadores que presentan el
sndrome burnout sino tambin en los receptores de sus servicios.
A aplicao do modelo cognitivo de Aaron Beck na prtica pedaggica de professores
em uma escola da rede pblica de ensino fundamental do Brasil: desafios e perspectivas
Weslley Santana.
prtica privada, Belo Horizonte, Brazil.
Um dos principais desafios da Psicologia para o sculo XXI contribuir, com seu arcabouo
terico e emprico, para que outras cincias possam avanar ainda mais em seus respectivos
campos de conhecimento. Este trabalho prope a ampliao da conexo entre Psicologia e
Pedagogia por meio do modelo cognitivo de Aaron Beck, pesquisador e psiquiatra norte
americano, que atribui aos pensamentos (e no emoo) a responsabilidade pelos
comportamentos. Os resultados obtidos por Beck por meio da aplicao do modelo cognitivo no
campo da sade mental na dcada de 1960 e de seus sucessores em quadros psicolgicos e
psiquitricos diversos nas dcadas seguintes inspirou a sua proposio em uma das escolas
da rede municipal de ensino fundamental do Brasil, cujos professores apresentavam queixas
constantes sobre a indisciplina de seus alunos. No Pas, o ensino fundamental dividido da
primeira a nona srie, alcana alunos da faixa etria de 6 a 14 anos e precisa de especial
ateno de polticas pblicas em funo da comprovao de que, durante os quatro primeiros
anos do ensino bsico, o crebro infantil est em formao e, quanto mais for estimulado,
maior ser a capacidade de aprendizado e memria. Ao avaliar a proposta, lanou-se a
hiptese de que o comportamento de professores, familiares e alunos precisava ser
compreendido sob a gide das diferentes avaliaes que cada um destes agentes fazia sobre
si, sobre o mundo e sobre seu futuro, ainda que a demanda inicial voltava-se exclusivamente
para o treinamento dos docentes em medidas corretivas da situao de indisciplina. E por
isso que os professores foram ensinados a identificar e corrigir padres distorcidos de
pensamento conscientes e inconscientes desencadeadores de alteraes em seus
funcionamentos e consequentes prejuzos em suas performances profissionais. Como
concluso, a aplicao do modelo cognitivo de Beck mostrou-se adequada para
instrumentalizao dos docentes em sua prtica profissional, permitindo-lhes a compreenso
da relao com seus alunos em uma perspectiva mais ampla, flexvel e realista. Alm disso, a
abordagem contribuiu para melhorar no apenas o relacionamento dos professores com alunos
e familiares, mas mostrou-se til tambm para melhorar o relacionamento entre os professores
e seus colegas de trabalho, bem como com a direo da escola. Entre os principais ganhos,
segundo registro dos prprios professores, esto a segurana adquirida para lidar com os
alunos, familiares e direo da escola; a mudana na forma de pensar e de agir frente as
situaes conflituosas na escola e benefcios advindos da utilizao das tcnicas em suas
vidas pessoais. A hiptese inicial deste trabalho, ou seja, de que o comportamento indesejvel
(inicialmente a indisciplina) poderia ser alterado tendo por base intervenes na forma de
pensar, se confirmou. Com isso, abre-se espao para que a proposta deste trabalho seja

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aplicada em outros nveis da educao, ampliando-se a contribuio da Psicologia em prol da


melhoria da educao no Brasil e no mundo.
Penas Alternativas: Uma Medida Eficiente para Prevenir e Combater a Criminalidade?
Guilherme Santos.
Unimar Universidade de Marlia, Marilia, Brazil.
O presente trabalho tem como objetivo promover uma reflexo acerca da eficcia das penas
restritivas de direitos no tocante reduo dos ndices de reincidncia criminal, verificando se
estes so realmente significativos se comparados aos ndices de recidivas dos condenados s
penas privativas de liberdade, e em caso positivo, quais seriam as suas possveis causas, ou
seja, se tal fato ocorre em virtude da reduo da estigmatizao destas pessoas ou apenas
porque os crimes de menor potencial ofensivo, principalmente os que no so cometidos
mediante violncia fsica ou grave ameaa s vtimas, so apenados desta forma. Atravs da
anlise de dados estatsticos e de pesquisa bibliogrfica, verificou-se quais os possveis
empecilhos substituio definitiva da priso destes indivduos em medidas alternativas, como
a prestao de servios comunitrios, pagamento de prestao pecuniria em favor da vtima e
pagamento de cestas bsicas, levando-se em considerao no apenas os fatores econmicos
e sociais, como tambm os fatores subjetivos. Para uma melhor compreenso do presente
estudo, foram utilizadas as perspectivas do Behaviorismo Radical e da Terapia do Esquema
acerca dos fatores determinantes que levam os indivduos a delinquirem. Constatou, atravs
dos dados colhidos na capital de So Paulo, a qual comporta o maior nmero de pessoas
apenadas por crimes e contravenes no Brasil, em primeiro lugar que o perfil das pessoas
condenadas a penas restritivas de direitos diverso daquelas que cumprem pena de priso; e
em segundo, que existem algumas lacunas no sistema de cumprimento de referidas penas, tais
como o lapso temporal espaado entre a autuao do processo de execuo e a expedio do
mandado de priso, que fazem com que, de um total de pessoas condenadas a penas
alternativas, um nmero aproximado de apenas 27,5% cumprem-nas efetivamente. Assim,
torna-se possvel observar que no apenas modificando a forma de aplicao das sanes
carcerrias em restritivas de direitos que far com que os ndices de recidivas declinem de
forma satisfatria, j que esta modalidade de punio somente possui eficcia dependendo dos
fatores internos destes indivduos, aliados a uma correta aplicao e fiscalizao destas
medidas alternativas, ou ainda, talvez seja o caso de, no atual contexto brasileiro, refletir
seriamente sobre a possibilidade de investir sistematicamente no tratamento psicolgico,
associado s sanes alternativas, como uma forma realmente eficaz de se prevenir e
combater a reincidncia criminal.
Training Program Development of Cognitive Behavioral Therapy for Depression
Targeting Nursing Professionals
Yuko Shiraishi, Sayaka Kato, Satoe Higashi.
Medicine, University of Miyazaki, Miyazaki city, Japan.
Objective: To attempt to structure the content of theoretical training in regards to training
program development of cognitive behavioral therapy (CBT) for nurses. Method: The content of
training was theoretically based on five domains of competence required to practice CBT
included in the measures for Improving Access to Psychological Therapies (IAPT) by the
National Health Services: Generic therapeutic competences, Basic CBT competences,
Specific behavioural and cognitive therapy, Problem specific competences and
Metacompetences. Knowledge and techniques necessary to acquire each domain were

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reviewed in reference to items listed in IAPTs measures in a similar way as well as to the draft
of cognitive therapy system proposed by Fujisawa, etc., based on which outcomes were
simulated. Results: 1. Generic therapeutic competences This training targeted nursing
professionals who were working at the department of psychiatry; therefore we assumed that
knowledge as well as general assessment methods on mental disorders had already been
learned. Motivational interviewing is not usually addressed in fundamental education of
psychiatric nursing science; therefore was included in the content of education. Outcome
indices were established, including to understand skills necessary to develop and maintain
therapeutic alliance between nurses and patients when CBT is introduced, etc. 2. Basic CBT
competences. and Specific behavioural and cognitive therapy. We prepared in accordance
with the content of training by Ito and Ohno. The content of education in this case incorporated
basic skill practice of CBT such as basic model, Socratic questioning and cognitive
restructuring . Ito was incorporated into the content of education since understanding of human
experiences with a basic model is considered as the basics of CBT. Outcome indices were
established, including to understand structuring of CBT sessions, consider utilization of CBT
factors in nursing practice, ability to understand and utilize basic techniques of CBT, etc. 3.
Problem specific competences and Metacompetences. Case examination was added to this
training in order to utilize it in nursing practice. In this case, cognitive formulation (assessment),
goal setting, planning, setting of approaches to cognition and behavior were addressed as a
group work by using nursing cases in order to develop competence to expand CBTs theory
more in line with nursing practice, in reference to the workshop by S. Freeman and Okada.
Outcome indices were established, including the ability to conduct assessment depending on
the cases and understand the importance to select the best suited intervention technique, etc.
Discussion: The content of education and outcome indices were prepared in accordance with
IAPTs five domains at this time, although evaluation of adequacy and revision is necessary by
actually conducting the training in the future.
Therapists as Agents of Implementation: A Investigation of Therapists' Views of Training
Suzanne Straebler, Zafra Cooper.
Psychiatry, University of Oxford, Oxford, United Kingdom.
Context: Despite the existence of a number of evidence based psychological treatments
(EBPT), few patients receive them. This is generally attributed to inadequate therapist training
and commonly held attitudes concerning the relevance of EBPTs to clinical practice. Relatively
little is known about how therapists learn EBPTs. Attendance at a training workshop given by an
expert constitutes the major source of training with many trainees not benefiting from the
recommended follow-up supervision because of the expense and scarcity of expert supervisors.
The extent to which these workshops meet training needs and shape attitudes towards the
implementation of EBPTs needs further investigation. Objectives: To explore therapists views
on learning EBPT after attending training workshops. Design: Qualitative analysis of in-depth
interviews by a constant comparative approach. Participants: 17 therapists, including doctoral
level trained psychologists, specialist nurses and CBT therapists, who attended a training
workshop on CBT-E for eating disorders given by the leading expert. Results: As expected,
therapists tend to enjoy attending training workshops generally reporting that the workshop
brought the treatment manual to life. However, few therapists thought that their practice would
change significantly as a result. Most found the lecture-based workshop too short and would
have preferred much more experiential learning. Interestingly, although therapists described
themselves as competent to deliver the treatment, many thought that for some interventions the
training was not detailed enough. Many did not intend to offer the treatment to all of their eating
disorder patients believing that another treatment would be more beneficial for their complex

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patients. Still more believed they would be unable to deliver the treatment as a complete
package due to practical barriers (e.g., inability to see patients twice a week). Many reported
using a combination of treatments rather than sticking to one model, believing that this would be
more beneficial for their patients. Paradoxically this was despite a generally favorable view of
EBPTs. Conclusions: Therapists are essential in bridging the research to practice gap and yet
research on the topic of therapist training has been relatively neglected. This study shows that
therapists have both practical (restrictions on resources) and attitudinal concerns (beliefs about
suitability) about adhering to treatment protocols. In addition the frequently held expectation that
therapists are competent to deliver treatments following training workshops may lead them to
believe that they do indeed have the ability to deliver a treatment while at the same time thinking
that the training was neither sufficiently detailed nor experientially based for them to carry out
certain treatment interventions. If we are to ensure that patients are offered consistent and
effective treatments, these issues must be addressed.
Factores de Riesgo y Proteccin en Estudiantes de Nuevo Ingreso en la Licenciatura en
Psicologa
Antonio Tena.
Psicologa, Universidad Iberoamericana, Mxico D.F., Mexico.
Abstract Central: Introduccin: Hoy en da muchas universidades muestran inters en
identificar los factores que pueden poner en riesgo el bienestar psicolgico, la formacin
acadmica y las actividades profesionales de sus estudiantes. La literatura reporta tres
principales factores de riesgo en el rendimiento acadmico; Castro y Solano (2001) y Avanzini
(1985) consideran a los recursos intelectuales como factores importantes; Hernndez y Polo
(1993) mencionan que el fracaso escolar proviene de errores en la planificacin de los estudios
y Santn (1999), Portellano (1989) Mndez, Macas y Olivares (1993), Dvila, Ruz, Moncada y
Gallardo (2011) lo atribuyen a factores emocionales. Ante las dificultades acadmicas y los
trastornos de conducta que algunos estudiantes de Psicologa presentan desde el ingreso a la
licenciatura; se consider importante realizar una evaluacin psicolgica a sus estudiantes de
nuevo ingreso con el objetivo de identificar factores de riesgo y proteccin en estudiantes para
incidir en su formacin universitaria y sus actividades profesionales. Mtodo: Se aplicaron las
siguientes pruebas psicolgicas y el cuestionario de tutoras (CUTU), el SCLR90 (Inventario de
Sntomas Derogatis), y el MMPI-2 versin en espaol con normas para estudiantes
universitarios mexicanos. Participaron 434 estudiantes de ambos sexos de 18 a 21 aos de
edad. La muestra incluye 361 mujeres, 73 hombres. 332 sin tutora acadmica y 102 con tutora
acadmica. Resultados: Las pruebas estadsticas paramtricas destacan que se encontraron
diferencias entre las variables: Sexo con promedio de bachillerato, puntaje de admisin,
promedio de licenciatura, nmero de indultos, CUTU, SCL-R90 (12 escalas) y MMPI-2 (42
escalas). Bajas (si o no) con promedio de bachillerato, puntaje de admisin, promedio de
licenciatura, nmero de indultos, CUTU y SCL-R90 (12 escalas). Proyectando un modelo de
prediccin se encontr que: el promedio de licenciatura es el de mayor importancia, seguido del
predictor promedio de bachillerato, posteriormente se encuentran el puntaje de admisin, el
nmero de bajas, el nmero de indultos, el CUTU y si han tenido tutora acadmica. Las
alumnas reportan sentimientos de tristeza, depresin y ansiedad; su comportamiento es
demandante, histrinico, persuasivo e impulsivo, desean que las situaciones se adapten a
ellas. Los hombres reportan comportamientos inmaduros y rebeldes hacia las figuras de
autoridad, tienden a culpar a los dems de sus problemas. Pruebas estadsticas paramtricas
destacan que se encontraron diferencias entre las variables sexo, numero de indultos, puntaje
de admisin, promedio de preparatoria. Conclusiones: Un promedio de preparatoria menor a 7
es predictor de que tendrn problemas de adaptacin y no alcanzarn el puntaje de calidad. El

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MMPI-2 y el SCL-R90, solo se justifican en el seguimiento de alumnos con estas dos


caractersticas: puntaje menor a 7 de preparatoria y tres o ms factores de riesgo en el CUTU.
Se debe promover una formacin integral que involucre al estudiante, a la institucin educativa
y al entorno familiar para que acten como factores protectores contra las posibles dificultades
que tenga que enfrentar el estudiante y de sta manera facilitar su desempeo social,
acadmico y personal.
ONLINE SUPERVISION AND TRAINING - PRELIMINARY DATA AND KNOWLEDGE
EXCHANGE
Henrik Tingleff1, Randy Fingerhut2, Arthur Freeman3, Mehmet Turkcapar4, Rafael Kichic5.
1. Scandinavian Institute for Cognitive Therapy and Training, Copenhagen, Denmark, 2. La
Salle University, Philadelphia, PA, USA, 3. Midwestern University, Chicago, IL, USA, 4.
H.Kalyoncu University,, Ankara, Turkey, 5. Institute of Cognitive Neurology, Buenos Aires,
Argentina.
This presentation is an invitation to future collegial exchange of experiences regarding the new
and very promising area of online therapist training. The focus will be how we can easily and
cost effectively make use of online solutions when the goal is to reach beyond borders and
make high quality training more easily available to individuals, groups and organizations all
around the world; in particular, to individuals who lack available resources within their own
countries. Henrik Tingleff will discuss the concept of and the reflections behind a Danish based
interna-tional program - using live online training and supervision with experts from abroad. The
discussion will include an account of recommended online solutions for therapist training and
illustrations of specific setups used for webinars, online supervision, and other types of online
sessions within the Danish program. The professional, technical, and teaching related potentials and challenges will also be discussed. Randy Fingerhut will present preliminary data on
an international pilot study involving eight trainers from four countries. This study is designed to
examine the feasibility of using SkypeTM in CBT training. The presentation will include issues
such as the aspects of cross-cultural super-vision and the challenges of establishing a good
dialogue when teaching and learning online. Dr. Fingerhut will present descriptive data on the
trainer and trainees experience- based on modified versions of the Working Alliance Inventory
for Supervisors and Supervisees and the Supervision Outcomes Survey as well as open-ended
questions designed by the authors. Arthur Freeman and M. Hakan Turkcapar, active
supervisors in the previously presented training programs will discuss their specific experiences
with online supervision. Their discussion will focus on the experiences gained as an online
supervisor and the possibilities and limitations in providing and receiving training online. Both
presenters will outline directions for areas of future research. Rafael Kichik will discuss the
increasing interest in and need for clinical training in CBT in Ar-gentina. He will explain how
training in specific CB techniques, such as, EX/RP and interocep-tive exposure poses
challenges for supervisors and how online role-plays can be useful in helping supervisees learn
complex interventions. Supervision through Skype can be particularly useful for trainees who
practices are far away from urban areas where they can obtain close supervision. This is
paritcularly important in Argentina because the large majority of professionals, who prac-tice
CBT work in Buenos Aires. The panel discussion will leave plenty of time for questions and
discussion with the audience. We plan on inviting colleagues from the audience to share their
experiences with online training and provide suggestions for future applications of this
technology for training in CBT. Our intention is to establish a network of practitioners from all
over the world interested in online CBT training as a base for future collaboration and research
in this field.

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Anger Treatment Using Novice Therapists and Acceptance Strategies


Martti Tuomisto1, 2, Tuula Lehtonen1, Sari Vist1, Lauri Parkkinen1.
1. University of Tampere, School of Social Sciences and Humanities, Tampere, Finland, 2.
Tampere University Hospital, Department of Psychiatry, Tampere, Finland.
Abstract Central: Anger is a clinical problem has received more attention only during the last
two decades. The problem situations with anger are often complex. This gives student
therapists in psychology a suitable opportunity to get multi-faceted experience from assessment
and treatment of psychological problems. In this project, novice student therapists treated
clients (n > 40) with anger problems using a broad battery of questionnaires (e.g., symptom
scales, anger and hostility scales, and Acceptance and Action Questionnaire, AAQ-2) and selfobservation and intensity assessment of anger situations. In the treatment, the student
therapists used acceptance and skill strategies, and problem-solving. The treatment included
one introductory session and eight treatment sessions. The results were obtained in multiple
baseline design of some clients on each baseline (e.g., anger situations and intensity).
Questionnaire data were obtained on three occasions: before the baseline (I), and before (II)
and after (III) the treatment phase. Some results are already available showing positive
significant changes in anger intensity and hostility (e.g., in the Cook-Medley Hostility Scale
scores, mean (SD) - I: 172.4 (23.7), II: 168.9 (25.3), III: 158.9 (23.9) - I-III, p <.001, I-II, p<.01)
and acceptance (AAQ-2 scores - I: 43.3 (10.6), II: 43.9 (10.4), III: 49.7 (12.1) - I-III, p<.001, I-II,
p.001). The clients reported that they were either satisfied or very satisfied with their treatment.
The results show that even novice student therapists may obtain valuable results in the
treatment of anger with effective methods.
Diagnostico de Competencias en la Prctica del Psiclogo Clnico y de la Salud en
Mxico
Jose Luis Ybarra1, Luz Orozco Ramirez1, Magdalena Calvillo2.
1. Universidad Autnoma de Tamaulipas, Cd. Victoria, Mexico, 2. Hospital Infantil de Cd.
Victoria, Cd. Victoria, Mexico.
En la actualidad, existe una amplia proliferacin de tratamientos psicolgicos y eso exige un
control de la calidad de los mismos. Es as como la investigacin de la eficacia y efectividad de
los diferentes tipos de intervencin es un tema clave para que la Psicologa adquiera el estatus
de una disciplina cientfica. Este estudio presenta el resultado del diagnostico de competencias
profesionales y el conocimiento y utilizacin de la practica clnica basada en la evidencia en
una muestra de 30 psiclogos de Ciudad Victoria, Tamaulipas, Mxico. Se ha diseado ad hoc
para esta investigacin un instrumento que consta de las siguientes escalas: a) Escala de
evaluacin de conocimientos y aplicacin de tratamientos con validez emprica. b) Escala de
Autopercepcin de Competencias Profesionales del psiclogo clnico y de la salud. c) Escala de
importancia y frecuencia de competencias que se utilizan en el proceso clnico d) Escala de
diseo, uso y difusin de guas de tratamiento. Los resultados muestran que los psiclogos
refieren sentirse ms competentes en el diagnstico y menos competentes en promocin de la
salud. Referente a la frecuencia con la cual utilizan competencias necesarias para su prctica,
se destaca la competencia referente a desarrollo personal adems de atencin a la diversidad y
la tica profesional, siendo el percentil ms bajo en la competencia de consultora. En cuanto a
la importancia de dichas competencias, consideran la ms importante a la competencia de
desarrollo personal y relaciones interpersonales y la competencia con menor percentil fue la de
consultora. Al analizar sobre el conocimiento que tienen sobre los tratamientos eficaces tiles
para cada trastorno, el 65% refieren tener conocimiento y el 35% no lo tienen. Sin embargo el
95% indica que necesita capacitacin sobre ello. Referente a las guas de tratamiento, aunque

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lo consideran muy importante, el 60% no elabora guas de tratamiento y el 70% no le da


difusin con otros colegas. Al comparar los grupos que tienen o no tienen conocimiento sobre
los tratamientos eficaces para los trastornos psicolgicos, existen diferencias significativas en la
autopercepcin de la competencia de investigacin (Mann-Whitney U=14.0 p=.012)
percibindose ms capaces en investigacin los que conocen la prctica clnica basada en la
evidencia. En cuanto a la frecuencia e importancia de las competencias, existen diferencias
significativas entre los grupos en la frecuencia de la competencia de metaconocimientos
(Mann-Whitney U= 18.5 p=.028); es decir que quien tiene un mayor conocimiento en prctica
clnica basada en la evidencia es aquel psiclogo que se est capacitando frecuentemente.
Como conclusin, los psiclogos deben de fortalecer la competencia de promocin de la salud
y la de investigacin, y otra rea de oportunidad es la consultora siendo esta competencia
fundamental ya que permite la capacitacin y supervisin en revisin de casos clnicos entre
colegas y esto fortalecera a crear guas de tratamiento adecuadas a la poblacin mexicana. En
cuanto a la prctica clnica basada en la evidencia aunque se tiene conocimiento, se necesita
una mayor capacitacin y actualizacin permanente.
Evaluation of Environmental Stressors in Inclusive Education Context in Brasil
Kelly silveira2, Snia Enumo1, Kely Paula2, Renata Pozzatto2, Carolina Garcez2.
1. Pontifcia Universidade Catlica de Campinas, Campinas, Brazil, 2. Universidade Federal do
Esprito Santo, Vitria, Brazil.
Abstract Central: The literature on stress in Brazilian teachers presents insufficiency on
resources to evaluation of stressful events. In Inclusive Education specially, the limitation is
even greater. The stress and coping transactional perspective of teachers have generated
possibilities in assessment of perceived stressors. A stressors and categories list have been
used in several international researches, and it was used to pre-adaptation for Portuguese. The
present study aimed to map the stressors associated of Inclusive Education context and
elaborated an instrument to assess them. Seventeen teachers from Esprito Santo State, Brazil
were interviewed. They worked at public elementary school and they teach in the first, second
and third grades, with pupils with special needs. The participants spoke about demands on
teaching that contribute do stress, especially in inclusive classrooms. They also answered the
Stress Symptoms Inventory of Lipp, to evaluate physical and psychological symptoms of
stress. There were 9 teachers with significant physical and psychological symptoms of stress.
The stressors were analyzed and categorized, following the proposal of five major categories
evaluated in a preliminary study: Resources for Development of the Work, Relations with the
Institution, Relations with Family of Students, Impact of Extra Activities for the Development of
Work and Involvement of Students. All 225 potential stressors cited were categorized in these 5
categories, which were organized into 25 subcategories. The sums of subcategories more
frequently cited were aggression and indiscipline (14.,05), pupils with special needs in
classroom (12.5), problems with physical structure and offer of materials (12.25), little perceived
support (12), and have to deal with pupil with special needs in crowded classrooms (11.25).
Between teachers with more stress, there were more frequency of demands cited as real
stressors (p= 0.02; Mann Whitney U test). They cited more frequently problems related to
Involvement of Students (p= 0.021; Mann Whitney U test) and Relations with Family of Students
(no significance). The themes presented in each one of 25 subcategories were transformed into
items to delineate the Stressors List of School Context- Inclusive Education Version (SLSC-IE)
with 75 items. A team of five judges evaluated the initial list, according to their semantic
properties such as clarity, coherence and relevance to the constructs. For this initial procedure,
16 items were below 0.80 in concordance level about clearly. They were reformulated after
debate among judges, because of its importance to the instrument. The items showed

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acceptable levels, after another concordance analysis (>0.80). There was high concordance
about content (Kappa 0.75). However, one item was removed due to poor agreement about the
content, with concordance index of 0.40. The current version of SLSC-IE resulted in 74 items
and showed evidence of face and content validity, with high Kappa values. Next investigations
will analyze the model that was proposed. Nevertheless, the results obtained can help in
delineating new interventions to prevent or minimize teacher stress symptoms in the inclusive
context.
Psychosis/ Psicosis/ Psicose
Connecting the Dots: Moderated Online Social Therapy (MOST) for Long-term Functional
Recovery in First Episode Psychosis
Mario Alvarez-Jimenez1, 2, Sarah Bendall1, 2, Reeva Lederman3, Greg Wadley3, Gina Chinnery4,
Sonya Vargas3, Patrick McGorry1, 2, John Gleeson5.
1. Orygen Youth Health Research Centre, Parkville, VIC, Australia, 2. Centre for Youth Mental
Health, The University of Melbourne, Melbourne, VIC, Australia, 3. The Department of
Computing and Information Systems, The University of Melbourne, Melbourne, VIC, Australia,
4. Orygen Youth Health, Melbourne, VIC, Australia, 5. School of Psychology, The Australian
Catholic University, Melbourne, VIC, Australia.
Abstract Central: Background: Early intervention services have demonstrated improved
outcomes in first episode psychosis (FEP); however, recent evidence shows that treatment
benefits may not be sustainable over time. These findings have resulted in repeated
recommendations for the implementation of longer term treatment programs. An Internet-based
intervention specifically designed for young people with psychosis may provide a cost-effective
alternative to prevent loss of treatment benefits from early intervention. Methods: Our multidisciplinary team has developed a highly novel online intervention (MOST) in close consultation
with end-users within a specialist early psychosis program. MOST uniquely integrates: i) peerto-peer social networking, ii) individually tailored interactive cognitive behavioural interventions,
and iii) expert interdisciplinary and peer-moderation in a coherent platform designed to improve
long-term functional recovery in FEP. Moreover, MOST adopts a strengths-based approach
through which users are guided and prompted to identify, discuss and exercise key personal
strengths within the online environment and in real-life to enhance self-efficacy, foster social
functioning and reduce depression. The acceptability, safety and initial clinical benefits of MOST
have been recently examined through a 1-month pilot study with 20 participants with FEP.
Results: There were no dropouts during the pilot study. Seventy per cent of participants utilised
the system for at least 3 weeks, 95% used the social networking features, and 60% completed
at least 3 therapy modules. System usage was high during the study. There were no incidents
and the majority of participants reported feeling safe (100%), empowered (55%) and more
socially connected (60%) using MOST. Analysis revealed a moderate to large reduction
(d=0.60) in depressive symptoms at follow-up. Subsequent analysis of individual-level data
revealed that 7 of 10 participants with reduced depression scores were regular users of MOST.
Conclusions: Our results indicate that MOST is feasible, engaging and safe, may reduce
depression and augment social connectedness and empowerment in FEP. These findings have
significant implications for the enhancement of specialist FEP services. The potential of MOST
to improve long-term functional recovery in FEP is currently being evaluated through a 5-year
large Randomised Controlled Trial (RCT) comparing MOST vs. treatment as usual. During the
oral presentation MOST will be showed-cased, including first-account experiences from real
users. In addition, the initial findings from the large RCT will be discussed.

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CBT Intervention for Multiple Health Behaviour Change among People with Psychotic
Disorders: Results from a RCT
Amanda Baker1, Robyn Richmond2, Frances Kay-Lambkin2, 1, Sacha Filia3, David Castle4, Robin
Callister1, Jill Williams5, Vanessa Clark1, Terry Lewin6, Kathryn Woodcock1.
1. University of Newcastle, Newcastle, NSW, Australia, 2. University of New South Wales,
Sydney, NSW, Australia, 3. Monash University, Melbourne, VIC, Australia, 4. University of
Melbourne, Melbourne, VIC, Australia, 5. University of Medicine and Dentistry of New Jersey,
Piscataway, NJ, USA, 6. Hunter New England Mental Health, Newcastle, NSW, Australia.
Abstract Central: To our knowledge, The Healthy Lifestyles Project is the first RCT to evaluate
a multi-component cognitive-behavioural intervention addressing smoking and other health
behaviours among people with psychotic disorders. Participants with psychotic disorders
residing in the community and smoking 15 cigarettes/day (CPD) were randomly assigned to
either a multi-component CBT face-to-face intervention addressing multiple health risk
behaviours or to a largely telephone delivered intervention addressing smoking only. At
baseline, participants (N=235, Age, M=41.6 years, 59% male) were smoking on average 28.6
(SD= 15.3) CPD. CO verified point prevalence abstinence (last 7 days) was 16% (n=13) at 15
weeks and 13% (n=9) at 12 months for the face-to-face condition and 17% (n=15) and 13%
(n=9) for the telephone condition. At 15 weeks and 12 months, participants still smoking
reduced their mean CPD for both the face-to-face (Mean 10.8; SD=14.6 and Mean 6.5;
SD=12.1) and telephone delivered interventions (Mean 11.4; SD=12.1 and Mean 6.0; SD=11.4),
p<0.001 for both time points. Of the 132 subjects who had data at baseline and 12 months, 56
maintained their activity levels, 51 became more physically active, and 25 became less active
(p=0.003). There were no significant differences between conditions in terms of fruit and
vegetable serves/day or time spent sitting. Participants who received the face-to-face
intervention had an increase in total minutes per week of walking from a Mean of 231.1
(SD=373.3) minutes at baseline to a Mean of 353.1 (SD=546.1) at 12 months compared to
those who received the telephone intervention with a slight decrease in total minutes per week
of walking from a Mean of 231.9 (SD=413.8) at baseline to a Mean of 209.2 (SD=206.6) at 12
months (p=0.037). Face-to-face and telephone-delivered interventions for smoking are feasible
and effective among people with severe mental disorders. CBT interventions for multiple health
behaviour change appear worthy of further research among people with psychotic disorders.
The Utility of Befriending Therapy as a Psychological Placebo Control Treatment
Sarah Bendall1, Kelly Allott1, Eoin Killackey1, Mario Alvarez-Jimenez1, Patrick McGorry1, John
Gleeson3, Henry Jackson2.
1. Orygen Youth Health Research Centre, Parkville, VIC, Australia, 2. Psychological Sciences,
The University of Melbourne, Melbourne, VIC, Australia, 3. Australian Catholic University,
Melbourne, VIC, Australia.
Abstract Central: Befriending is manualised therapy designed as a psychological placebo
control for use in randomised controlled trials (RCT) of cognitive behavioural therapy (CBT)
interventions. Specifically it has been designed to provide a treatment with: (i) high face validity
for participants; (ii) level of therapist contact matched to the CBT condition; (iii) non-specific
factors matched to the target condition (e.g., positive experiences of therapy and perceived
helpfulness of therapy); and also (iv) none of the specific elements of the CBT model (e.g.,
problem solving). It has initially been used in RCTs of CBT for psychosis but its use has recently
broadened to other groups and therapy models such as with young people with emerging
borderline personality disorder; older people with chronic obstructive pulmonary disease and
cognitive analytic therapy. The aim of the current study is to evaluate the utility of Befriending as

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a control treatment in relation to the above described characteristics. Data is presented from
The ACE Project, an RCT of CBT for first episode psychosis conducted at Orygen Youth Health
Research Centre in Melbourne, Australia. Participants (n=62) were randomised to either the
CBT condition or to Befriending. Expectations and enjoyment of therapy were measured by
client questionnaire. Time in therapy and the number of drop-outs were also recorded. Therapy
sessions were audio-recorded with at least one session from 53 of the 62 participants being
rated. The independent rater was blind to type of therapy delivered and employed a purposedesigned rating scale. Ratings were made for the presence of: 1) non-specific treatment factors;
2) CBT techniques; 3) Befriending techniques. Results showed that Befriending was
comparable to CBT on measures of expectancy, enjoyment of therapy and drop-out rate, but
significantly different with regard to time in therapy. The non-specific factors Collaboration
Empathy and Professionalism were rated as being present in a similarly high number of both
CBT and Befriending sessions. Of the Befriending sessions, 10 of 48 (21%) were contaminated
by CBT techniques. Nine of these contaminations were on the item Therapist gives client
information about the therapy process. Overall, the results suggest that Befriending is a
credible and acceptable control therapy. Importantly, therapists were able to conduct
Befriending without needing to implement more active strategies even in a highly distressed and
symptomatic group of young people with first episode psychosis. In order to improve
Befriendings matching with an active treatment, modification to increase time in therapy
sessions is recommended.
The Journey to TRIPP (TRauma-Informed Psychotherapy for Psychosis): A Randomised
Controlled Trial in First Episode Psychosis
Sarah Bendall1, Mario Alvarez-Jimenez1, Craig McNeil3, Shona Francey3, Patrick McGorry1,
Eoin Killackey1, Henry Jackson2.
1. Orygen Youth Health Research Centre, Parkville, VIC, Australia, 2. Psychological Sciences,
The University of Melbourne, Melbourne, VIC, Australia, 3. Orygen Youth Health, Melbourne,
VIC, Australia.
Abstract Central: Traumatic experiences, and their symptomatic and functional consequences,
are becoming increasingly important in the treatment of first episode psychosis (FEP). Our
recent data shows that post-traumatic stress disorder (PTSD) in FEP is common and results
from both childhood trauma and acute psychosis (47% and 39% respectively). Importantly,
reporting childhood trauma dramatically increases the risk of developing PTSD from the
experience of acute psychosis. Our recent research into clinicians attitudes to treating trauma in
psychosis showed that clinicians a) believe it is very important; b) have concerns about he
safety of any interventions especially in relation to exacerbation of acute psychotic symptoms
and c) think they lack the skills and knowledge to deliver trauma-focussed interventions. Thus
far however, very few treatment approaches for PTSD in psychosis have been trialled. We have
developed a trauma-informed psychotherapy for psychosis (TRIPP). TRIPP has been informed
by: i) our experimental data, ii) a systematic review of interventions for trauma and PTSD in
psychosis, and iii) a comprehensive survey of clinicians in our specialised FEP service. A
randomised controlled trial of TRIPP versus treatment as usual is currently underway. TRIPP
treatment is a broadly cognitive-behavioural intervention in two phases. The first phase includes
four modules: a comprehensive assessment module; an individual formulation module that
involves developing an understanding of the relationship between traumas, PTSD symptoms,
dissociation and psychotic symptoms; a safety module that encompasses distress management
both within and outside of therapy sessions, a psychoeducation module in relation to PTSD and
dissociation. These four modules can be completed concurrently depending on the presentation
of the client. The second phase involves treatment modules (e.g., emotional

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exposure/disclosure; dialogue with voices, combating avoidance; grounding) that are conducted
in a flexible manner according to the formulation. This world-first trial is unique as it is targeting
PTSD symptomatology for both childhood trauma and the trauma of acute psychosis in FEP; it
is specifically targeting those with diagnosis-level PTSD symptoms; it is investigating social
functioning as an outcome; and it is a treatment being delivered within the current case
management model of a public mental health treatment service, so requires no extra resource
for implementation. The rationale, treatment and interim outcome data will be presented and
discussed.
Self-Defining Memories and Identity in Schizophrenia
Marie Boulanger, Laurie Marchal, Sylvie Blairy.
University of Lige, Lige, Belgium.
Introduction. To date, the reciprocal relationship between autobiographical memory (AM) and
identity is well known. In schizophrenia, there is evidence that both identity and AM are
impaired. Indeed, identity has been described as fragmented, instable or still discontinuous in
these patients (Boulanger et al., submitted; deBonis et al., 1995; Nieznanski, 2004). Further,
schizophrenia patients (SCh) AM impairments were described as difficulties to retrieve specific
memories, which are unique episodes that occurred at a specific time and place (CuervoLombard et al., 2007; Dargembeau et al., 2008; Neumann et al., 2007; Wood et al., 2006). If
SCh have an impairment to specify information for mill run autobiographical memories (AMs),
they also meet deficits for AMs particularly important for construction and continuity to identity
named self-narratives (Benounna-Greene, 2001; Raffard et al., 2009, 2010; Robinson and
Taylor, 1998). The self-defining memories (SDMs) represent exemplar self-narratives that
individuals draw onto inform their sense of identity. They have been particularly relevant in
understanding the relationship between the identity and AM. Identity emerges during late
adolescence and early adulthood period called remimiscence bump period because, it is
characterized by a profusion of recalled memories in comparison to others periods of life span.
Possibly, many memories from this period are of SDMs (Singer & Salovey, 1993) and have a
powerful effect in binding the identity to a specific reality. Consequently, we supposed that
identity instability impairments showed by SCh are related to SDMs deficits. Method. 30 SCh
and 30 healthy controls paired participated to this study. They were asked to give ten enduring
I am statements that they felt defined their identity. Then, the participants selected the three
statements among the ten, which are the most personally significant to their sense of identity.
They were asked to recall three SDMs by each of three statements selected. Afterwards, they
were asked to give: (1) their age for each statement when they felt it was a significant part of
their identity, (2) a title and their age at the time that the remembered event occurred. In parallel,
the participants were completed neuropsychological measures, BDI-II, PANSS and, an identity
stability measure (a short version of LABEL from Gendre, 2008). Results. The SCh reported as
specific events as healthy controls however; SChs events contained less meaning-making than
those healthy subjects. Furthermore, patients recalled more events characterized by
hospitalization/stigmatization, failure and, fewer achievements than healthy subjects.
Discussion. The results are discussed on the light of previous research.
Mental Time Travel in First Degree Relatives of Schizophrenia Patients
Marie Boulanger, Aurlie Wagener, Graldine Duck, Laure Xhenseval, Mlissa Van de
Woestyne, Sylvie Blairy.
University of Lige, Lige, Belgium.

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Introduction. Genetic and environmental factors are important to explain the causation of
schizophrenia. The families studies can help us to better understand the genetic influence.
Indeed, the cognitive deficits found in the unaffected biological relatives of schizophrenia
patients parallel the deficits found in patients. These deficits might be putative endophenotypic
markers of schizophrenia, ie. characteristics that mark the presence of a genetic predisposition
to a certain disease or disability, in this case, the schizophrenia (Sitskoorn et al., 2004). In this
way, previous studies reported that compared to healthy controls (HC), the relatives show
cognitive impairments that are similar but milder degree than those of schizophrenia patients
(SCh). The deficits affect cognitive functions such as verbal memory, attention and executive
function; hence the interests to take into account the endophenotypic markers. To our
knowledge, no study has yet assessed the abilities to mental time travel in the relatives despite
that this cognitive function is impairment in SCh (Cuervo-Lombard et al., 2007; Dargembeau et
al., 2008; Wood and Brewin, 2006). The mental time travel allows individuals both to retrieve
past personal autobiographical information and to project into future personal events. Further, it
is related to the continuity and the stability of identity, which has also been described as
fragmented instable or discontinuous in SCh (Boulanger et al., submitted; deBonis et al., 1995;
Nieznanski, 2004). Consequently, the ability to mental time travel could be a relevant
endophenotypic marker. Method. 31 SCh, 33 relatives and 31 HC generated both ten past
memories and ten future events in response to cue words from TeMA (a French version of
AMT). In parallel, they completed cognitive tests, such as the Stroop Color-Word Test, the Trail
Making Test, the Digit Span Backward and Forward Test (WAIS-III) and questionnaires which
evaluated mood disturbances such as BDI-II and STAI-Y. Finally, participants were asked to
respond to a short version of LABEL, which measured identity stability. Results. SCh showed
deficits on all measures in comparison to HC. However no significant differences emerged
between relatives and HC on measures of time travel. Nevertheless, differences were found for
interference score (Stroop-Color-Words Test) and score on part B from TMT, as well as
relatives and SCh. Discussion. Despite the fact that the majority of the relatives scores on
different measures are not significant in comparison to HC and SCh, their results situated
between the results of both groups. These results are discussed in the light of previous
research.
Error-Related Negativity in Individuals with a History of Psychosis
Chi Chan, Benjamin Trachik, Lisa Kadison, Carlos Puentes, Maricel Pacheco, Jeffrey Bedwell.
University of Central Florida, Orlando, FL, USA.
Metacognition, or awareness of ones own thoughts and behaviors, consists of two important
processes: the monitoring component which involves the evaluation of ones own cognitive
functioning and the control component which refers to the way in which behavior is guided by
self-evaluation (Nelson & Narens, 1990). These processes are fundamental characteristics of
the way human beings think, behave, and interact with the world and are essential for guiding
goal-directed action and organization of internal and external information. Inadequate
monitoring of self-generated actions and thoughts may lead to psychosis such as delusions and
hallucinations (e.g., Frith, 1987; Frith & Done, 1989). One possible neural mechanism
underlying monitoring disruptions is abnormal functioning in the anterior cingulate cortex (ACC),
a brain region responsible for error monitoring. This study examined error monitoring in 10
individuals with a history of delusions and/or hallucinations (PSY) and 7 control individuals with
no history of psychosis (CTR) during performance on a modified version of the Flanker Task
(Eriksen & Eriksen, 1974). This task required participants to respond to a particular stimulus (the
target) while ignoring other irrelevant but distracting stimuli (the flankers) while emphasizing
both speed and accuracy. Electroencephalogram (EEG) technology was used to assess the

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error-related negativity (ERN), an event-related potential (ERP) generated by the ACC following
commission of an error, and the correct response negativity (CRN), a less prominent ERP in the
same region following production of a correct response. Preliminary examination revealed that
the PSY group exhibited a reduced ERN amplitude (M = -2.50; SD = 3.02) relative to the CTR
group (M = -3.35; SD = 3.57), cohens d = -0.26. In contrast, CRN amplitude was increased in
the PSY group (M = -1.28; SD = 2.23) compared to the CTR group (M = -0.874; SD = 1.22),
cohens d = -0.22. These preliminary observations suggest that psychosis proneness may be
associated with reduced ACC activity during commission of errors and increased ACC activity
during correct responses. Continuation of data collection will allow for inferential statistical
analysis. Findings may inform cognitive remediation interventions for individuals with severe
mental illness.
Does Assessment of Risk Status Matter in Relation to Subsequent Transition to
Psychosis and Treatment Patterns?
Agatha Conrad1, Terry Lewin1, 2, Vaughan Carr2, 3, Ulrich Schall1, 2, Sean Halpin4, Ketrina Sly1.
1. Centre for Translational Neuroscience and Mental Health, Hunter New England Mental
Health and the University of Newcastle, Newcastle, NSW, Australia, 2. Schizophrenia Research
Institute, Sydney, NSW, Australia, 3. School of Psychiatry, University of NSW at St Vincents
Hospital, Sydney, NSW, Australia, 4. School of Psychology, University of Newcastle, Newcastle,
NSW, Australia.
Abstract Central: Over the last few years the rates of transition to psychosis appears to be
declining from 54% Miller et al (2002) to 16% transitioning within 12 months (Simon & Ulmbrich
(2010), possibly due to improvements in assessment and provision of early intervention for
people at high risk for psychosis. Despite the improvements, ultra high risk criteria tend to yield
high rates of false positives. Recently a 10 year audit was completed of all presentations of
clients to the Psychological Assistance Service (PAS), which specialized in assessment and
treatment of young people aged 15 to 25 years who are at risk of developing a psychotic
disorder or who are in the early stages of a first episode of psychosis. The inclusion criteria
used by PAS were based on Comprehensive Assessment of at Risk Mental States (CAARMS)
(Yung et al., 2003). The CAARMS instrument allows for classification of risk with respect to
family history, recent deterioration in functioning, attenuated psychotic symptoms, and transient
self-limited psychotic symptoms of less than one weeks duration (BLIPS). Between Jan. 1997
and Dec. 2007, PAS staff saw approximately 1,875 clients, comprising 2,207 presentations,
59.8% by males and 40.2% by females. The average age of presenting clients was 18.79 years
(SD = 4.54). Of those assessed, 21.1% (N = 205) were identified as ultra high risk for
psychosis, while 18.6% (N = 181) were experiencing their first episode, and 17.1% (N = 167)
had an existing psychosis. Among those with another disorder (39.3%, N = 382), the highest
rates were for depression (16.9%) and personality disorder (8.4%). Approximately one-quarter
of PAS clients (24.3%) had at least one subsequent admission involving a drug and alcohol
disorder. Subsequent admissions involving other disorders included: 16.5% for schizophrenia,
13.6% for depression, 10.7% for personality disorders, and 6.8% for bipolar disorder. The
results will also focus on the relationship between transition rates to psychosis and UHR criteria,
and whether assessment of risk status influences subsequent outcomes or treatment patterns.
Schizophrenia and Violence at Home
David Corcoles, Agnes Sabate, Angeles Malagon, Maria Nascimento, Magda Bellsola, Ana
Gonzalez, Laura Badenas, Romina Cortizo, Luis Martin, Antoni Bulbena.
INAD- Hospital del Mar, Barcelona, Spain.

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- Introduction: There is good evidence from epidemiological studies that the diagnosis of
schizophrenia is associated with an increased risk of violence (2), is found in both males and
females, and is strongly associated with co-morbid substance abuse. Some studies have linked
the presence of positive symptoms, first psychotic episode, duration of untreated psychosis and
lack of insight with violent behavior. - Objective: The primary objective was to identify factors
related to violent behavior in patients diagnosed with psychotic disorder attended by our group,
a multidisciplinary mobile outreach team (EMSE). - Methodology: We evaluated a total of 249
patients diagnosed with psychotic disorder between 2007 and 2012. We administered the
following scales: PANSS (Positive and Negative Syndrome Scale) GAF (Global Assessment of
Functioning), CGI (Clinical Global Impression), GEP (Severity of psychiatric illness scale, AVAT
(Instrument to assess violent behavior in mental illness) and SUMD (Scale unawareness of
mental disorders). To study the correlation between the scales and the score of the AVAT
instrument we used the Pearson correlation. Clinical variables were also compared between
aggressive and non-aggressive patients using Chi-square and Student s t. - Results: There is a
positive correlation between AVAT and PANSS-P (r = 0.544), ICG (r = 0.472), GEP (r = 0.515)
and a negative correlation between AVAT and GAF (r = -0357). The correlation between AVAT
and SUMD is positive (r = 0.119) but not statistically significant, - Conclusion: The presence of
positive symptoms and clinical severity has been linked to increased aggressiveness and to
predict the occurrence of violent behavior in the course of psychotic disorder. Unlike other
studies, no correlation was observed with the lack of insight.
Do jogo da bola ao jogo da vida
Rosane Costa1, 2, Acio Gama1, 2.
1. Universidade Estcio de S, Nova Friburgo, Brazil, 2. UNESA, Nova Friburgo, Brazil.
O presente resumo fruto do trabalho realizado no municpio de Nova Friburgo - RJ (Brasil) em
associao com a ONG Gol de Placa, Laboratrio de Prticas Sociais / UNESA e o Decimo
Primeiro Batalho da Policia Militar do RJ. Este trabalho acontece dentro do Batalho de
Polcia Militar, onde ocorrem treinos na escola de futebol para crianas e adolescentes,
atendendo aproximadamente 200 crianas oriundas de escolas pblicas da regio, com idades
entre 06 e 15 anos. A nossa conceituao do atleta e dos seus padres cognitivos, nos
possibilita adequar e elaborar as intervenes ao funcionamento cognitivo de cada atleta e, as
informaes acerca dos problemas atuais da deles em diferentes esferas, ou seja, na famlia,
nas amizades, na escola e no prprio meio esportivo, entre outros. Para obtermos um resultado
satisfatrio na modalidade esportiva, fazemos com que o atleta tenha uma boa capacidade de
concentrao. Para ajud-los ensinamos duas estratgias muito teis: a tcnica da distrao ou
a da refocalizao. Na refocalizao, de acordo com Beck (1997), ensinamos o atleta a voltar a
sua ateno tarefa realizada. Para exemplificar teramos um jogador passando por problemas
familiares, o qual relata desviar sua ateno para eles durante o jogo e, ento os ensinamos a
re-focalizar o jogo do qual participa. J, a tcnica da distrao faz com que o jogador selecione
os eventos nos quais se atentaria, diminuindo os prejuzos ao time e a si mesmo. Utilizamos o
Progressivo para que o atleta aprenda a avaliar suas tenses em algumas musculaturas
especficas e, depois, a relax-las. A nfase fisiolgica faz esse tipo de relaxamento se aplicar
muito bem ao esporte, amenizar estados ansiosos e auxiliar na recuperao do atleta depois
de um treinamento intensivo ou de uma competio acirrada e, conjuntamente com a
respirao diafragmtica de forma consciente que possvel baixar nveis e ansiedade e
tenso muscular, constituindo-se assim, em tcnicas utilizadas pela TCC para enfrentamento
da ansiedade e estresse. Autores Acio Acioli Raquel Bolais Rosane de Albuquerque Costa

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Modelagem de Comportamentos Alternativos para o Controle da Esquizofrenia


Felipe Epaminondas1, 2, Ilma Britto2.
1. Universidade So Judas Tadeu (USJT), So Paulo, Brazil, 2. Pontifcia Universidade Catlica
de Gois (PUC-GO), Goinia, Brazil.
Abstract Central: O objetivo do presente estudo foi utilizar o reforamento diferencial de
comportamentos alvos no repertrio de uma pessoa com o diagnstico de esquizofrenia
observando as mudanas gerais em seu repertrio social e suas vocalizaes. Para essa
finalidade foram utilizados os procedimentos da Anlise Aplicada do Comportamento. O
participante foi uma pessoa do sexo masculino, de 47 anos, solteiro, semi-analfabeto,
descendente de famlia de poucos recursos econmicos e que houvera sido internado em
vrias instituies especializadas para tratamentos psiquitricos desde os 18 anos de idade. A
escolha do participante foi feita a partir de observaes diretas dos seus comportamentos no
ptio da instituio em que se encontrava. Foram selecionados trs classes de
comportamentos-problema para sofrerem interveno: o baixo contato ocular, baixo tom de voz
e falas curtas. Para o controle dos procedimentos foi utilizado o Delineamento de Linha de
Base Mltipla. As intervenes foram feitas em sesses individuais de conversa livre entre o
pesquisador e o participante. O pesquisador apresentava reforadores sociais contingentes ao
comportamento alvo, trocando o mesmo quando este se estabilizava em uma alta freqncia. A
interveno foi eficaz para aumentar o repertrio social do participante, no entanto, no foi
possvel observar generalizao destas respostas em outros ambientes, o que pode ser
explicado pelo controle de estmulos na instituio.
Esquizofrenia; Una Visin Cognitiva: Resultados de un Programa de Entrenamiento en
Terapia Cognitivo Conductual (TCC) para Profesionales de Salud Mental
Samantha Flores1, Rebeca Robles2, Mara Hasbach2.
1. Instituto Jalisciense de Psicoterapia Cognitivo Conductual, Guadalajara, Mexico, 2. Instituto
de Psicoterapia Cognitivo Conductual, Mexico, Mexico.
La esquizofrenia tiene una prevalencia mundial de 1% y se encuentra entre las diez principales
causas de discapacidad relacionada a una enfermedad en el mundo (Lpez et al, 2006). Los
programas de tratamiento actualmente existentes para este trastorno proponen un enfoque
multidisciplinario. La American Psychological Association en su Catalog of Clinical Training
Opportunities (2007) present un compendio de intervenciones sugeridas para el manejo de
este trastorno de las cuales parte pertenecen al enfoque cognitivo-conductual, de donde se
extrajeron las intervenciones para este programa de entrenamiento: psicoeducacin, terapia
cognitiva para sntomas positivos (alucinaciones e ideas delirantes) y negativos, terapia de
competencia social y rehabilitacin cognitiva. Se busc: a) determinar el efecto del programa
sobre la adquisicin de conocimiento respecto a la teora cognitiva de los sntomas de la
enfermedad; las estrategias de intervencin y su aplicacin as como la adquisicin de
habilidades teraputicas para su manejo y b) determinar el efecto del programa de
entrenamiento en la modificacin de opiniones hacia la TCC para la esquizofrenia.
Investigacin prospectiva pre-experimental con ensayo clnico controlado. Se integr al grupo
de estudio con 18 participantes (16 psiclogos y 2 psiquiatras) en 16 sesiones semanales de
tres horas; 14 concluyeron el entrenamiento, contaban con una media de edad de 37 aos,
92% eran mujeres y 50% de ellos contaba con estudios de posgrado. Se evaluaron la
adquisicin del conocimiento cognitivo y habilidades teraputicas a travs de cuestionarios,
observacin de desempeo en juegos de roles y reportes de trabajo con pacientes as como
con una vieta clnica; las opiniones respecto al enfoque psicoteraputico se midieron con una
escala visual anloga. . El aprendizaje se evidenci con un incremento en conocimientos

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respecto a la terapia cognitiva para tratamiento de las alucinaciones, ideas delirantes y


sntomas negativos (p = <.0001) as como en conocimientos de rehabilitacin de los dficits
cognitivos (p = .005). Las habilidades teraputicas se incrementaron de manera importante (p =
<.0001) a la par de la seguridad al administrar el programa. Las opiniones respecto al enfoque
psicoteraputico para manejo de la esquizofrenia se incrementaron de manera positivas (p =
.001) as como la disponibilidad e inters para trabajarlo. La mayora de los participantes solia
tener desconocimiento respecto a la posibilidad de rehabilitar y las estrategias para hacerlo con
este grupo de pacientes, esto ltimo es de vital importancia pues se suele pensar que debido a
las dificultades cognitivas de los pacientes, estos no sern aptos para trabajar en un modelo de
psicoterapia de corte cognitivo, estas opiniones se modificaron a la par de la adquisicin de
conocimientos pues tal como lo explica Schunk (1991) el aprendizaje implica no solo
adquisicin y modificacin de conocimientos, estrategias y habilidades; sino tambin cambios
en creencias y actitudes. Palabras clave: terapia cognitivo conductual, esquizofrenia,
entrenamiento, evaluacin.
Ethnicity, Patient Perceptions of Quality of Family Environment, and Symptom Severity
in Schizophrenia
Kayla Gurak, Amy Weisman de Mamani.
Psychology, University of Miami, Coral Gables, FL, USA.
Numerous studies have demonstrated a strong relationship between quality of family
environment and patient symptom severity in schizophrenia (Blanchard et al., 2004; Rosenfarb
et al., 2006). While this relationship has been studied extensively, the family environment is
typically rated through family members perspectives, using measures of Expressed Emotion.
With the exception of a few studies (e.g., Weisman, 2005; Cutting & Doherty, 2000; Schiffman
et al., 2002), there is a dearth of research on how patients perceptions of their family
environment relate to symptom severity. The present study measured a latent variable termed
Perceived Quality of Family Environment. This construct included three indicators, 1) patient
perceptions of warmth of primary caregiver, 2) patient perceptions of criticalness of primary
caregiver (both rated from the Perceptions of Expressed Emotion Scale (Weisman and
Rosales et al., 2003)), and 3) patient perceptions of family cohesiveness (rated from the Family
Cohesion subscale of the Family Environment Scale (Moos & Moos, 1981)). It was
hypothesized that higher patient ratings on Perceived Quality of Family Environment (FAMENV)
would predict lower levels of symptom severity, as measured by the Brief Psychiatric Rating
Scale (BPRS, version 4.0), (Ventura et al., 1993). Previous studies have also demonstrated that
Hispanic patients with schizophrenia demonstrate lower levels of symptom severity and better
course of illness than do ethnicities from more industrialized countries (Weisman, 1997; Vega &
Sribney, 2003). Another objective of the present study was to replicate this ethnic pattern. In
other words, we hypothesized that Hispanics would demonstrate lower levels of symptom
severity than the other ethnicities in the comparison group. Participants included 109 adult men
and women diagnosed with either schizophrenia or schizoaffective disorder. 20% of the sample
identified as Caucasian, 28.2% as African-American, 49.1% as Hispanic, and 2.7% as Other.
This sample consisted of 66.4% male and 33.6% female participants. Patient ages ranged from
18 to 63 (M=38.13, SD=12.33). Using structural equation modeling, results indicated that the
three indicators significantly loaded onto FAMENV in both comparison groups. The structural
regression model fit the data well, X2 (9) = 8.565, p= 0.4783. Root Mean Square Error of
Approximation (RMSEA = 0.000, Confidence Interval (CI) 0.000-0.147). Comparative Fit Index
(CFI) = 1.000. Greater FAMENV scores significantly predicted lower BPRS scores across ethnic
groups (b= -3.182, S.E.= 1.564, p = 0.042). Results also replicated prior research indicating that
when compared at the same level of FAMENV, Hispanics do indeed display lower symptom

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severity scores when compared to other ethnicities. Results suggest that patient perceptions of
quality of their family environment have the potential to be strong predictors of symptom severity
across ethnic groups. Future studies should attempt to replicate this finding in a larger sample.
Follow-up research is also needed that will help to pinpoint specific cultural factors that may
account for the lower levels of symptom severity in Hispanics compared to other ethnic groups.
Nuevas propuestas de diseo de tratamiento en terapia Cognitivo conductual para
Esquizofrenia
Nicols Hernndez Lira, Hernn Garca Cortes, Elizabeth Calzada Snchez, Amor de Mara
Hernndez Hernndez.
Instituto Cognitivo Conductual de Salud Mental de Mxico, Mxico, Mexico.
El trastorno de la Esquizofrenia ha sido estudiado desde hace mucho tiempo, pero
continuamente se esta investigando y proponiendo nuevos tratamientos psicolgicos, por lo
cual se considera importante ubicarnos en donde nos encontramos en cuanto a tratamientos y
tcnicas aplicadas para disminuir sntomas y a su vez proponer un nuevo tratamiento.
La primera intervencin es una propuesta de tratamiento para pacientes sin conciencia de
enfermedad con Esquizofrenia realizada por el Mtro. Nicols Alejandro Hernndez Lira, y la
cual lleva 2 aos en investigacin, ofreciendo en esta ocasin los primeros resultados que
arroja su propuesta.
La segunda intervencin la realiza el Psic. Hernn Garca Cortes presentando los resultados
preliminares de un ao de investigacin de los alcances que se reportan de las llamadas
terapias de tercera generacin aplicadas a la Esquizofrenia.
La tercera participacin es de la Psic. Elizabeth Calzada Snchez, que presenta los resultados
preliminares de una investigacin sobre el uso de las tcnicas cognitivas para el tratamiento de
la Esquizofrenia, realizando un meta anlisis de reportes de investigacin para conocer eficacia
y eficiencia de las mismas.
Por ultimo la cuarta intervencin es realizada por la Psic. Amor de Mara Hernndez Hernndez
que tratara sobre el estado del Arte en tratamientos psicolgicos para Esquizofrenia, realizando
un meta anlisis de reportes de investigacin sobre estas propuesta de intervencin y
conociendo logros y alcances de los mismos
Propuesta de tratamiento para pacientes sin conciencia de enfermedad con
Esquizofrenia (Mtro. Nicols Alejandro Hernndez Lira)
El presente trabajo presenta los primeros resultados de una investigacin de 2 aos en
pacientes con Esquizofrenia en la ciudad de Mxico, en el hospital psiquitrico Dr. Samuel
Ramirez Moreno, bajo una propuesta de plan de tratamiento basado en los aportes de Philippa
Garety, Nicholas Tarrier, Douglas Turkington y David Kingdon, donde se propone una nueva
estrategia para mejorar el raport y la cooperacin del paciente sin conciencia de enfermedad y
que no desea tratamiento psicoteraputico, intentando lograr que el paciente acuda a
tratamiento por voluntad propia sin que acepte an su enfermedad.
Los resultados preliminares demuestran que el grupo experimental de 20 pacientes logro
disminuir rpidamente los tres sntomas estudiados (delirios, conducta alucinatoria e ideas de
suspicacia, desconfianza y persecucin), en un espacio corto de tiempo (5 meses), en
contraste con el grupo control que tardo 9 meses en obtener el mismo resultado, pero sin
mantenerlo en los meses siguientes.
Entre los resultados preliminares se comenta que le tema de conciencia de enfermedad y la
nueva propuesta de la forma de abordarlo, permiti un control ms rpido y duradero sobre los
sntomas.
En la actualidad se esta en la fase de seguimiento.

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Alcances de las Terapias de Tercera generacin en el padecimiento de la


Esquizofrenia. (Mtro. Hernn Garca Cortes)
Existe en la actualidad una polmica de si las llamadas terapias de tercera generacin estn
logrando obtener resultados importantes en padecimientos como la Esquizofrenia o solo son
una moda.
El presente trabajo presenta los resultados preliminares de un ao de investigacin de los
alcances que se reportan de estas propuestas de terapias aplicadas a la Esquizofrenia.
Estos reportes de investigacin se han sometido a un metanlisis para conocer si realmente
son confiables y tienen valides metodolgica, por lo que se descartaron los reportes de caso
nico.
Los resultados preliminares del metanlisis reportan hasta el momento pocos logros en la
mejora de los sntomas de la Esquizofrenia, adems de que en varios se encontr una falta
importante de sustento metodolgico pues en las investigaciones se encuentran varios reportes
de caso nico sin poder ser contrastados entre si ni con otros tratamientos.
Se esta realizando an la ultima parte de la investigacin, pero se espera que la tendencia de
los actuales resultados contine, as mismo se desarrollar una parte de seguimiento a 6
meses para observar permanencia en los resultados.
El estado del Arte en Tcnicas Cognitivas para la Esquizofrenia. (Psic. Elizabeth Calzada
Snchez)
En donde nos encontramos en las terapias Cognitivo Conductuales en el tratamiento para la
Esquizofrenia?, se han propuesto o desarrollado nuevas tcnicas? Que avances se han
obtenido?, Cuantas investigaciones han logrado obtener un buen resultado a la luz de un meta
anlisis, cuales son las tcnicas ms aplicadas en la actualidad y realmente son ms cognitivas
o conductuales?.
Estas son las preguntas que se intentan contestar en esta exposicin como resultado de una
investigacin que se realiza en la actualidad tomando como muestra reportes en internet,
publicaciones, encuestas entre psiclogos y psiquiatras que se dedican a al planteamiento
cognitivo conductual en los ltimos 8 meses.
Todo esto para conocer los avances reales en tcnicas psicoteraputicas para este tipo de
trastorno y saber si lo que se propone en la actualidad realmente logra marcar una diferencia
entre lo que se hacia y lo que se hace.
An falta por integrar informacin de meta anlisis de investigaciones, pero parece que la
tendencia hacia nuevas tcnicas y sus resultados favorables es lenta debido al escaso rigor
metodolgico de muchas investigaciones, a la poca replica de las mismas y a la poca
publicacin que se hace al respecto, por lo que se continuara el anlisis en los 10 meses
restantes de la investigacin para ver si esta tendencia se mantiene.
El Estado del Arte en tratamientos para Esquizofrenia (Psic. Amor de Maria Hernndez)
Existen varias propuestas de tratamiento desde el enfoque cognitivo conductual para
Esquizofrenia, pero cuantas de ella realmente orecen resultados comprobados a travs de
investigacio0nes que pueden superar un meta anlisis.
Se presentarn los primeros resultados de la investigacin sobre tratamientos cognitivo
conductuales y sus resultados analizados desde un meta anlisis en la cuestin de
investigacin.
Los resultados preliminares arrojan que pocos son los estudios que pueden pasar esta
validacin metodolgica, pues la mayora de las investigaciones son estudios de casos o con
poco numero de muestras, lo que no permite realmente presumir que sus resultados sean
estadsticamente validados o se puedan ampliar a otras poblaciones mas all de las
originalmente estudiadas.

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Se realiz la bsqueda a partir de los artculos publicados analizando los resultados que
mencionan tener y la metodologa que emplean, a travs de los motores de bsqueda:
Se contina en la bsqueda de ms investigaciones y en anlisis de los ltimos resultados.
PSICOTERAPIA COGNITIVA EN ESQUIZOFRENIA: APLICACIONES CLINICAS EN
PACIENTES INSTITUCIONALIZADOS
Guillermo Jemar.
Hospital Jose T. Borda, CABA, Argentina.
OBJETIVOS:Proponer un marco terico, con bases y fundamentos, a cerca de la aplicacin y
resultados de la teora cognitiva en Esquizofrenia a partir de la observacin y aplicacion clnica
de pacientes internados en un hospital monovalente neuropsiquitrico. MATERIAL Y
METODOS: Se propone un marco terico, con bases y fundamentos, a cerca de la aplicacin y
resultados de la teora cognitiva en Esquizofrenia. Se describen casos clnicos de pacientes en
tratamiento, su estado al comienzo, durante y despus de un tiempo del mismo, valorando la
evolucin y resultados. Se valora a la teora cognitiva como una alternativa terapeutica til en
este tipo de Procesos, por ser una herramienta de organizacin del pensamiento y de conducta
en los individuos que los padecen. DESARROLLO: La esquizofrenia es un conjunto de
alteraciones mentales que se caracterizan por la prdida de continuidad de las asociaciones,
de la afectividad,de la atencin y de la voluntad, ambivalencia y autismo. La teora cognitiva
explica las respuestas emocionales y de conducta como producto de los pensamientos, las
interpretaciones y las creencias. Se aborda segn este modelo a pacientes internados en un
Hospital Monovalente Neuropsiquitrico , considerando todos aquellos factores que inciden en
su evolucin (medio ambiente, tratamientos concomitantes, posibilidades de inclusin social).
Algunos pacientes mejoran buena parte de su capacidad de trato interpersonal, y logran
mantener ciertas actividades laborales. Durante el curso de la observacin, en mas de una
crisis aguda de sintomatolgica, consiguen calmar su angustia y adaptar su conducta
comprendiendo que sus creencias y manifestaciones sensoperceptivas sonproducto de sus
alteraciones sensoperceptivas,y pueden cuestionarse su percepcin distorsiva con respecto a
la realidad. CONCLUSIONES: La teora cognitiva es un modelo aplicable a la Esquizofrenia, en
alguno de sus sntomas y estadios, puesto que se logra un mayor conocimiento y organizacin
de los pensamientos y sistema de creencias.
Therapist Factors and Therapeutic Alliance in Cognitive Behavioral Therapy for
Psychosis
Esther Jung1, Martin Wiesjahn1, Tania Lincoln2.
1. Philipps Universitt Marburg, Marburg, Germany, 2. Universitt Hamburg, Hamburg,
Germany.
Abstract Central: Background: The strength of therapeutic alliance (TA) is consistently
associated with therapy outcome, regardless of treatment orientation or alliance measure.
Among patients with schizophrenia, the strength of TA has been shown to be associated with
better treatment adherence, higher symptom reduction, improved global and social functioning,
higher levels of quality of life, and better performance in rehabilitation. Given the consistent
association between TA and therapy outcome, it is important to identify factors which influence
or predict the development of TA. Different patient characteristics, e.g. the level of positive and
negative symptoms, and social functioning, have been shown to be associated with TA.
However, therapist factors might be influencing the formation of TA as well. Therapist personal
attributes, e.g. being warm, respectful and trustworthy, and therapist experience, have been
shown to be positively associated with TA. So far, the relationship between therapist

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characteristics and TA has not been analyzed in patients with schizophrenia. The aim of this
study was to identify relevant therapist factors as predictors for therapeutic alliance in cognitive
behavioral therapy for psychosis. We chose to examine therapist empathy, genuineness, and
unconditional positive regard towards the patient, which have been postulated as essential for
building a good relationship and foster therapeutic change by Rogers (1957). Further, we aimed
to analyze therapist expertise/competence and convincingness as possible predictors for TA.
Method: The sample consists of 56 patients with schizophrenia spectrum disorders participating
in a trial on mechanisms of change in CBT for psychosis at the outpatient clinic of Marburg.
Forty-four of the participants were taking antipsychotic medication, 40 % were female. Patients
were treated with individualized CBTp according to a published manual by eleven therapists
who had received training in CBTp interventions. The number of patients treated by each
therapist varied from one to twelve. All therapists were still in clinical training and conducted
therapy under intensive supervision. We plan to analyze bivariate correlations between therapist
characteristics at baseline and TA at session five and conduct regression analysis to analyze
the amount of variance each therapist factor explains in TA. Therapeutic alliance is assessed by
patients and therapists using the Helping Alliance Questionnaire (HAQ). Therapist factors are
rated by patients using the subscales empathy, genuineness, and positive regard of the Bonner
Fragebogen fr Threapie und Beratung (BFTB) [Bonner Questionnaire for Therapy and
Counseling] and the subscales therapist competence and therapist convincingness of the
Fragebogen zur Erfassung relevanter Therapiebedingungen (FERT) [Questionnaire to Assess
Relevant Therapy Conditions]. Outlook: At present, the trial is still ongoing but completion is
expected by April 2013. Thus, results derived from the analysis of the full sample will be
presented. However, preliminary analysis on n=39 patients reveal significant associations
between baseline therapist factors and TA. The practical implications of the findings, e.g.
concerning the clinical training of therapists will be discussed.
The Development of a Specialised CBT for Early Psychosis: Translation to a User
Friendly Manual
Antony Kidman, Rachael Murrihy, Yael Perry, Anna Dedousis-Wallace@uts.edu.au, Danielle
Ellis, Megan Varlow.
Health Psychology Unit, University of Technology Sydney, Greenwich, NSW, Australia.
Abstract Central: There is ample evidence to suggest that psychosocial treatments are a
beneficial adjunct to medication for individuals with psychosis. Outcomes from studies
investigating the use of Cognitive Behavioural Therapy following a 1st episode of psychosis
have shown promising results. Despite this, CBT for early psychosis is not yet routinely
available as part of the standard clinical practice. The current pilot study aimed to evaluate the
feasibility and effectiveness of CBT for 1st episode psychosis in the community-based setting.
Relationships were developed with local community mental health teams, general practitioners
and psychiatrists to create a wide range of referral sources. Upon meeting eligibility criteria, 25
participants were offered up to 20 sessions of individual CBT, as well is additional booster
sessions. Clinical assessments of positive, negative and comorbid symptoms, as well is global
functioning were taken before therapy and after 6 and 12 sessions. Three-month follow-up
assessments were conducted where possible. Findings suggest that participants showed
improvements in psychotic symptoms, mood and global functioning. Additionally, the low
dropout rate and positive feedback from participants and referrers suggests that the service was
highly acceptable. A number of difficulties emerged with regards to establishing the service.
Once these were addressed, referrals increased and positive outcomes observed stop it was
concluded that CBT freely psychosis can yield positive outcomes when delivered as part of
mental health services across a variety of settings. Obstacles to service establishment and

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provision and issues pertaining to the translation of laboratory treatment protocols into realworld practice will be discussed. This manual is one of the publications that has emerged from
research project conducted by the staff of the health psychology unit into the use of CBT in the
treatment of psychosis. The use of psychotherapy in conjunction with pharmacotherapy for
psychosis has attracted increasing research interest of late. However, besides publishing results
in reputable journals, it is equally important to get the benefits of these studies to mental health
workers in the field. These include case managers, social workers, mental health nurses and
health professionals interested in this severely debilitating mental health disorder in clinics and
community health centres, especially those in isolated places. The concept of translation in
health research is frequently mentioned in the literature and that means getting the results of
useful, evidence-based research out to practitioners who are dealing in this case with patients
suffering from psychosis to improve outcomes and reduce relapse rates. This user friendly
manual does just that because it is carefully designed and written in understandable language
with tables, diagrams and handouts that will enable practitioners to engage in work more
effectively with their patients.
Group Cognitive Behavioral Therapy for Social Anxiety in First-Episode Psychosis: An
Uncontrolled Study
Martin Lepage1, 2, Tina Montreuil2, Ashok Malla1, 2, Kartrina Messina2, Ridha Joober1, 2, Claude
Belanger2, Gail Myhr1.
1. McGill University, Montreal, QC, Canada, 2. Douglas Institute, Verdun, QC, Canada.
Abstract Central: Social anxiety has received only scant attention so far in schizophrenia and
related psychoses but some data suggest it represents a significant obstacle to vocational and
functional outcome. Objective: This uncontrolled study investigated the efficacy of a novel
group-based cognitive behavioral therapy (CBT) aimed at reducing social anxiety in early
psychosis. Method: Twenty-nine patients with first-episode psychosis or at increased risk of
developing psychosis and comorbid social anxiety attended a group-based cognitive behavior
(CBGT) intervention. The CGBT was provided weekly for 14 weeks in 1.5-hour sessions.
Baseline, post-treatment and follow-up ratings of social anxiety were measured using: the Social
Interaction Anxiety Scale, the Social Phobia Inventory, and the Brief Social Phobia Scale.
Psychotic symptomatology and general psychopathology changes were also measured before
and after the intervention. Results: Participants significantly improved on all three outcome
measures of social anxiety after completing this intervention (all ps <.002). Similarly,
participants who completed treatment also showed a significant reduction on measures of
depression, negative symptoms and stigma. Conclusions: This brief manualized CBGT
intervention was demonstrated to be an effective treatment of social anxiety symptoms in FEP
in an uncontrolled pilot study and needs to be tested in a larger randomized controlled trial.
Social Relationships and Quality of Life Moderates Distress associated with Delusional
Ideation
Michelle Lim1, 3, John Gleeson2, 3, Henry Jackson3, Katya Fernandez1.
1. Washington University in St Louis, St Louis, MO, USA, 2. Australian Catholic University,
Melbourne, VIC, Australia, 3. The University of Melbourne, Melbourne, VIC, Australia.
Abstract Central: Individuals who followed a particular New Religious Movement (NRM)
reported significantly less distress even though they reported similar levels of delusional
ideation, conviction, and preoccupation when compared with individuals diagnosed with
psychotic disorders. Protective factors including social relationships and quality of life (QOL)

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were hypothesized to explain attenuated distress levels. NRM individuals (n = 29), individuals
diagnosed with psychotic disorders (n = 25), and control individuals (n = 63) were recruited.
Psychotic symptoms, delusion-proneness, and facets of social relationships and QOL were
measured. NRM participants reported significantly higher social relationship quality and higher
QOL than individuals with psychosis. More specifically, NRM participants reported more distinct
and less reciprocated supports, and significantly higher psychological QOL when compared with
control participants. Delusion-proneness was associated with higher distress levels, and this
relationship was moderated by social relationship quality and quality of life. Findings highlight
the importance of establishing social networks and quality of life for people who report
distressing delusional beliefs.
Who Stays, Who Benefits? Predicting Changes in Cognitive Behavioural Therapy of
Psychosis
Tania Lincoln1, Stephanie Mehl2, Stefan Westermann2, Winfried Rief2.
1. Psychology, University of Hamburg, Hamburg, Germany, 2. Philipps University Marburg,
Marburg, Germany.
Abstract Central: Objective: RCTs have attested the efficacy of CBT in reducing psychotic
symptoms. However, it is unclear which patients benefit from these interventions and why. In
order to further improve therapy and provide a basis for dissemination, knowledge of predictors
of change is relevant. Previous studies have identified some baseline predictors of change,
such as delusion conviction, duration of illness, and symptom severity and these results warrant
replication. Furthermore, the predictive value of medication compliance and neurocognitivevariables has not been investigated and predictors of dropout are under-researched. This article
presents the secondary analysis of dropout and completer data from a previously published
randomized controlled effectiveness study of CBT for psychosis (T.M. Lincoln et al., 2012).
Method: Eighty patients with DSM-IV schizophrenia spectrum disorders who were seeking
individualized outpatient treatment for psychosis were investigated with regard to predictors of
change. Relevant predictors were assessed at baseline and during treatment. Improvements in
symptoms and functioning were assessed at post-treatment and one-year follow-up. Results:
Baseline variables predicted 24% to 32% of the variation in change from pre- to post
assessment and 56% to 63% of the variance in change from pre- to one year follow-up. Most of
the findings from previous studies could be replicated: Longer duration of disorder and history of
hospitalization, younger age, higher symptom severity and lower baseline functioning were
predictive of less change. However, the predictive value of higher insight and better
neurocognitive functioning could not be corroborated. The novel predictors medication
adherence, comorbidity, and reasoning biases were associated with outcome, but did not
explain additional variance over and above the variance explained by previous predictors. Low
social functioning was the main predictor of drop-out during treatment. Conclusions: More
severely disordered patients who stay in therapy benefit from it. Low IQ, education and
neurocognitive dysfunctions pose no barrier to improvement during CBT. However, more efforts
need to be undertaken to understand why patients discontinue therapy.
Is There a Healthy Way of Responding to Paranoia? A Comparison of Reactions to
Paranoid Thoughts in Persons with Psychotic Disorders and Healthy Controls in
Germany and Chile
Tania Lincoln, Caroline Wsten, Laura Stendel, Caroline Mbius.
Psychology, University of Hamburg, Hamburg, Germany.

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Abstract Central: Although many people have paranoid thoughts at least occasionally, most do
not develop full-blown paranoia or psychosis. One reason for this could be that healthy persons
have a more functional way of responding to paranoid thoughts than patients with psychotic
disorders. We report on two recent studies comparing reactions to paranoid thoughts in patients
with psychotic disorders and healthy controls in Hamburg, Germany (n= 64) and in Santiago de
Chile, Chile (n=75). We hypothesized that patients will be characterized by higher levels of
dysfunctional responses to paranoid thoughts. Furthermore, we investigated whether lower selfreflectiveness is associated with more dysfunctional responses. All participants completed the
Paranoia Checklist and were asked to underline the paranoid thoughts that occur most
frequently. Responses to paranoid thoughts were then assessed with the Reactions to Paranoid
Thoughts Scale (RePT) that includes emotional distress, composed, communicative, believing,
devaluating, physical, positive-distracting, normalizing and concealing reactions. Selfreflectiveness was assessed by the Beck Cognitive Insight Scale (BCIS). In study 1 (Hamburg)
we found that the patients (n=30) responded to paranoid thoughts with more emotional distress,
and more pronounced physical responses than healthy controls (n=34). Furthermore, they
tended to devaluate the thoughts more and normalize them less. There were no differences
between the groups in the remaining RePT subscales. Cognitive self-reflectiveness in the BCIS
was associated with more normalizing but also with more emotional distress in response to
paranoid thoughts in the patient sample. In study 2 (Santiago de Chile) we also found that the
patients (n=36) responded to paranoid thoughts with more emotional distress (n=39) and more
pronounced physical responses than healthy controls. In addition, we found that the patients
tended to conceal their thoughts from others more frequently than the healthy controls.
Cognitive self-reflectiveness was associated with more normalizing and more communicative
responses in the patient sample. Overall, the results indicate that patients with psychotic
disorders tend to respond to paranoid thoughts in a less functional manner than healthy
controls. These differences seem to be generalizable to different settings and cultures and may
be partly responsible for the transition from non-clinical to clinical states. Higher levels of selfreflectiveness seem to facilitate the endorsement of certain functional responses. From a
therapeutic perspective, it might therefore be helpful to promote cognitive self-reflectiveness and
to support patients in developing more functional responses to paranoid thoughts, such as
sharing them with others, accepting them and normalizing them.
Integrated Neurocognitive Therapy (INT): Final Results of an International RCT including
a 1-year Follow-Up
Daniel Mueller1, Stefanie Schmidt1, 2, Volker Roder1.
1. University Hospital of Psychiatry, University of Bern, Bern, Switzerland, 2. University Hospital
of Child and Adolescent Psychiatry Bern, University of Bern, Bern, Switzerland.
Abstract Central: Objectives: Nowadays the treatment of cognition is one of the main topics in
the therapy of schizophrenia patients. The NIMH MATRICS initiative established a consensus
on separate neurocognitive and social cognitive domains that are relevant for the treatment of
schizophrenia. Therefore, we expanded the well evaluated and implemented Integrated Therapy
Program (IPT) and we developed the Integrated Neurocognitive Therapy (INT) designed for
schizophrenia outpatients. This new cognitive-behavioral group therapy approach covers all
cognitive MATRICS domains. INT is partly computer based and intends to restitute and
compensate neurocognitive and social cognitive (dys-) functions. This bottom up and top
down approach puts a strong focus on the patients daily life context to promote transfer and
generalization. INT additionally intends to facilitate intrinsic motivation and resources. Methods:
During the last 5 years, INT was evaluated in an international randomized multi-cite study in
Switzerland, Germany and Austria, which was supported by the Swiss National Science

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Foundation. INT was compared with treatment as usual (TAU). INT patients received 30 therapy
sessions twice a week, lasting 90 minutes each. A comprehensive assessment battery
comprising proximal and distal measures was applied before and after therapy and at a 1-year
follow-up. Expert ratings were administered blindly. Finally, 169 outpatients from 8 centers could
be included in the study. Results: INT patients obtained significantly stronger effects in proximal
outcome as composite scores in neurocognition and social cognition indicated it. In detail, the
superiority of INT reached significance level in speed of processing, attention, reasoning and
problem solving, emotion perception, and partly in attribution and schema. Effects could be
maintained at follow-up of one year. Additionally, INT patients showed significantly reduced
negative symptoms, increased social functioning and coping (distal outcome measures).
Furthermore, the improved motivation and insight into illness during therapy supports the
didactic strength of INT technology. Finally, the low drop-out rate of 10.3% of the INT patients
during the study represents a high acceptance by the patients. Conclusion: Results support
evidence that INT is an efficient, economic, easy to handle and well accepted new group
therapy approach for schizophrenia outpatients.
The Phenomenological Model of Psychotic Vulnerability: Possible Implications for
Psychological Interventions in the Clinical High Risk (Prodromal) Population
Barnaby Nelson1, Louis Sass2, Borut Skodlar3.
1. University of Melbourne, Melbourne, VIC, Australia, 2. Rutgers University, Piscataway, NJ,
USA, 3. University Psychiatric Hospital of Ljubljana, Ljubljana, Slovenia.
Abstract Central: The early intervention movement for treatment of schizophrenia and other
psychotic disorders has extended to include pharmacological and psychological treatment of
putatively prodromal (or ultra-high risk) patients. The psychotherapy that has been trialed to
date is cognitive-behaviour therapy, due to its apparent success with patients with established
psychotic disorder and its current popularity as a therapeutic modality. In this paper we present
phenomenological models of psychotic, particularly schizophrenic, vulnerability, which
emphasise a disturbed basic sense of self (ipseity) and intersubjectivity. We argue that these
phenomenological models indicate that cognitive-behaviour therapy may not be the most
suitable therapy for prodromal patients, and may even be counterproductive. A central element
of this argument is that cognitive-behaviour therapys emphasis on cognitive reflection and
challenging may encourage a core pathological process in these patients (hyper-reflexive
awareness). The paper explores alternatives for psychotherapy that emerge from
phenomenological accounts of psychosis, while recognising the paradoxical aspects of
psychotherapy with these patients. These alternatives include strategies that provide an
intersubjective space where patients can evolve a more robust pre-reflective self-awareness
(first-person perspective), second-person perspective and experience of trustworthy
relationships when encountering others; empathic attunement afforded by the
phenomenological approachs sensitivity to psychotic experience; and strategies that encourage
a form of immersion or absorption in present activity, including mindfulness and creative flow.
We also suggest the possible value in combining therapeutic modalities (even ones that may
seem contradictory) and of the need to empirically test therapeutic strategies other than CBT in
the ultra-high risk population.
Facial Emotion Perception Enhancement Training (FEPET) for Schizophrenia
Soohyun Park, Junghye Kwon.
Clinical and Counseling psychology, Korea University, Seoul, Republic of Korea.

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The purpose of this study was to develop a new training program (FEPET, Facial Emotion
Perception Enhancement Training) for remediation of facial affect recognition, which has been
demonstrated to be impaired in schizophrenia and affect patients poor social functioning. This
study aimed to evaluate whether FEPET is effective in improving emotion perception, social
cognition and social functioning of patients with schizophrenia. A total of 50 patients were
randomly assigned to either FEPET plus standard rehabilitation program or standard
rehabilitation program only (TAU). The FEPET, a manualized CBT program, was conducted
twice a week on a group basis for 6 week. This program was designed to improve facial emotion
recognition based on elemental, global, and contextual ways, using various types of material
(e.g., pictures, photos, video clips, cartoons) and activities (e.g.,education, game, role- play).
Both groups will be assessed at pre-test and post- test on measures of emotion perception,
social cognition, neurocognition, and functional outcomes to examine effectiveness of FEPET.
The study is currently in progress, and is scheduled to be completed on early march, 2013. The
ANCOVA analyses will be performed to examine the effect of FEPET. Also, it will be
investigated to what extent emotion perception ability is related to neurocognitive components
and social functioning of schizophrenia.
Can the Mind Change the Brain? Neural Changes Following Cognitive Behaviour Therapy
for Psychosis
Emmanuelle Peters, Veena Kumari, Elizabeth Kuipers.
Psychology, Institute of Psychiatry, King's College London, London, United Kingdom.
Abstract Central: A growing body of evidence demonstrates that persistent positive symptoms,
particularly delusions, can be improved by cognitive behaviour therapy for psychosis.
Heightened perception and processing of threat are believed to constitute the genesis of
delusions. The present study aimed to examine functional brain changes following cognitive
behaviour therapy for psychosis. The study involved 56 outpatients with one or more persistent
positive distressing symptoms of schizophrenia. Twenty-eight patients receiving cognitive
behaviour therapy for psychosis for 6-8 months in addition to their usual treatment were
matched with 28 patients receiving treatment as usual. Patients symptoms were assessed by a
rater blind to treatment group, and they underwent functional magnetic resonance imaging
during an affect processing task at baseline and end of treatment follow-up. The two groups
were comparable at baseline in terms of clinical and demographic parameters and neural and
behavioural responses to facial and control stimuli. The cognitive behaviour therapy for
psychosis with treatment-as-usual group (22 subjects) showed significant clinical improvement
compared with the treatment-as-usual group (16 subjects), which showed no change at followup. The cognitive behaviour therapy for psychosis with treatment-as-usual group, but not the
treatment-as-usual group, showed decreased activation of the inferior frontal, insula, thalamus,
putamen and occipital areas to fearful and angry expressions at treatment follow-up compared
with baseline. Reduction of functional magnetic resonance imaging response during angry
expressions correlated directly with symptom improvement. This study provides the first
evidence that cognitive behaviour therapy for psychosis attenuates brain responses to
threatening stimuli and suggests that cognitive behaviour therapy for psychosis may mediate
symptom reduction by promoting processing of threats in a less distressing way.
Asertividad, Afrontamiento y Malestar Psicolgico de Cuidadores de Personas con
Enfermedad Mental Grave
Gloria Roldn, Isabel Salazar, Manuela Ramrez, Elisa Guarnido, Encarnacin Carrillo, Laura
Garrido, Carmen Lpez, Mara Lpez, Diego Vico.

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Hospital Universitario Virgen de las Nieves, Granada, Spain.


Abstract Central: La presencia de malestar psicolgico en los familiares-cuidadores de
personas con alguna enfermedad mental grave tiene un amplio respaldo emprico. Parte de
estos problemas se relaciona con el alto nivel de perturbacin cognitivo, emocional y
conductual que caracteriza dichas enfermedades y que afectan de manera importante no slo
al individuo que lo padece sino a su entorno inmediato. No obstante, tambin se ha planteado
que el malestar tambin puede relacionarse con las caractersticas propias del familiar. El
objetivo de este trabajo fue explorar si las estrategias de afrontamiento y la asertividad del
familiar-cuidador estaban relacionadas con su malestar psicolgico (ansiedad, depresin,
estrs). Participaron 118 familiares-cuidadores de 82 pacientes con esquizofrenia, trastorno de
la personalidad o trastorno bipolar de las Unidades de Salud Mental del Hospital Universitario
Virgen de las Nieves de Granada (Espaa). Estos cuidadores tenan entre 19 y 79 aos (M=
55,1; DT= 12,6) y el 70,3% era mujer. Se utilizaron: el Inventario de ansiedad de Beck, el
Inventario de depresin de Beck II y la Escala de estrs percibido para evaluar el malestar
psicolgico, por una parte, y el Inventario de asertividad (Assertion Inventory, AI; Gambrill y
Richey, 1975) y el Inventario de estrategias de afrontamiento para evaluar las dos habilidades
psicolgicas, por otra parte. Se encontr que el 80,0% de los que tiene ansiedad no es asertivo
en comparacin con el 40,7% que si es asertivo (p= 0,012). La asertividad no se relacion
significativamente con la depresin ni el estrs percibido. En cuanto a las estrategias de
afrontamiento, se encontr que el 84,2% de los que presenta ansiedad utiliza poco/nada la
estrategia de solucin de problemas en comparacin con el 45,4% que si la usa (p= 0,004), el
89,5% de los que presenta depresin utiliza poco/nada la estrategia de solucin de problemas
en comparacin con el 46,4% que si la usa (p= 0,001), asimismo, el 65,4% de los que tiene
depresin utiliza la autocrtica frente al 43,8% que no la usa o lo hace poco (p= 0,033). Por otra
parte, el 24,2% de los que percibe estrs utiliza poco/nada la reestructuracin cognitiva frente
al 8,0% que si la usa (p= 0,041). Estos resultados parecen indicar que las estrategias de
afrontamiento tienen una mayor asociacin con los niveles de malestar de los familiares en
comparacin con la asertividad que slo se relacion con la ansiedad. Concretamente un uso
deficiente de dos estrategias orientadas al problema, como son la solucin de problemas y la
reestructuracin cognitiva, est ms relacionado con la presencia de problemas psicolgicos y
el uso excesivo de una estrategia orientada a la emocin, como lo es la autocrtica, se relaciona
con la depresin. En cualquier caso, estos resultados son discutibles a la luz de que el nmero
de personas evaluadas es pequeo y no pueden hacerse generalizaciones. *Este trabajo ha
sido posible por la subvencin concedida por el Servicio Andaluz de Salud (SAS111215).
Estrategias de Afrontamiento y la Valoracin de la Propia Salud en Cuidadores de
Pacientes con Trastorno Mental Grave
Gloria Roldn, Isabel Salazar, Encarnacin Carrillo, Elisa Guarnido, Manuela Ramrez, Laura
Garrido, Diego Vico, Mara Lpez, Carmen Lpez.
Hospital Universitario Virgen de las Nieves, Granada, Spain.
Abstract Central: Recibir el diagnstico de un trastorno mental grave (TMG) (p. ej., trastorno
psictico, trastorno de la personalidad, trastorno bipolar) suele causar un impacto en el
paciente y la familia. No obstante, no es poco frecuente que las personas ms cercanas del
entorno del paciente informen de varios meses/aos lidiando con los comportamientos
perturbadores de la enfermedad mental, que habrn afectado y enrarecido las interacciones
familiares, as como las rutinas y el desarrollo personal/profesional de cada uno de ellos. En
este tiempo cada uno habr ido perfilando sus estrategias de afrontamiento y habr visto cmo
se han afectado entre otras cuestiones, su propio estado de salud. El objetivo de este trabajo

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fue examinar la relacin entre las estrategias de afrontamiento y la salud percibida por 118
cuidadores de personas con TMG. De los evaluados, el 70,3% era mujer y la edad media era
de 55,1 aos (DT= 12,6). Los pacientes (n= 82) tenan un trastorno psictico (64,6%), de la
personalidad (33,0%), bipolar (1,2%) o un TMG sin especificar an (11,1%) y estaban siendo
atendidos en las Unidades de Salud Mental del Hospital Universitario Virgen de las Nieves de
Granada (Espaa). Se utilizaron el Inventario de estrategias de afrontamiento (Coping
Strategies Inventory, CSI; Tobin, Holroyd, Reynolds y Wigal, 1989) y el Cuestionario de salud
SF-36 (SF-36 Health Survey, SF-36; Ware, Snow, Kosinski y Gandek, 1993). Se encontr que
las estrategias de afrontamiento de mayor uso fueron el pensamiento desiderativo, el
aislamiento social y la solucin de problemas y las menos utilizadas fueron la reestructuracin
cognitiva, la autocrtica y la expresin emocional. Analizando las relaciones con las
dimensiones de salud evaluadas con el SF-36 se observ que aquellos que tenan un menor
aislamiento social tenan un mejor rol fsico, rol emocional e informaban menos dolor corporal;
los que utilizaban ms la solucin de problemas tenan un mejor rol fsico y mayor vitalidad; los
que utilizaban ms la reestructuracin cognitiva tenan una menor percepcin de dolor corporal,
mayor vitalidad y mejor rol emocional y los que utilizaban menos la autocrtica tenan mayor
vitalidad y mejor rol emocional, siendo todas estas relaciones significativas (p 0,05). No se
hallaron resultados importantes con el pensamiento desiderativo y la expresin emocional. Se
podra concluir que el uso de las estrategias orientadas a resolver las situaciones
problemticas/difciles son las que tienen un mejor impacto positivo en distintos aspectos de la
salud, mientras que las estrategias orientadas a la emocin no parecen tener un impacto
importante, con excepcin de la autocrtica que, segn los resultados, su menor uso favorece la
salud mental. Aunque estos resultados son interesantes, la investigacin tiene algunas
limitaciones a considerar como el tamao y forma de seleccin de la muestra. *Este trabajo ha
sido posible por la subvencin concedida por el Servicio Andaluz de Salud (referencia del
proyecto: SAS111215).
Educacin y Salud Fsica y Mental de los Familiares-Cuidadores de Pacientes con
Trastorno Mental Grave
Gloria Roldn, Isabel Salazar, Elisa Guarnido, Encarnacin Carrillo, Manuela Ramrez, Laura
Garrido, Mara Lpez, Diego Vico, Carmen Lpez.
Hospital Universitario Virgen de las Nieves, Granada, Spain.
Abstract Central: A la fecha no se tienen datos sobre la relacin entre el nivel de educacin y
la salud de los familiares-cuidadores de pacientes con trastorno mental grave (TMG) (p. ej.,
trastorno psictico, trastorno de la personalidad, trastorno bipolar). No obstante, Zahid y Ohaeri
(2010) que evaluaron la carga en 121 familiares cuidadores, que convivan con pacientes con
esquizofrenia, informaron que la carga estaba asociada con un menor nivel de educacin.
Estos antecedentes motivaron el anlisis entre el nivel de escolaridad y la percepcin que
tenan de su salud los familiares-cuidadores de pacientes con TMG. Fueron evaluados 118
cuidadores, entre 19 y 79 aos, de 82 pacientes con un diagnstico principal de algn TMG,
que estaban siendo atendidos en las Unidades de Salud Mental del Hospital Universitario
Virgen de las Nieves de Granada (Espaa). Los instrumentos utilizados fueron: el Inventario de
ansiedad de Beck (Beck Anxiety Inventory, BAI; Beck, Epstein, Brown y Steer, 1988), el
Inventario de depresin de Beck II (Beck Depression Inventory II, BDI-II; Beck, Steer y Brown,
1996) y el Cuestionario de salud SF-36 (SF-36 Health Survey, SF-36; Ware, Snow, Kosinski y
Gandek, 1993). Este ltimo evala ocho dimensiones que se agrupan en salud fsica
(funcionamiento fsico, rol fsico, dolor corporal, salud general) y salud mental (vitalidad,
funcionamiento social, rol emocional, salud mental). Se encontr que aquellos con menor nivel
de escolaridad tenan mayores niveles de ansiedad (BAI) y de depresin (BDI-II) y perciban

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poca salud mental (evaluada con el SF-36) que aquellos con ms escolaridad. Por otra parte,
quienes tenan un mayor nivel de escolaridad tenan un alto funcionamiento fsico, menor
percepcin de dolor corporal, mayor salud general, mejor rol fsico, mayor vitalidad y mejor rol
emocional (SF-36) que los de menos escolaridad, siendo todas estas relaciones significativas
(p 0,05). Estos resultados indican una asociacin significativa entre el nivel de educacin de
los cuidadores y sus problemas fsicos y mentales. Un nivel educativo mayor se asocia con una
percepcin positiva de salud fsica y mental, mientras que un nivel bajo/nulo de educacin se
relaciona con problemas afectivos y de ansiedad clnicamente importantes. Estos datos
parecen ir en la misma lnea de los obtenidos por Zahid y Ohaeri (2010), aunque en su caso, el
concepto de carga abarcaba ms cuestiones. *Este trabajo ha sido posible por la subvencin
concedida por el Servicio Andaluz de Salud (referencia del proyecto: SAS111215).
Efectos de Dos Programas Alternados de Entrenamiento en Habilidades Sociales Sobre
la Cognicin Social en Personas con Esquizofrenia
Anne-Rachel Schehr Buchs.
Pontificia Universidad Javeriana, Bogot, Colombia.
La esquizofrenia se define como un trastorno mental crnico grave, que incluye, como uno de
sus rasgos distintivos, el dficit en el funcionamiento social e interpersonal. Este dficit es
relativamente estable a lo largo del tiempo y constituye una fuente de estrs y juega un papel
mayor en las recadas y exacerbaciones sintomticas (Lieberman, 2005), impidiendo al 80% de
los pacientes seguir una vida laboral satisfactoria. En Amrica Latina se estima que hay ms de
6 millones de personas afectadas por este trastorno. Hoy en da, el tratamiento de la
esquizofrenia se basa fundamentalmente en dos tipos de actuacin: utilizacin de frmacos
antipsicticos y terapias psicosociales, en lo que se llama terapia combinada. Los tratamientos
psicosociales son las intervenciones familiares psicoeducativas, el entrenamiento en
habilidades sociales y los tratamientos cognitivo-conductuales, dirigidos tanto a los sntomas
positivos de la enfermedad como a las alteraciones de los procesos cognitivos. Dichas
intervenciones reducen las readmisiones hospitalarias, previenen las recadas, disminuyen los
sntomas, mejoran el funcionamiento social y ocupacional, aumentan la capacidad para
funcionar independientemente y proveen de soporte a los familiares y cuidadores (Corrigan,
1991). Sin embargo, si estas terapias de rehabilitacin producen efectos positivos, no sabemos
todava cmo funcionan o cuales son los vectores de cambio. Adems, an no se han
publicado muchos estudios que validan empricamente estos programas en el contexto
latinoamericano. El desafo yace en la identificacin de los componentes esenciales de las
habilidades sociales y la cognicin social. Recientemente, una nueva aproximacin terica, la
Teora de los Marcos Relacionales ha propuesto una conceptualizacin analtico-funcional tanto
de la conducta verbal como de la cognicin (Hayes, Barnes-Holmes, Roche, 2001). Esta
aproximacin plantea que los dficits en trminos de cognicin social se encuentran al nivel de
los procesos verbales bsicos (respuestas relacionales) y no en el conocimiento de las reglas.
Esta aproximacin se basa en la utilizacin de operantes relacionales bsicas que no son
contexto-especficos, y promueve el contacto y la sensibilidad a las contingencias. Por lo cual
permite una aproximacin generativa de la adquisicin de las habilidades sociales, que conlleva
ms potencial que las aproximaciones tradicionales basadas en el aprendizaje de reglas de
conducta social. Esta investigacin, pretende evaluar y comparar el efecto de dos tipos de
intervenciones teraputicas sobre la cognicin social de personas con esquizofrenia, la primera,
orientada al aprendizaje de reglas de conductas sociales (Bellack, 2004), la segunda, orientada
al desarrollo de respuestas relacionales basndose en el manejo de los marcos decticos
(McHugh, 2004), lo que permitir mejorar nuestra comprensin de la cognicin social en estas
personas. Se aplicar un diseo de grupo de tratamientos mltiples de corte transversal, con

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mediciones pre y post test y de seguimiento a 3 y 6 meses, que permite la comparacin de los
efectos del orden de aplicacin de ambos programas de intervencin.
Pathways to Functional Outcome in Schizophrenia: Social Cognition, Negative
Symptoms, and Functional Capacity as Mediator Variables
Stefanie Schmidt1, 2, Daniel Mueller2, Volker Roder2.
1. Stefanie Schmidt, University Hospital of Child and Adolescent Psychiatry Bern, University of
Bern, Bern, Switzerland, 2. University Hospital of Psychiatry Bern, University of Bern, Bern,
Switzerland.
Abstract Central: Background: Functional impairments are an essential diagnostic feature of
schizophrenia. They often persist after symptom remission and despite novel treatments for
schizophrenia patients. Our recent meta-analysis supports the relevance of social cognition,
negative symptoms and functional capacity as mediators between neurocognition and functional
recovery in schizophrenia. However, no study has assessed these variables at different
measurement points in order to infer the temporal order postulated by the mediator model.
Moreover, comparing resulting models of the treatment and control group could shed light on
potential change mechanisms. Methods: Data were collected in the context of an international
RCT evaluating the Integrated Neurocognitive Therapy (INT) in comparison to treatment as
usual (TAU). 169 outpatients with a diagnosis of schizophrenia according to DSM-IV-TR
participated in the study. The sample was analyzed separately for INT (n=86) and TAU group
(n=83). We adopted a longitudinal design with three measurement points (baseline:
neurocognition; after 3 months/after therapy: social cognition, negative symptoms and functional
capacity) and after 1 year (functional recovery). Based on prior research, path analysis was first
performed linking all variables in the model. Post hoc modifications were based on theory,
model fit statistics and the statistical significance of each path. Results: Social cognition,
negative symptoms and functional capacity served as mediators between neurocognition and
functional outcome in the INT group. All indirect paths were significant and resulted in a good
model fit. This mediator model could not be confirmed in the TAU group. Conclusions: The
results of this study provide further evidence for integrated treatments. Social cognition,
negative symptoms as well as functional capacity seem to be viable targets to optimize current
cognitive remediation therapy approaches.
A Novel Cognitive-Behavioral Group Therapy Approach for the Prevention of Psychosis
Stefanie Schmidt1, 2, Daniel Mueller2, Anastasia Theodoridou3, Frauke Schultze-Lutter1, Benno
Schimmelmann1, Volker Roder2.
1. University Hospital of Child and Adolescent Psychiatry Bern, University of Bern, Bern,
Switzerland, 2. University Hospital of Psychiatry Bern, University of Bern, Bern, Switzerland, 3.
University Hospital of Psychiatry Zurich, Zurich, Switzerland.
Abstract Central: Background: Impairments in neuro- and social cognitions as well as in social
skills are currently regarded as important determinants of functional outcome. They are already
present before the onset of psychosis and are predictive of the transition to psychosis.
Moreover, empirical findings and theoretical models postulate that people at risk of psychosis
exhibit difficulties in mastering developmental tasks (e.g., developing a sense of identity,
autonomy and social relationships) and have difficulties in processing information related to the
own person. Current integrated cognitive remediation therapy approaches have shown to be
effective in improving cognitive and psychosocial outcomes in schizophrenia patients. However,
in the context of early intervention they have to be adapted to the specific needs and

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developmental tasks of individuals at high risk of psychosis. Methods/Objectives: Against this


background we developed a novel group-therapy approach designed for early intervention in
psychosis. It aims at improving the key neuro- and social-cognitive domains combined with
interventions on self-referential processes and interpersonal skills. Special emphasis was put on
self-management abilities of the participants. We carried out a pilot study and administered an
assessment battery prior to and following the treatment to evaluate the feasibility and the
efficacy of the treatment. Results: Preliminary results suggest that this intervention is a feasible
and well accepted new group therapy approach for people at risk of psychosis. Additionally, we
report changes in cognitive functions, psychopathology and social functioning after therapy.
Factors Associated with Care Givers' Emotional Over-Involvement (EOI) in Long Term
Mental Health Difficulties
Bill Sellwood1, Kevin Bookfield2, Stephanie Keith3, James Reilly1.
1. Clinical Psychology, University of Liverpool, Liverpool, United Kingdom, 2. Five Boroughs
NHS Trust, Wigan, United Kingdom, 3. Cheshire and Wirral NHS Trust, Chester, United
Kingdom.
Abstract Central: Expressed emotion (EE) predicts outcome for a variety of mental health
difficulties. One component, emotional over-involvement (EOI), has received little attention in
terms of contributory and maintenance factors. Two studies are presented investigating
associations between EOI and guilt-proneness, shame-proneness and emotional empathy
exhibited by caregivers of those experiencing mental health problems. In Study 1, fifty-eight
caregivers completed questionnaires evaluating EOI, shame proneness, guilt proneness and
emotional empathy. Significant correlations were detected between shame-proneness and EOI
but not with the other variables studied. For theoretical reasons it was thought that the measure
of guilt used may have been inadequate and in study 2 a new scale concerning care givers guilt
about mental health symptoms was developed and evaluated. Sixty Five caregivers completed
this new measure as well as those used in study 1. Shame and guilt about mental health
predicted EOI, whereas general guilt proneness did not. Clinical implications concerning shame
and guilt in the context of EOI are discussed. Directions for future research are outlined.
Expressed Emotion (EE) and the Escalation of Depressive Symptoms in Patients with
Recent-Onset Schizophrenia
Stephanie Triana1, Irwin Rosenfarb2, Keith Nuechterlein3, Nicholas Brietborde4, Sharon Foster2.
1. University of Texas Health Sciences Center, San Antonio, TX, USA, 2. Alliant International
University, San Diego, CA, USA, 3. University of California, Los Angeles, CA, USA, 4. University
of Arizona, Tucson, AZ, USA.
Abstract Central: This study examined the relationship among the factors that comprise
expressed emotion (EE; criticism, hostility, emotional overinvolvement, warmth, and positive
remarks) in relatives of 128 patients with recent-onset schizophrenia and determined whether
EE predicts the emergence of depressive symptoms over a one-year period in those patients.
Results indicated that emotional overinvolvement (EOI) correlated significantly with warmth
(r=.387, p<.05) and the correlation between EOI and warmth was significantly higher than the
correlation between EOI and criticism (z=2.65, p<.01) and EOI and hostility (z=2.91, p<.01).
Preliminary results also indicated that EE failed to predict the onset of depression in Anglo
patients. For Latino patients, however, a curvilinear relationship was found between EOI and
depression (quadratic EOI =6.28, p<.01); both high and low levels of EOI were associated with
depression onset. The results indicate that in a recent-onset sample, emotional overinvolvement

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may be indicative of a positive relationship between patients and relatives. The data also
suggest, replicating previous research, that for Latinos, moderate levels of EOI are associated
with positive outcome.
The Impact of a Culturally Informed, Family Focused, Therapy for Schizophrenia on
Patient Psychiatric Symptoms and Shame and Guilt in Schizophrenia Caregivers
Amy Weisman de Mamani1, Giulia Suro1, Kayla Gurak1, Michael Mejia2, Jessica Maura1, Marc
Weintraub1.
1. Universityof Miami, Coral Gables, FL, USA, 2. Psychology, Univeristy of Miami, Coral Gables,
FL, USA.
Abstract Central: In this talk we will discuss a family based, Culturally Informed Therapy for
Schizophrenia (CIT-S), and its impact on patient psychiatric symptoms and caregiver shame
and guilt. We will describe CIT-S, which includes the following 5 segments (family collectivism,
psycho-education, spirituality, communication training, and problem solving) and compare it
against a psycho-education only treatment as usual (TAU) condition. In former research we
established that CIT-S is effective in lowering patient psychiatric symptoms (presented at the
annual meeting of the American Psychological Association, 2012). In the current talk, we will
briefly review this data. However, this talk will focus more on recently analyzed data that
examined the impact of CIT-S on caregivers self-conscious emotions (shame and guilt). This is
important because prior research has indicated that shame proneness is associated with higher
levels of general emotional distress in caregivers (Weisman de Mamani, 2010). Furthermore in
a recent study, (Wasserman, Weisman de Mamani, & Suro, 2012), greater shame and guilt
about having a relative with schizophrenia were both linked with greater likelihood being
classified as high in expressed emotion. Expressed emotion is a measure of relatives criticism,
hostility and emotional over involvement towards schizophrenia patients, and is a very a robust
predictor of poor course of illness. Therefore, lowering caregiver shame and guilt is clearly
important and is a central aim of CIT-S. In the present study, we hypothesized that caregivers,
who received CIT-S, relative to those that received TAU, would demonstrate lower levels of both
shame and guilt at treatment termination. Our sample included 81 caregivers of patients with
schizophrenia (Confirmed by the SCID-DSM-IV) who completed either CIT-S or TAU. Shame
and guilt were assessed using the Self-Directed Emotions for Schizophrenia Scale. As
hypothesized, an ANCOVA controlling for ratings of guilt at baseline indicated a significant
pattern for participants who received CIT-S (M = 1.59, SD=1.93), compared to those who
received TAU (M= 4.19, SD=2.43), to demonstrate lower levels of guilt at termination F= 4.42, p
< .05 Similarly, an ANCOVA controlling for shame at baseline demonstrated lower levels of
shame for participants who received CIT-S (M= 1.92, SD=1.42) compared those who received
TAU (M=5.48, SD=1.96) upon treatment termination F = 4.13, p < .05. Results of our study
indicate that our recently developed family-focused and culturally-tailored treatment approach
may help to assuage the self-conscious emotions experienced by many caregivers of patients
with schizophrenia. Further study implications will be discussed. References Weisman de
Mamani, A. (2010). Self-conscious emotions, general emotional distress, and expressed
emotion in family members of patients with schizophrenia. Journal of Nervous and Mental
Disease, 198, 305-308. Wasserman, S., Weisman de Mamani, A., & Suro, G. (2012). Shame
and guilt/self-blame as predictors of expressed emotion in family members of patients with
schizophrenia. Psychiatry Research, 196, 27-31.
Testing Crows Hypothesis: A Comparison of Positive and Negative Symptoms in Anglo,
Latino, and African-American Patients with Schizophrenia

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Amy Weisman de Mamani, Tiffany Caldas, Michael Mejia.


Psychology, Univeristy of Miami, Coral Gables, FL, USA.
Prior research has indicated that there are ethnic differences in the incidence of schizophrenia
with African Americans demonstrating a higher occurrence than other ethnic groups (e.g.,
Fearon et al. 2006). However, little is known about how schizophrenia symptoms vary by
ethnicity. There are two main classes of schizophrenia symptoms: positive (e.g., hallucinations
and delusions) and negative (e.g., flat affect and poverty of speech). Approximately three
decades ago, Crow (1980, 1985) proposed that negative symptoms indicate irreversible
structural brain abnormality and therefore, unlike positive symptoms, may be less responsive to
environmental factors. If Crows theory is correct, this may lead us to hypothesize that
environmental factors associated with culture and ethnicity may have more of an impact on the
expression of positive, compared to negative, symptoms. We aimed to test this hypothesis in
the current study. Specifically, based on Crows theory, we used Analyses of Variance
(ANOVAs) to test the hypothesis that positive, but not negative, symptom severity would vary
among ethnic groups. As a secondary study aim, we used Tukeys post hoc tests to pinpoint
where differences occurred. Our sample consisted of 47 patients (16 Anglo, 17 Latino, and 14
African-American) diagnosed with schizophrenia. Symptom severity was measured using the
Brief Psychiatric Rating Scale (BPRS; Ventura et al., 1993). We used Guys (1976) criteria to
calculate composite positive and negative symptom scores. Following this criteria, a positive
symptom rating was obtained by summing across the items of conceptual disorder, grandiosity,
hallucinations, and unusual thought content. A negative symptom rating was obtained by
summing across the items of emotional withdrawal, motor retardation, blunted affect, and
disorientation. In line with Crows hypothesis, ANOVAs revealed ethnic differences in positive
F(2, 44) = 3.53; p < .05, but not negative, symptoms F(2, 44) = 1.35; p > .05. This appears to
support Crows hypothesis and suggests that efforts to target environmental and sociocultural
factors may be more effective in reducing positive than negative symptoms. With respect to
specific ethnic differences in severity of positive symptoms, African Americans displayed the
highest degree of symptom severity and Latinos displayed the lowest. However, Tukeys post
hoc tests revealed that the only ethnic difference to reach statistical significance was between
African Americans and Latinos. The high degree of positive symptom severity observed in
African Americans in the current study is in line with prior research (Fearon et al. 2006; Minsky
et al., 2003). Future research is needed to identify whether certain environmental factors (e.g., a
persistent struggle related to racism; James, 1994) may lead to a greater incidence of positive
symptoms in this population. Latinos demonstrated the lowest level of psychosis. Future
research is needed to assess whether certain protective factors observed in Latinos (e.g. low
levels of high expressed emotion in families, a known marker of poor prognosis for
schizophrenia; Weisman de Mamani et al. 2007), may account for this pattern as well.
Are Continuum Beliefs About Psychotic Symptoms Associated With Stereotypes About
Schizophrenia?
Martin Wiesjahn1, Alison Brabban2, Esther Jung1, Ulla Gebauer1, Tania Lincoln3.
1. Psychology, Philipps-Universitt Marburg, Marburg, Germany, 2. Mental Health Research
Centre, Durham University, Durham, United Kingdom, 3. Universitt Hamburg, Hamburg,
Germany.
Abstract Central: Contact to people with schizophrenia and causal beliefs about the disorder
have both been shown to correlate with stigmatization of those diagnosed with schizophrenia.
However, the associations are complex and heterogeneous. So far, the effects of antistigma
campaigns that have implemented personal contact have been limited and interventions

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promoting biological causal explanations have even increased stigmatization in some cases.
Possibly a more suitable strategy for antistigma interventions could be to incorporate continuum
beliefs, which propose that symptoms of schizophrenia lie on a continuum with normal
experiences. The present study considers the potential for interventions focused on continuum
beliefs by investigating the association between continuum beliefs and stigmatization. Within a
sample of 120 participants of an online study, higher levels of continuum beliefs (assessed with
the Continuum Beliefs Questionnaire, CBQ) were significantly correlated with lower stereotype
scores. This association remained significant after controlling for known correlates of
stereotypes (contact, causal beliefs, and educational level). We did not find an association
between continuum beliefs and social distance. It is concluded that the promotion of continuum
beliefs should be considered in the development of new antistigma campaigns.
Uma Proposta para Tratamento de Terapia Cognitivo-Comportamental de Grupo
Ambulatoiral para Pacientes com Esquizofrenia
Salmo Zugman1, Carmen Neufeld2.
1. UFPR, Curitiba, Brazil, 2. USP, Ribeiro Preto, Brazil.
A terapia cognitivo-comportamental para esquizofrenia (TCC-E) um tratamento baseado em
evidncias para esquizofrenia. Foi desenvolvida, para pacientes com resposta parcial ao uso
adequado de medicamentos, a partir dos modelos cognitivos gerais para depresso e
ansiedade. Ao invs do quadro global, a TCC-E foi conceitualizada em separado para os
diferentes domnios sintomatolgicos da esquizofrenia. Sua eficcia tambm diferenciada, a
TCC-E mostrou ser mais eficaz nos tratamentos dos sintomas positivos. Os dados de eficcia
da terapia cognitivo-comportamental de grupo (TCCG-E) para esquizofrenia so menos
consistentes, mas o suficiente para serem considerados promissores. A TCCG-E pode oferecer
vantagens sobre a abordagem individual. Primeiro, em locais onde a disponibilidade de pessoal
e tempo limitada, a interveno de grupo seria a mais vivel. Segundo, a TCCG-E pode ter
benefcios especficos. Os pacientes poderiam sentir-se menos isolados ao poderem
compartilhar suas dificuldades. O ambiente grupal favorece a modelagem de comportamentos
mais adequados e propicia mais oportunidades mtuas de reforamento. O objetivo do
presente trabalho identificar um modelo TCCG-E para ser adaptado lngua portuguesa,
para aplicao em pacientes ambulatoriais com esquizofrenia e delrios que no remitiram
completamente apesar do uso adequado da medicao antipsictica. Para tanto revisamos a
literatura em busca de artigos sobre protocolos de TCC-E. A busca no encontrou protocolos
que pudessem ser diretamente aplicados populao brasileira. O protocolo, baseado no
modelo cognitivo geral, considerado mais facilmente adaptvel foi o proposto por Roberts,
Pinkham e Penn (2006) para alucinaes auditivas. Na adaptao para delrios deste protocolo
foi mantido o formato de grupo fechado e intencionalmente pequeno de cinco a sete pacientes.
O grupo prev a participao de dois terapeutas e foi planejada a realizao de 12 sesses
estruturadas. Os autores sugerem a realizao de entrevistas individuais prvias para
homogeneizar o grupo em termos de funes cognitivas, fase da doena e motivao dos
pacientes. Tambm defendem a documentao da evoluo dos pacientes com testes
validados para o transtorno. A ordem de aplicao do protocolo foi mantida, alterando-se
apenas o contedo das sesses especificamente voltadas para as alucinaes. Por exemplo, o
mdulo de psicoeducao e normalizao dos delrios ao invs de utilizar um documentrio
sobre vozes, produzido pela BBC, utilizar exemplos de personagens histricos que foram mal
compreendidos em suas pocas. Devido as suas ideias terem sido demasiado avanadas. A
discusso sobre o contedo das vozes quando transposto para discusso de contedo dos
delrios baseou-se no modelo de continuidade entre os pensamentos normais e as ideia
delirantes, em termos de convico, preocupao e nvel de interferncia sobre as atividades

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normais. Espera-se que mais estudos possam ser realizados e com isso aumentar a base de
dados sobre a eficcia dessa abordagem de tratamento. Referncias Kingdon, D.G. Turkington,
D. (1991). The use of cognitive behavior therapy with a normalizing rationale in schizophrenia:
preliminary report. Journal of Nervous and Mental Disease, 179 (4), 207-211. Rector,N.R. Beck,
A.T. (2002). Cognitive therapy for schizophrenia: from conceptualization to intervention. The
Canadian Journal of Psychiatry, 47 (1), 41-50. Roberts, D.L. Pinkham, A.E; Penn, D.L. (2006)
Schizophrenia. In P.J. Bieling, R.E. McCabe e M.M. Antony (Org.), Cognitive-behavioral therapy
in groups. Ney York: The Guilford Press.
Sex, Couple & Marital Problems/ Problemas de la Sexualidad y de Pareja/ Problemas de
la Sexualidade y Relaes do Casal
Couples in Contact: A Cognitive-Behavioral Psycho-educational Program to Increase
Marital Satisfaction in Latino Couples
Maria Ampuero1, Maria Ampuero2.
1. Children's Center, Desert Moutain Children's Center, Apple Valley, CA, USA, 2. Walden
University, Minneapolis, MN, USA.
Abstract Central: A Cognitive-Behavioral Psycho-educational Program to Increase Marital
Satisfaction in Latino Couples Across different nations and cultures, marriage is considered a
legal union, and involves a committed relationship between two people with the purpose of
building a life together that will meet the needs of love, companionship, fidelity, belonging, and
emotional and sexual intimacy (Markham, Halford, &Lindahl, 2000). Marriage has many
dimensions or relational characteristics which are best understood by measuring what is known
as marital satisfaction (Markham et al., 2000). Over the past decades, there has been an
abundance of research conducted on marital satisfaction on different cultures and how it
benefits couples and their families. While there is a variety of educational programs for Latino
couples, based on the needs of this cultural group and presented in the Spanish language,
there is limited research of these programs with respect to the marital satisfaction in Latino
couples. This researcher did not find any resources examining the possibility of increasing the
perceived marital satisfaction in Latino couples. Also, they do not have enough culturally
relevant resources to enhance their relationships thereby increasing their satisfaction. The
purpose of this study is to determine whether or not a Cognitive-Behavioral psycho-educational
program developed to increase marital satisfaction is associated with reported increases in
marital satisfaction among Latino couples who are having challenges within their marriage. The
research findings from this study may potentially contribute to positive social change by
providing Latino couples with a program that will not only help enhance their marital relationship
and improve their quality of life, but also will reduce the rate of divorce and mental health issues
related with a poor marital relationship. The intervention consists of a 10 week sessions of 2
hours each, implemented among 30-50 Latino couples by this researcher using a psychoeducational program based on cognitive and behavioral therapies. It included two components:
an educative approach (general information and education), and cognitive- behavioral
techniques (i.e., communication training and problem solving) . The Marital Satisfaction
Inventory-R (Snyder, 1997) will be used for pre and post test.
Relacionamento Amoroso x Qualidade de Vida: Um Estudo com Universitrios em So
Lus - Ma sob a Perspectiva da Anlise do Comportamento
Yanne Azevedo, Carolina Reis, Daniela Ferreira, Milena Sarney Costa Maciel Moura.
Psicologia, Universidade Ceuma, So Lus, Brazil.

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A cultura ocidental moderna no s enfatiza a importncia do amor enquanto fonte de


satisfao e realizao, como dissemina ideias a respeito do que possa construir como um
objeto de amor. Os temas relacionados a amor, envolvendo escolha de parceiros e
relacionamentos afetivos, so tradicionalmente discutidos sob uma perspectiva internalista.
Geralmente se considera que escolha de um parceiro est relacionada ao sentimento do amor
ou da paixo, sentimentos que brotam do indivduo independente de sua vontade, de sua
histria de vida ou da cultura na qual est inserido. Assim, o amor costuma ser visto como um
sentimento autnomo, com vida prpria, muitas vezes responsvel por momentos de alegria e
prazer e outras por sofrimento, desiluso, tristeza e depresso. Diferente da viso internalista
das pesquisas feitas anteriormente, a Anlise do Comportamento prope uma viso
externalista do amor e dos relacionamentos amorosos, considerando aspectos relacionados a
este sentimento, tais como escolha do parceiro, regras sobre um relacionamento ideal, etc,
como resultantes de aspectos filogenticos, ontogenticos e culturais. Tarantino aponta a
relao existente entre relacionamento amoroso e qualidade de vida uma vez que, segundo
este autor, h uma maior incidncia de doenas orgnicas e mentais entre pessoas solteiras.
Afirma que a baixa autoestima, sentimento de solido, alterao no humor, depresso, cncer,
doenas cardiovasculares so sintomas mais frequentes em pessoas sem relacionamento
amoroso. A Anlise do Comportamento conceitua qualidade de vida de forma particular e
individual, apontando que o que pode ser considerada como uma vida com qualidade para uma
pessoa pode ser considerada como sem qualidade por outra pessoa. Beckert (2002) prope
que a ideia de qualidade de vida est em oposio da depresso. Buscando-se uma,
estaremos prevenindo a ocorrncia da outra. Diante destas e outras questes relacionadas ao
tema, este trabalho tem por objetivo investigar a respeito da relao entre qualidade de vida e
relacionamentos amorosos, sob a perspectiva da Anlise do Comportamento. Foram
entrevistadas 50 (cinquenta) universitrios de ambos os sexos que responderam a um
questionrio semiaberto sobre o tema. Dentre os resultados obtidos foi observado que pessoas
com relacionamento amoroso apresentaram maior ndice de consumo de bebidas alcolicas e
cigarros, diferente do que mostra a literatura. Por outro lado, entre as pessoas sem
relacionamento amoroso, 50% praticam atividades fsicas, o que pode estar relacionado ao o
fato de que 61,1% esto procura de um parceiro e que 72,2% deste consideram a beleza
como dos critrios de escolha. Em relao a problemas orgnicos, observa-se que na maioria
dos itens, a maior parte dos entrevistados sem relacionamento amoroso, apresenta menos
problemas de sade do que aqueles com relacionamento amoroso, apesar destes ltimos, na
maioria das vezes, considerarem estar se relacionando afetivamente como algo positivo. Diante
disso, pode-se concluir que ter um relacionamento amoroso no critrio para a no existncia
de problemas de sade e no implica, necessariamente, em ter qualidade de vida,
considerando a noo de qualidade de vida como proposta por Beckert.
Sex and Emotions: Insight in the emotions underpinning sexual pain
Charmaine Borg2, Moniek ter Kuile1, Stephanie Both1, Peter de Jong2, Charmaine Borg2, Ellen
Laan3, Philomeen Weijenborg1, Willibrord Weijmar-schultz4, Charmaine Borg2, Peter de Jong2,
Moniek ter Kuile1, Mark van Overveld5, Jacques J.D.M van Lankveld7, Reinhilde J. Melles6,
Charlotte C. Tuijnman-Raasveld1, Ellen de Groot1.
1. Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Centre,
Leiden, Netherlands, 2. University of Groningen, Department of Clinical Psychology, Groningen,
Netherlands, 3. Department of Sexology and Psychosomatic Obstetrics and Gynaecology,
Academic Medical Centre,, Amsterdam,, Netherlands, 4. Department of Gynaecology and
Obstetrics, University Medical Centre Groningen (UMCG),, Groningen, Netherlands, 5. Erasmus
University Rotterdam, Rotterdam School of Management,, Rotterdam,, Netherlands, 6.

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Maastricht University Medical Center, Department of Psychology, Center of Sexology,


Maastricht, Netherlands, 7. Open Universiteit, Heerlen, Psychology Department, Heerlen,
Netherlands.
In the current DSM version (DSM-IV-TR) under the umbrella of sexual pain disorders lays
vaginismus and dyspareunia. Vaginismus is commonly described as a persistent difficulty to
allow entry of a penis, a finger and/or object, despite the womens wish to do so. There is a
variable involuntary pelvic muscle contraction, (phobic) avoidance and
anticipation/fear/experience of pain. Dyspareunia is concisely defined as recurrent or persistent
pain during sexual activities with attempts or successful completion of penile-vaginal
intercourse. For the last decade accentuation is put on its psychological component with general
focus on the role of negative emotional reactions towards sexual stimuli. Numerous studies
frame complaints related to vaginismus as a specific penetration phobia with focus on the
emotion of fear of catastrophe and fear of pain. That said, increasing evidence indicates that
disgust is also a prominent candidate here which could be the driving force of the expressed
fear. Similarly in dyspareunia there is evidence suggesting that the persistent or recurrent
genital pain generally reported by women inflicted with this disorder is also related to negative
emotional responding. In this symposium we shall discuss psychophysiological data that
investigated the negative emotions in both clinical groups as compared to controls.
The 1st speaker Peter de Jong will set the ball rolling by discussing a series of four studies
conducted with patients inflicted with vaginismus and dyspareunia. Recently it has been
suggested that vaginismus might be considered as a specific penetration phobia. Thus one
would expect that the symptoms associated with vaginismus reflect fear-induced defensive
responses. Accordingly, during his presentation Peter de Jong will argue that this fear of
penetration may at least partly be fuelled by disgust-related preoccupations. In this presentation
data about the disgust physiological response towards sexual stimulation will be discussed,
together with data about disgust individual traits such as disgust propensity trait could perhaps
increase the vulnerability for this disorder. He will conclude this presentation with discussing the
potential implications for the treatment of women with lifelong vaginismus.
The 2nd speaker, Moniek ter Kuile, will keep in line with the negative emotions underlying the
fear response and avoidance behaviour that are commonly associated with vaginismus. From a
cognitive behavioural stance, exposure treatment aimed at reducing avoidance behavior, and at
increasing sexual-penetration behavior, should help to disconfirm these fearful penetration
beliefs. During this presentation Moniek will present data whether the effect of exposure therapy
was mediated by catastrophic penetration beliefs, which exposure explicitly aims to alter and
whether treatment effect was moderated by pre-treatment levels of sexual disgust.
The 3rd speaker Charmaine Borg will discuss another path that could explain the negative
emotional responding in vaginismus and dyspareunia. She will explain how strong adherence to
conservative values and/or relatively strict sex-related moral standards could restrict the sexual
repertoire and thereby lower the threshold for experiencing negative emotions, which may
generate avoidance behaviour - that are consistently associated with the core symptoms
experienced by women with vaginismus.
The 4th and final speaker Stephanie Both will depart from vaginismus and redirect attention
towards women with dyspareunia (a disorder from the same diagnostic category of sexual pain
disorders). There is some evidence to suggest that the persistent or recurrent genital pain
associated with sexual intercourse in dyspareunia is related to fear- reflected in the pelvic floor
muscle hyperactivity and diminished sexual arousal. Stephanie will introduce a newly developed
device that was used to measure pelvic floor muscle activity and sexual arousal in response to
sexual and threatening stimuli in women with superficial dyspareunia.
After the speakers tie together the findings presented from both theoretical as well as from a
clinical perspective they will stimulate the floor for a discussion.

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Disgust and Fear of Sexual Intercourse


Vaginismus is characterized by persistent difficulties to allow vaginal entry of a penis, a finger,
or an object, despite the womans expressed wish to do so by. It may result in considerable
emotional distress and often takes a chronic course. Over the last decades, many psychological
treatments for lifelong vaginismus have been developed. However, research to provide an
empirical basis for vaginismus-specific treatments, is still lagging behind. Recently, it has been
suggested that vaginismus might be considered as a specific phobia (of penetration).
Accordingly, the vaginistic symptoms would reflect fear-induced defensive responses. On the
basis of 4 subsequent studies in this presentation it will be argued that this fear of penetration
may at least partly be fuelled by disgust-related preoccupations. Study 1 showed that women
suffering from vaginismus (n =24) display higher levels of disgust propensity than women with
dyspareunia (n =24) or women without sexual complaints (n = 24). Study 2 showed that erotic
materials displaying sexual intercourse elicited physiological disgust responses (as indexed by
facial EMG) in women with vaginismus (n = 26) but not in matched controls (n =26). As a
conceptual replication, study 3 showed that patients with vaginismus (n=39) also reported
stronger sexual disgust as indexed by the Sexual Disgust Questionnaire (SDQ) than matched
controls (n=39), whereas such enhanced sexual disgust was absent in women suffering from
dyspareunia (n=45), or in men with erectile disorder (n=28). The therapeutical implications of
these findings will be discussed.
Therapist-aided exposure for women with lifelong Vaginismus: Does fear or disgust
mediates or moderates treatment outcome? Process and prognostic factors
Introduction: Vaginismus is commonly described as a persistent difficulty in allowing vaginal
entry of a penis or other object. Lifelong vaginismus occurs when a woman has never been able
to have intercourse. Fear and avoidance behavior are considered to be key factors in
vaginismus. From a cognitive-behavioural point of view, it is hypothesized that maladaptive
catastrophic beliefs regarding vaginal penetration underlay the fear response and avoidance
behavior in women with vaginismus. By reducing avoidance behavior, and increasing successful
penetration behavior, exposure therapy is considered to disconfirm these fearful penetration
beliefs. Very, recently, it has been suggested that disgust propensity (i.e. the tendency to
response with disgust to any given stimulus) may be a likely candidate to vaginistic complaints
in addition to fear related catastrophic beliefs regarding vaginal penetration. Aim: The present
study investigated whether the effect of exposure therapy was mediated by catastrophic
penetration beliefs, which exposure explicitly aims to alter and whether treatment effect was
moderated by pre-treatment levels of sexual disgust. Method: Seventy women with lifelong
vaginismus were ad random allocated to exposure or a waiting-list control period of 3 months.
Exposure consisted of a maximum of tree, 2-hr sessions during one week at a university
hospital. Two follow-up sessions were scheduled over a 5-week period. Patients were
measured at baseline, post-treatment and 3 month follow-up. The main outcome measure
vaginistic complaints was assessed with the vaginismus subscale of the GRISS at pretreatment, at 6 and 12 weeks. Change scores in catastrophic penetrations beliefs (VPCQ
scales) between pre-treatment and 6 weeks were used to measure the mediating variables.
Pre-treatment Sexual Disgust scores (SDQ scales) were used to predict treatment outcome.
Outcome: The preliminary results of this study will be presented.
Vaginismus: Restricted General and Sex-Related Moral Standards
Relatively strong adherence to conservative values and/or relatively strict sex-related moral
standards logically restricts the sexual repertoire and will lower the threshold for experiencing
negative emotions in a sexual context. In turn, this may generate withdrawal and avoidance
behaviour, which is at the nucleus of vaginismus. We here aimed to examine whether indeed

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strong adherence to conservative morals and/or strict sexual standards may be involved in
vaginismus. We used the Schwartz Value Survey (SVS) to investigate the individuals value
pattern and the Sexual Disgust Questionnaire (SDQ) to index the willingness to perform certain
sexual activities as an indirect measure of sex-related moral standards. The SVS and SDQ
were completed by three groups: women diagnosed with vaginismus (N=24), a group of women
diagnosed with dyspareunia (N=24), and a healthy control group of women without sexual
complaints (N=32). This study showed that specifically, the vaginismus group had relatively low
scores on liberal values together with comparatively high scores on conservative values.
Additionally, the vaginismus group was more restricted in their readiness to perform particular
sex-related behaviors than the control group. The dyspareunia group, on both the SVS and the
SDQ, placed between the vaginismus and the control group, but not significantly different than
either of the groups. In conclusion one could say that the findings are consistent with the view
that low liberal and high conservative values, along with restricted sexual standards, are
involved in the development/maintenance of vaginismus.
Sex and fear: Genital arousal and pelvic floor activity in response to erotic and fear
stimuli in women with dyspareunia and healthy sexually functional controls
Dyspareunia in women, a persistent or recurrent genital pain associated with sexual intercourse,
is hypothesized to be related to fear associated pelvic floor muscle hyperactivity and diminished
sexual arousal. In the few psychophysiological studies that attended to the role of these
components the focus was on either pelvic floor muscle activity or sexual arousal. Recently, we
developed a new device that enables simultaneous assessment of genital response and pelvic
floor muscle activity, by combining vaginal photoplethysmography measuring vaginal pulse
amplitude (VPA), with measurement of pelvic floor muscle activity by EMG electrodes (Both,
van Lunsen, Weijenborg, & Laan, 2012). A study will be presented in which this new device was
used to measure pelvic floor muscle activity and sexual arousal in response to sexual and
threatening stimuli in women with superficial dyspareunia compared to healthy sexually
functional controls.
Applying the Cognitive Model in Case of Patient Anxiety Related to Sexual Compulsion
Joyce Britto.
Pratica Privada, Varzea Paulista, Brazil.
O caso clinico traz informaes relevantes a respeito do processo teraputico realizado em
paciente na abordagem da TC, que traz claramente sua eficcia no trato do transtorno do
indivduo, buscando o ajuste de suas cognies. A paciente do sexo feminino, de 30 (trinta)
anos, estagiria de psicologia, trabalha como estagiria em um hospital da regio em que
mora, casada h 10 (dez) anos, tem uma filha de quatro anos e hoje filha de pais
separados, no faz e em nenhum momento fez uso de medicaes, passou por uma avaliao
psicolgica h aproximadamente sete anos atrs, na abordagem Yunguiana e no teve xito na
adaptao, cessando o processo teraputico. Ela trouxe como queixa principal um problema
conjugal relatando ter cometido adultrio por diversas vezes, tornando a situao fora de seu
controle classificando como hiptese teraputica um possvel esquema de vulnerabilidade.
Suas queixas secundrias foram no gostar de ser contrariada quanto as suas atitudes ou
opinies, querendo tudo a seu modo, tornando basicamente clara a hiptese teraputica o
esquema de perfeccionismo. O intuito principal da procura por terapia, est relacionado ao fator
de no conseguir se livrar do desejo de ter relao sexual com outros homens, trazendo a
questo do gostar muito do esposo e querer ter uma famlia estabilizada, como almejou quando
se casou. Ela foi atendida em 19 (dezenove) encontros de 50 minutos. Seus escores iniciais
foram: BAI 9 BDI 13 e BHS 6, tendo oscilaes durante o processo teraputico, com elevao
dos escores quando relatada as reas de maior impacto para paciente e em situaes vividas

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no cotidiano com relao ao relacionamento conjugal, tendo queda significativa quanto aplicado
corretamente o modelo cognitivo, terminando com os escores BAI 2 BDI 3 e BHS 2. De
maneira geral, a TC acrescenta em muito o processo teraputico de um paciente em constante
sofrimento emocional. Ela teve grande modificao, uma vez que aprender a lidar com seus
pensamentos, tem trazido resultados imediatos da situao vivenciada no momento. no
entanto, tem alcanado resultados satisfatrios com relao a situaes que, em determinados
momentos, se deixava dominar pelos seus Pensamentos Negativos e no encontrava
respostas para um determinado momento de sua vida. Sua cognio mais constante era com
relao a rea conjugal trazendo o Pensamento Negativo Meu marido no me ama como
deveria, sentindo elevada tristeza e como fuga a busca por relao sexual com outros
homens, aps o processo teraputico e a aplicao do modelo o pensamento alternativo foi
Ele me ama da maneira especial dele flexibilizando sua cognio fazendo o desafio de
Pensamento e medindo a vantagem e desvantagem de manter ou no o pensamento negativo,
disfuncional.
Nuevas Estrategias Teraputicas para la Intervencin en Alteraciones de la Sexualidad
Compartida
Ren Caldern1, Juan Jose Moles2, Guillermo Rodriguez2, Ren Caldern1, Juan Jose Moles2,
Guillermo Rodriguez2.
1. Direccin General, Centro de Psicologa Cognitiva Comportamental CEPSICC, La Paz,
Bolivia, 2. Centro de Investigaciones Psiquitricas Psicolgicas y Sexolgicas de Venezuela,
Caracas, Venezuela.
Autores y Conferencistas:
Dr. Guillermo Rodriguez: Presidente Honorario del 7mo WCCBT, Presidente de ALAMOC,
Coordinador Acadmico del CIPPSV de Venezuela
Dr. Juan Jos Moles A: Past President de ALAMOC, Vicepresidente Honorario del 7mo
WCCBT, Director del CIPPSV de Venezuela.
Dr. Ren Caldern Jemio: Past President de ALAMOC, Director General del CEPSICC de
Bolivia , Profesor Emrito de la UMS
La sexualidad es un medio de comunicacin, expresin afectiva y relacionamiento en la
valoracin interpersonal. La mayor parte de los seres humanos viven y actan sin un
conocimiento real de su sexualidad y al de los dems, lo que produce un efecto negativo en
escalas significativas en la vida individual y social de la pareja. Actualmente las parejas han
generado confusin en cuanto a roles de funcionamiento, provocando competencia de poder,
conductas emocionales en la comunicacin, conflictos de autoridad en la dinmica familiar y
actividades extramaritales. Las creencias son factores cognitivos y afectivos que llevan a
ejercer una regulacin sobre los procesos de ejecucin sexual donde tambin intervienen loc
componentes emocionales como efecto de como la persona se percibe en relacin a su
sexualidad que en forma individual desarrolla en funcin de sus experiencias y vivencias
personales e interpersonales. En suma la sexualidad no responde a slo efectos qumicos o
fisiolgicos sino responde a factores de construccin cognitiva del autoconocimiento y
construccin de la representacin de la propia sexualidad, as esta misma es nica al igual que
la personalidad en su desarrollo y conducta. El Simposio tiene el objetivo de presentar de una
forma integrada tres grandes temas comunes y de alta frecuencia en la problemtica de la
sexualidad relacionados con las formas de construccin en si misma a partir de procesos del
aprendizaje que tienen que ver con la informacin, educacin, experiencias y orientacin que
se desarrollan a pesar de ser en el mundo un tema restringido en la educacin en general.. A
partir de la exposicin de los especialistas se desarrollar tambin dos problemas antagnico
que muestran los extremos de la problemtica tanto en las alteraciones de adicciones como en

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el rea de la apata o el deseo sexual disminuido. Presentando modelos terapeticos


actualizados y efectivos de abordaje sobre todo relacionados a los problemas frecuentes de la
pareja en la actualidad. El anlisis de las alteraciones que se presentan y sus posibles
intervenciones desde la Terapia Cognitivo Comportamental muestran la efectividad de las
mismas en cuanto a la restructuracin de los componentes cognitivos y su repercusin sobre
los factores de autovaloracin y el manejo emocional.
Influencia de las Creencias en el Desempeo Sexual
Autor y Conferencista: Dr. Guillermo Rodriguez
Un buen desempeo de la funcin sexual depende de factores de salud, por una parte, y de
factores emocionales y/o psicolgicos, por otra No hay discusin en que una persona sana o
sin manifestaciones de enfermedades limitantes en el ejercicio de la funcin sexual tiene un
mejor desempeo en la b+squeda de dar y recibir placer durante el ejercicio sexual. Pero, no
solo los factores inherentes a la salud fsica pueden ser significativos. El o los factores psicoemocionales, los nexos afectivos con quien lo hago y las creencias con respecto al desempeo
pueden influir de manera importante. Existen creencias en relacin al color de la piel, la
alimentacin, al tamao y forma de estructura del cuerpo que pueden ayudar o perturbar el
buen desempeo. En esta intervencin destacaremos tres creencias que influyen en la
operatividad de la funcin sexual: a) El tiempo de ejecucin b) El tamao de alguna parte del
cuerpo y c) La moral como parmetro de lo que se puede negar o permitir en las variantes a
implementar.
Las Adicciones Sexuales Como Comportamiento Autodestructivo.
Autor y Conferencista: Dr. Juan Jos Moles
Entenderemos por conducta autodestructiva toda accin deliberada, conscientemente o no, que
genera dao fsico y/o psicolgico de diversa magnitud hacia la persona que la est
produciendo. Resulta un poco extrao en un apartado referente a las conductas
autodestructivas hablar de algo fisiolgicamente tan natural como es la sexualidad, sin
embargo, quizs sea prioritario comenzar por diferenciar lo que se entiende por motivacin
sexual a adiccin sexual, esta ltima hace referencia a una accin compulsiva, vale decir, un
comportamiento ritualstico realizado ms all de su posible gratificacin, con el fin de solventar
un estado de intenso malestar emocional presente en el sujeto, a sabiendas por parte del
mismo de lo inadecuado de la accin, esforzndose sin xito por evitarla. Se desprende de
todo lo dicho que ante la ausencia de una motivacin sexual como tal, la fuente de
discriminacin se hace prcticamente inexistente por lo que no se tomarn las precauciones
necesarias en aspectos relativos ni a la persona ni a las condiciones de realizacin. El
desarrollo de la adiccin sexual, como el resto de las conductas autodestructivas, cumple un
proceso de aprendizaje el cual implica diversas etapas. Comenzando por actividades solitarias
como es el uso del Internet y la pornografa, la prostitucin y actividades sexuales
perturbadoras e incluso dainas para un tercero. Lo cierto es que esta conducta autodestructiva
genera sufrimiento en la persona, la adiccin es frustrante en cualquier etapa porque traspasa
la motivacin sexual. En el adicto sexual, como se dijo, el individuo se siente atrapado en un
ciclo interminable en donde la obsesin, la compulsin de bsqueda, la accin sexual y la
justificacin del hecho estn inmersas en la frustracin personal, la insatisfaccin, el conflicto
con personas cercanas (pareja, familia, amigos) y la imposibilidad de resolucin.
La Verdadera Realidad Sobre la Apata Sexual en la Pareja y Como Afrontarla
Autor y Conferencista: Dr. Ren Caldern Jemio.
La sexualidad es inherente al desarrollo humano y a los procesos del aprendizaje. Para las
personas puede ser fuente de placer, plenitud, goce, bienestar. Tambin puede ser una manera
de aceptarse a s mismo y a las otras personas. La repercusin de estas alteraciones en la

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sexualidad compartida producen diferentes trastornos, y entre los principales est la apata
sexual, como y esta relacionada con la ausencia de pasin o falta de deseo sexual. Tiene que
ver con los estmulos sexuales efectivos, tanto psicolgicos, como la presencia o pensamiento
del objeto afectivo, como fisiolgicos, como los abrazos, caricias o los besos, o una
combinacin de ambos. Las causas psicolgicas primordiales son los altos niveles de ansiedad
de origen diverso, como haber tenido una estricta educacin moral, experiencias previas no
satisfactorias, miedo a la intimidad, temores o estrs, o la existencia de sentimientos negativos
hacia uno mismo, como no sentirse atractivo o mantener una autovaloracin negativa. Otro
factor se refiere a la forma habitual que tiene una pareja de relacionarse y de saturar su
espacio de intimidad. La incomunicacin, el tedio y la indiferencia son causas comunes de la
apata sexual. El abordaje teraputico Cognitivo Comportamental contempla diversas
estrategias que intervienen principalmente en las estructuras del pensamiento en la afectividad
y en las emociones, ya que la sexualidad como expresin en la comunicacin de la pareja
viene a ser el espacio de la integralidad entre un equilibrio de valoracin y de un proyecto
comn que comparten los miembros de cada pareja. Los modelos teraputicos cognitivocomportamentales apuntan esencialmente a incrementar los niveles de satisfaccin y
retroalimentacin en la pareja, creando espacios de motivacin, erotismo, comunicacin e
interacciones reforzantes a partir de una conjuncin de actividades en objetivos y metas
comunes.
La Supervivencia de Ser Pareja en el Complejo mundo de Hoy
Ren Caldern1, Juan Jose Moles2, Guillermo Rodriguez2, Guillermo Rodriguez2, Juan Jose
Moles2, Ren Caldern1.
1. Centro de Psicologa Cognitiva Comportamental CEPSICC, La Paz, Bolivia, 2. Centro de
Investigaciones CIPPSV Psiquitricas Psicolgicas y Sexolgicas de Venezuela, Caracas,
Venezuela.
Autores y Conferencistas:
Dr. Guillermo Rodriguez: Presidente Honorario del 7mo WCCBT, Presidente de ALAMOC,
Coordinador Acadmico del CIPPSV de Venezuela
Dr. Juan Jos Moles A: Past President de ALAMOC, Vicepresidente Honorario del 7mo
WCCBT, Director del CIPPSV de Venezuela.
Dr. Ren Caldern Jemio: Past President de ALAMOC, Director General del CEPSICC de
Bolivia , Profesor Emrito de la UMSA
El objetivo de este simposio es el de analizar, evaluar y presentar formas de abordaje
teraputico a los problemas de la compleja temtica de ser pareja superviviente en el complejo
mundo de hoy en el que el entramado entorno lleno de exigencias y cambios promueve
muchas necesidades individuales y en mayor magnitud siendo pareja, en la construccin de
una familia como espacio donde no slo se debe mantener la armona y el equilibrio de la
convivencia sino mantener adems sentimientos vivos, cumpliendo compromisos y evitando la
saturacin de la relacin que provoca una serie de conflictos, En el Simposio partir de las tres
exposiciones se aborda temas que van desde las formas de seleccin de la pareja en las que
se caracteriza las diferencias y la compatibilidad que existe a partir de las vivencias
experiencias, formas de crianza, educacin y aprendizaje y que repercuten en un espacio en el
que se presentan diferencias que producen conflictos de la atraccin y rechazo. As mismo se
expondr la problemtica de la afectividad y del amor analizado desde un ngulo cientfico en
el espacio de la convivencia de la pareja cuya relacin en el tiempo va provocando deterioro en
un espacio de supervivencia de la rutina basada mas en deberes que en gratificaciones. Por
otro lado se expone una de las problemticas de mayor trascendencia en las parejas
disfuncionales de hoy y es la relacionada con los celos que llevan a alteraciones y deterioro de
la pareja desde los procesos simples de la confianza, afectividad, y comunicacin hasta las

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patologas mas complicadas que generan la violencia y la agresividad. Los modelos de Terapia
Cognitivo Comportamentales que se presentan y recomiendan forman parte de un modelo
general integral de intervencin que promueve no slo la superacin de los problemas a partir
de cambios de conductas y esquemas de pensamiento, a partir del mejoramiento en la prctica
de las relaciones interpersonales sino apuntando al manejo de una mejor inteligencia afectiva y
emocional que facilite y enriquezca el bienestar y la tan ansiada felicidad que es el objetivo
abstracto de las parejas y no se lleva a cabo sobre todo porque no se desarrollan habilidades
adecuadas de convivencia y de una verdadera funcionalidad de la pareja apuntando a un
proyecto comn de vida que tambin se constituye en uno de los dficits de las parejas en
general en el contexto siempre de mejorar la salud social .
Por que no tengo pareja?
Autor y Conferencista: D, Guillermo Rodriguez
Es comn or a las personas decir cuando desean encontrar una pareja que andan buscando a
alguien :Que sea como, Que piense como yo, Que nos gusten las mismas cosas, Que sea mi
alma gemela, Mi media naranja. Que sea mi clon, Mi otra mitad
Tales expresiones hacen pensar que la seleccin de su pareja ha de hacerse entre aquellas
personas que sean muy parecidas a sus gustos, intereses o preferencia, en las distintas
situaciones o realidades en donde interactan.
Nuestra carga gentica, nuestros procesos de socializacin, los progenitores y su cultura de
crianza y las realidades sociopolticas nos hacen distintos. Cada uno de nosotros tiene su
propia historia de vida en donde las realidades de situaciones vividas hacen que las
experiencias tengan una particular significacin para cada uno de nosotros.
Dentro del proceso de enamoramiento, llammoslo noviazgo o acercamiento amoroso, se debe
hablar sobre las conductas de agrado y desagrado que existen entre las dos. Toda pareja tiene
o pasa por situaciones de insatisfacciones que deben ser conocidas para poder enfrentarlas.
Las parejas eternamente felices y que no tienen o enfrentan incomodidades conductuales
porque nunca discutimos, estamos de acuerdo en todo o entre nosotros no hay ni un si ni
un no, son especmenes ajenos a la realidad emocional, afectiva y amorosa que vence
cualquier dificultad mientras exista eso que llamamos amor. Mientras yo sepa cules son tus
caractersticas positivas o negativas, mientras no las ignore, ni las sobredimensiones, estoy en
capacidad de tolerarlas y hacerlas soportables.
Hasta hace algn tiempo los orientadores y terapeutas trabajamos con las llamadas parejas
tradicionales conformadas por l y ella. Hoy en da hay una realidad a la cual no podemos
escapar, tambin hay parejas no tradicionales constituidas por l y l o ella y ella. Igualmente,
en estas parejas no tradicionales debe quedar establecido el PARA QU de la relacin. An
siendo homosexual (gays o lesbianas), existen diferencias significativas para enfrentar las
relaciones como cualquier pareja tradicional, manifiestan insatisfacciones que deben ser
manejadas inteligentemente.
La Pareja en su Laberinto del Amor
Autor y Conferencista: Dr. Juan Jose Moles A.
Es un hecho innegable la necesidad afectiva del ser humano as lo importante que para l
resulta la gratificacin ertica, el encuentro de la pareja ideal supone en teora la compensacin
de estos dos aspectos tan vitales para su vida emocional. No obstante lo anterior, llama la
atencin como en las ltimas dcadas, los ndices de matrimonios que terminan en
separaciones y divorcios se han incrementado de una manera alarmante, de un 10 a 12% de
finales de siglo XIX hasta el 50% Dar una respuesta al por qu de est crisis es algo realmente
complejo pues son diversos los aspectos que la originan, pero sin entrar en mayor detalle, vale
la pena comenzar diciendo que una relacin de pareja exitosa, o al menos estable, tiene mucho
que ver con el equilibrio existente entre los niveles emocionales que marcan la atraccin entre

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ellos y los niveles racionales que implican la compatibilidad de caracteres que permiten
complementar el proyecto de vida de cada uno en otro relativo a la pareja. Si bien la crisis de
pareja es una realidad, no podemos asumir una postura pesimista o escptica hacia la
importancia de lo que efectivamente representa la pareja en la vida de la mayora de las
personas. De acuerdo a Robert Sternberg la intimidad, la pasin y el compromiso parecieran
ser los tres ingredientes bsicos para preservar la llama de afectividad en la pareja. En muchos
casos ocurre que la pareja no sabe, o ha desmejorado las habilidades de como ser funcional,
generndose conflictos: no siempre las parejas estn en la disposicin o capacidad de poder
solucionar de una manera operativa, es entonces cuando se debe buscar cualquier formula
para confrontar bien lo que est ocurriendo y evaluar las alternativas de cambios, una ayuda
profesional pudiese ser el camino. La Terapia Cognitiva- Conductual ha resultado en la prctica
clnica de amplia utilidad para parejas en estado de insastisfaccin o perturbacin viven en
conflicto. En el principio de reciprocidad, el abordaje teraputico explora tanto las creencias
subyacentes a los comportamientos disfuncionales y los estados emocionales que acompaan.
Se trata en el aqu y el ahora, de intervenir los elementos inherentes a las situaciones de
conflicto a objeto de encontrar soluciones concretas.
Los Celos desde el lado Obscuro de la Pare
Auto y Conferencista:: Dr. Rene Calderon Jemio
Cuando las parejas se forman, esperan satisfacer una serie de necesidades emocionales para
su desarrollo personal y social. Si bien todos esperamos satisfacer este tipo de necesidades a
travs de una pareja, esto no siempre es asi y mucho menos se lo expresamos a nuestra
pareja. La formacin de nuestra afectividad proviene de donde venimos y como son y han sido
nuestras experiencias de vida; como han sido nuestras experiencias sexuales y sentimentales
con otras personas. El resultado es que muy pocas personas se conocen a si mismas y por lo
tanto es muy difcil encontrar parejas que realmente se conocen. Al inicio de cualquier relacin
de pareja, se definen, compromisos de amor, respeto, permanencia, fidelidad, sexualidad,
convivencia, as como otros aspectos que pueden ser los causantes de establecer una relacin
de pareja. Lo cual rompe con la creencia ms difundida, de que la pareja se une solo por amor
y para formar una familia. El problema se agudiza por que al formarse una pareja se espera
que la pareja forme una relacin estable y en cierto modo exclusiva, sobre todo en lo sexual y
lo amoroso. Al romperse la visin interna de la fidelidad, el efecto de los celos generalmente se
agudiza. La persona que se asume como engaada, reacciona de muy diversas maneras,
desde la depresin, hasta la violencia fsica o emocional contra la pareja. La terapia Cognitiva
Comportamental para el tratamiento de los celos tiene como objetivo modificar el
comportamiento sobre los pensamientos de engao que tiene la persona celosa. La
reestructuracin de las cogniciones resulta til para operar las distorsiones del pensamiento.
Para evaluar la eficacia de la intervencin, se utilizan principalmente, cuestionario de celos,
medida del grado de conviccin en la creencia, escalas subjetivas de ansiedad y estado de
nimo y resultados de registros y autorregistros de conductas de comprobacin y control de la
conducta de la pareja.
Deployment-Related Benefit Finding in Military Service Members and Their Partners:
Associations with Relationship Satisfaction Over Time
Sarah Campbell1, Elana Maurin2, Keith Renshaw1.
1. Psychology, George Mason University, Fairfax, VA, USA, 2. American School of Professional
Psychology at Argosy University, Arlington, VA, USA.
A great deal of research has focused on effects of combat deployments on service members
(SMs) in the context of the recent conflicts in Iraq and Afghanistan. Much of that work has
focused on posttraumatic stress symptoms (PTSS), some of which has included a focus on

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SMs relationships. PTSS are associated with poor relationship functioning (Taft et al., 2011),
and in turn, poor relationship functioning is associated with poorer prognosis for PTSS (e.g.,
Evans et al., 2009). Despite this growing body of knowledge, little research has focused on
factors that enhance relationship functioning in these couples. One such protective factor may
be benefit finding (BF), or the experience of positive changes in the context of a stressful
experience. BF has been shown to buffer the negative individual effects of a number of different
stressors (e.g. Davis et al., 1998), but little research has explored effects of BF on relationship
functioning in general. Also, we identified no research on partners deployment-related BF (i.e.,
the experience of positive individual or relationship changes after having experienced a
deployment). We examined these issues across two time points in 61 SMs deployed during the
Iraq/Afghanistan conflicts and their spouses/partners. SMs reported on PTSS at baseline, and
4-6 months later, SMs and partners reported on deployment-related BF and relationship
satisfaction. Primary aims were: (1) explore associations of BF with relationship satisfaction,
controlling for SMs PTSS; (2) explore whether BF moderated associations of SMs PTSS with
both partners relationship satisfaction; (3) explore whether SMs and partners BF interacted in
predicting both partners relationship satisfaction. We conducted dyadic path analyses with both
partners relationship satisfaction as outcome variables and SMs Time 1 PTSS, both partners
BF, and relevant interaction terms as predictor variables. The overarching model was an
excellent fit for the data, and SMs PTSS were negatively associated with both SMs (l=-.25) and
partners (l=-.31) relationship satisfaction. Aim 1: Neither SMs nor partners BF was significantly
associated with their own satisfaction, but partners BF was positively associated (l = .28) with
SMs satisfaction. Aim 2: SMs BF was not a significant moderator, but partners BF marginally
moderated (l=.18, p<.08) the association of SMs PTSS with partners satisfaction. Aim 3: The
interaction between SMs and partners BF was marginally significant in predicting both SMs
(l=-.19, p<.10) and partners (l=-.20, p<.10) satisfaction. Probes of the findings for Aims 2 and 3
indicated that, when partners had high levels of BF, the associations of SMs PTSS with
partners satisfaction and SMs BF with both SMs and partners satisfaction were all
nonsignificant (ps>.40). In contrast, when partners had low levels of BF, all of these
associations were significant or marginally significant (ps.08) in expected directions. The
overall pattern of finding suggests that, when partners report positive changes related to SMs
deployments, the relationship as a whole is more resilient to stress, regardless of SMs PTSS or
own levels of BF. In contrast, if partners report lower BF, stressors demonstrate stronger
associations with outcomes.
Importancia de los valores personales en la relacin de pareja Dr. Hctor Cevallos
Hctor Cevallos.
1. prctica privada, Guayaquil, Ecuador, 2. Universidad Espirtu Santo, Guayaquil, Ecuador.
En la relacin de pareja, al igual que en todo comportamiento humano de importancia,
intervienen nuestras convicciones personales las cuales forman actitudes y valores, por eso es
comn que encontremos la pareja ideal en unas reas de la vida pero no en todas y es as que
tenemos que adaptarnos a la parte que no nos gusta si nos interesa continuar la relacin o
aceptar que aunque nos gustemos mucho o nos queramos mucho, no somos compatibles. En
la etapa de enamoramiento conviene tener claro qu es lo que buscamos, con que prioridad y
que es lo que nuestra futura pareja nos puede dar; y viceversa qu es lo que ella busca y qu
estamos dispuestos a darle. Entre estos valores estn: 1. Apariencia y cuidado personal. 2.
Sexualidad, pasin. 3. Ingresos econmicos. 4. La capacidad de administrar la economa. 5.
Confianza, amistad. 6. Fidelidad: cumplimiento de promesas y compromisos. 7. Compaa:
estar al lado cuando se lo (la) necesita. 8. Manifestaciones de cario y afecto, ternura. 9.
Actividades en tiempo libre, distracciones, diversiones. 10. Temas comunes de conversacin.

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11. Formas de comunicarse: actitudes, tono de voz 12. Crianza y educacin de los hijos. 13.
Responsabilidades domsticas. 14. Niveles de dependencia o independencia. 15. Relaciones
con la familia poltica. 16. Actividades sociales, amistades. 17. Cuidar la salud. 18. Valores
conservadores, tradiciones, convencionalismos, relacionados con creencias de honor. 19.
Convicciones acerca de tica, Conducta Moral, Dios, Religin. 20. Tolerancia de diferencias,
defectos y debilidades, capacidad de perdonar errores. En el proceso de adaptacin de la
pareja conviene fomentar la comunicacin para lograr acuerdos beneficiosos para ambos, sin
embargo las expectativas impregnadas con la calidad de imprescindibles a travs de
tradiciones culturales, familiares o personales y que no son logradas, podran echar a perder el
mejor de los esfuerzos por mejorar una relacin. La propuesta de este taller es reconocer
nuestras propias convicciones y valores, utilizar diferentes tcnicas cognitivo-conductuales
modernas para aprender a ver como deseables pero no indispensables algunas de las
convicciones y valores impregnados desde pocas tempranas de la vida, que no se adaptan a
la actualidad. Aceptando que existen improntas que no podrn modificarse.
Association Between Female Sexual Self-Efficacy and Depression and Anxiety
Symptoms
Itor Finotelli Jr.3, 1, Oswaldo Rodrigues2, 1, Marilandes Braga1, Moara Carvalho1, Erlei Tavares1,
Maria Tavares1.
1. Grupo de Estudos e Pesquisas do Instituto Paulista de Sexualidade (GEPIPS), Campinas,
Brazil, 2. Instituto Paulista de Sexualidade, So Paulo, Brazil, 3. Universidade So Francisco,
Itatiba, Brazil.
There are evidences demonstrating a significant impact of depression and anxiety symptoms in
sexual function. To investigate such evidences, this study has correlated the Female Sexual
Self-Efficacy Scale (SSES-F) with the Beck Depression Inventory (BDI-II) and Anxiety Inventory
(BAI). The sample consists of 269 women from four universities and a clinical psychologist. The
participating universities accounted to 60% of the sample. The others were in the process of
psychotherapy and had complaints of sexual dysfunction. Their ages ranged from 18 to 56
years (M = 28.59, SD = 8.86), about marital status, 51% were married, 48% single and 1%
divorced. Regarding education, 92% of them had at least incomplete higher education. The
instruments were administered individually and collectively in universities in the initial care at the
clinic, both applications have occurred in appropriate locations following the ethical
requirements in the research. The SSES-F is a scale which uses the concept of self-efficacy in
the ability to measure the sexual behavior performance. It consists of 28 items in four
dimensions named desire/arousal, penetration ability, solitary pleasure and sexual
assertiveness. For measurement, a level measuring scale between 10 and 100 points is used,
the score is obtained by averaging the responses and also the items dimensions. About the
inventories, are self-report scales that describe the severity of depression and anxiety
symptoms . Each has 21 affirmative evaluated through a number from zero to three points. The
score is obtained as they sum the scores of these items and varies between 0 and 63. For the
BDI, it is still possible to obtain scores for somatic-affective and cognitive dimensions. The data
collected were subjected to partial correlation (Pearson at 0.05) eliminating the effect of
differences between clinical and non-clinical group. The results showed only slight negative
associations between of penetration ability SSES-F and the BDI cognitive dimension. It has
been observed that there are more associations considered only in the clinical group. These
data question the evidence of negative interference of depression and anxiety symptoms in
female sexual self-efficacy. They have considered possible influences of other variables in this
data set. Further studies will be necessary to evaluate the associations found so far.

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Association Between Male Sexual Self-Efficacy and Depression and Anxiety Symptoms
Itor Finotelli Jr.3, 1, Oswaldo Rodrigues1, 2, Marilandes Braga1, Moara Carvalho1, Erlei Tavares1,
Maria Tavares1.
1. Grupo de Estudos e Pesquisas do Instituto Paulista de Sexualidade (GEPIPS), Campinas,
Brazil, 2. Instituto Paulista de Sexualidade, So Paulo, Brazil, 3. Universidade So Francisco,
Itatiba, Brazil.
There are evidences demonstrating a significant impact of the depression and anxiety
symptoms in sexual function. To investigate such evidence, this study has correlated the SelfEfficacy Scale-Sexual Erectile Function (SSES-E) to the Beck Depression Inventory (BDI-II) and
Anxiety Inventory (BAI). The sample consists of 364 men from four universities and a clinical
psychologist. Participants from universities accounted to 75% of the sample. The others were in
the process of psychotherapy and had complaints of sexual dysfunction. Ages ranged from 18
to 67 years (M = 33.76, SD = 10:48), about marital status, 47% were married, 43% single, 9%
divorced and 1% widowed. Regarding education, 85% of them had at least incomplete higher
education. The instruments were administered collectively in universities and individually during
the initial care at the clinic, both applications occurred in appropriate locations following ethical
requirements in the research. The SSES-E is a scale which uses the concept of self-efficacy in
the ability to measure the sexual behavior performance. It consists of 25 items and two
dimensions named obtaining and maintaining the erection. For measurement, a level measuring
scale between 10 and 100 points is used, the score is obtained by averaging the responses and
also the items dimensions. About the inventories, are self-report scales that describe the
severity of depression and anxiety symptoms. Each has 21 affirmative evaluated through a
number from zero to three points. The score is obtained as the sum of scores of these items
and varies between 0 and 63. For the BDI, it is still possible to obtain scores for somaticaffective and cognitive dimensions. The data collected were subjected to partial correlation
(Pearson at 0.05) eliminating the effect of differences between clinical and non-clinical group.
The results showed mild and moderate negative associations between the score of the SSES-E
and the dimensions: obtaining and maintaining the erection and the BDI score and the
dimensions: somatic and cognitive-affective. For the BAI, the only score has been associated to
a slightly negative to the dimension: SSES-E maintaining the size of the erection. These data
have indicated the negative interference of depressive symptoms on sexual self-efficacy. On
anxiety symptoms, the same interference was restricted to the maintenance of behaviors
supporting the sexual activity. It is suggested that these associations should be considered in
interventional and diagnostic procedures of male sexual dysfunction.
Psicoterapia y Sexoterapia de Parejas Inmersas en Violencia Machista
Idhaly Guzmn.
1. Grupo Ambos Especialistas en Salud Psicolgica y Sexolgica, Caracas, Venezuela, 2.
Sociedad Venezolana de Psicologa Sexolgica, Caracas, Venezuela.
Abstract Central: La psicoterapia y la sexoterapia de parejas inmersas en violencia machista,
requiere de un abordaje holstico que sobrepasa la intervencin basada en la interaccin de los
paradigmas de modificacin conductual (clsico, operante y mediacional) e incluye la
reconstruccin de la identidad psicosexual y sociosexual desde una perspectiva de derechos y
gnero. La labor del/la especialista, sensible para visibilizar el abuso verbal, sexual o fsico
contra la compaera, como la piedra angular del problema que opera en las relaciones
aquejadas de disfunciones sexuales; facilita la calidez y la calidad de su atencin. La ilustracin
de un caso, describir la experiencia clnica ejercida durante los ltimos diez aos, bajo la
metodologa del anlisis cognitivo-conductual aplicado: observacional de diseo multivariable

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de interaccin, con enfoque de intervencin interdisciplinaria apoyada psiquitrica y legalmente.


En coherencia con una visin objetiva y moderna se aborda la teraputica basada en la
atencin plena y el enfoque Zen, teniendo como meta primordial el bienestar de la persona y la
pareja. Dicha accin con soporte documental y de campo, es el producto de cuatro etapas de
investigacin continua: (1) estudios de casos en un servicio de atencin en violencia basada en
el gnero; (2) estudios de casos en consulta psicolgica/sexolgica privada; (3) estudio
descriptivo de las actitudes y comportamientos violentos en parejas y proveedores/as de salud
y, (4) participacin en el diseo de un protocolo de atencin integral a vctimas/sobrevivientes
de violencia domstica. Los resultados, muestran que cuando se brinda asistencia integral,
capaz de detectar, atender y erradicar la violencia machista como vehculo de la sintomatologa
psicolgica y sexolgica presente en los/as pacientes, entonces, se logra en primer lugar, la
eliminacin de un mayor riesgo de reincidencia de la violencia con sus devastadoras secuelas
y, en segundo lugar, el renacer de la vivencia de la sexualidad y la afectividad, desde una
percepcin verdaderamente armnica, placentera y saludable en lo individual y en lo conyugal;
en el marco de la prevencin de la vulneracin de los derechos humanos, entre ellos, los
sexuales y reproductivos. Es recomendable que los/as proveedores/as de servicios de salud,
obligatoriamente experimentemos la oportunidad de aumentar la sensibilizacin y la
capacitacin que provea la propia disminucin de barreras que inadvertidamente actan,
cuando el tema gnero toca la puerta personal y profesional. El problema ha sido asunto de
todos/as, ya que compartimos una base sociocultural que nos ha condicionado a entender las
vinculaciones entre hombres y mujeres desde una concepcin poco reconocedora de la
igualdad. En este sentido, la solucin, es responsabilidad y posibilidad de todos/as,
especialmente en quienes gozamos de un sitial de honor como gestores/as de cambios
positivos en la sociedad.
La Construccin de la Conducta de la Pareja en la Era del Facebook
Aida Jimenez1, Carmen Rivera2.
1. Clinical Psychology, Carlos Albizu University, San Juan, USA, 2. Universidad de Puerto Rico,
San Juan, USA.
Abstract Central: El facebook es la red social mas popular del Siglo veintiuno que est
relacionado con formacin y construccin de identidad de las personas. A pesar de su
popularidad, existen pocas investigaciones sobre el efecto que tiene el uso de facebook en el
moldeamiento y construccin de la pareja. El presente estudio es uno transversal, que tiene el
propsito de examinar el efecto que tiene el uso de facebook en la conducta de cada miembro
de la pareja y su impacto en el moldeamiento de la relacin. Este estudio se enmarca en un
modelo narrativo familiar de construccionismo social. La muestra de este estudio consiste de
150 participantes entre las edades de 21 a 64 aos de edad que residen en Puerto Rico. Los
criterios de inclusin de los participantes fueron: tener mas de 21 aos de edad, estar en una
relacin estable por mas de seis meses y ser un usuario de facebook. El diseo fue uno mixto.
En esta presentacin se discutirn datos preliminares del estudio.
Tcnicas Cognitivas en Disfunciones Sexuales
Jacqueline Lamboglia.
Instituto de Neurociencias, Guayaquil, Ecuador.
Abstract Central: Si bien las tcnicas conductuales dirigidas a tratar las disfunciones sexuales
fueron expuestas por Masters y Johnson y Helen Kaplan desde la dcada de los aos 70 y
desde all han tenido relativamente pocos cambios, para complementar lo anterior, en esta

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conferencia hago nfasis en la importancia de estar atentos y profundizar en la investigacin de


las convicciones e interpretaciones personales dainas de nuestros pacientes y si es posible
intentar que el mismo paciente ponga en evidencia los errores y los corrija, para lo cual nos
servimos de algunas tcnicas cognitivas, como son: 1. Flecha Vertical Para segn el tema a
tratarse, encontrar las interpretaciones y convicciones acerca de m; de los otros, del mundo, el
futuro. 2. Busqueda de significados personales de los hechos y de las palabras usadas. 3.
Evidencias a favor y en contra de esas Interpretaciones y convicciones 4. Busqueda de
Utilidad, inutilidad o dao de interpretaciones, convicciones, emociones, sensaciones, y
acciones. 5. Los Registros de Pensamientos para detectar y reconocer constantemente
nuestras interpretaciones y convicciones 6. Temas Clave para buscar Convicciones Nuevas 7.
Experimentos Conductuales dirigidos a poner a prueba las convicciones. 8. Los Planes de
Accin dirigidos a desarrollar nuevas capacidades, y convicciones ante problemas identificados
9. Visualizacin con los ejercicios anteriores 10. Recoger evidencias de que una conviccin
daina o inconveniente no es 100% verdad 11. Asociar con emociones y sensaciones
desagradables las interpretaciones, convicciones y acciones dainas: recuerdos, imgenes,
visualizaciones y otras sensaciones desagradabl. 12. Registrar las evidencias de que ocurre
cuando no sigo las interpretaciones, convicciones, emociones, sensaciones, ni conductas
dainas anteriores. 13. Bsqueda de Nuevas Interpretaciones Convicciones, emociones y
conductas ms tiles y realistas. 14. Evaluar Utilidad/Dao de nueva interpretacin, conviccin,
emocin, sensacin, conducta 15. Asociar con emociones y sensaciones agradables las
interpretaciones, convicciones y acciones tiles y realistas: recuerdos, imgenes,
visualizaciones y otras sensaciones agradables. 16. Etiquetar las nuevas convicciones
benficas 17. Las Pruebas Histricas que permiten recordar experiencias que corroborarn las
creencias que sabemos nos conviene fomentar. 18. Los Registros de Experiencias a Futuro
que nos confirmarn las creencias que sabemos nos conviene consolidar. 19. Registrar las
evidencias de que s sigo las interpretaciones, emociones, sensaciones, conductas y
convicciones Creencias Nucleares actuales benficas. 20. Estimar la confianza en % de
nueva conviccin.
Estudio de Caso de un Tratamiento de Terapia Cognitivo Conductual para Conductas
Sexuales Excntricas
Carlos Martn Mosqueda.
Administracin, Instituto Jalisciense de Psicoterapia Cognitivo Conductual, Guadalajara,
Mexico.
Introduccin: El presente estudio de caso tuvo como objetivo poner a prueba un tratamiento
basado en la terapia cognitivo conductual, diseado ex profeso para intervenir a un sujeto con
conductas de exhibicionismo, voyeurismo, travestismo y filia por la pornografa. Cabe sealar
que no se cumplieron los criterios para determinar el diagnstico de Parafilias. Muestra: Sujeto
masculino casado de 47 aos. Procedimiento: Se evalalo pre y post-tratamiento con los
inventarios de: Cuestionario de esquemas de Young, el Inventario de ansiedad de Beck, el
inventario de depresin de Beck y el Cuestionario sobre la sexualidad de Snell y Papini. El
tratamiento de realiz de diciembre de 2011 a mayo de 2012, con supervisin a seis meses y
consto de 3 etapas: la primera etapa se focalizo en disminuir las conductas excntricas,
mediante el entrenamiento e implementacin de tcnicas como control estimular,
sensibilizacin encubierta, condicionamiento aversivo, autocontrol y reestructuracin cognitiva.
La segunda etapa se centro en modificar los esquemas de bsqueda de aprobacin y
abandono que presentaba el paciente, la intervencin se realizo bajo los postulados de la
terapia centrada en los esquemas de Young y entrenamiento en asertividad. La ltima etapa
tuvo como objetivos el recondicionamiento orgsmico y el restablecimiento de la relacin de

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pareja, fueron necesarios entrenamientos en recondicionamiento orgsmico, imaginera


racional emotiva, entrenamiento en intimidad asertiva, solucin de problemas, comunicacin
efectiva en pareja y prevencin de recadas. Anlisis de datos: Consisti en comprar los
puntajes brutos obtenidos en cada uno de los instrumentos de las evaluaciones pre y post
tratamiento. Resultados: Inventario de esquemas de Young se obtuvieron como puntajes
principales en el pretratamiento: Abandono: 94, Bsqueda de Aprobacin: 96; en el posttratamiento: Abandono: 30, Bsqueda de aprobacin: 20. Inventario de ansiedad de Beck:
Pretratamiento: 35 pts. Post-tratamiento 7 pts. Inventario de Depresin de Beck:
Pretratamiento: 29 pts. Post-tratamiento 8 pts. Cuestionario sobre la sexualidad de Snell y
Papini: Pretratamiento: ligeramente insatisfecho con su vida y desempeo sexual; Posttratamiento: satisfecho con su vida sexual. Los cambios se mantuvieron a seis meses despus
de terminada la intervencin. Discusin: Se logr la erradicacin total de las conductas
sexuales excntricas desde el segundo mes de intervencin y se mantuvieron los cambios en
los seis meses de seguimiento. El paciente modifico los esquemas desadaptativos,
fortaleciendo una filosofa de auto aceptacin. El presente trabajo pretende documentar una
intervencin con conductas sexuales excntricas, ya que la mayora de los protocolos
establecidos en los manuales estn destinados para sujetos que si cumplen los criterios de
Parafilias. Por lo que la finalidad de esta investigacin es servir como antecedente para medir
la efectividad de intervenciones con problemticas que no alcanzan el diagnostico de trastorno,
pero de igual manera afecta la vida de los sujetos y de sus parejas. Es necesario realizar la
implementacin de la propuesta de tratamiento con una poblacin mayor y as lograr la
generalizacin de resultados.
Psicopatologa, Evaluacin e Intervencin Cognitivo Comportamental para el Manejo de
los Celos en la Relacin de Pareja
Nancy Martnez1, 2, Leonardo Garca1, Berha Avendao2, Sofia Barreto1.
1. Universidad El Bosque, Bogot, Colombia, 2. Universidad Catlica de Colombia, Bogota,
Colombia.
Abstract Central: Los celos en la relacin de pareja son un tpico de investigacin cientfica
desde 1977 en la APA (Salovey, 1991). El presente estudio rene tres investigaciones, una
terica, otra de tipo psicomtrica y con resultados a nivel descriptivo-correlacional y la ltima
sobre la validacin de la intervencin sobre celos en pareja. Primero se presenta una revisin
terica que permite conceptualizar, caracterizar y clasificar la celotipia, para posteriormente
profundizar sobre los factores implicados en su adquisicin y mantenimiento a nivel biolgico,
psicolgico y sociocultural. Posteriormente se presentan los resultados del anlisis psicomtrico
de la Escala Interpersonal de Celos (Mathes y Severa en 1992 , adaptado al espaol por
Martnez y Rodrguez, en 1996) con una muestra de 500 estudiantes universitarios
pertenecientes a nueve universidades de la ciudad de Bogot. Se trat de un estudio
descriptivo de tipo instrumental con aplicaciones psicomtricas, cuyos datos se analizaron
desde el marco de la teora clsica de los test y desde la TRI. Los resultados indicaron niveles
aceptables de consistencia interna y validez de la escala, y una estructura factorial con cuatro
factores. Adicionalmente se aplic un cuestionario con cuatro preguntas sociodemogrficas:
sexo, edad, nivel acadmico y estado civil y 12 preguntas referidas a la relacin de pareja, Se
encontr relacin estadsticamente significativa entre los celos y las variables: tiempo de
relacin, percepcin sobre qu tan celoso es el participante, qu tan celoso considera a su
pareja, frecuencia de disgustos por causa de los celos y severidad de los mismos. Finalmente
se presenta una gua de intervencin cognoscitivo-comportamental para el manejo de los celos
con su respectiva validacin por contenido y una validacin emprica realizada mediante un
estudio de caso y rplicas.

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Sexo Inteligente y Disfrute de la Intimidad


Jorge Mesta.
Universidad de San Martn de Porres, Lima, Peru.
Abstract Central: La sexualidad siempre nos ha parecido algo ms bien ligado a los instintos
que a la inteligencia, sin embargo durante el ao 2002, la pareja de psiclogos Sheree Conrad
y Michael Milburn, profesores e investigadores de la Universidad de Massachussets-EUA,
introdujeron un revolucionario concepto, el cual desarrollaron en su libro Inteligencia Sexual.
Para estos autores, la dimensin ertica de cada persona est determinada por su coeficiente
de inteligencia sexual que constituye una parte de nuestra capacidad intelectual, tan importante
como la inteligencia emocional. Existen tres pilares fundamentales para aquellas personas que
deseen ser sexualmente inteligentes, estos son: adquirir los conocimientos precisos, descubrir
nuestro propio sexo y la conexin con los dems. Todo esto hace posible que las personas
puedan disfrutar ms de la sexualidad en todas sus formas. Para esto es importante tambin
tener en cuenta algunos factores que pueden dificultar aquel disfrute, como son los factores
orgnicos, los psicolgicos y los de aprendizaje. Asimismo se postula a la Terapia Racional
Emotiva Conductual como una alternativa para abordar los problemas en el disfrute de la
intimidad.
Direct Attributions for Service Members Symptoms Moderates the Association of
Service Members PTSD and Spouses Distress
Keith Renshaw1, Elizabeth Allen2, Howard Markman3, Scott Stanley3.
1. Psychology, George Mason University, Fairfax, VA, USA, 2. University of Colorado at
Denver, Denver, CO, USA, 3. University of Denver, Denver, CO, USA.
Abstract Central: Spouses perceptions of service members (SMs) combat exposure during
deployment has been found to moderate the association of SMs PTSD symptoms with spousal
distress, such that the association weakens as spouses perceive greater combat exposure
(Renshaw et al., 2008, 2011). Furthermore, spouses perceptions of re-experiencing symptoms
of PTSD are associated with greater relationship satisfaction, after controlling for perceptions of
other symptoms (Renshaw & Caska, 2012). These findings have been interpreted as reflective
of an attributional process, whereby spouses are less distressed if they view symptoms as
caused by external events like combat. However, the findings have not been replicated, and no
study has directly assessed spouses attributions for symptoms. A sample of 440 wives of Army
soldiers (most of whom deployed at least once since 2001) provided self-report of marital
distress, perceptions of SMs PTSD symptoms, perceptions of SMs combat experiences, and
attributions (internal and external) for SMs symptoms. A significant interaction (p<.05) indicated
that the association between SM PTSD and spouse marital distress was again weaker as
spouses perceived more combat (regression R2=.09). Furthermore, perceptions of reexperiencing symptoms were once again positively associated with relationship satisfaction ( =
.18) when controlling for other symptoms. With regard to attributions, external attributions for
symptoms of PTSD were positively correlated with perceptions of combat exposure (rp = .31)
and perceptions of re-experiencing symptoms (rp = .18), and negatively correlated with
perceptions of numbing/withdrawal symptoms (r = -.28). In contrast, internal attributions for
symptoms were uncorrelated with perceptions of combat (r = -.16), negatively correlated with
perceptions of re-experiencing symptoms (rp = -.28), and positively correlated with perceptions
of numbing/withdrawal symptoms (rp = .27). Moreover, although external attributions did not
significantly moderate the association of PTSD with relationship satisfaction, internal attributions

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were a significant moderator (interaction p < .05), with the association weaker at lower levels of
internal attributions. Finally, attributions fully mediated the positive association of perceptions of
re-experiencing symptoms with relationship satisfaction and partially mediated the negative
association of perceptions of numbing/withdrawal symptoms with relationship satisfaction.
These results support the importance of spouses attributions in the effects of combat-related
PTSD symptoms on marital relationships, with the first direct assessment of such attributions.
Interestingly, perceptions of combat were only related to external attributions. Internal
attributions appeared independent of perceived combat but were a strong predictor of distress
and moderator of the association of SM PTSD and spouse distress. The types of symptoms
partners reported were significantly associated with both types of attributions. These results and
their clinical implications will be discussed in the context of an overall cognitivebehavioral/interpersonal model of PTSD.
The Role of Psychologist and the Psychodiagnosis and Psychotherapy Processes
Focused on Sexuality
Oswaldo Rodrigues1, 3, Diego Viviani1, 3, Carla Zeglio1, 3, Carolina Fernandes1, 3, Itor Finotelli Jr.2,
3
, Juliana Simo3, 1.
1. Instituto Paulista de Sexualidade, So Paulo, Brazil, 2. Universidade So Francisco, Itatiba,
Brazil, 3. Grupo de Estudos e Pesquisas do Instituto Paulista de Sexualidade, So Paulo,
Brazil.
The psychotherapic approach of the sexual complaints is initiated with erectile dysfunction
treatments by means of systematic desensitization in the 1950s and is developed throughout
the 1960s and 1970s upon acknowledgment of other sexual complaints, requiring new
organizations for diagnoses and treatments. The current approach of the So Paulo Sexuality
Institute (Instituto Paulista de Sexualidade) has allowed for easy manners for diagnosis and
treatment. Diagnosis shall be comprised of acknowledgment of the major complaint and
secondary complaints, sexual and no sexual. Submission to physicians for a physical evaluation
is always attempted in parallel. Psychosexual diagnosis - Semi-structured interview with the
complainant, Sexuality Inventories (according to the major complaint), Beck Depression
Inventory, Beck Anxiety Inventory, Sexual Desire Inventory, Sexual Self-Efficacy Scale,
Psychological Personality Tests, as required. Semi-structured interview with the partner Sexuality Inventories (according to the major complaint), Beck Depression Inventory, Beck
Anxiety Inventory, Sexual Desire Inventory, Sexual Self-Efficacy Scale, Psychological
Personality Tests (if understanding psychiatric aspects is required). In addition to the major
complaint which brings the patient to the first appointment, other sexual issues that may require
technical care need to be acknowledged. Sexual issues to be recognized - man: sexual desire
inhibition, extraordinary/specific sexual preferences/paraphilia, hyper-sexuality (compulsive or
not), erectile dysfunction, fast/premature ejaculation, ejaculatory inhibition, anorgasmia,
dyspareunia (intra or post-intercourse), post-intercourse cephalalgia. Woman: sexual desire
inhibition, extraordinary/specific sexual preferences/paraphilia, hyper-sexuality (compulsive or
not), Excitation dysfunction, vaginismus, anorgasmia, dyspareunia (intra or post-intercourse),
post-intercourse cephalalgia. Couple: couples sexual inadequacy. General psychological issues
to be acknowledged: difficulties in marital relationship, lack of assertiveness, lack of or low
emotional expressiveness, depressive status, anxiety status, psychiatric issues. Psychotherapy
focused on sexuality, usually taking place with weekly 50-minute sessions, preferably with the
couple, but usually intercalating individual sessions with the patient who is the focus of the
major complaint. As a focal process, some common techniques are used more frequently,
although these should be introduced at an appropriate time respecting individual differences. In
relation to the usual psychotherapic techniques in sexual psychotherapy; intercourse

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suspension, relaxation techniques, verbal and non-verbal communication techniques, assertive


training techniques, bibliotherapy, therapy bath, Sensorial Focalization, managed masturbation,
psychopedagogic orientations. The psychotherapic processes focused on sexuality allow for an
increasing solution of the sexual complaint throughout the weeks, producing decrease of
anxieties and the symptom. In this proposal, the focus is more specific, allowing for
acknowledgment of secondary sexual complaints that could produce failures in the use of
techniques aimed at the major complaint.
The Maladaptive Cognitive Schemes Most Common in Patients Suffering from Gender
Identity Disorder
Lajos Simon.
Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Gender identity disorder or transsexualism as it is more commonly known is a highly complex
clinical entity. It is identifiable disease which can be successfully treated by reassignment
surgery. Transsexual individuals identities need to be recognised as authentic. Trans gendered
persons face many difficulties due to social and familial lack of acceptance and understanding
of gender identity disorder. There are many dysfunctional early maladaptive schemes (EMS)
maladaptive active in the patients cognitive operation which is closely connected to the family
and society reactions given to this disorder. The rejective and mistrustful prime parental
behaviours can be detected in the background. The gender unity of an individual is based on
the one hand on the chromosomal and phenotypical setting which defines the emotional
behaviour and societal integration. The psychosocial gender is not the sum of the cultural
values related to gender, attitudes, gender roles and characteristics. In transsexual patients
there is a strong desire to exist and be accepted as the member of the other gender which is
connected to the inner need to change his/her body as well by hormone therapy and
reassignment surgery. Behavioural dimensions of transsexualism: Personal outlook- clothing,
bodily manipulations (hair, skin, nails, breasts, penis, testicles) Attitude and communication in
harmony with the chosen gender role Non-verbal communication - movements, gestures,
postures, speach Cognitive dimension of transsexualism: Cognitive patterns and attitude in
harmony with the chosen gender role Coping with the interpersonal and inner psychological
conflicts characteristic to the gender chosen by the patient The maladaptive schemes, their
interpretation and the results of our research will be presented in the poster. Our research
theoretically has been based on the Young Schemes Questionnaire, the Young Parenting
Inventory and the Symptoms Checklist-90-R. The most common early maladaptive schemes in
transsexual patients are Self-Sacrifice, Social Isolation, Defectiveness/Shame and Vulnerability
to Harm and Illness.
Female anorgasmia: application of techniques in the sexual therapy
Juliana Simo.
Instituto Paulista de Sexualidade, So Paulo, Brazil.
We produced the case study on female anorgasmia and the application of techniques in the
sexuality therapy. This subject was chosen for being a clinical case that proved how much the
sexual symptom has an efficient solution when an approach focused on dysfunction treatment is
used. We used the female Sexuality Inventory form A1 as methodology. The Beck Inventory
(BDI). The Beck anxiety Inventory. The Sexual Desire Inventory (SDI-2). Sexual Self-Efficacy
Scale form F. Self-Efficacy Scale form E. The aim of the psychotherapic work was, in addition to
resolution of the anorgasmia complaint, learning by the patient of the experience of a more

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satisfactory sexuality with her partner. The customer at stake is 40 years old and is in her third
marriage. She says she has no desire, or excitation, or even orgasm. The work was initiated in
weekly 50-minute sessions only with the patient and, after establishment of the relationship, her
husband was called to take part, but only in specific sessions aimed at making the customers
process easier. After answering and clarifying the information contained in the inventories, the
patient was told to suspend intercourse and develop sensorial focalization exercises 1 A with
her husband. Concomitantly, reading of the book: The Red Tent was proposed. In the
following sessions, we began the educative activities. For such, the patient was told to read the
informative guide Growing up. This is a book with accessible language that approaches sex
in a different way. Then, the patient was asked to hold a mirror and look her vagina closely. The
mirror therapy of the genitals is made aimed at progressive exposure of the patient in
anxiogenic situations. As the patient looks, she starts to be desensitized, until she fully
extinguishes her anxiety in a situation. She had never looked to herself so intimately. She
reported to have had difficulties in finding the clitoris. But, she stated that the experience to
knowing herself was interesting and that she found her vagina a beautiful part of her body. In
sequence, she was introduced to tale reading. And, then, the patient was requested to make the
bath therapy. The bath therapy goal is improving the persons contact with the own corporal
sensations. She will be able to encourage feeling, smell, vision, hearing and even taste. This
time is specially built and prepared, requiring creativity and emotional investment from the
customer. In the next stage, she was requested to stimulate her clitoris directly, firstly by using
lubricator and, then, taking it from activity, but continuing to stimulate the clitoris. Throughout the
treatment and with application of the techniques focused on sexuality the patient discovered,
therefore, to have desires and how to express them more assertively. She recognized her
excitation and developed repertories involving the five senses that provide a more satisfactory
sexual relation. Consequently, she learned to get to orgasm and obtain from the treatment the
solution of her sexual dysfunction.
Constructs and concepts in psychology applied to sexual psychotherapy
Juliana Simo1, Oswaldo Rodrigues2, 1, Itor Finotelli Jr.3, 1, Diego Viviani1, Carla Zeglio2, 1,
Carolina Fernandes1.
1. Instituto Paulista de Sexualidade, So Paulo, Brazil, 2. Asociacin Latinoamericana de
Anlisis y Modificacin del Comportamiento, Buenos Aires, Argentina, 3. Universidade So
Francisco, Itatiba, Brazil.
Sexual psychotherapy is a clinical psychology area applied to treatment of sexual complaints. In
this approach, some constructs and concepts from psychology that are important as part of the
treatment process or as basis for specific techniques: Social Learning is described as the
capacity of an individual to reproduce an observed behavior. It is an essential process of
socialization, described by three assumptions, social learning itself, the reciprocal determinism
and self-efficacy. Application of such concept assists both in identification of inadequacies of an
individual and in composition of strategies and interventions in its modeling process,
reproduction of the observed behavior, monitoring and enhancement. An efficient learning
model is considered in the change of a behavior, which observation of the other allows for
creation of a cognitive image of the way to act of an individual, serving as guideline for actions.
Self-efficacy is described as the feeling that allows for adequacy and competency for facing
problems. The individual perceives self-esteem, trust or own value which allow for him/her to
believe that he/she can perform certain behavior as required. Such concept is used to check
trust and effort the individual shall use in certain sexual function. Male and female sexual selfefficacy scales will allow for understanding the beliefs on sexual performance of the individual in
a variety of sexual situations. Social abilities are the set of behaviors emitted in view of the

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needs of an interpersonal situation, provided that they maximize the gains and reduce losses for
the social interactions. Great part of the behavioral problems is kept by production of positive
and negative reinforcers. The social abilities are worked in parallel to the sexual dysfunction
approach. Both the individual and the couple are the focus of such approach. Cognitive
Structure, two aspects are presented to be considered when we associate cognitions and
sexual complaints: Contents that may be des/constructive for sexual performance; distortive
irrational cognitive processes. The content aspect is more visible and even held liable for the
sexual issue. The distortive thought processes may be held liable for several anxiogenic and
depressive statuses related to the sexual issue. Thought anticipation and reading, tunneling,
negative aspect magnification, positive aspect minimization processes are some distortive
processes found in such sexual issues. Assertiveness in sexual behavior, when the couple
looks for assistance and treatment for their dysfunctional sexual the punitive verbal behavior
repertory, and not only it, is already established. Social ability, a constant in the lives of each of
the individuals comprising the couple, no longer exists as priority in a life of a couple. The
possibility to develop a quality sexual life to both and together, takes place from the process to
assertively communicate the needs and what is not satisfactory in the sexual relation. Upon
statement of an inadequate sexual behavior in a couple, the behavior to express the negative
feelings becomes an important variable to be worked by in the psychotherapy process. The goal
is that the couple may learn to admit failures, agreement, among many other behaviors.
Variation of Sexual Desire and Time of Relationship, An Exploratory Study
Diego Viviani1, Oswaldo Rodrigues2, 1, Itor Finotelli Jr.3, 2.
1. Instituto Paulista de Sexualidade, So Paulo, Brazil, 2. Asociacin Latinoamericana de
Anlisis y Modificacin del Comportamiento, Buenos Aires, Argentina, 3. Universidade So
Francisco, Itatiba, Brazil.
Being in a relationship with someone is not always easy, because many times we need to let go
some behaviors, create new rules, respect differences, work limitations and create a new home
structure that can be functional. This Essay was aimed at checking the sexual desire and its
evolution according to the time of relationship; in order to achieve that, it is necessary to
understand what may influence the sexual response. As a result, one needs to understand the
human sexual response and exploit its nuances, mainly taking into consideration that life quality
of a couple is associated with the biopsychosocial sphere, i.e., psychological, social and
biological features that permeate individual and dual life of this couple; therefore, external and
internal events may cause, or keep a sexual dysfunction associated with desire both for men
and for women. It is also possible to perceive that some types of beliefs spread by the common
sense also influence the way these people understand and live sexual relationship, and such
conditions may make some disagreements easier. Therefore, thinking and rethinking on such
spheres is also efficient for treatment of these difficulties. Realizing how communication may
work for the couple is extremely important, because through it the couple may reduce the interrelation disagreements, as well as may exploit the possibility to keep sexual practice, i.e., sex in
addition to being practiced, may also be spoken, in order to know the partner, understand
his/her wishes and combine wishes to phantasies as new possibilities of pleasure. For this
essay, around 150 people were studied, out of whom, 109 were men and forty-one were
women, all pieces of data were obtained through the Sexual Desire Inventory (SDI - 2),
contained in the dead file of a clinic specialized in psychotherapy focused on sexuality of the city
of So Paulo, during 1997 and 2007; the individuals researched were in relationships of one
month to 40 years and all of them had some direct or indirect sexual complaint, the instrument is
comprised of 14 questions, which assess sexual, individual, dyadic desire and by non-specific
person, the analysis was made through segregation of each sub-item getting to obtainment of

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the averages of the responses as of each category. The results found brought the perception
that both social affirmations, to increase desire due to relationship time and increase of
intimacy, or decrease of desire due to the routine may be true; however, it shows that the sexual
repertory and quality of communication may directly influence this relationship. In accordance
with the results found, it is worth stressing that the first social affirmation appears more
frequently in the female discourse, in turn, the discourse that keeping sexual activity with a fixed
partner throughout time is outworn and that is usually more related to men tends to have certain
discrepancy, as compared to the results obtained characterizing certain increase of male sexual
desire throughout the relationship.
Therapy Context, Process & Delivery/ Contexto de la Terapia, Proceso y Difusin/
Contexto da Terapia de Processamento e Disseminao
Coaching Basado en REBT para Tiburones Jvenes: Herramientas Aplicadas a los
Retos Culturales y ticos de los Lderes Jvenes en Entorno Financiero de la Economa
Emergente Colombiana
Leonardo Amaya.
Psicologa, Universidad del Rosario, Bogot, Colombia.
Abstract Central: Coaching basado en REBT para tiburones jvenes: herramientas
aplicadas a los retos culturales y ticos de los lderes jvenes en entorno financiero de la
economa emergente colombiana. Las demandas culturales de xito profesional en jvenes de
altos ingresos del mundo financiero estn notablemente relacionadas con la construccin
cultural del xito. Esos sistemas de creencias influyen en las relaciones internas en los
equipos de trabajo de alto desempeo, el estrs, desgaste emocional y la toma de decisiones.
En la economa de crecimiento rpido de Colombia, los smbolos de estatus material e
inmaterial incluyen la distancia simblica entre los que triunfan y los loser. La identidad as
construida influye tanto en la percepcin de calidad vital, la satisfaccin laboral y social y puede
llegar a interferir inadecuadamente en la proactividad de las conductas, incluyendo el modelo
tico vital y la escala de valores. Dominic DiMattia es el primer y ms reconocido desarrollador
de aplicaciones organizacionales de la teora REBT: Rational Effectiveness Training. A partir de
este modelo, presentamos un modelo de evaluacin e intervencin coaching, mediante
estudios de caso con jvenes lderes del sistema financiario en Colombia.
Complexities and advances in the treatment of Social Anxiety Disorder
Glen Bates1, James Williams1, Anthony Mackie1, Georgia Panayiotou2, Marios Constantinou3,
Glen Bates1, Glen Bates1, Georgia Panayiotou2, Maria Karelka2, Maria Karelka2.
1. Life and Social Sciences, Swinburne University, Hawthorn, VIC, Australia, 2. University of
Cyprus, Nicosia, Cyprus, 3. Center for Cognitive Behavioral Psychology, Nicosia, Cyprus.
Social Anxiety Disorder (SAD) is one of the most common anxiety disorders and well research
CBT treatment protocols have been developed for its treatment. However, despite the efficacy
of these group and individual treatment approaches, a substantial number of clients fail to
respond or fail to maintain treatment gains. The aim of this symposium is to consider aspects of
SAD that contribute to non-response and to examine new treatment innovations aimed at
improving therapeutic outcomes. The first paper presents research establishing the existence of
narcissistic subtypes of clients with SAD. Narcissism has not previously been considered in
relation to SAD and the paper gives insights into the specific barriers to treatment faced by this
subgroup of SAD clients. The second paper examines the role of experiential avoidance,

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anxiety sensitivity and behavioral inhibition as predictors of the severity of SAD symptoms. The
remaining two papers in the symposium examine new innovations in SAD treatment. Paper
three describes the incorporation of techniques from acceptance and commitment therapy to
assist clients to engage in exposure tasks. These innovations are directed at avoiding treatment
drop outs which often occur when exposure tasks commence to the clients detriment. The final
paper focuses on group therapeutic factors which to date have not been explicitly incorporated
into CBT group therapy protocols. Findings indicate that reciprocal interactions within group
sessions and group process variables are closely associated with therapeutic gains. Taken
together the four papers highlight the importance of considering SAD as a multifaceted and
heterogeneous disorder which requires careful matching of treatment methods to client needs.
Are there narcissicstic subtypes within socail anxiety?
Recent ethological theories of social anxiety have emphasized that social anxiety is related to
perceptions of social rank. While a submissive type of social anxiety (cf. DSM-IV-TR) has been
extensively studied, recent cluster analytic studies have identified a variation associated with
dominant/aggressive, impulsive and disinhibited behaviors. Interestingly, the dominant/impulsive
social anxiety subtypes share similarities with narcissistic personality. However, the possibility of
narcissistic social anxiety subtypes has not previously been studied. Thus, the aim of the
current series of studies was to explore the possibility of narcissistic social anxiety subtypes.
Two studies were conducted one involving 349 people and the other 612. Cluster analysis
revealed five distinct social anxiety subgroups. The same subgroups were identified in Study 1
and Study 2. On the basis of group differences in social anxiety, narcissism and anger, the
groups were labeled narcissistic social anxiety group (NSA), covert narcissistic social anxiety
group (CNSA), angry covert narcissistic social anxiety group (AnCNSA), general social anxiety
group (GSA) and low social anxiety group (LSA). In both studies, the covert narcissistic social
anxiety subgroups were found to be more impaired in relation to social anxiety. On most indices,
the narcissistic social anxiety subgroups were more impaired than the non-narcissistic social
anxiety subgroups in Study 1 and 2. Results of Study 2 revealed that the NSA group was
associated with higher perceived social rank than any of the other social anxiety subgroups with
the NSA group evincing high endorsement of Social Comparison items measuring perception of
competence/efficacy relative to others. Specific problems likely to be faced in treatment by
these subgroups are discussed
Experiential Avoidance Mediates the Effects of Anxiety Sensitivity in Social Anxiety, but
Behavioral Inhibition Remains its Strongest Predictor
Growing evidence supports that anxiety sensitivity is a strong correlate of anxiety pathology. It
may represent a temperamental predisposition to anxiety and other disorders, and evidence
suggests that it exerts its effects indirectly: Its association with disorders like depression was
found to be mediated by experiential avoidance. Socially anxious individuals are highly
concerned about how apparent their somatic symptoms may be to others, and therefore anxiety
sensitivity may play a role in this disorder as well. The present study examines the role of
experiential avoidance and anxiety sensitivity in predicting social anxiety symptoms. The model
positing that experiential avoidance is a mediator between anxiety sensitivity and anxiety
symptoms is tested for its ability to distinguish high and low socially anxious individuals,
selected for their extreme scores on a symptom specific questionnaire. A series of regression
analyses indicated that indeed both anxiety sensitivity and experiential avoidance predict social
anxiety group membership and that experiential avoidance is a mediator in this association.
Regarding anxiety sensitivity, it is the mental concerns factor of this construct (measured with
the ASI-16) that best predicts social anxiety. A hypothesis was also examined that experiential
avoidance and anxiety sensitivity would explain additional variance to that predicted by better
known correlates of social anxiety, specifically Self-Consciousness and Sensitivity to

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Punishment. The latter hypothesis was not supported. Findings overall, lend support to the
hypothesis that anxiety sensitivity is a predictor of social anxiety mediated by experiential
avoidance but that the strongest overall predictor was sensitivity to punishment (a behavioral
manifestation of behavioral inhibition), which may represent a strong temperamental
vulnerability factor.
Increasing willingness to engage in exposure as a way to combat treatment drop out in
social anxiety
Social anxiety disorder can be a severe condition that interferes with daily functioning, and, like
most anxiety disorders involves a tendency to avoid both phobic situations and contexts where
the experience of anxiety may arise. Meta-analytic results regarding the effectiveness of CBT
treatments for Social phobia indicate that one of the shortcomings of therapy involves the
considerable drop-out rates (12.2-18% in Taylor, 1996; 19.5% in Heimberg et al, 1998). Attrition
before treatment completion presents a problem, as the utility and effectiveness of treatment
could be compromised. Though socially anxious clients may drop out of treatment for various
reasons, there has been some suggestion that drop out may immediately precede exposure
initiation. This may be associated with the unwillingness of socially anxious individuals to
tolerate negative affect and the anxiety that will invariably increase during exposure tasks.
Finding ways to increase motivation and willingness to engage in exposure may thus combat
this problem. The present paper will explore attempts at utilizing Acceptance and Commitment
Therapy (ACT, Hayes et al, 1999) as a way to increase the client's willingness and engagement
in exposure exercises and as a way to decrease treatment drop out. Acceptance and
Commitment Therapy teaches skills associated with tolerance of internal experiences (thoughts
and emotions) and commitment to living life in accordance with ones values, in spite of
emotional or other obstacles. Two case studies of individuals diagnosed with social anxiety will
be presented and discussed in this respect.
Making better use of the group in CBt group therapy for social Anxiety Disorder
Group CBT protocols have been developed to treat a wide range of clinical populations.
However, many people do not improve, thereby highlighting the need for further investigation
and refinement of the protocols. One obvious area for enhancement would be to utilise the
group aspect of the therapy more effectively. This is because, even though existing CBT
protocols are delivered in groups, the content and focus of the therapy is essentially the same
as that provided within individual CBT. For example, the protocols tend to maintain a focus on
individual cognitions and behaviours, with relatively little attention being paid to the unfolding
relationships between the group members. There is, however, an extensive body of literature
documenting group therapeutic factors which are relational in nature (i.e., they arise from the
interactions amongst group members), and which may be utilised by the therapist to promote
psychological growth in the members.
This project investigated the relevance of these group therapeutic factors to psychological
growth within SAD in order to identify enhancements to current group CBT protocols. A
qualitative investigation was conducted of clients important moments in their exopereince of
group therapy experience. Findings revealed that group factors were prominent in the clients
explanations of their therapeutic gains. Recommendations are made for the incorporation of
modifications in treatment which incorporate the complex and reciprocal relationships between
particular therapist interventions, interpersonal and group process variables, and psychological
change.
Instituto de Psicoterapia Cognitivo-Comportamental (IPC): Uma Experincia em
Formao, Ensino, Pesquisa e Atendimento Comunidade em Clnica-escola no Brasil

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Luciana de Toledo Bernardes da Rosa(UNIP/IPC), Giedre Ingrid das Neves Pereira


Costa(UNIP/IPC), Lara Matara Ferreira Miquelin (UNIP/IPC), Rosana Maria Garcia
(UNIP/IPC), Jssica Gubolin (IPC), Carina Todesco(IPC)
Luciana Bernardes da Rosa1, 2, Giedre Costa1, 2, Lara Miquelin1, 2, Rosana Garcia1, 2, Carina
Todesco1, Jssica Gubolin1.
1. Instituto de Psicoterapia Cognitivo-Comportamental - IPC, So Jos do Rio Preto, Brazil, 2.
Universidade Paulista - UNIP, So Jos do Rio Preto, Brazil.
O Instituto de Psicoterapia Cognitivo-Comportamental foi criado em maio de 2010, com o
objetivo de oferecer formao ao profissional em psicologia, atravs do desenvolvimento de
habilidades e competncias terico - praticas indispensveis a um trabalho clinico tico e de
qualidade, com enfoque na terapia cognitivo-comportamental. Nosso trabalho se estende ao
compromisso social de oferecer atendimento comunidade, atravs da oferta de servios
diferenciados, em parceria com organizaes pblicas e privadas; diagnstico e tratamento
clnico especializado; e a realizao de pesquisas cientficas que possam contribuir para o
desenvolvimento e sedimentao de uma prtica psicolgica eficiente e atualizada. Seguindo
estes objetivos formulou-se o curso de especializao fundamentado em cinco eixos
estruturantes, a saber: 1) Bases tericas e metodolgicas das Terapias Cognitivocomportamentais; 2) Avaliao e diagnstico dos transtornos mentais dentro da TCC; 3)
Tcnicas de Tratamento; 4) Prtica Clnica e 5) Procedimentos metodolgicos e pedaggicos
em Psicologia, totalizando 600 horas de formao. A prtica clnica baseia-se nos princpios
terico-metodolgicos da terapia cognitiva proposta por Aaron T Beck. As supervises, assim
como as aulas, so realizadas quinzenalmente, por professores titulados e treinados na
abordagem proposta. Os alunos gravam e transcrevem as sesses, afim de desenvolver
habilidades e competncias teraputicas acuradas. O eixo 5 que refere-se aos procedimentos
metodolgicos prope o desenvolvimento de pesquisas cientficas, com delineamentos qualiquantitativos. Da cumpre-se o objetivo de formar clnicos-pesquisadores. Algumas das reas
de interesse so estudos de caso clnico, meta-anlises da produo cientfica nacional e
investigaes sobre relao e conduta teraputica, procurando contribuir assim com o
desenvolvimento do conhecimento em TCC. Com o trabalho desenvolvido foi possvel
estruturar o servio oferecido comunidade pela clnica-escola, onde elaborou-se um protocolo
de avaliao do atendimento que propiciou a caracterizao da clientela atendida, bem como o
acompanhamento dos resultados destes, possibilitando assim revises de condutas e
aprimoramento do processo clinico dos psiclogos em formao. O IPC conta com uma equipe
de 04 psiclogas experientes e 03 em formao, sendo estas ltimas dedicadas a realizar
atendimentos comunidade; com estes atendimentos nota-se o desenvolvimento do
pensamento clnico, de competncias e habilidades dentro da abordagem proposta, alm do
crescimento pessoal dos envolvidos.
Facilitadores y Obstculos de la alianza teraputica
Claudia Bregman1, Tania Borda2, Margareth Oliveira3, Eliane Falcone4, Ileana Caputto5, Mara
Esther Lagos5.
1. Fundacion Aigle, Ciudad Autonoma de Buenos Aires, Argentina, 2. Universidad Catolica
Argentina, Ciudad Autonoma de Buenos Aires, Argentina, 3. Pontifcia Universidade Catlica do
Rio grande do Sul (PUCRS), Porto Alegre, Brazil, 4. Universidade do Estado do Rio de Janeiro,
Rio de Janeiro, Brazil, 5. SUAMOC, Montevideo, Uruguay.
Esta Mesa Redonda Clnica est organizada por miembros de la Asociacin Latinoamericana
de Psicoterapias Cognitivas (ALAPCO). La propuesta es enfocar un aspecto central de los
procesos psicoteraputicos, la alianza teraputica. En el campo de las terapias comportamental

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cognitivas los desarrollos respecto de la alianza teraputica han quedado relegados a un


segundo plano a favor del protagonismo de las tcnicas especficas. Sin embargo es creciente
el inters de los clnicos de estos abordajes por entender el proceso sobre la base de un
modelo coherente e integrado con el procesamiento cognitivo de la dada interpersonal
(terapeuta y paciente). Esta preocupacin se debe probablemente a las dificultades
encontradas en aquellos tratamientos que no alcanzan los resultados deseados. El objetivo de
esta propuesta es presentar una revisin actual de la relacin teraputica, sobre la base de
entenderla como un elemento activo en el proceso de cambio. Es decir que adquieren especial
protagonismo las variables del terapeuta y del paciente en el desarrollo del proceso teraputico.
La calidad de la relacin teraputica es producto de los resultados teraputicos y a la vez es
una condicin para los resultados beneficios. Por lo tanto nos proponemos reflexionar acerca
de cmo lograr una buena alianza para la instalacin del proceso teraputico y cmo intervenir
para mantenerla en un buen nivel en cada una de las fases del mismo teniendo en cuenta
diferentes condiciones clnicas. Con el objetivo de examinar aspectos de este constructo se
presentar una introduccin general del tema a cargo de Caputto: La relacin teraputica;
aspectos que los pacientes resaltan como facilitadores de la alianza. La misma se basar en
los resultados de la aplicacin de un cuestionario administrado a los pacientes confeccionado
en Uruguay. Luego se expondrn diferentes consideraciones en los modos de construir e
intervenir sobre la alianza teraputica teniendo en cuenta cuatro situaciones clnicas. Bregman
har hincapi en las peculiaridades de la alianza teraputica a tener en cuenta en los
tratamientos para pacientes con trastornos de ansiedad. Falcone presentar las caractersticas
particulares por las cuales atraviesa la alianza teraputica en los tratamientos de los trastornos
de personalidad. Da Silva Oliveira desarrollar los aspectos pertinentes a las situaciones
clnicas en pacientes con Sndrome Metablico en donde interviene un equipo interdisciplinario
Borda se centrar en las singularidades de la alianza teraputica en el tratamiento de nios con
trastorno obsesivo compulsivo en los cuales participa la familia.
Avances y Perspectivas de la Terapia Cognitivo Comportamental en los Trastornos
Emocionales
Ren Caldern1, 3, Ren Javier Calderon Mndez1, 2, Jorge Landaeta1, 2, Ren Caldern1, 3,
Ren Javier Calderon Mndez1, 2, Jorge Landaeta1, 2.
1. Centro de Psicologa Cognitiva Comportamental CEPSICC, La Paz, Bolivia, 2. Universidad
San Francisco de Asis USFA, La Pas, Bolivia, 3. Universidad Mayor de San Andres, La Paz,
Bolivia.
Autore y Conferencistas:
Dr. Ren Caldern Jemio. Past President de ALAMOC, Director General del CEPSICC de
Bolivia, Profesos Emrito de la UMSA
Mgr. Ren Javier Caldern Mndez: Coordinador Acadmico del CEPSICC de Bolivia, Director
de la Fundacin EMPRODE de Bolivia, profesor de la USFA.
Mgr. Jorge Landaeta: Investigador y Consultor del CEPSICC de Bolivia, Profesor de la USFA
El objetivo del Simposio es de mostrar los avances, perspectivas y la contribucin tanto en el
campo del desarrollo conceptual como en el orden metodolgico y de intervencin de la
Terapia Cognitivo Comportamental como un aporte a la salud social, afectiva y emocional de
las personas , las parejas, familias y los grupos humanos mediante la presentacin de tres
estudios relacionados con problemas producto de investigaciones clnicas longitudinales
realizada en Bolivia sobre el sndrome de la depresin, la ansiedad y problemas emocionales
en las parejas disfuncionales que surgen como producto de las concomitancias de la
modernidad y la adaptacin de los seres humanos a los distintos cambios y transformaciones
del entorno a partir de los nuevos ajustes que se van dando en detrimento de las necesidades

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bsicas de las personas y sobre todo del espacio de sus relaciones interpersonales provocando
en los seres humanos mayores niveles de vulnerabilidad emocional a tiempo de presentarse
nuevas y mayores alternativas de afrontar la vida cotidiana y la adaptacin equilibrada al
context., El nfasis de la intervencin teraputica cognitiva comportamental basada en la
comprensin y entendimiento de los problemas depender bsicamente de la formulacin y
configuracin de las alteraciones clnicas e interrelacin de variables especficas y pertinentes
de los problemas de manera sistemtica para facilitar el razonamiento teraputico en el objetivo
de lograr una mayor efectividad en la intervencin y la superacin de los problemas . Para este
fin se presentaran modelos de abordaje teraputico sobre los componentes cognitivos,
afectivos, emocionales, y comportamentales de la depresin, la ansiedad y los problemas
emocionales de las parejas en relacin a las capacidades de afrontamiento a sus distintos
entornos de interaccin.
Intervencin y tratamiento en los casos de la Depresin Mayor
Autor y Conferencista: Dr Ren Caldern Jemio
El presente trabajo se sustenta en un estudio e investigaciones longitudinales realizadas desde
hace mas de 20 anos por el autor sobre los distintos sndromes depresivos en una poblacin de
casos diagnosticados como depresivos crnicos. En primera instancia el anlisis funcional
define la conducta problema de forma concreta y explicita y estudia sus relaciones con
elementos del contexto personal e interpersonal del paciente, en concreto hace hincapi en los
antecedentes (prximos y remotos) y los consecuentes y en los pensamientos y afectividad. Es
decir, estudia tambin los aspectos especficos emocionales, cognitivos y conductuales que se
asocian a la conducta problema. Beck afirma que en los trastornos emocionales existe una
distorsin sistemtica en el procesamiento de la informacin, que produce unos pensamientos
irracionales que son la causa de la depresin. Segn este modelo, la perturbacin emocional
depende del potencial de los individuos para percibir negativamente el ambiente y los
acontecimientos que les rodean. La depresin se debe a una distorsin cognitiva, en la que el
depresivo distorsiona la realidad vindose de forma negativa en la triada cognitiva, el mismo, el
mundo y el futuro. En la Exposicin se expondr formas de tratamiento que consisten en
detectar los pensamientos negativos de los sujetos y analizarlos y cambiarlos racionalmente.
La aportacin que se puede dar desde el punto de vista corporal es que las sensaciones que
sentimos son debidas a pensamientos automticos. Cuando pensamos mucho sobre un tema
vamos reduciendo el pensamiento de forma que generalizamos y dejamos indicado el
contenido y lo nico que sentimos es la preparacin para actuar En este sentido se presentaran
modelos de intervencin que permiten la superacin de los sntomas y la estructura
depresogena y, las emociones y la sensaciones asociadas. Tambin se presentaran los
resultados de casos tratados cuyos resultados permiten relacionar categoras y variables
relacionadas con los factores socioculturales
Abordaje Teraputico en casos de Ansiedad Generalizada con Agorafobia y Ataques de
Pnico
Autor y Conferencista: Mgr. Ren Javier Caldern Mndez
El objetivo de la presentacin de este trabajo es revisar la eficacia de los tratamientos Cognitivo
Comportamentales para los trastornos de ansiedad generalizada con sndrome de agorafobia y
ataques de pnico exponiendo los casos de pacientes que tienen que luchar contra la
ansiedad, con los sentimientos y pensamientos que lleva asociados su tremendo esfuerzo, esta
marcando la direccin de su vida, en lugar de sus aspiraciones, objetivos y valores que le
llevaran a ser mas feliz. Cuando el paciente se ha colocado en posicin de luchar por sus
valores, pese a sus problemas, ha aceptado la filosofa de la tcnica bsica de la
desensibilizacion, que consiste en enfrentarse a las situaciones temidas sin dar las conductas
de evitacin.

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La tcnica de afrontamiento de la ansiedad que haba demostrado de forma mas fehaciente su


eficacia se llamaba desensibilizacion sistemtica y de ella tomo su nombre la fase que aqu
describimos. Sin embargo, en el proceso de avance de la terapia cognitivo conductual se han
ido matizando los elementos que hacan que esa tcnica funcionase y se ha demostrado que lo
fundamental es la exposicin a los estmulos temidos. Los ansiosos con agorafobia y a como
una forma de evitar el estar solos e indefensos con miedos extremos que se convierten en
ataques de pnico afirman que, a lo largo de toda su vida, no han tenido mas remedio que
enfrentarse a las situaciones temidas. Lo hacen todos los das y no les ha servido para nada.
Pero la exposicin teraputica es algo mas, ya que consiste, efectivamente, acudir a las
temidas, pero dejando, adems, de dar las respuestas de evitacin, aplazamiento. Se trata, no
solamente buscar y acudir a las situaciones temidas, sino hacerlo de una forma diferente. Se
mostraran as mismo resultados de estudios realizados en nuestro medio relacionados con el
tema del trabajo a presentar
Tcnicas de Intervencin en Problemas Emocionales de Parejas disfuncionales
Autor y Conferencista: Mgr Jorge Landaeta
Se presenta un trabajo bajo una nueva perspectiva de abordaje. Lo que realmente vemos de la
pareja son sus conductas, es lo visible pero por detrs de dichas conductas hay un conjunto de
pensamientos y emociones que interactuan con distintas situaciones en las que los valores
personales son importantes , sumandose atribuciones causales con respecto a la conducta de
los dems (lo que pensamos acerca de la actuacin de los dems), sesgos en la percepcin,
es decir DISTORSIONES COGNITIVAS QUE PRODUCEN EN LAS PERSONAS UNA SERIE
DE SENTIMIENTOS DESAGRADABLES como la ansiedad, los celos, el resentimiento, el
dolor, que nos colocan en el disparadero de actitudes no siempre beneficiosas en las
relaciones de pareja como las discusiones interminables, acciones que daan al otro miembro
de la pareja, venganzas Se presentara un modelo en el que se configura el complejo
entramado de pensamientos, sentimientos y actitudes de cada miembro de la pareja que estn
interrelacionando para generar el conflicto. El siguiente paso es aprender a aplicar una forma
alternativa de pensar y de reducir los sentimientos desagradable que provocan malestar con la
pareja. As como desarrollar formas de actuar que nos permitan resolver las desavenencias con
el otro. Las tcnicas que se utilizan en la Terapia de Pareja Cognitivo-Conductual son las
tcnicas que hoy por hoy demuestras mayor efectividad.
Gestalt-Terapia e ACT: Possveis Dilogos entre a Psicoterapia Gestltica e a Terapia de
Aceitao e Compromisso
Luis Callegario.
Psicologia, Universidade Ceuma, So Lus, Brazil.
Abstract Central: Estudo com a finalidade de buscar aproximaes tericas e prticas entre a
Gestalt-Terapia e a Terapia de Aceitao e Compromisso (ACT). Objetivo: Analisar as bases
histricas, filosficas e conceituais, expor as teorias e descrever a compreenso do processo
psicopatolgico e, por fim, pontuar os principais pontos de dilogo encontrados em ambas as
teorias. Mtodo: reviso da literatura dos principais autores das duas teorias e suas bases
epistemolgicas. Concluso: a Gestalt-Terapia considerada uma abordagem psicoterpica
humanista de cunho fenomenolgico-existencial. O modelo psicopatolgico da GT situa-se em
torno das perturbaes no contato do homem com o mundo e com as suas prprias
experincias. J a Terapia de Aceitao e Compromisso baseada no behaviorismo radical de
Skinner e na Teoria dos Quadros Relacionais (RFT). caracterizada por ser uma abordagem
comportamental contextual que incorpora em suas prticas clnicas a aceitao experiencial,
mindfulness, a presentificao da experincia do cliente, engajamento em atitudes baseadas
em valores, abertura experiencial, uso de metforas e histrias e o foco na relao teraputica.

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Para a ACT e a GT os indivduos deixam de entrar em contato com sua experincia presente e
realizar o aprendizado necessrio caso estivessem em contato com a realidade, e passam a
viver focados em seus pensamentos, sentimentos e emoes que podem no estar conectados
com sua experincia presente.
Luto Materno e a Importncia da Terapia do Luto
Ana Laura Callejon, CAmila Barros, Patrcia Malheiros.
UNIMAR, Marlia, Brazil.
Observa-se como as mes ficam desamparadas diante da morte de um filho e a dificuldade em
superar uma dor to profunda sem a ajuda teraputica. importante ampliar o conhecimento
das tcnicas psicolgicas utilizadas para o enfrentamento do luto. Estas possuem a finalidade
de aliviar a dor e tambm de auxiliar a assimilao da morte de seu filho. Uma das
possibilidades teraputicas conhecida como Terapia do Luto, a qual uma forma de
Psicoterapia Breve que pode facilitar o processo de elaborao do luto materno. O objetivo do
trabalho fazer uma reflexo sobre os alcances e a importncia da Terapia do Luto no
processo de elaborao da dor das mes que perderam seus filhos. Para tanto, realizamos
uma reflexo sobre a questo do vnculo e do apego, construdos entre me e filho ao longo do
desenvolvimento humano e a perda e como esses aspectos se transformam diante do luto
materno. A terapia do luto que caracterizada como um tratamento de natureza psicolgica,
cuja durao limitada e assim tem como meta proporcionar uma melhor qualidade de vida do
paciente atravs do alvio dos sintomas, restaurao do nvel de funcionamento que existia
anteriormente ao problema, compreenso das foras que desencadearam o distrbio e
compreenso das medidas que podem contornar as dificuldades atuais no meio. Baseia-se nas
seguintes premissas: a autorizao para sofrer, o livrar-se da culpa e voc pode ser feliz
novamente, uma alternativa para amparar a me enlutada, proporcionando um ambiente
propcio para as manifestaes de sofrimento e de pesar, ou seja, permitir a vivncia do seu
luto. Atravs das pesquisas realizadas at o momento, pode-se afirmar que possvel a
utilizao das tcnicas e mtodos adotados pela Terapia do Luto para restabelecer a me
emocionalmente e a sua vida ps-luto.
Projeto de Extenso em Assistncia Psicolgica ao Acadmico (PROAPA UNESP/Marlia, Brasil ): Um Trabalho em Enfoque Cognitivo-Comportamental
Ana Laura Callejon, Regina Rondina, Carmen Andrade.
UNIMAR, Marlia, Brazil.
A origem, evoluo e disseminao das Terapias em Enfoque Cognitivo-Comportamental
(TCCs) relativamente recente, em termos da histria da Psicologia Clnica como um todo;
configura um campo ainda em expanso. Diante disso, fundamental a implantao de
programas psicoteraputicos baseados nessa abordagem, no mbito de instituies pblicas e
privadas, de modo a diversificar as modalidades de interveno teraputica disponveis
comunidade nas diversas regies do Brasil. Em outubro de 2009, foi iniciado o Projeto de
Extenso em Assistncia Psicolgica ao Acadmico (PROAPA), junto Universidade Estadual
Paulista Julio Mesquita Filho (UNESP, Unidade Marlia, So Paulo, Brasil). O projeto oferece
assistncia psicolgica em enfoque cognitivo - comportamental ao corpo discente da
instituio. Assim sendo, este manuscrito apresenta dados sobre o perfil da clientela atendida
no PROAPA, durante os anos letivos de 2010 e 2011. Este estudo consiste em uma pesquisa
descritiva de carter documental. Foi efetuado um levantamento de dados sobre a natureza do
projeto e principais caractersticas da clientela atendida, no perodo compreendido entre os

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anos letivos de 2010 e de 2011, atravs de consultas junto documentao que consta dos
arquivos do projeto. O PROAPA atende a uma populao discente composta por
aproximadamente 2300 alunos, matriculados em curso de graduao e ps graduao da
UNESP (Unidade Marlia). Em 2010, atravs de uma parceria sob a forma de convnio de
estgio, acadmicos do curso de Psicologia da Universidade de Marlia (UNIMAR/SP)
passaram a desenvolver estgios extracurriculares supervisionados em Psicologia Clnica no
PROAPA sob enfoque cognitivo - comportamental , cujo processo teraputico consiste em
intervenes de natureza cognitiva e estratgias destinadas modificao de padres de
comportamento. Psiclogos voluntrios tambm desenvolvem tambm sesses de assistncia
psicoterpica aos acadmicos junto ao PROAPA. O projeto recebe recursos provenientes de
fontes diversas no mbito da UNESP, como Proex (Pr Reitoria de Extenso Universitria),
Fundunesp (Fundao para o Desenvolvimento da UNESP) e tambm da Diretoria da Unidade,
que concede as bolsas de estgio. Aps as entrevistas iniciais para cadastro e avaliao dos
inscritos, nos casos em que se constata a necessidade de interveno em enfoque cognitivo
comportamental, o acadmico encaminhados para psicoterapia. O levantamento de dados
revelou que durante os anos letivos de 2010 e 2011 foram efetuadas 89 entrevistas para
cadastro e triagem de estudantes que buscaram pelo servio de assistncia psicolgica. Dentre
os estudantes inscritos no perodo citado, 30,3% so do sexo masculino e 69,7%, feminino. A
faixa etria varia de 19 a 32 anos de idade; 95,5% so solteiros e 4,5% casados; 76,40% so
provenientes de cursos nas reas Humanas e 23,60%, de Biolgicas. O PROAPA vem
promovendo a articulao entre as atividades de ensino, pesquisa e extenso, atravs da
realizao de pesquisas cientficas, com base na documentao que consta dos arquivos do
projeto. Tendo em vista o aparecimento de numerosos relatos de abuso e dependncia de
substncias qumicas entre a clientela que procura o servio, pretende-se, futuramente,
desenvolver estudos cientficos sobre a comorbidade entre sintomas e / ou transtornos
psicolgicos e drogadico, bem como acerca da eficcia da interveno em enfoque cognitivo
comportamental, em casos clnicos dessa natureza.
Intervencin Cognitivo Conductual en una adolescente con fobia social especfica
Dacia Yurima Camacho Mata, Luz Orozco Ramirez.
Universidad Autonoma de Tamaulipas, Victoria, Mexico.
El trastorno de fobia social (FS) es el trastorno ms frecuente en adolescentes, de acuerdo a
diagnsticos realizados en un contexto clnico (Olivares, Piqueras & Rosa, 2006), con una
prevalencia que oscila entre el 3 y el 13 % (American Psychiatric Association [APA], 2002). La
fobia social se define como un temor acusado y persistente por una o ms situaciones sociales
o actuaciones en pblico en las que el sujeto se ve expuesto a personas ajenas al mbito
familiar o a la crtica de los dems. La persona teme actuar por miedo a ser humillado o a que
la situacin resulte embarazosa. (APA, 2002). Se distinguen dos tipos: a) Fobia social
generalizada y fobia social especfica (Turner, Beidel & Townsley, 1992, citado en Olivares,
Piqueras& Alczar, 2006). En los ltimos aos, investigaciones han revelado (Sierra, Zubeidat y
Fernndez, 2006; Bunge, Gomar & Mandil, 2008) que la fobia social est asociada a ciertos
estilos de crianza relacionados con sobreproteccin excesiva, experiencias de aprendizaje
relacionadas con fracaso en interacciones sociales, y vulnerabilidad biolgica. Suele
presentarse entre los 14 y 16 aos (Olivares, Caballo, Garca-Lpez, Rosa & Lpez-Gollonet,
2003), el adolescente manifiesta una elevada susceptibilidad a la crtica, a la valoracin
negativa por parte de los dems y al rechazo (Sierra, Zubeidat & Fernndez, 2006), al grado
que se ve afectada su autoestima y sus habilidades sociales. Cabe sealar que antes de
desarrollarse como una trastorno de ansiedad, la fobia social suele expresarse de manera ms
sutil como timidez durante la infancia (Zubeidat, Fernndez, Sierra & Salinas, 2008). Al ser un

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trastorno internalizado, la conducta del nio no es percibida como un problema. Bungr, Gomar
y Mandil (2008) sealan la eficacia de la Terapia Cognitivo Conductual (TCC) y la Psicoterapia
Conductual para el tratamiento psicolgico de la ansiedad en nios y adolescentes. Dentro de
la TCC, la combinacin de exposicin, habilidades sociales y tcnicas cognitivas alcanza los
mayores niveles de efectividad (Prez, Fernndez, Fernndez & Amigo, 2006). Se presentan
los resultados de un estudio de caso llevado a cabo en una adolescente de 17 aos de edad
con diagnstico de fobia social especfica. En su infancia vivi en un ambiente de
sobreproteccin por parte de sus padres, donde se reforzaba la conducta evitativa, lo cual no le
permiti a la paciente desarrollar habilidades para afrontar situaciones de ansiedad. Se elabora
el mapa clnico de patognesis y el mapa de alcance de metas propuesto por Nezu, Nezu y
Lombardo (2006) para la formulacin de casos y diseo de tratamiento, el cual tiene un
enfoque Cognitivo Conductual que integra: Psicoeducacin., Reestructuracin cognitiva,
tcnicas de resolucin de problemas; Entrenamiento en habilidades sociales, relajacin
muscular progresiva de Jacobson; Ensayos de conducta en el consultorio y exposicin en vivo.
Los resultados muestran una disminucin gradual de la sintomatologa que se mantienen en el
seguimiento realizado a tres meses y con ello se corrobora la eficacia de la Terapia Cognitivo
Conductual en el tratamiento de la fobia social tanto a corto como mediano plazo.
The latest developments in internet-based treatments of common mental disorders
Per Carlbring1, Gerhard Andersson5, 6, Robert Johansson5, Anna Nyblom5, Per Carlbring1, Pim
Cuijpers7, Per Carlbring1, Johanna Boettcher1, 2, Linda Leek3, Lisa Matson3, Emily Holmes8,
Michael Browning4, Gerhard Andersson5, 6, Fjola Dogg Helgadottir9, Christopher Fairburn9, Pim
Cuijpers7, Lisanne Warmerdam7, Gerhard Andersson5, 6, Robert Johansson5, Kien Hoa Ly5,
Heleen Riper7, Nick Titov10, Britt Klein11, James Bennett-Levy10, Ron Rapee10, Clare Shann10,
Blake Dear10, Colin MacLeod12.
1. Department of Psychology, Stockholm University, Stockholm, Sweden, 2. Freie Universitt,
Berlin, Germany, 3. Ume university, Ume, Sweden, 4. University of Oxford, Oxford, United
Kingdom, 5. Linkping University, Linkping, Sweden, 6. Karolinska Institutet, Stockholm,
Sweden, 7. Vrije Universiteit, Amsterdam, Netherlands, 8. MRC Cognition and brain Sciences
Unit, Cambridge, United Kingdom, 9. University of Oxford, Oxford, United Kingdom, 10.
Macquarie University, Sydney, NSW, Australia, 11. Australian National University, Canberra,
ACT, Australia, 12. University of Western Australia, Perth, WA, Australia.
The field of internet-based treatments is rapidly expanding and evolving. In this symposium, with
speakers from Australia, The Netherlands, The United Kingdom and Sweden, the latest
developments in the treatment of common mental disorders is presented and discussed. We will
cover interventions for depression and social anxiety disorder as well as web-based training of
therapists and trainee preferences. In addition, lessons from an Australian national treatment
service delivering internet-based treatments for common mental disorders are discussed.
Besides internet-delivered interventions a new study using CBT for depression through a mobile
phone application will present its first results. Finally, a 14-day Internet-based cognitive bias
modification program will present its results including six-month follow-up.
Let the patient decide? A pilot preference study Internet-based psychodynamic versus
cognitive behavioral therapy for depression.
Major depression is a world-wide problem that can be treated with various forms of
psychotherapy. There is strong research support for treating major depression using cognitive
behavior therapy delivered in the format of guided self-help via the Internet (ICBT). Recent
research also suggests that psychodynamic psychotherapy can be delivered as guided self-help
via the Internet (IPDT) and that it can be as effective as ICBT for mild to moderate depression.

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However, no head-to-head comparison between the two treatments exists. In the field of
Internet interventions it is largely unexplored if treatment preference affects outcome and
adherence. Overall, there are few preference studies in the field of CBT and in particular this is
called for when there are indications that treatments may be equally effective (Cuijpers et al.,
2008). In this study, participants were allocated to IPDT or ICBT based on their preferences
following a brief description of the two treatments. More than half of the participants preferred
ICBT (N = 30) over IPDT (N = 14). Differences in efficacy between treatments were explored.
Correlations between strength of preference and treatment outcome, adherence to treatment
and completion of the whole treatment program were also investigated. Data were collected
before and after treatment, as well as in a 7-month follow-up. During the treatment period, both
programs performed equally well in reducing symptoms. More participants who received IPDT
completed the entire program. At follow-up, mixed-effects models showed that the ICBT
treatment was more efficient in terms of quality of life. The ICBT group also had a significant
increase in participants who recovered from their depression from post-treatment to follow-up.
Exploratory analyses indicated that strength of preference was correlated with adherence to
treatment and completion of the whole program, and long-term outcome for the ICBT group.
Overall, few differences were found during the acute treatment phase, but the long-term effects
were in favour of ICBT. Strength of preference for treatment seems to have a predictive value.
Further research comparing the efficacy of ICBT and IPDT, and the effects of preference
matching and strength of preference, is warranted.
Treatment of social anxiety disorder using a 14-day Internet-based cognitive bias
modification program.
Biases in attention processes are thought to play a crucial role in the aetiology and maintenance
of Social Anxiety Disorder (SAD). However, results on the assessment and modification of
attention bias are not consistent. Research so far has mostly concentrated on the biased
attention towards social threat cues and modification programmes that aim to reduce this bias.
Other data suggests that individuals with SAD show attentional avoidance, a bias away from
threat. The goal of the present study was to examine the efficacy of a programme intended to
train attention towards positive social cues (reducing the bias towards threat) compared to the
efficacy of a programme instead intended to train attention towards negative social cues
(reducing the bias away from threat). In a randomised, controlled, double-blind design, the two
training conditions (towards positive stimuli versus towards negative stimuli) were compared to
a control training condition. A modified dot probe task was used, and delivered via the Internet.
A total of 129 individuals, diagnosed with SAD, were randomised to one of the three groups and
took part in a 14-day programme with daily training/control sessions. Attention bias was
assessed before and after the training period applying a dot-probe task. Social anxiety
measures as well as secondary outcome measures were administered before and after the
training and at 6 months follow-up.
Preliminary analyses indicated that attentional bias did not change significantly as a function of
exposure to the three training conditions. All three conditions led to reduced symptoms of social
anxiety from pre- to post-training and to follow-up-assessment. Only the probe task procedure
intended to train attentional bias towards negative cues showed large effects and was also
significantly superior to the control condition in the reduction of social fears. There were no
significant differences in social anxiety outcome between the training conditions intended to
induce attentional bias towards positive cues and the control condition. Change on secondary
outcome measures (depression, quality of life) was moderate and did not differ between the
three groups.
To our knowledge, this is the first RCT where exposure to a condition designed to induce an
attentional bias towards threat yielded better outcomes than did exposure to conditions
designed to train attention towards positive cues, or than to leave attentional selectivity

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unaltered. The possible implications of this finding for the clinical hypothesis of the detrimental
effect of attentional avoidance in SAD will be discussed. Particularly given that the intended
attentional training manipulation did not significantly modify attentional selectivity, our results
suggests that this programme for social phobia is at a pre-clinical stage and warrants further
research.
Web-based training in psychological treatments: A study of trainee preferences.
One barrier to the dissemination of evidence-based treatments is that few clinicians have
received training in how to deliver these treatments. A potential solution is "web-based training".
This involves the trainee having access to a clinically-rich website that has been designed to
provide the basis for the training in the treatment in question. If web-based training is to be
successful it needs to fulfill three core requirements. First, it needs to inform the trainee about
the strategies and procedures that characterise the treatment. Second, it needs to demonstrate
how best to deliver the treatment. Finally, it must match the perceived needs of the trainee, as
otherwise there is likely to be poor compliance. As part of the groundwork for developing a webbased training program, we conducted a study of trainee preferences.
For data collection, a web-based self-report questionnaire was sent to 393 therapists who had
volunteered to give feedback on the training website as it was developed. The therapists were
from Australia, Canada, Denmark, Iceland and the UK, and 209 completed the survey. The top
desired properties were: 1) the ability to ask questions; 2) clear and easy navigation; and 3)
availability of handouts for use in therapy. The respondents also specified what they did not
want: 1) advertisements; 2) too much content on the screen; and 3) the ability to be in touch
with each another via the website. These findings, at least one of which was unexpected,
demonstrate the importance of surveying users' views in advance, and during, the website
development process.
CBT for depression through the mobile phone: First results of the ICT4Depression
project.
Depression is expected to be the disorder with the highest disease burden in high-income
countries by the year 2030. ICT4Depression (ICT4D) is a European FP7 project which aims to
contribute to alleviate this burden by making use of depression treatment and ICT innovations.
In this project we developed an ICT-based system for use in primary care that aims to improve
access as well as actual care delivery for depressed adults. Innovative technologies within the
ICT4D system include 1) flexible self-help treatments for depression, 2) automatic assessment
of the patient using mobile phone and web-based communication 3) wearable biomedical
sensor devices for monitoring activities and electrophysiological indicators, 4) computational
methods for reasoning about the state of a patient and the risk of relapse (reasoning engine)
and 5) a flexible system architecture for monitoring and supporting people using continuous
observations and feedback via mobile phone and the web. The general objective of the ICT4D
project is to test the feasibility and acceptability of the ICT4D system within a pilot study in the
Netherlands and in Sweden during 2012 and 2013. At the conference, an overview of the
system will be presented, as well as the results of the pilot studies.
Lessons from an Australian national treatment service in delivering internet-delivered
treatments for common mental disorders.
In December 2012, the MindSpot Clinic, a publicly funded national remote treatment service,
began operating in Australia. The internet-delivered treatment courses used at the MindSpot
Clinic were developed and tested at the eCentreClinic, Macquarie University, Australia. This talk
will present preliminary outcome data, patient details, and information about acceptability to
consumers and therapists, of this new service. Lessons learned in modifying and applying these
interventions will also be presented.

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The Impact of Information on Attitudes towards E-Mental Health Services


Leanne Casey, Angela Joy, Bonnie Clough.
School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
E-mental health services are internet-based treatment options for mental illness. There has
been a proliferation of these services in recent years. However, the limited research available
indicates that attitudes about e-mental health services are less than optimal. Past research has
found that providing information about services can improve attitudes. This study investigated
the relationship between knowledge of e-mental health services and attitudes toward e-mental
health services. The attitudes examined were the perceived helpfulness of e-mental health
services, and the likelihood of using the services. Participants (N = 217) were randomly
assigned to one of three conditions: provision of e-mental health information by means of film;
provision of e-mental health information by text; or provision of no e-mental health information.
Main effects were found for type of e-mental health service and for both perceived helpfulness
and likelihood of future use. Participants perceived online programs without therapist assistance
as being significantly less helpful, and reported reduced likelihood of engaging these programs
when compared to other e-mental health services. There was also a main effect for type of
information intervention, in that the text group reported higher likelihood of e-mental health use
in the future, whereas there were no effects for the film group. Results indicate that participants
perceive important differences between types of e-mental health services, and that a brief text
intervention can improve attitudes toward these services. Limitations of the present study and
directions for future research are discussed.
Estilo Personal del Terapeuta: Cmo Intervienen Terapeutas CognitivoComportamentales con Diferentes Niveles de Experiencia
Claudia Castaeiras, Alejandro Curtarelli, Fernando Garca, Beatriz Gmez, Matias Ighani,
Aldana Lichtenberger, Hctor Fernndez-Alvarez.
Fundacin Aigl, Buenos Aires, Argentina.
En el marco del programa de investigacin sobre el Estilo Personal del Terapeuta se ha
desarrollado una Gua de Observacin de la Conducta Verbal de los Terapeutas (GOTA-v). El
objetivo de este trabajo es describir y comparar el tipo de preguntas y afirmaciones que realizan
terapeutas cognitivo-comportamentales con distintos aos de experiencia clnica. Se analizaron
los registros de audio de 4 terapeutas, dos de ellos noveles (hasta 5 aos de experiencia) y dos
experimentados (ms de 15 aos de experiencia). Para ello se llev a cabo un procedimiento
de identificacin de unidades de anlisis y categorizacin de las intervenciones verbales de
acuerdo a los criterios de la GOTA-v. Los resultados indican que la GOTA-v permite detectar
diferencias en las intervenciones verbales que realizan terapeutas cognitivo-comportamentales
con distintos niveles de experiencia.
Advances in CBT-based Internet Interventions
Kate Cavanagh1, Heleen Riper2, Gerhard Andersson3, Abi Millings4, Per Carlbring5, Maria
Tillfors6, Pim Cuijpers2.
1. School of Psychology, University of Sussex, Falmer, United Kingdom, 2. VU University
Amsterdam, EMGO+ & Leuphana University, Innovation Incubator, Amsterdam, Netherlands, 3.
Department of Behavioural Sciences and Learning, Linkping University, Linkping, Sweden, 4.
Department of Psychology, Uppsala University, Stockholm, Sweden, 5. University of Sheffield,
Sheffield, United Kingdom, 6. rebro University, rebro, Sweden.

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The evidence base for CBT-based internet interventions in common mental health problems is
expanding rapidly. Recent reviews and meta-analyses have produced promising findings
regarding CBT-based internet interventions in terms of effectiveness and acceptability. The
attractions of CBT-based internet interventions as a treatment option for common mental health
problems include this developing evidence base, relative advantage in terms of costeffectiveness, increased availability and accessibility, and the congruence of CBT-based
internet intervention services with various other contemporary healthcare drivers such as
increased choice, reduced stigma, patient empowerment and self-care.
The state of the art is rapidly evolving. This symposium explores recent advances in the design
and delivery of CBT-based internet interventions as well as extensions in therapeutic content
and methods for identifying those most and least likely to benefit from internet interventions. We
present five empirical papers which showcase advances in this field. Three papers focus on
technological developments exploring the development of blended learning approaches (Riper),
the use of smart-phones and tablet devices (Andersson) and the potential for augmentation of
CBT-based internet interventions with sensor technologies (Millings). The final two papers
explore the applicability of internet interventions to third-wave CBT approaches such as
mindfulness (Carlbring) and showcase research methods which may help us to further
understand what works for whom in CBT-based internet interventions (Tillfors).
These recent advancements in CBT-based internet interventions and their implications for
research and practice will be discussed (Cuijpers).
Blending CBT treatments for depression in specialised care services
Presenter: prof. dr. Heleen Riper, VU University Amsterdam, EMGO+ & Leuphana University,
Innovation Incubator
Co-authors: Lisa Kooistra, Jenneke Wiersma, Patricia van Oppen
Ample studies have shown the clinical and cost-effectiveness of Internet-based Cognitive
Behavioural Therapy for the treatment of minor and major adult depression (iCBT). The
implementation and uptake of iCBT in specialised mental care services is however rather low for
reasons that are related to patients as well as therapists. CBT treatments that combine
evidence based face to face CBT with iCBT may overcome some of the aforementioned
obstacles. This format of CBT treatment delivery is defined as blended CBT (bCBT). bCBT
uses the advantages of online and offline treatment delivery and offers a way to match patients
preferences and needs with the format of treatment delivery. This approach may improve
treatment adherence and patient involvement, and lessen the workload of therapists by
diminishing the duration and/or frequency of face-to-face contacts. We will present the results of
our feasibility project on Blended CBT depression treatment for ambulatory patients in
specialised mental care services in the Netherlands. These results entail a demonstration of 2
prototypes for bCBT delivery that we have developed. These prototypes are characterised by
different levels of technological components, duration of sessions and patients selfmanagement activities. Both have been developed in close collaboration with relevant
stakeholders such as patients, professionals and intervention developers. In addition, we
present the results of our feasibility and acceptability survey on bCBT for depression among
patients and professionals in routine practice.
Smartphone and Internet-delivered ICBT versus interpersonal psychotherapy for social
anxiety disorder: a randomized controlled trial
Gerhard Andersson1,2 , Jesper Dag, 1, Robert Persson Asplund1, Brjnn Ljtsson2,, Tomas
Furmark3, Per Carlbring4
1Department of Behavioural Sciences and Learning, Linkping University, Linkping, Sweden
2Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm,

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Sweden
3Department of Psychology, Stockholm University, Stockholm, Sweden
4 Department of Psychology, Uppsala University, Stockholm, Sweden
There are now several controlled studies showing that guided ICBT can be effective in reducing
symptoms of social anxiety disorder (SAD). With the exception of one trial in which applied
relaxation was tested there are no studies on other treatments such as internet-delivered
interpersonal psychotherapy. A new development in the field of internet interventions is to make
the treatment available via smartphones. In the present study we adapted our internet
intervention for presesentation on a smartphone. We also made it possible for participants to
access the treatment via computer and iPAD. Instead of using a standard waiting list control
group we developed a new self-help treatment based on interpersonal psychotherapy (IPT). IPT
has been tested previously as a treatment for SAD. We recruited and included 52 participants
with a diagnosis of SAD. They were randomized to either CBT or IPT delivered via
smartphone/computer. The treatment lasted for 8 weeks and was guided by therapists. 52%
were women and the mean age of the sample was 37 years. A majority of 62% had generalized
social phobia. Results at posttreament showed that both treatments lead to improvements on
the Liebowitz Social Anxiety Scale with within-group effect sizes being d= 0.91 (CI95% 0.52 to
1.3) for CBT and d=0.36 (CI95% 0.07 to 0.66) for IPT. Results showed a small but significant
difference in favour of CBT. There were 6 dropouts from the IPT treatment and 3 from CBT. In
terms of usage, participants used smartphone 42.81%, computer 50.05%, and tablet 7.14% of
the time they were connected to the treatment platform. We conclude that guided self-help can
be delivered via smartphones and that ICBT is probably more effective than IPT. Further
research should investigate long-term effects and moderators of outcome.
Can the effectiveness of an online stress management program be augmented by
wearable sensor technology?
Abigail Millings, Joanna Morris, Sally Easton, Christine Mohr, & Angela Rowe
Purposes: Technological advances over the past decade have resulted in a variety of online
self-help programs for sub-threshold and mild mental health problems. How can current and
future technology be utilised to improve engagement and augment the effectiveness of these
programs? One option is to incorporate feedback about the users physiological state into the
program, via wearable sensors. We describe a mixed methods study (a randomised controlled
trial and qualitative interviews) of a newly developed sensor system, using ECG and EEG
sensors for both monitoring and biofeedback and neurofeedback exercises, alongside a
Cognitive Behaviour Therapy based stress management program.
Method: Ninety-eight stressed, but not depressed university students were randomised to
receive either: the program plus the sensors, the program only, or no intervention. Mental health
was measured at baseline, immediately after the 4-week intervention, and again 4 weeks later.
Participants were interviewed at immediate follow to provide qualitative feedback about their
experiences of the program and the sensors.
Results: Significant reductions in stress and trend reductions in depressive symptoms were
observed for the program only group at follow up, and these reductions continued at second
follow up. A similar but weaker pattern of result was observed for the program plus sensors
group. Qualitative data explicate the failure of the sensors to augment program effectiveness,
highlighting participation burden as a key issue. However, specific feedback regarding the
sensors was mixed - some aspects (neurofeedback) were perceived very positively, and others
(24hour monitoring of vagal tone) were perceived more negatively, and preferences were
expressed for some ways of using the sensors over others.
Conclusions: The newly developed stress management programme could be an effective way to
improve student mental health. Wearable sensor technology has something to offer online
program, but more development and research is needed.

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Internet-based Mindfulness treatment for mixed anxiety disorders


Per Carlbring 1
Daniel Phlsson 2
Viktor strm 2
Ola Schenstrm 3
Gerhard Andersson 4,5
1 Department of Psychology, Stockholm University, Sweden
2 Department of Psychology, Ume University, Sweden
3 Mindfulness center, Lule, Sweden
4 Department of Behavioural Sciences and Learning, Psychology, Linkping University, Sweden
5 Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm,
Sweden
In 2011 Vllestad, Sivertsen, and Nielsen randomized 76 individuals suffering from any of the
major anxiety disorders to either a wait-list or an eight-week group intervention based on
mindfulness. The results were promising and they concluded that mindfulness-based stress
reduction is an effective treatment for anxiety disorders and related symptomatology. The
present study is an attempt to transfer this group intervention into an internet-based mindfulness
treatment. A total of 91 participants presenting with social phobia, generalized anxiety disorder,
panic disorder or anxiety disorder not otherwise specified were randomized to an 8 week fully
automated treatment program or an attention control condition (discussion group).
By the time of the conference 6-month follow-up data will be available. However, immediate
results indicate that relative to the attention control condition statistically significant interaction
effects were found for the treatment condition on all outcome measures (BAI, BDI-II, QOLI, ISI).
The effect sizes were medium for symptoms of anxiety and mood disorders, but small for
enhanced quality of life and sleep problems. Considering that no therapist contact was included
the results are promising for heterogeneous anxiety disorders, but replication in a non-self
recruited population is needed.
Individual variation in social avoidance and depressive symptoms among people with
social anxiety disorder and the relationship with treatment outcome of guided internetbased self-help
Maria Tillfors1, Tomas Furmark2, Gerhard Andersson3, and Per Carlbring4
1rebro University, Sweden, 2Uppsala University, 3Linkping University, and 4Stockholm
University
Randomized clinical trials show that cognitive behavioral therapy (CBT) in various formats
(individual, group, as well as guided internet delivered self-help) is effective for people with
social anxiety disorder (SAD). However, even with the best psychological treatments, more than
one in four shows a suboptimal treatment response. The heterogeneity in treatment response in
clinical samples is important to further investigate. Co morbid depressive symptoms as well as
high levels of avoidance behavior have been shown to predict suboptimal treatment response.
In addition, it can be hypothesized that combinations of factors that predict poor treatment
outcome may especially increase risk for poor treatment outcome. In other words, there may be
subgroups of individuals with different profiles of risk factors for poor treatment response.
Therefore, this study aims to examine patterns of social avoidance and depressive symptoms
within individuals in a clinical sample of people with SAD. Furthermore, the aim is to relate inter
individual differences on combinations of these variables to treatment outcome, specifically,
level of social anxiety. This could extend our knowledge on heterogeneity in clinical samples in
relation to treatment response. Aim: To distinguish subgroups of social avoidance and
depressive symptoms in a clinical sample with SAD before and after guided internet-based
CBT, and compare them on levels of social anxiety and diagnosis of SAD. Methods: A clinical

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sample of 167 patients who received guided internet-based CBT was used. The design was
prospective and data was obtained at pre- and post-treatment. Cluster analysis was used to
identify subgroups of people characterized by different profiles of social avoidance and
depressive symptoms. These profiles were examined in relation to social anxiety. We further
examined individual stability and change between subgroups from pre- to post treatment.
Results: We identified four subgroups, including one subgroup scoring high on both social
avoidance and depressive symptoms (the high problem profile) and one subgroup that
consisted of the opposite pattern (the low problem profile), at both time-points. It was typical that
people in the high problem profile continued to belong to a profile with high levels of social
avoidance and depressive symptoms after treatment. It was atypical that people in this
subgroup moved to the low problem profile. The high problem profile had higher levels of social
anxiety than the other subgroups both before and after treatment. Importantly, the post
treatment scores of social anxiety in the high problem subgroup were still in the same range as
scores of people in clinical samples before entering treatment. Converging upon this, we found
that people belonging to the high problem subgroup were underrepresented among those who
no longer fulfilled the criteria for a diagnosis of SAD after treatment. Conclusions: The results
show that combinations of high levels of depressive symptoms and social avoidance behavior in
individuals with SAD entering internet CBT constitute a clear risk profile for poor treatment
response. It is important to specifically target social avoidance and depressed symptoms in
people with SAD in guided internet-based CBT.
Attachment focused research on cognitive behavioural therapy and beyond
Kate Cavanagh1, Abi Millings4, Kathy Carnelley2, Angela Rowe3, Kate Cavanagh1, Katherine
Jackson1, Kathy Carnelley2, Abi Millings4, Kate Cavanagh1, Kathy Carnelley2, Angela Rowe3,
Abi Millings4, Angela Rowe3, Kate Cavanagh1, Abi Millings4, Kate Cavanagh1, Kathy Carnelley2,
H. King3, Laura Shepstone3.
1. School of Psychology, University of Sussex, Falmer, United Kingdom, 2. University of
Southampton, Southampton, United Kingdom, 3. University of Bristol, Bristol, United Kingdom,
4. University of Sheffield, Sheffield, United Kingdom.
Bowlbys Attachment Theory (1969) posits that experiences with primary caregivers in infancy
and loved ones throughout life serve to define cognitive-affective components, known as
internal working models of relationships, which guide affect regulation behaviours. Insecure
attachment orientation is linked to a range of psychopathologies including depression, anxiety
and low self-esteem. Conversely, secure attachment orientation is associated with increased
resilience and problem-solving orientated approaches to interpersonal stressors. Attachment
orientation, the extent to which we are able to feel safe and secure in interpersonal contexts,
can powerfully influence our experience of close relationships, including those developed in the
therapeutic context. For example, the literature suggests that attachment orientation can
influence both therapeutic process (Slade 1999; Eames & Roth, 2000) and outcomes (Tasca et
al., 2006). This suggests that those experiencing greater attachment security are more able to
engage with therapy process and more likely to benefit from this.
Relatively little research has explored the role of attachment orientation in relation to cognitive
behavioural therapies. This symposium begins by reviewing recent social-cognitive adult
attachment literature of direct relevance to cognitive behavioural therapy and presenting a
framework within which attachment theory and cognitive behavioural models of mental health
might be integrated (Millings et al. ). The symposium goes on to present three empirical studies
which explore the role of attachment orientation in cognitive behavioural therapies and related
processes (mindfulness, problem-solving).
Carnelley et al. explore the role of individual differences in attachment orientation on attitudes to
and engagement with cognitive behavioural therapies. Rowe et al. investigate the impact of

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attachment security and self-compassion priming on willingness to engage in mindfulness


practice. Cavanagh et al. present a study testing the effect of attachment security priming on
social and interpersonal problem solving. Each of these studies indicate that attachment
orientation may be importantly related to engagement with, and benefit from therapeutic
interventions in cognitive behavioural therapy and beyond, and supports further integration of
attachment theory and cognitive behavioural theory and therapy in research and in practice.
What does social-cognitive attachment research have to offer CBT?
Bowlbys Attachment Theory (1969) posits that experiences with primary caregivers in infancy
and loved ones throughout life serve to define cognitive-affective components, known as
internal working models of relationships, which guide affect regulation behaviours. Becks (1967;
2008) cognitive model of depression proposes that cognitive vulnerabilities towards depression
are often caused by adverse experiences in early life resulting in dysfunctional attitudes, which
are stored in schema, and become reactivated by stressful events and perpetuated by negative
cognitive biases. A small body of literature (Atkinson & McBride, 2009; Williams & Riskind
2004a; 2004b) has begun to explicate the overlap between these two theories and its
implications for the treatment of common mental health problems, with particular reference to
Cognitive Behavioural Therapy (CBT). In this talk, we build on this literature by reviewing recent
social-cognitive adult attachment literature of direct relevance to CBT. In so doing, we consider
what social-cognitive research into adult attachment can offer CBT implementation and practice.
Specifically, we discuss attachment as a predictor of therapeutic orientation, links between adult
attachment models and common thinking errors, the attachment-related content of inner beliefs,
and the potential use of attachment security priming in the context of CBT. This talk provides the
theoretical standpoint utilised by the following talks in this symposium.
Attachment and Attitudes Toward and Engagement with a Therapeutic Task
Those high in avoidance are less likely to seek therapy (Riggs et al., 2002), more likely to drop
out of cognitive behavioural therapy (CBT; Tasca et al., 2006), yet show the most improvement
(Fonagy et al., 1996). In contrast, secure individuals typically have a positive alliance with
therapists (Slade, 2008). We extend research by examining how attachment orientation
influenced participants attitudes toward, and engagement with, a CBT task (thought challenge).
We expected those high (versus low) in avoidance to be less motivated to do the task, have
more negative attitudes and feelings toward the task and engage with it less. We investigated
possible mediators of this link: experiential avoidance (Gamez, Chmielewski, Kotov, Ruggero, &
Watson, 2011), and psychological flexibility (Bond et al., 2011). Session 1: Attachment patterns
and mediators were assessed. The experimenter instructed participants to notice when they
displayed cognitive thinking errors (homework). Session 2: We told participants they would take
part in a therapeutic exercise which they might find psychologically challenging but insightful.
Participants were 99 (76% female, MeanAge=21) undergraduates who reported attitudes
toward the task, completed the task, and finally reported engagement with and feelings toward
the task. Results showed that before the task those high (versus low) in avoidance reported
being less curious about their feelings, those high (versus low) in anxiety anticipated negative
emotions during the task, but thought they would learn something useful. During the task:
Participants were asked to reflect back to the automatic negative thought and report their
feelings at the time. Results showed that highly anxious participants and highly avoidant
participants reported more negative feelings. After the thought challenge task dismissingavoidant individuals reported fewer negative feelings than did fearfuls and secures. Also, those
high in avoidance considered a less significant negative thought, were more distracted during
the task, thought the task was less pleasant, and felt they didnt learn anything valuable,
whereas those high in anxiety found the task unpleasant and difficult but considered a
significant thought during the task (suggesting more engagement). Finally, there was some

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evidence that experiential avoidance and psychological (in)flexibility mediated these links. This
study has clinical implications for understanding individual differences in engagement with
therapy.
Comparing the Therapeutic Benefits of Attachment Security Priming and SelfCompassion Priming Delivered Prior to Engagement in Mindfulness Meditation
Mindfulness meditation is a process of cognitive control, emotional reappraisal and existential
insight that is increasingly being used as a clinical intervention to improve psychological health.
Benefits of mindfulness training have been reported in relation to a number of psychological
outcomes, such as depression, stress and anxiety. Individuals vary in the extent to which they
find mindfulness difficult, with obvious implications for their engagement and willingness to
undertake mindfulness training. The two studies described herein examine how engagement
and willingness to persevere with mindfulness training might be enhanced. We compared two
potential enhancers: compassionate mind training and attachment security priming. In Study 1
(N=55) we compared self compassion and security primes both qualitatively and quantitatively.
Participants were semantically primed for self compassion or attachment security (or a neutral
prime) by writing for 10 minutes about feelings of compassion towards the self, an attachment
relationship characterised by attachment security, or about a trip to the supermarket,
respectively. They subsequently reported levels of self and other compassion, felt security and
interpersonal expectations and a thematic analysis was conducted on the scripts. The prime
conditions differed significantly in terms of the level of felt security reported post-prime, with
participants in the secure prime condition reporting higher levels of security than either the self
compassion or the neutral prime groups. The thematic analysis suggested important similarities
and differences between the conditions. Both the self compassion and security primes activated
themes related to self acceptance but the secure prime also revealed a theme of energy.
Participants in the self compassion prime commonly reported finding it difficult to write about self
compassion. In Study 2 (N=53) we compared the effectiveness of the primes on state
mindfulness and willingness to engage in further mindfulness training. Participants were primed
with one of the three primes and then engaged in a mindfulness meditation taster. The taster
involved an explanation of mindfulness followed by an introductory mindfulness session.
Relative to the neutral prime, both the security and self compassion primes increased
participants willingness to engage in further mindfulness training, although state mindfulness
scores did not differ between the groups. We conclude that the enhancement of both self
compassion and felt security prior to engagement in a mindfulness programme could be
beneficial for improving individuals willingness to further engage in mindfulness training.
Attachment security and interpersonal problem solving: Can security priming enhance
problem-solving skills?
Difficulties in interpersonal and social problem-solving are characteristic of depression and poor
problem-solving ability may moderate the relationship between stressful life events and
depression onset (Nezu, 1987). Problem-solving therapy is an effective intervention for
depression indicating that problem-solving ability influences the prognosis of depression (Bell &
DZurilla, 2009). Attachment theory (Bowlby, 1969, 1973, 1980) proposes that responsive early
caregiving nurtures feelings of safety and security that enable infants to confidently explore their
surrounding world. Exploratory behaviour, in the context of a secure base provides a sound
learning environment for problem-solving skills in adulthood. There is some evidence that feltsecurity is associated with enhanced problem-solving skills in adulthood, and moreover, that
both of these factors are inversely related to measures of depression and anxiety. This suggests
that the association between attachment security and mental health outcomes may be mediated
by problem-solving ability. A number of researchers have called for more experimental research
exploring the causal pathways between secure attachment, exploratory behaviour, and related

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outcomes (e.g. Feeney & Van Vleet, 2010). Research shows that priming adults with mental
representations of secure attachment results in enhanced creative problem-solving (Mikulincer,
Shaver & Rom, 2011). The present study explored whether these effects could be extended to
interpersonal and social problem-solving. Participants were assessed for dispositional
attachment orientation, and primed with either attachment security or a neutral prime. As
expected, security priming led to improved performance on both social and interpersonal
problem-solving tasks. This effect was moderated by latent attachment anxiety for interpersonal
problem-solving. The results suggest that secure attachment may be causally related to social
and interpersonal problem-solving competence, and provide empirical support for the theoretical
relationship between the attachment and exploratory behavioural systems. The implications of
these findings for research and practice in cognitive behavioural therapy will be discussed.
Kleptomania - Description of the Social-Demographic and Clinical Profile/ Evolution in a
23 Patient Treatment Program in CBT
Aparecida Christianini, Carmem Oliveira, Daniela Bertoni, Hermano Tavares.
Psychology, AMITI-HC-FMUSP, So Paulo, Brazil.
ABSTRACT Kleptomania is classified as an impulse disorder that characterizes for the recurring
failure to resist the urge to steal unnecessary objects of personal use, regardless of its monetary
value. The stealing behavior entails deep social suffering, marriage consequences, and
professional compromising. The present study has as an object to point out preliminary data of
a descriptive analysis from a greater study, having as a goal to identify the social-demographic
and clinical profile of a sample of 23 kleptomaniac patients, reporting the evolution of said
patients in a treatment program in individual and group CBT. The patients treated are part of
Pro-Amiti/HC-FMUSP (Integrated Outpatient Impulse Control Program). They were treated by a
staff (psychologists and psychiatrists). The program was structured on CBT and consisted of 20
weeks for group and individual. The used inventaries used is the study were Beck Depression
Inventory (BDI), Beck Ansiety Inventary (BAI) e Kleptomania Symptom Assessment Scale (KSAS), in a comparative in the begging, middle and end of the treatment. The study presents: the
description of the social-demographic and clinical profile, frequent comorbidities, suicide
attempts index, sexual abuse and alcoholism in first degree relatives. In the comparative
analysis of the applied inventaries, a decrease in the depressive and anxious symptoms as well
as the stealing behavior was observed, suggesting that the outpatient treatment used proved
itself effective. The most frequent comorbidities found in this sample were depression (65%),
GAT (61%), compulsive shopping (48%), with smaller percentiles in bulimia nervosa, bipolar
disorder, borderline personality disorder and sexual compulsion. The rates of suicide attempts
reached (30%), alcoholism in first degree relatives and sexual abuse (35%). The
characterization of the social-demographic profile of the patients treated had an average of 33
years old, 14 years of formal educations, being 70% of the female sex, 74% caucasian, 53%
married, 56% have jobs. The elevated degree of comorbidities, the presence of attempts of
suicide and alcoholism in first degree relatives, the prevalence of the female sex of the studied
sample matches with findings in studies in kleptomanias literature. It can be concluded that a
treatment program in CBT individual and in group presented improvement in the stealing
behavior, as well as in depressive and anxious traits. The patient profile in this study pointed to
an age group of productive individuals, with high educational degree and high unemployment
rates, suggesting a socioeconomic damage generated by this disorder. Key words: kleptomania,
treatment in CBT, social-demographic and clinical profile. e-mail: cidrchris@uol.com.br;
mcaroliv@hotmail.com; daniela@bertoni.com.br; hermano@uol.com.br

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PsychAssist: Preliminary Results from the Development and Trial of a Therapeutic


Smartphone Application
Bonnie Clough, Leanne Casey.
School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
Abstract Central: Although homework completion improves the outcomes associated with
CBT, many patients fail to adhere to this vital component of their treatment. Non adherence can
also increase patient non-attendance and dropout, leading to even poorer therapy outcomes.
Use of technological adjuncts in CBT may be able to increase patient completion of homework
and improve therapeutic outcomes. A therapeutic Smartphone Application (PsychAssist) has
been developed that contains electronic, interactive, versions of homework tasks. This
application allows patients to complete homework via the mobile phone, whenever and
wherever they choose. Homework can be carried with the patient at all times, is easily
accessible and usable, and can be accessed by therapists between therapy sessions. A
Randomized Controlled Trial (N = 120) is currently being conducted to assess the efficacy of
this application in the treatment of adult anxiety disorders. Participants were randomly allocated
to complete between session tasks either by means of the PsychAssist application, or by
traditional paper and pen. It was predicted that the use of PsychAssist would enhance patient
adherence to homework tasks, leading to improved therapeutic outcomes and maintenance of
treatment gains. Preliminary results of the trial will be presented and discussed.
A Controlled Trial of SMS Appointment Reminders to Increase Client Attendance and
Reduce Dropout
Bonnie Clough, Leanne Casey.
School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
Client dropout and non-attendance are two forms of non-adherence that are common
throughout psychological practice. Depending on the definition of dropout, it has been estimated
that approximately 40-60% of individuals attending mental health clinics drop out before
completion of treatment (Baruch, et al., 2009). The percentage of non-attended scheduled
appointments in mental health settings has been estimated to be as high as 60%, with an
average of about a third of appointments not kept (Lefforge, Donohue, & Strada, 2007). Nonattendance and dropout increases the length of waiting lists, leads to poor use of staff time and
resources, loss of income for therapists and clinics, and compromises the effectiveness of
treatment programmes (Chen, 1991; Conduit, Byrne, Court, & Stefanovic, 2004; Lefforge, et al.,
2007). Appointment reminders and prompts have been researched as one strategy for
decreasing no-shows and preventing dropout. Early research focused on reminders sent by
mail, although more recent research has utilized telephone reminders. This study focused on
Short Messages Service (SMS) as an adjunctive technology to reduce dropout and appointment
non-attendance. Specifically, the study investigated the effects of SMS reminders on dropout
and non-attendance in a university outpatient psychology clinic. In a controlled trial 140
consecutive adult patients at the clinic were randomized to either receive SMS appointment
reminders, or receive no SMS appointment reminders. It was predicted that the reminders would
reduce non-attendance and client dropout, after controlling for time spent on the waitlist. Results
of the study will be discussed, as well as implications for clinical practise and future research.
Predictors of Resilience in Caregivers of Elderly Relatives
Maria Crespo, Violeta Fernndez-Lansac, Ana Teresa Piccini, Carmen Sobern.
Facultad de Psicologa. Universidad Complutense de Madrid, Madrid, Spain.

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Introduction: Caring for a relative with dementia often has negative effects on caregiver's
physical and psychological health. However, many caregivers cope successfully the stressors
derived from care, and even they obtain uplifts of their experience, showing high resilience
levels. This study presents an analysis of resilience in caregivers of elderly relatives, exploring
what factors allow to predict its development. Method: Resilience was assessed (by CD-RISC)
in 111 family caregivers of dependent elderly. Regression analysis was performed to study the
influence on resilience of a great number of variables, clustered in the following categories:
caregiving context (e.g. sociodemographic aspects of caregiver and elderly), stressors (e.g. time
spent in caregiving, use of formal resources, cognitive impairment of elderly), appraisals (e.g.
burden, caregiving satisfaction) and mediator factors (e.g. personality traits and resources).
Results: The participants showed moderate scores on resilience. Resilience was significantly
predicted by diagnosis and elderly cognitive impairment; caregiver reaction to care recipient
problems; caregiving satisfaction; and mainly by caregiver` self-esteem, neuroticism and
extraversion. The model accounted for 58.2% of the variance, with good generalizability (R2adjusted R2 difference = 0.029). Conclusions: Clarifying factors that are implicated in the
development of caregiver resilience is the key to know how prevent the development of
symptoms associated to chronic stressful situations. Findings of this study show that stressors
regarding care recipient status affect to caregiver` adaptation. However subjective aspects
related to caregiver personality and appraisals are the best predictors of their resilience.
Elaborating future interventions that focus on improving individual resources and skills of
caregivers will contribute to promote a successfully adaptation at caregiving, being a good
alternative to traditional treatment programs applied in this population. Some clinical guidelines
will be proposed and its implications will be discussed.
A Goal Management Program for Depressed and Anxious Older Adults
Micheline Dub1, Sylvie Lapierre1, Lyson Marcoux1, Michel Alain1, Sophie Desjardins1, Paule
Miquelon1, Richard Boyer2.
1. Psychology, Universit du Qubec Trois-Rivires, Trois-Rivires, QC, Canada, 2. Centre
de recherche Fernand-Seguin, Hpital Louis-H. Lafontaine, Universit de Montral, Montral,
QC, Canada.
Introduction: Retirement marks important changes in the organization of life. As people age,
they face losses and changes they sometimes have difficulty adapting to. Their personal
projects must be revised; some can no longer be achieved as originally wished, others become
downright unattainable. As these losses increase, some individuals sink into depression.
Furthermore, the increase of physical fragility can also cause anxiety. However, since having
goals and projects is related to mental health, it is possible that psychological well-being could
be maintained and improved with a goal-based intervention. In an exploratory study, this type of
intervention was offered to depressed elderly persons with the objective of decreasing their
depression and anxiety. Method: The 14-week group program (Dub et al., 2007) was aimed at
helping the participants set, plan, and pursue their personal goals through a learning process
based on the literature on goal intervention. Measures were taken three times (pre, post, and six
month after the end of the program). At baseline, participants were anxious (Geriatric Anxiety
Inventory, Pachana et al., 2010) and moderately depressed Beck Depressive Inventory-II (BDIII). Results: Repeated Manovas (3 times by gender) were performed on the data of the 24
participants (14 females, 10 males) aged 65 to 84 years (M = 68.6). Results indicated no time
by gender interactions, a gender effect only for the BDI-II (F(1,22) = 4.24, p = 0.05), and a time
effect for all goal, depressive and anxiety indicators. Progress could be observed on the Goal
Realization Process Questionnaire (Bouffard et al., 2004) (M pretest = 134.36, M post-test =

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154.84, M follow-up = 150.66, (F(1,22) = 9.74, p < 0.005). The depressive symptoms had
decreased significantly as revealed by the BDI-II (M pretest = 20.96, M post-test = 10.06, M
follow-up = 10.52, (F(1,22) = 30.60, p < 0.001) as anxiety symptoms measured by Pachana
Inventory (M pretest = 12.04, M post-test = 8.15, M follow-up = 7.67, (F(1,22) = 12.23, p =
0.002). Conclusion: The results showed that the program was effective in enhancing the mental
health of the participants. The improvement was maintained six months later. The program
efficacy, the gender effect, and the concomitant increase of goal abilities and decrease of some
specific depressive and anxiety symptoms will be discussed. Reference: Dub et al. (2007).
Impact of a personal goals management program on the subjective well-being of young retirees.
European Review of Applied Psychology, 57, 183-192.
Possibilities of a Technical Eclecticism: Incorporation of Psychodrama-Style Techniques
to the Acceptance and Committment Therapy
Nikolett Eisenbeck.
Departamento de Psicologa, Universidad de Almera, Almera, Spain.
Abstract Central: The Acceptance and Committment Therapy (ACT, Hayes, Stroshal, & Wilson
1999) is one of the modern, third wave cogntive behavior therapies, that seems to have the
strongest empirical evidence and theoretical support among them (see Ruiz, 2010). ACT is an
experiential therapy, using various exercises and metaphors in the context of the behavioral
change of the client. In comparison, pychodrama is almost a hundred year-old therapy and set
of techniques. Its core concept is the spontaneity-creativity, which means to be ready to
improvise and respond in the present moment. According to the psychodrama, through this
process it is possible to discover new solutions to problems of the client. Despite of the
extensive theoretical differences between them, the aim of the present paper is to demonstrate
the possible use of specific psychodrama techniques in a modern cognitive behavior therapy.
These techniques include such as the mirroring, the doubleing, the soliloquy and the role
reversal. Furthermore, this paper attempts to understand these techniques from a contextualbehavioral perspective. Finally, the presentation describes different problems and possible
interventions where the implementation of these techniques could be feasible not only in the
ACT context, but in other cognitive behavioral therapies too.
Examining the Feasibility of CBT Training via Skype
Randy Fingerhut1, Henrik Tingleff2.
1. Psychology, La Salle University, Philadelphia, PA, USA, 2. Scandinavian Institute for
Cognitive Therapy and Training, Copenhagen, Denmark.
Abstract Central: Despite the well-established efficacy of cognitive behavior therapy (CBT),
there appears to be a gap in this treatment reaching the individuals who can most benefit from it
(Shafran et al., 2009). One possible explanation for the difficulties in disseminating CBT is
mental health practitioners lack of access to quality training. Videoconferencing technologies
are increasingly being used in clinical settings when face to face contact is prohibitive.
Preliminary data indicates that psychotherapy via videoconferencing shows equivalent efficacy
to face to face psychotherapy (Ruskin et al., 2004; OReilly et al., 2007). Videoconferencing is
also prevalent in educational settings. It is believed that this technology can be valuable in
training practitioners around the world who may not have access to certified CBT trainers and
cannot afford to travel to places where they are available. SkypeTM is a voice-over-internet
protocol (VoIP) service that allows peer to peer video communication via the internet. Recent
calculations from the company indicate that 40 million individuals concurrently use SkypeTM at

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any given time (Skype, 2012). The authors will present data from a pilot study designed to
examine the feasibility of using SkypeTM to train individuals in CBT. Eight CBT trainers from the
United States, Denmark, Turkey, and Argentina will conduct a one-hour CBT training session
with eight international trainees. All trainers will be members of The Academy of Cognitive
Therapy or The Association of Behavioral and Cognitive Therapies and have two or more years
of supervisory experience. Trainees will consist of individuals who are studying to be a
psychologist, counselor, or their countrys equivalent of practitioner and will have a novice level
of experience and training in CBT. In advance of the training sessions, trainees will email their
trainer summary information about a current client. The summary will include the clients
presenting problems, diagnoses, number of treatment sessions, and 1-3 supervisory questions
and goals for the training session. Training sessions will focus on addressing supervisory
questions, explaining CBT concepts, and demonstrating the use of CBT techniques. The
sessions will include time for feedback and questions and answers. After the training sessions,
trainers and trainees will complete a series of online questionnaires to assess the quality of the
experience. Questionnaires will include modified versions of the Working Alliance Inventory Training (WAI-T; Bahrick, 1989) and the Supervision Outcomes Survey (Worthen & Isakson,
2000). In addition, participants will answer open-ended questions designed by the authors to
gather qualitative information about the training sessions, focusing both on their acquisition of
CBT techniques and their experience in having a trainer/trainee from a different cultural
background than their own. The authors will present descriptive data on these measures and
will discuss the implications of the results. In addition, they will discuss future directions for
research, including examination of training retention, direct comparisons to face to face
supervision, and an assessment of the cost effectiveness of this mode of training.
Una Visin Breve Pero Completa de lo que Implica Hacer Psicoterapia Desde la Ciencia
Conductual Contextual (CBS): Contextualismo Funcional, Teora del Marco Relacional,
ACT, FAP... y Amor
Manuel Garayar.
Consulta privada, Lima, Peru.
Abstract Central: Hay una forma de hacer psicoterapia que es coherente con una forma de
hacer psicologa cientfica que es llamada Ciencia Conductual Contextual (CBS), la cual
emerge pero tambin va ms all del anlisis conductual tradicional, para cubrir ms
efectivamente algunos de los asuntos que conciernen a los clnicos (especialmente el
sufrimiento humano relacionado a cogniciones, emociones, etc.) La CBS es la estrategia
asumida por algunos psiclogos para influir en su ambiente o, en otras palabras, para cambiar
su mundo. La CBS implica acciones que emergen, y que al mismo tiempo, son coherentes con
un paradigma cientfico que tiene diferentes niveles que podemos identificar y que estn
articulados entre ellos. El nivel filosfico es el Contextualismo Funcional, una perspectiva
epistemolgica para hacer psicologa desde un punto de vista radicalmente pragmtico que
tiene su propia metfora raz (continuo acto-en-contexto) y un criterio de verdad (utilidad) el
cual es contrastado con la meta de prediccin e influencia de todo evento psicolgico con
precisin, alcance y profundidad. El nivel terico incluye todos los ya bien conocidos y
empricamente validados principios y leyes sobre el comportamiento humano; y una
aproximacin no mentalista sobre la cognicin y el lenguaje que es llamada Teora del Marco
Relacional (RFT), la cual es un intento de lidiar cientficamente con las cogniciones y otros
eventos privados apelando solamente a variables directamente manipulables. Finalmente, el
nivel aplicado o prctico incluye todo el rango de tcnicas y procedimientos usados en la
intervencin psicolgica. Los ejemplos clnicos de esta prctica incluyen terapias como la
Terapia de Aceptacin y Compromiso (ACT) y la Psicoterapia Analtico Funcional (FAP). ACT

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es una terapia contextual donde el terapeuta entrena al cliente (a travs del uso de metforas,
la prctica de la conciencia plena y ejercicios experienciales) en las habilidades para
discriminar cuando dar o no control a sus pensamientos, emociones, sensaciones corporales,
etc., y elegir una forma de comportarse de acuerdo a lo que el cliente necesita para ser efectivo
en vivir la vida en una forma que el cliente experimenta y elige como importante. FAP llama la
atencin del terapeuta hacia las conductas clnicamente relevantes que el cliente muestra
durante la interaccin con el terapeuta tal que ste puede aplicar las consecuencias necesarias
para incrementar o disminuir las conductas de inters para ayudar a cliente a vivir la vida en
una forma que es importante o valorada para ste. La articulacin de filosofa, teora y prctica
lleva a la conclusin de que la psicoterapia desde la aproximacin de la CBS no es una mera
tecnologa sino una forma de hacer psicologa cientfica a lo largo de diferentes niveles. La CBS
aplicada al trabajo clnico es una alternativa que es un intento sistemtico de usar la ciencia de
la forma ms efectiva posible para aliviar el sufrimiento humano, tal como la terapia de
conducta lo promovi desde largo tiempo atrs, pero dando algunos pasos ms, que son
necesarios para ser ms efectivos en el logro de esa meta. Todo esto implica algo que es la
esencia de la psicoterapia desde el enfoque de la CBS: Amor.
Cross Cultural DBT: An Update on Acculturation, Treating Hispanic/Latinos with
Borderline Personality Disorder with DBT and Culturally Sensitive Interventions
Suhadee Henriquez, Aurora Farias, Sofia Mendoza, Adriana Carrillo, Ulises Ramirez, Lizbeth
Gaona, Maximo Nunez, Lynn McFarr, Deborah Flores.
Harbor-UCLA Medical Center, Torrance, CA, USA.
La comunidad hispana est compuesta por personas de diferentes nacionalidades, razas,
niveles educativos y socioeconmicos. Suhadee Henrquez, Aurora Farias, Sofa Mendoza y
Adriana Carrillo exponen brevemente las caractersticas principales de (DBT) Terapia
Conductual Dialctica (TCD) desde una perspectiva transcultural con adultos, adolescentes y
familias hispanas. Vamos a hablar de los innumerables esfuerzos para ofrecer un tratamiento
para los Hispanos que es efectivo y modificado para las necesidades individuales del paciente
teniendo en cuanta los valores culturales. Hemos desarrollado un programa integral en Espaol
para los pacientes hispanos, utilizando adaptaciones culturales en la clnica ambulatoria
Harbor-UCLA en Los Estados Unidos. Algunas adaptaciones culturales incluyen, (1) a "La
Lotera Mexicana" con el fin de aumentar el cumplimiento de la tarea, completar tarjeta de
diario, y incrementar la asistencia al grupo de habilidades (2) tarjetas de diario adaptadas a las
capacidades cognitivas de cada paciente, muchas veces usando fotos o visuales (3) "dichos" y
"cuentos" con el fin de utilizar un lenguaje universal para ayudar a comprender habilidades,
conceptos y hasta para usar como ejercicios de conciencia plena (4) Por ultimo practicamos
siendo consientes de los valores culturales que incluyes en "personalismo" ,familismo, y
respeto. Los participantes: 1) adquieran conocimientos de los temas sobre la aculturacin en
una poblacin hispana y las adaptaciones del DBT, 2) sern capaz de describir la relacin entre
las habilidades de DBT y los resultados clnicos desde una perspectiva intercultural, y 3)
describir la importancia de las estrategias de focalizacin en DBT en una cultura y nivel de
desarrollo.
Cross Cultural DBT: Dialectical Behavioral Therapy (DBT) in the Latin American Culture
Suhadee Henriquez1, Aurora Farias1, Sofia Mendoza1, Adriana Carrillo1, Pablo Gagliesi2, Juan
Pablo Boggiano2, Domingo Marquez4, Kathleen Kelly3, Alianis Santos5.
1. Harbor-UCLA Medical Center, Torrance, CA, USA, 2. Fundacion Foro, Buenos Aires,
Argentina, 3. Medical Sciences Campus, University of Puerto Rico, Ponce, USA, 4. Red

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Metropolitana de Psicologia, Ponce School of Medicine and Health Sciences, Ponce, USA, 5.
Ponce School of Medicine and Health Sciences, Ponce, USA.
The Hispanic/ Latino community is made up of people from many different nationalities, races,
educational and socioeconomic levels. We will discuss the countless efforts being done across
the globe to provide Hispanic/Latino patients with an array of information, modified to fit the
individuals needs and cultural adaptation using Dialectical Behavior Therapy a cognitivebehavioral therapy technique developed by Marsha M. Linehan. This therapeutic model is the
most empirically supported treatment available for patient suffering from suicidal ideation,
parasuicde behavior, and specifically for individuals who meet criteria for borderline personality
disorder. Currently this therapeutic model has been expanded and validated to treat patients
with substance abuse disorders, eating disorders, impulsive behavior, and treatment-resistant
depression.
Analisis Cienciometrico de Intervenciones Psicolgicas Basada en el Uso de la Hipnosis
Maria Hernandez-Pozo1, 2, Miguel Muoz-Lopez2.
1. Universidad Nacional Autonoma de Mexico, CRIM, Cuernavaca, Mexico, 2. Universidad
Nacional Autonoma de Mexico, FES Iztacala, Tlalnepantla, Mexico.
Abstract Central: La hipnosis es una tcnica que se ha desarrollado con el paso de los siglos,
cada vez con mayor peso clnico y cientfico. Actualmente la hipnosis constituye un mtodo
slido de apoyo a tratamientos contra el dolor crnico y control de emociones ante situaciones
que generan miedo y ansiedad como la ciruga u otro tipo de fobias, por lo cual se presenta
como una alternativa al uso de frmacos por los especialistas en salud. Por otro lado dentro del
campo de las ciencias del comportamiento, adems de controlar respuestas de miedo y
ansiedad sirve como apoyo a las diversas tcnicas cognitivo conductuales estimulando su
asimilacin y desarrollo. Esta investigacin presenta un estudio cienciomtrico de las
investigaciones realizadas en los ltimos quince aos acerca de la hipnosis, a partir de
publicaciones en revistas especializadas publicadas en espaol o en ingls, que estn
indizadas en al menos una de dos bases bibliomtricas internacionales especializadas. Se
presenta y discute de manera crtica las aplicaciones contemporneas de la hipnosis, los
campos en que ha tenido xito su aplicacin, sus limitaciones, las redes de investigacin
generadas durante el lapso bajo estudio y se mencionan proyecciones probables para estudios
futuros.
El Efecto de Retroalimentacin en la Triada Teraputica y el Progreso del Cliente: Una
Mirada Cualitativa
Celsie Hiraldo, Caleb Esteban, Aida Jimnez, Jos Martnez.
Universidad Carlos Albizu, San Juan, USA.
La finalidad de este estudio de metodologa cualitativa es aportar cientficamente al desarrollo
de guas e intervenciones clnicas y de supervisin basadas en resultados empricos y
sensibles a la diversidad cultural que repercutan sobre el logro de resultados positivos en
psicoterapia para el cliente. Hallazgos recientes publicados en la literatura cientfica apuntan a
un crecimiento paulatino de la investigacin sobre el proceso de supervisin en psicoterapia por
varias razones; entre stas, la dificultad para evaluar experiencias vinculadas al proceso y la
falta de inclusin de variables tales como la retroalimentacin del cliente y cmo ello afecta los
resultados psicoteraputicos. Acorde a la metodologa de la Teora Fundamentada, este
estudio pretende desarrollar un modelo terico que explique cabalmente la interrelacin entre

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las variables asociadas a la inclusin de la retroalimentacin en la triada teraputica (cliente,


terapeuta en adiestramiento clnico y supervisor/a) sobre los resultados positivos y la
adherencia al tratamiento psicolgico de una muestra de 30 clientes adultos (hombres y
mujeres) en Puerto Rico. Luego de haber recopilado la data de la primera fase del estudio,
aquellos/as terapeutas en adiestramiento clnico de la Clnica de Salud Mental de la
Comunidad, Inc., localizada en San Juan, Puerto Rico, que previamente fueren asignados a la
condicin experimental y que accedan voluntariamente a participar sern individualmente
entrevistados. La informacin recopilada en dichas entrevistas ser clasificada y analizada
cualitativamente utilizando el software de anlisis de datos cualitativos de QSR International
(NVivo-10) que permite la elaboracin de conclusiones rigurosas basadas en la evidencia.
Finalmente, se proveern conclusiones detalladas y una discusin de los resultados junto a una
explicacin de las implicaciones asociadas a la inclusin de la retroalimentacin en el proceso
de psicoterapia y supervisin clnica, as como su efecto sobre el progreso y adherencia del
cliente al tratamiento psicolgico.
Terapeutica en los Servicios Penitenciarios Argentinos
Guillermo Jemar.
Hospital Jose T. Borda, CABA, Argentina.
Abstract Central: Se busca lograr el objetivo de desarrollar un marco terico desde donde se
base el razonamiento clinico psiquitrico y el teraputico, entender la conducta de los
residentes de un servicio penitenciario de Jvenes Adultos, y proponer distintas herramientas
de abordaje para limitar las consecuencias negativas sobre la estructura de la personalidad, y a
partir de ella de conductas distorsivas que impidan su adaptacin social de los mismos. La
necesidad de entender la conducta penitenciaria deviene de un complejo proceso de bsqueda
de un abordaje eficaz desde la medicina y especialmente de la psiquiatra, que mejore la
calidad de vida de quienes se encuentran en este tipo de rgimen y que sufren diversas
patologas que provienen de su historia personal y familiar, el medio ambiente en donde se
desarrollaron, de las circunstancias que los llevaron a tener que pasar una parte importante de
su vida en un rgimen carcelario, y de todas las caractersticas de este que influyen
negativamente sobre el desarrollo de la estructura de la personalidad. Las caractersticas
culturales de la sociedad en donde se desarrolla este anlisis, la formacin del personal
encargado de la seguridad y salud de los residentes privados de su libertad, las condiciones
edilicias, de higiene y alimentacin, son variables intervinientes y concurrentes que contribuyen
tanto positiva como negativamente al transcurrir de la conducta, y que delimitar el tipo y
calidad de vida de esta poblacin mientras transcurra su estancia en este rgimen, as como el
modo de interaccin social futura.
Emboyding Mindfulness: A Qualitative Exploration of Change Processes in MindfulnessBased Cognitive Therapy
Miae Jeon, Jungmo Kim.
University of Calgary, Calgary, AB, Canada.
Abstract Central: The purpose of this study was to explain processes during attending MBCT
by which how therapeutic effects happens and how these effects brought into therapeutic
effects. The results have shown embodying mindfulness as a high-order construction for
process of mindfulness based on 5 core categories: seeking problem solving, contextual
condition, applying mindfulness, mindfulness practice and reducing symptoms. The embodying
mindfulness is a process by which participants experienced experiential learning about relating

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their experience to mindful understanding. These findings suggest that the mindfulness process
makes sense only when the participants are able to be aware of mindfulness through selfinitiative seeking and embodying as a part of new perspective. Facilitators' role and meaning for
practicing mindfulness are discussed.
Treatment method x Therapeutic Relationship - a Neglected Interaction? A Mediation
Analysis based on Experimental Control of the Therapeutic Relationship
Viktor Kaldo1, Jonas Ramner2, Susanna Jernelv1.
1. Karolinska Institutet, Stockholm, Sweden, 2. Stockholm University, Stockholm, Sweden.
Abstract Central: Background The issue of whether the effects of psychotherapy are due to the
treatment itself or to the relation to the therapist have been hotly debated for a long time within
the area of psychotherapy research. Manualized self-help treatments present a unique
possibility of keeping the basic method constant (with regards to rationale for treatment, specific
methods, self-monitoring format etc), manipulating the therapeutic relationship (i.e.
administrating the treatment with or without support from a therapist) while studying client
involvement and usage of specific treatment methods. In CBT delivered as self-help, a
relationship between the presence of therapist support and enhanced outcome has been found.
In this study we aimed to investigate whether this relation can be explained by direct, general
effects of therapist support or if the increased effect is mediated by increased use of specific
techniques. Method In this study, data from a previous RCT on a CBT self-help book to treat
insomnia is used to compare a group receiving the book plus support (n=44) with a group
receiving the book only (n=45). Outcome was defined as pre to post change on the Insomnia
Severity Index (ISI). Homework involvement was measured through the participants ratings of
how much they have used the expectedly most important treatment methods (stimulus control,
sleep restriction and scheduled sleep). Structural Equational Modeling (SEM) was used to
perform the mediation analysis. In the SEM-model the three ratings of homework use was
combined in one latent variable called Homework Use. The validation of this measure based
on retrospective self-ratings was confirmed through its high and significant correlation (r=0.71)
with a corresponding latent variable based on therapists weekly ratings of homework in the
treatment group with support. In the SEM-model, Support (i.e. support vs no support) was the
independent variable, change in ISI the dependent variable and the latent variable of Homework
Use the mediator. Results The SEM model included rather few parameters to be estimated,
model fit was very good (Chi-2(4)=4.29, p=.36, RMSEA=0.29; NFI=0.96) and no adjustments
was needed. Before the mediator was included, the Total effect of Support was significant
(r=0.45). However, there was a full mediation of Homework Use that reduced the direct effect of
Support to a non-significant r=0.14 while the indirect (mediated) effect became significant
(r=0.31). Conclusion The effect of the therapeutic relation was fully mediated and to a large
extent (68%) explained by an increased use of homework, demonstration an important
interaction between relation and treatment techniques.
Centro de Formacin Clnica: Propuesta para cubrir necesidades concretas Ganar/Ganar
Adrian Kertesz.
Universidad de Flores, Buenos Aires, Argentina.
Abstract: en CFC tiene como propsito articular respuestas a necesidades concretas de
diferentes instancias, segn la filosofa Ganar/Ganar. Comunidad: la cobertura de salud,
mediante atencin psicolgica ambulatoria con aranceles accesibles Obras Sociales: la
cobertura de la atencin psicolgica a valores competitivos. Profesionales: la posibilidad de

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comenzar desde el inicio de su vida post universitaria atendiendo pacientes propios. Mediante
un Programa especfico, abocado a optimizar recursos, los psiclogos recin recibidos ingresan
en un programa de formacin interdisciplinaria, con supervisin adecuada. A su vez los
pacientes que consultan tienen el respaldo de la supervisin de su terapeuta, integrado en el
plan de formacin continua. La Obra Social resuelve el dilema costo/idoneidad al subir la
calidad clnica de su cuerpo de servicio clnico, ya que los profesionales noveles son
adecuadamente supervisados. Nuestro Centro es independiente, no depende de Universidad o
Sistema Social de Cobertura de manera alguna, aunque tenemos convenios con ambas
instancias para acceder al plantel de profesionales noveles y de pacientes, respectivamente.
En el presente trabajo analizaremos: Caractersticas del Programa de Formacin Continua
Requerimientos del Supervisor Modos de articulacin con Las Universidades y las Obras
Sociales Alcance, limitaciones y propsitos del Servicio Articulacin con otras instancias en
Salud mental Proyecciones futuras. By Adrian Kertesz 2012 Mdico Psiquiatra U.B.A. (1986)
y Ap.S.A. (1997). Creador del Modelo Epigentico, basado en el AQAL de Ken Wilber
(Psicologa Integral). Miembro Clnico Didctico de ANTAL , Director Mdico de MAVIA
(Institucin de Acompaantes teraputicos), CET Itaqu (Centro Educativo Teraputico),
Docente en Consejera Integral (www.concienciaintegral.com) y mdico psiquiatra de planta de
la Clnica Innovaciones en Salud, S.A.. Su enfoque apunta a establecer redes interdisciplinarias
de valor, optimizando recursos mediante una articulacin cuidadosa y diseada en base a cada
contexto, promoviendo relaciones recprocas Ganar/Ganar. Autor de Los Desafos del
Centauro, CCS Ediciones, Madrid, 2008 y Amantes y Socios, versin electrnica, 2012. e-mail:
adrian.kertesz@hotmail.com celular: (54-11) 113.187.6535 Skype ID: adrian.kertesz1
Pesquisa aplicada: investigaes observacionais e experimentais do fenmeno clnico /
Applied research: observational and experimental investigations of clinical phenomenon
Roberta Kovac1, Roberto Banaco1, 2, Denis Zamignani1, Dante Malavazzi1, Bernardo
Rodrigues1, Camila Lima1, Giovana Del Prette1, Victor Mangabeira3, 1, Emerson Simes1, 3,
Adriana Fidalgo1, 2, William Perez1, 3, Pedro Zuccolo3, 1, Yara Nico1, Daniel Caro1, 2, Sueli
Amaral1, Moema Pinto1, 2.
1. Applied Behavior Analysis, Ncleo Paradigma, So Paulo, Brazil, 2. Pontifcia Universidade
Catlica de So Paulo - PUC-SP, So Paulo, Brazil, 3. Universidade de So Paulo, So Paulo,
Brazil.
Nas ltimas dcadas ocorreu um grande avano no estudo dos fenmenos e processos
envolvidos na prtica clnica. Especialmente no mbito da clnica analtico-comportamental, os
avanos conceituais nos estudos sobre controle de estmulos e sobre comportamento social e
verbal tm levantado questes de grande relevncia para um melhor entendimento da prtica.
Decorrem deste avano conceitual um grande interesse pela investigao dos processos
envolvidos na constituio das relaes de equivalncia de estmulos e de quadros relacionais,
bem como dos chamados estudos de processo em psicoterapia. O fenmeno dos quadros
relacionais permite o entendimento das relaes simblicas, to importantes para a
compreenso da queixa clnica, enquanto as pesquisas de processo permitem o entendimento
ponto a ponto do processo de mudana que ocorre no interior da interao teraputica. O
presente simpsio visa a apresentao de diferentes modalidades de investigao
desenvolvidas no mbito da prtica clnica, desde o fenmeno dos quadros relacionais at
diferentes nuances da interao teraputica.
Controle contextual da transferncia/transformao de funo: implicaes clnicas
Transferncia de funo de dica contextual para respostas relacionais de igualdade e
oposio entre membros de uma classe de equivalncia

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O comportamento simblico definido como comportamento controlado por uma classe de


estmulos arbitrariamente relacionados por prticas convencionadas de uma comunidade
verbal, que se tornaram substituveis no controle do comportamento em alguns contextos. Isso
significa que podemos ser afetados por smbolos (palavras escritas, gestos, sons, imagens)
como seramos afetados pelas coisas a que esto arbitrariamente relacionados
(tradicionalmente, denominados de referentes). Tal fenmeno tem sido estudado pela rea de
equivalncia de estmulos e denominado transferncia de funo. Muitos experimentos tm
documentado que se um dado estmulo pertencente a uma classe de equivalncia adquire
determinada funo comportamental (discriminativa, eliciadora, reforadora positiva e
negativa), outros estmulos pertencentes classe adquirem a mesma funo indiretamente.
Resultados similares tem sido observados em experimentos na rea da RFT (Relational Frame
Theory). No entanto, em tais experimentos, outras relaes arbitrrias entre estmulos para
alm da relao de equivalncia so investigadas - por exemplo: oposio, diferena,
comparao, hierarquia etc. Quando as relaes estabelecidas entre os estmulos no so de
igualdade (ou equivalncia), a funo apresentada pelos estmulos arbitrariamente
relacionados no partilhada ou transferida, mas sim transformada. Segundo a Teoria dos
Quadros Relacionais (Relational Frame Therory), elementos do contexto determinam como e
quais funes especficas sero transferidas ou transformadas. As dicas contextuais para as
respostas relacionais modulam a valncia da funo transformada (Crel). Outros elementos do
contexto controlam quais funes esto em vigor (Cfunc). Entende-se que o responder
relacional est sempre sob controle de dicas contextuais (Crel). O presente estudo teve como
objetivo investigar se o controle contextual do responder relacional pode ser transferido entre
os membros de uma mesma classe de equivalncia.
Primeiramente, os participantes foram expostos a um treino no arbitrrio com objetivo de
estabelecer duas figuras sem sentido como dicas contextuais para respostas relacionais de
igualdade e oposio. Em seguida, relaes arbitrrias de igualdade e oposio foram
estabelecidas entre palavras sem sentido (igual/A1-B1; igual/A1-C1; oposto/A1-B2; oposto/A1C2) e relaes derivadas foram testadas (e.g., igual/B1-C1; oposto/C1-B2). Na fase seguinte,
as dicas contextuais de igualdade e oposio foram inseridas em uma classe de equivalncia
com outras figuras sem sentido. A transferncia de controle contextual foi testada substituindo
as figuras sem sentido originalmente estabelecidas como dicas contextuais por outras figuras
equivalentes nas tentativas de treino no arbitrrio e de treino e teste das relaes arbitrrias,
sem feedback. Cinco de dez participantes obtiveram resultados positivos para a transferncia
de funo da dica contextual e trs destes cinco tambm apresentaram a transformao de
funo no teste de transformao de significado.
Palavras-chave: Comportamento verbal; equivalencia de estmulos, teoria dos quadros
relacionais
Estudo sobre relaes entre o dizer e o fazer: algumas variveis que operam no controle
do planejamento de sesses teraputicas.
Investigou-se a correspondncia fazer-dizer sobre conduo de processo teraputico, e
mudanas no comportamento do terapeuta como efeito de entrevista de coleta de dados, em
procedimento de linha de base mltipla. Participaram deste estudo dois terapeutas recmformados e dois clientes, um de cada terapeuta, em processo teraputico. Os dois processos
tiveram 15 sesses teraputicas gravadas em udio e transcritas. Em mdia, 12 episdios de
determinada classe de respostas foram selecionados como foco de 4 entrevistas cada uma
delas obedecendo a um de trs critrios selecionados a partir de manuais de psicoterapia (dois
a respeito de comportamento desejveis e um de comportamento indesejvel de ocorrer
durante as sesses teraputicas) . Durante as entrevistas, a pesquisadora relatava o trecho
antecedente e perguntava ao terapeuta o que ele tinha feito naquela situao, lendo, em
seguida, o registrado da sesso teraputica. Procedeu-se a uma comparao entre as

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respostas relatadas durante a entrevista com as respostas observadas nas sesses


teraputicas. Observou-se correspondncia entre o comportamento relatado e o observado e
que o relatar solicitado no procedimento melhorou o desempenho do terapeuta segundo os
critrios da literatura. Discute-se a produo de correspondncia verbal e de ajustes no
responder que o relatar produz no desempenho.
Palavras chave: correspondncia, relato verbal., contingncia, entrevista, anlise de sesses
teraputicas.
Efeitos de Intervenes Reflexivas sobre o Repertrio do Cliente no Processo
Teraputico Analtico-Comportamental
Na literatura de pesquisa clnica h um debate a respeito do estilo de interveno teraputica e
seus efeitos na promoo da mudana. Entre os estilos possveis, encontram-se as
intervenes reflexivas. Pesquisadores de diferentes abordagens psicolgicas apresentam
evidncias de que este tipo de interveno influencia no desenvolvimento do processo
teraputico de maneira distinta de intervenes mais diretivas e prescritivas. No campo da
terapia analtico-comportamental, tal discusso de grande importncia, uma vez que nas
ltimas dcadas, alguns autores tem proposto a utilizao de estratgias reflexivas. O presente
trabalho teve por objetivo investigar as caractersticas particulares dos episdios de carter
mais reflexivo dentro de uma sesso teraputica. Com base nisto, uma terapeuta atendeu uma
cliente, verbalmente competente, por 20 sesses, todas filmadas com o consentimento da
mesma. Depois, trs sesses (segunda, dcima e dcima oitava) foram categorizadas de
acordo com o Sistema Multidimensional para a Categorizao de Comportamentos na
Interao Teraputica (SIMCCIT). Estas sesses foram escolhidas para caracterizar trs
momentos distintos do atendimento. A partir desta categorizao se pode atribuir qualificadores
para as relaes estabelecidas pela cliente nestas sesses, de acordo com a complexidade
destas relaes. Alm disso foi aplicado o Questionrio de Avaliao de Sesses, de Stiles, a
fim de verificar o impacto da terapia na cliente e na terapeuta. Os dados demonstraram que os
episdios de estabelecimento de relaes do cliente seguiram com maior frequncia e com
maior qualidade episdios reflexivos do terapeuta. Paralelo a isso, os dados do impacto sobre o
atendimento demonstraram que inicialmente o impacto para a cliente foi negativo e ao passar
das sesses este valor foi diminuindo e se aproximando de valores positivos. Mais pesquisas
ainda precisam ser feitas para examinar de forma mais detalhada as peculiaridades das
intervenes reflexivas, porm estes dados preliminares apontam para a importncia deste tipo
de interveno na produo de relaes de melhor qualidade do cliente.
Palavras chave: Pesquisa de processo; SIMCCIT; Avaliao de sesso teraputica
Mindfulness Online: The Feasibility of a Web-Based Mindfulness Course and its Impact
on Stress, Anxiety, and Depression
Adele Krusche1, Eva Cyhlarova2, Scott King3, J. Mark Williams1.
1. Psychiatry, University of Oxford, Oxford, United Kingdom, 2. Mental Health Foundation,
London, United Kingdom, 3. Wellmind Media Ltd, Brighton, United Kingdom.
Abstract Central: Objectives: Stress has been shown to have a number of negative effects on
health over time. Mindfulness interventions have been shown to decrease perceived stress but
access to interventions is limited. Therefore, the effectiveness of an online mindfulness course
for perceived stress was investigated. Participants: Our sample consisted of 100 self-referrals to
the online course. The average age of participants was 48 years and 74% were female.
Interventions: The online program consisted of modules taken from Mindfulness Based Stress
Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) and lasted for
approximately six weeks. Primary and Secondary Outcome Measures: Participants completed
the Perceived Stress Scale (PSS) before the course, after the course, and at one month follow-

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up. Completion of formal (e.g. body scan, mindful movement) and informal (e.g. mindful meal,
noticing) mindfulness activities were self-reported each week. Results: Participation in the online
mindfulness course significantly reduced perceived stress upon completion and remained stable
at follow-up. The pre-post effect size was equivalent to levels found in other class-based
mindfulness programs. Further, people who had higher PSS scores before the course reported
engaging in significantly more mindfulness practice, which was in turn associated with greater
decreases in PSS. Conclusions: Because perceived stress significantly decreased with such
limited exposure to mindfulness, there are implications for the accessibility of mindfulness
therapies online. Future research needs to evaluate the course effectiveness not only for
perceived stress, but also other health benefits for which face-to-face mindfulness therapies
have been shown to help, such as anxiety and depressive symptoms. Novel findings: Follow-up
data will also be presented investigating the change in perceived stress, anxiety and depression
using the PSS, Generalised Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire
depression items (PHQ-9) for a sample of 273 self-referrals.
Case formulation in behavioral and cognitive-behavioral therapies
Willem Kuyken1, Steve Hollon3, Jacqueline Persons2, Christopher Martell4.
1. University of Exeter, Exeter, United Kingdom, 2. San Francisco Bay Area Center for Cognitive
Therapy, San Francisco, CA, USA, 3. Vanderbilt University, Nashville, TN, USA, 4. Martell
Behavioral Activation Research Consulting, Milwaukee, WI, USA.
When clients describe various presenting issues and co-morbid Axis I and II diagnoses, what
should be the primary focus for the work? If clients presentation is more complex, what
treatment strategies should I use, and in what order? In the realities of clinical practice clients
rarely present in ways that neatly fit a particular theory or protocol. Case formulation is at the
heart of cognitive and behavioral therapies because it is where evidence-based therapies and
clients unique presentations come together. An individualized case formulation is used it to
select and adapt interventions from cognitive-behavioral protocols to fit a particular case. It
empowers therapists by helping them describe and understand their clients more complex
presentations in cognitive and behavioral terms. The panel will begin with an overview of case
formulation (Willem Kuyken). It will then have presentations from leading cognitive (Jacqueline
Persons) and behavioral (Christopher Martell) therapists about how they approach case
formulation. The presentations will include case examples that illustrate more straightforward
presentations where a particular protocol is clearly indicated, as well as more complex
presentations where case formulation comes into its own. The panel will end with an opportunity
for questions and discussions, facilitated by Steve Hollon who has been involved in many of the
key cognitive and behavioral trials in the last 30 years. This panel discussion will be of interest
to CBT therapists who wish to learn how case formulation can help them become more effective
therapists with clients who present with unique and co-morbid presentations.
Internet-based therapies for mental health disorders: The National eTherapy Centre
Michael Kyrios1, Stefan Hofmann3, Jo Abbott1, Michael Kyrios1, Denny Meyer1, Michael Kyrios1,
Claire Ahern1, Maja Nedeljkovic1, Richard Moulding1, Jo Abbott1, Michael Kyrios1, Jo Abbott1,
Neil Thomas1, Michael Kyrios1, John Farhall2, Susan Rossell1, Maja Nedeljkovic1, Debra
Osborne1.
1. Brain & Psychological Sciences, Swinburne University, Hawthorn, VIC, Australia, 2. Latrobe
University, Bundoora, VIC, Australia, 3. Boston University, Boston, MA, USA.

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Internet-based psychological treatment programs (eTherapies) are increasing being used as


effective treatment for mental health conditions. The field continues to expand, as individuals
who would not or could not access traditional forms of therapy look for health information online.
The symposium will present the latest research from Anxiety Online, a full service psychological
assessment and treatment clinic for mental disorders run by The National eTherapy Centre in
Australia. Anxiety Online provides information about a range of mental disorders, free
automated psychological assessment and automated self-help programs, plus low cost
therapist-assisted programs over 12 weeks. The first paper demonstrates that Anxiety Online
self-help programs are widely accessed and that program completers have a significant
reduction in clinical symptoms. The second paper presents promising initial outcome data for
the therapist-assisted online cognitive behavioural therapy program for Obsessive Compulsive
Disorder (OCD). The third paper outlines new developments in eTherapy that enable programs
to tailor to clients specificities thereby encouraging increased engagement in therapy. The
fourth paper presents the role that eTherapy can play in psychosis self-management and
recovery. The final paper evaluates the cost effectiveness of eTherapy and face-to-face therapy
for Generalised Anxiety Disorder (GAD). Taken together, the symposium highlights that
eTherapies can be an effective medium, from both a clinical and economic standpoint, for the
treatment of a variety of mental health disorders.
Automated and therapist-assisted cognitive-behavioural eTherapy for anxiety disorders
Anxiety Online is an online clinic for the assessment and treatment of anxiety disorders. Online
cognitive behavioural therapy treatment programs are offered to adults in automated self-help
(offered internationally) and therapist-assisted (offered to Australian residents) forms for the
treatment of Generalised Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Posttraumatic stress disorder, and Obsessive-Compulsive Disorder. Data is collected from clinic
users at pre-treatment, post-treatment (12 weeks after commencing a program), and at 1- to 5years post-program follow-up using a naturalistic, participant choice, quasi-experimental design.
Between October 2009 and October 2012, there have been 13,734 pre-treatment assessment
completers, with 36.7% starting a program. The majority (97%) of users choose a self-help
program, and for those who complete a self-help program there are significant reductions in
clinical disorder severity (Cohen d range 0.43-0.84) and the number of clinical disorders
diagnosed (Cohen d range 0.20-0.43) using an online assessment tool, as well as a significant
increase in confident in managing ones mental health (Cohen d range 0.54-0.73). Therapistassisted programs show similar trends. The Anxiety Online service is helping to make treatment
more accessible, with 30.7% of users never having accessed any mental health assistance
before.
eTherapy for Obsessive-Compulsive Disorder (OCD)
The gold standard psychological treatment for Obsessive-Compulsive Disorder (OCD) is
cognitive-behaviour therapy, whether in the form of face-to-face individual or group treatment.
However, the dissemination of these treatments is hampered by a number of obstacles
including geographic remoteness, consumer reticence, and the lack of an adequately trained
specialist workforce. Alternative forms of effective treatment that can overcome some of these
obstacles include bibliotherapy and computer-based programs. The National eTherapy Centre
has developed an online cognitive-behavioural program for OCD that can be accessed via the
internet. The program, termed OCD STOP, consists of 12 modules and can be accessed in
either therapist-assisted or automated self-help formats. The program includes interventions for
the mood difficulties commonly seen in OCD, exposure and response prevention strategies,
behavioural experiments and cognitive therapy strategies, and response prevention
interventions. This paper presents promising initial outcome data showing a significant reduction
in Yale-Brown Obsessive Compulsive Scale scores (Cohens d 1.1) after therapist-assisted

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cognitive-behavioural eTherapy. Implications for future iterations of the program and for its
dissemination through mental health and primary care services are discussed.
Novel developments in eTherapy
Electronic and communication technologies have been found to be an effective method of
delivering cognitive behavioural interventions, especially to persons in rural and remote areas,
those who fear seeking help due to stigma concerns, or those who have preferences for selfhelp treatment. The National eTherapy Centre at Swinburne University of Technology have
been leaders in moving online treatment beyond single programs available through research
trials. A range of novel developments are currently being implemented. Users of the Anxiety
Online service (to be named Mental Health Online) will soon be able to complete
transdiagnostic treatment programs, where theyll be able to receive treatment for up to 3
mental health symptoms or disorders at a time. Theyll also receive a program tailored to their
age and gender. In addition, service users will be able to communicate with a therapist via
email, instant messaging, audio chat, video chat or through virtual reality environments. This
presentation will discuss showcase these developments and discuss best practices issues in
their delivery. These advancements in eTherapy help make online treatments more engaging
and better tailored to the individuals demographic profile and communication preferences, as
well as advance the area of remote and low intensity psychological treatment.
e-Therapy in severe mental illness: Towards promoting self-management and recovery
for people with psychosis.
Although etherapies have been widely used to address depression and anxiety disorders, their
use in severe mental illness has been limited. In this presentation we consider the challenges
and opportunities for the use of online therapeutic resources for people with psychotic disorders.
Online resources may be helpful not only in promoting self management in those accessing
independently, but also in providing the mental health workforce with structured tools in
delivering intervention based upon cognitive behavioural interventions for psychosis.
Additionally, in the context of increasing value placed on peer interaction as a way of promoting
personal recovery in psychosis, multimedia and user forums may provide a means of aiding
people in accessing stories of recovery and learning from others experiences. We describe a
four-year state-funded research program to develop an online portal for severe mental illness in
Victoria, Australia, which incorporates these elements, termed Self Management and Recovery
Technology (SMART). The program will be conducting extensive consultation in making best
use of technology in severe mental illness, and conducting trials of therapist-guided use of
online resources, independent remote access and routine service implementation.
Online self- help, online therapist- assisted self-help and face-to-face cognitive behaviour
therapy for generalised anxiety disorder: A cost-effectiveness scoping study
This study will expand on the limited research on the cost-effectiveness of different treatment
models for the delivery of Cognitive Behavioural Therapy (CBT) for Generalised Anxiety
Disorder (GAD). The study aims were to evaluate the alternative programs and to develop and
test a protocol for conducting an economic evaluation for use with other online delivered anxiety
disorders. Three alternative CBT treatment models were evaluated: self-help; an online 12-week
self-directed CBT program; an online 12-week therapist-assisted CBT program; and a 12-week
face-to-face therapist delivered CBT program. Effectiveness data (treatment efficacy, attrition
rates and responder rates) and cost information (intervention costs, individual and productivity
costs) were the key inputs utilised to evaluate the alternative programs. Data was drawn from
Anxiety Online clinical data for both the self-help and therapist assisted self help programs and
publically available information for the therapist delivered program. All internet based
interventions were shown to be very cost-effective methods of delivering psychological

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treatment. In addition, self-help programs were shown to provide a viable alternative costeffective mode of treatment delivery in Australia, particularly for motivated clients and for those
clients for whom access to professional help is limited.
Couples Therapy via Videoconferencing: Bridging the Demand Gap
Andrea Kysely.
Curtin University, Bentley, WA, Australia.
Abstract Central: Therapy has traditionally been conducted face to face, and rarely with the
assistance of technology (Castelnuovo, Gaggioli, Mantovani, & Riva, 2003). However the
pervasive demand created by the greater populations needs to access mental health
intervention, has led to the development of technologies that are changing this traditional
medium through which therapy is provided (Castelnuovo et al.). Perhaps the closest form of
mirroring these face-to-face interactions is the use of videoconferencing, with empirical
evidence now suggesting that this medium may be a justifiable and effective means of
conducting therapy, and establishing a strong therapeutic alliance (Krauss, 2011). This
innovative Australian study is amongst the first to explore the phenomenon of couples therapy,
in particular behavioural couples therapy and couple education, conducted via
videoconferencing. The aim of the current research was to compare face-to-face and
videoconferencing conditions, where 30 recruited couples were assigned to either condition. All
couples took part in a couples behavioural education program called Couple CARE, in which
self-change is promoted in order to increase relationship satisfaction (Halfrod et al, 2006). Data
was collected for each couple at pre, post and at 3 month follow up intervals on a number of
measures reflecting relationship satisfaction, areas of desired change in the relationship, and
working alliance. The study involved qualitatively exploring couples expectations previous to
engaging in therapy, the couples experience, and their satisfaction with the therapy process.
Thematic analysis identified both overwhelming support for the videoconferencing medium,
satisfaction with its use, and a marked absence of perceived limitations. This also included
evidence of the working alliance between the therapist and the couple and how it was in fact
established, and strengthened via this unique medium. These results were further reflected in
statistical analysis using general linear mixed models that showed no significant effect of which
condition couples were placed in. Analysis of pre and post working alliance scores also reflected
a significant increase in the couples perceived alliance with the therapist. These findings
suggest that couples therapy and education conducted via videoconferencing is no worse than
therapy conducted face to face, and that an alliance can be established without the therapist
being in the same location as the client, and rather connected via a video screen. The findings
furthermore promote couples therapy via videoconferencing as a viable alternative to face-toface interventions, especially for those couples who are geographically or circumstantially
isolated, and may not have access to the treatment they require.
The Application and Research Advances of Cognitive Behavioral Therapy in China
Zhan-Jiang Li1, Chee Wing Wong2, Jing Liu1, Hai-Ying Han1, Xiao-Miao Li1.
1. Department of Psychology, Beijing Anding Hospital, Capital Medical University, Beijing,
China, 2. Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China.
The purpose of this symposium is to share with researchers all over the world the application
and research advances of cognitive behavioral therapy (CBT) in China. As is known to all, CBT
has been applied worldwide for decades and its efficacy has been well supported by a large
number of clinical researches in the treatment of various kinds of mental disorders, such as
depression, anxiety disorders, schizophrenia, and so on. Our research group, led by Professor

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Li Zhanjiang, dedicates to explore the effectiveness of CBT among Chinese patients and
therefore further spread CBT in mainland China. Beijing Anding Hospital, Capital Medical
University, is a top class psychiatric hospital in China, integrating medical treatment, education,
research, prevention and international cooperation in one body. And Professor Li Zhanjiang, the
vice-president of the hospital, has done great contributions to the training, studying and applying
of CBT in China. In this symposium, one the one hand, several CBT therapists from our
research group would like to introduce to the world what we have done in recent years, and on
the other hand, we would also like to propose the future research directions from our
perspectives. The contents of the presentations include the current situations of the application
of CBT in hospitals, the updated results from CBT efficacy studies treating depression, the pilot
study on the practicality of CBT techniques among Chinese CBT experts, as well as an
exploration of the psychological characteristics of Chinese patients in their ways of emotion
regulation. Meanwhile, we hope to have an in-depth discussion with CBT experts and
practitioners from the rest of the world on the culture differences in applying CBT, as well as the
advantages and difficulties in doing further research in China.
The Status of CBT Application and Research in China
In China, the application of cognitive behavioral therapy (CBT) is under steady growth. Most of
CBT treatments are conducted in psychiatric hospitals or in the clinical psychological
departments in general hospitals. A great number of patients showed significant improvement in
their symptom reductions and qualities of life, among which were sufferers with Major
Depression, Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, Panic Attack,
Schizophrenia, Internet Addiction Disorder, Postpartum Depression, Social Phobia, Attention
Deficit Hyperactivity Disorder, heroin dependence, and so on. However, the training system of
CBT therapists is still immature. And great importance should be attached on the proper
application of CBT principles and techniques to Chinese patients, given that there might be
certain underlying culture differences in the acceptance of CBT techniques. In Beijing Anding
hospital, our research group has undergone a series of researches, which can be divided as
three parts. The first part includes some RCT studies on the efficacy of CBT among Chinese
patients; the second part is to develop both the patient and therapists CBT procedure manuals,
under the guidance of the results revealed in researches on techniques and treatment
processes; and the third part is to uncover the bio-psycho-social mechanisms of CBT. Taking
into consideration of the current situations in our country, we believe our work will help to
facilitate the standardization of CBT applications, and to discover further the mechanisms of
CBT along with researchers all over the world.
Randomised Controlled Ttrial of Cognitive Behaviour Therapy versus Andepressant
Therapy for First-episode Major Depressive Disorder Patients in China
Background: Cognitive behavioral therapy (CBT) has the most research evidence for
depression in a range of populations, but in China, the great majority of depression patients
receive antidepressants treatment. Few RCTs have examined the efficacy of CBT with Chinese
depression patients. Objective: The aim of this study is to develop a CBT manual for Chinese
depression patients and to determine the clinical effects of CBT under the guidance of the
treatment manual on the first-episode major depressive disorder. Methods: This study
developed a CBT mannual for Chinese depression patients. Patients with DSM-IV-TR major
depressive disorder (n=77) were randomly assigned to CBT group (n=31) and antidepressant
group (n=46) for 24 weeks, both with 3 months follow up. The main outcome assessment tools
include 17-item Hamilton Depression Scale (HAMD-17), Montgomery-Asberg Depression
Rating Scale (MADRS), the 12-item Short-Form Health Survey Questionnaire (SF-12) and
Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). Results:
Time has significant effect on HAMD, MADRS, Q-LES-Q-SF (P<0.05), no significant effect on

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PCS, MCS (P>0.05). Group factor has no significant effect on all the scale above (P>0.05).
Except MADRS (P<0.05), all the other measures have no significant effect on interactive factor
of group and time (P>0.05). Conclusions: No differences in outcome were observed between
CBT group and antidepressant group. CBT may provide an effective alternative to standard
treatment with pharmacotherapy for first-episode depression patients.
The Research of Related Psychological Elements of Emotional Regulation
Characteristics in Generalized Anxiety Disorder
Objective: Through the psychological scale, we study the emotional regulation characteristics in
Generalized Anxiety Disorder (GAD) and the related psychological elements. Methods: 54 GAD
patients and 55 health controls were included. Each participant received psychological scales
assessment. Toronto-Alexithymia Scale (TAS-26) included 4 subscales: Difficulty Describing
Feelings (DDF), Difficulty Identifying Feelings (DIF), Reduced Daydreams (RD) and Externally
Oriented Thinking (EOT). The Positive and Negative Affect Scale (PANAS) included 2
subscales: the Positive Affect (PA) and the Negative Affect (NA). These scales were used to
study the emotion regulation characteristics in GAD. In Hamilton Anxiety Rating Scale (HAMA) ,
the Psychic Anxiety (HAMA-PSY) and Somatic Anxiety(HAMA-SOM) were recorded. The StateTrait Anxiety Inventory- Trait (STAI-T) score was also written down. Three-dimensional
Personality Questionnaire (TPQ) included 3 dimensions: Novelty Seeking (NS), Harm
Avoidance (HA) and Reward Dependence (RD) in each of which consisted of 4 subscales.
Results: There were the differences of emotional regulation between two groups: GAD patients
score of TAS-26 (73.19.3), DDF(16.34.4) and DIF(21.84.3) were obviously higher than
controls; RD (14.63.6) obviously lower than the controls; GAD patients PA(24.45.9) were
strikingly lower than controls, and the NA (27.66.6) higher than controls. NA and DIF had
remarkably influence on HAMA. The related psychological elements of emotional regulation in
GAD patients: PSY(12.093.70) was obviously higher than SOM(8.674.11); GAD patients
STAI-T (49.411.5) was obviously higher than controls; GAD patients TPQ-HA was higher than
controls (t=11.22, P<0.001), however GAD patients TPQ-RD was lower than controls (t=-2.86,
P<0.01). The results of stepwised regression suggested: STAI-T could predict DDF or TAS total
score alone, but STAI-T and SOM could predict DIF. Conclusions: The characteristics of
emotional regulation in GAD patients are the difficulties of describing, differentiating emotion
and intense negative emotion, more fantasy, reduced positive emotion. There are some
characteristics of personality in GAD patients: high trait anxiety, high harm avoidance tendency
and low reward dependence. The extent of trait anxiety in GAD patients has significant impact
on the emotional regulation and can predict the difficulty of describing emotion alone, also can
predict the negative extent with psychic anxiety. However, the trait anxiety and somatic anxiety
can also predict the difficulty of differentiating emotion.
Cognitive-Behavioral Therapy Techniques in the Treatment of Depression: A Delphi
Study
Objective: To investigate the application of Cognitive-Behavioral Therapy (CBT) techniques in
the treatment of depression and explore the suitability of these techniques in developing a
treatment manual in China. Methods: A 34-item questionnaire on CBT techniques was
developed from literature review. Thirty one CBT experts were invited in the Delphi study to rate
each techniques through dimensions of maneuverability, frequency of utilization, contribution to
outcomes, and the acceptability by patients. The investigation was conducted two rounds.
Results: The establishment of therapeutic alliance, assessment, psycho-education, identification
of automatic thoughts rank high in the list, while techniques of cost-benefit analysis, problem
solving, challenging suicidal believes, social skill training were among the least favorite ones.
And the coefficient of variation of activity monitoring, social skill training, problem solving and
behavioral experiments on the acceptance dimension are greater than 0.25. The Kendalls

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concordance coefficients on the four dimensions range from 0.259 to 0.315 (p<0.05).
Conclusions: The results suggest that basic techniques of CBT, such as the establishment of
therapeutic alliance, assessment, psycho-education are widely used and accepted by CBT
experts in the treatment of depression. However, less consensus were reached as to the use of
behavior techniques, especially in the dimension of acceptability by depression patients.
Evaluating Emotion-Focused Therapy Among Angry Adolescents Using the Emotional
Awareness, Regulation and Transformation Scale
Nelly Limbadan.
1. Ateneo de Davao University, Davao City, Philippines, 2. Psychological Association of the
Philippines, Quezon City, Philippines.
Aimed at addressing the increasing number of violence and aggression in the school setting,
this paper evaluated the use of Emotion-Focused Therapy (EFT) in managing the anger level
and intensity of some adolescents. Using the Adolescent Anger Rating Scale, the level of anger
was determined employing the pretest-post test design. This is a two-phase study wherein the
first phase consists of developing a tool to measure the effectiveness of EFT to the identified
participants. This tool is developed by the researcher which is called the Emotional Awareness,
Regulation and Transformation Scale (EARTS). The second phase involved the conduct of the
therapy as a psychotherapeutic intervention, which was run for 12 sessions. Identified as the
participants of the study, are 16 high school students of a private sectarian university, who were
placed in the Strict Disciplinary Probation Status. As a program to lessen the expression of
anger, EFT was given as an alternative intervention to help these adolescents deal properly with
this very upsetting and controlling emotion. A significant improvement was observed with the
participants after the therapy was conducted.
ACT-Based Brief Intervention in an Adolescent with Difficulties in Social Relationships: A
Case Study
Juan Lpez, Adrin Barbero-Rubio, Nikolett Eisenbeck.
Psicologa, Universidad de Almera, Espaa, Almera, Spain.
Based on systems of classification of mental disorders, the case presented in this study is a
considered subclinical. The intervention was directed to an 11 year-old adolescent with high
academic performance who has severe difficulties in her social relations. The case analysis was
conducted from a functional-contextual perspective, conceptualizing the clients problem as a
maladaptive pattern of verbal regulation. Thus, the Experiential Avoidance Disorder (TEE) was
analyzed, which is an inflexible pattern of regulation characterized by numerous ways of
responses attempting to avoid any kind of discomfort presented in form of thoughts, feelings or
other private events, in order to be able to functioning. In this case, the pattern involved the
abandonment of personally valued actions in the domain of social life. The offered treatment
was the Acceptance and Commitment Therapy (ACT), for its strong empirical evidence and its
adherence to basic research of processes involved in the clinical change from the perspective of
the Relational Frame Theory (RFT). It is emphasized the briefness of the intervention, which
consisted of four treatment sessions, preceded by an evaluation and followed by two follow-up
sessions. The study presents the application of numerous experiential exercises y metaphors
adapted to the clients problems. The results are associated with previous studies and support
the suitability of this therapeutic approach in subclinical cases and/or preventive interventions.

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Comportamento Suicida e o Tratamento Psicoteraputico na Abordagem Cognitivo


Comportamental
Eduardo Machado, Carmen Andrade.
Universidade de Marlia (UNIMAR), Marlia, Brazil.
MACHADO, Eduardo Becker. ANDRADE, Crmen Valria dos Santos. A morte inerente ao
ciclo vital humano. Suicdio o ato voluntrio de uma pessoa de tirar a prpria vida. Existem
diversos motivos que levam um indivduo a decidir pela morte. O objetivo desse trabalho,
realizado atravs de uma pesquisa bibliogrfica o de verificar como a Teoria CognitivoComportamental compreende o ato suicida e como trabalha em psicoterapia com pacientes
suicidas. Conhecer os fatores de risco que predispem ao aparecimento de uma condio
mrbida uma estratgia vlida para a sua preveno. Esse princpio aplica-se ao
comportamento suicida. Hoje, o suicdio se encontra no campo dos transtornos mentais
(angstias, depresso, alteraes de comportamento, bipolaridade entre outros) adquirindo o
status de patologia. O suicdio um fenmeno multicausal que compreende fatores internos e
externos. O ato suicida parece resultar da interao dos fatores ambientais, culturais, sociais,
relacionais, biolgicos e psicolgicos. O comportamento suicida classificado, com freqncia,
em trs categorias: ideao suicida, tentativa de suicdio e suicdio consumado. A Terapia
Cognitivo-Comportamental integra tcnicas e conceitos vindos de duas abordagens, ou seja, a
cognitiva e a comportamental. A Terapia Cognitiva utiliza o conceito da estrutura
biopsicossocial na determinao e compreenso dos fenmenos relativos psicologia
humana, no entanto constitui-se como uma abordagem que focaliza o trabalho sobre os fatores
cognitivos da psicopatologia. Com a Terapia Cognitiva os indivduos atribuem significado a
acontecimentos, pessoas, sentimentos e demais aspectos de sua vida, com base nisso
comportam-se de determinada maneira e constroem diferentes hipteses sobre o futuro e
sobre sua prpria identidade. O desenvolvimento da teoria comportamental permitiu o
conhecimento a respeito das leis gerais do comportamento tornando-o mais previsvel. Tal
conhecimento o ponto no qual a terapia comportamental se apia para o desenvolvimento de
sua prtica clnica. Por acreditar que o comportamento se desenvolve em uma relao
funcional, a teoria comportamental no trabalha com categorias, e sim com a compreenso de
que um comportamento se d na anlise funcional. A Terapia Cognitiva focaliza seu trabalho
em identificar e corrigir padres de pensamento conscientes e inconscientes, para esta teoria
existe uma inter-relao entre cognio, emoo e comportamento no funcionamento normal e
anormal (psicopatolgico) do ser humano. A pesquisa ainda encontra-se em andamento mas,
at o momento, parece que diversos motivos podem levar uma pessoa a tentar suicidar-se e a
terapia Cognitivo-Comportamental pode ser um timo recurso para o tratamento de suicidas.
Behavioural and Cognitive Interventions in Criminal Justice: Programme Outcomes and
Enhancing Service Delivery
James McGuire.
University of Liverpool, Liverpool, United Kingdom.
Abstract Central: Behavioural and cognitive therapies are extensively applied and researched
in the area of mental health and have a well-established role in that field. But they are also to
date the best supported and most firmly evidence-based approaches for the reduction of
offender recidivism, one of the main objectives of criminal justice systems throughout the world.
Building upon the accumulated research in this field which now amounts to a large number of
studies, this paper has four objectives. First, it will outline the basic cognitive-behavioural model
on which the most effective interventions have been based to date, which consist of variations
of social problem-solving and skills-training methods targeted on risk factors for criminal

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recidivism. Second, it will present an integrative review of research from that area, drawing on
several meta-analytic studies of the effectiveness of structured, offence-focused, behavioural
and cognitive programmes. Doing so will include work both within the mainstream penal
system, focusing on a wide variety of types of offence, and in secure mental health services,
presenting results concerning the latter from a recent meta-analysis by the author and
colleagues. Third, it will summarise the outcomes of wide dissemination of these types of
programmes in prison and probation services in the United Kingdom, where the author will
report the results of large-scale evaluation research, and also in other countries, demonstrating
the applicability of these methods in diverse cultural settings. Fourth, drawing on these findings
it will then identify current gaps in the links between theory, research and practice. This will
address the inter-relationships between the methods incorporated in programmes and the nonprogrammatic features of successful implementation. On this basis, the paper will conclude by
indicating several steps that can be taken to enhance and strengthen service delivery and
intervention effectiveness.
French Adults' Views on the Acceptability of Psychotherapies
Maria Teresa Munoz Sastre.
Psychologie de la Sant, Universit Toulouse 2, Toulouse, France.
French Adults Views on the Acceptability of Psychotherapies Mara Teresa Muoz Sastre Mirail
University, Toulouse, France Two hundred French adults were presented with a series of
vignettes depicting a situation in which a psychotherapist proposes a therapy to a patient. These
vignettes were obtained by orthogonal crossing of three factors: (a) level of scientific evidence
that this kind of therapy works (absence of data, absence of evidence that it works, some
evidence, and strong scientific evidence), (b) frequency of use of this therapy among local
psychotherapists (not frequently used, employed sometimes, and frequently employed), and (c)
patients usual level of appreciation of this kind of therapy (not very well appreciated, OK, and
very well appreciated). Participants were instructed to judge of the degree of acceptability of
each of the 36 situations (4 x 3 x 3). Two clusters of participants emerged. For a majority of
them, the level of scientific evidence was the most important factor for judging acceptability. For
a not
Mindfulness: conceptual approaches, explanations and empirical evidence. Mindfulness:
aproximaciones conceptuales, explicaciones y evidencia emprica
Amanda Muoz Martnez, Ivonne Grau Gonzalez, Yors Garca Olaya, Claudia Caycedo,
Claudia Caycedo, Yors Garca Olaya.
Psicologia, Fundacion Universitaria Konrad Lorenz, Bogot, Colombia.
The symposium aim is show the different perspectives from which it has addressed the
minfulness, the elements involved in this and the current debates around the issue, regarding
your components and relevance of the concepts that have been identified (e.g. the five facets of
mindfulness). We present the importance of translational research to establish the explanatory
mechanisms of mindfulness, in order to relate the developments in basic and applied
psychology. Finally we present the outcomes from a study in which we observed the effect of
mindfulness on parental control mothers (with low economic resources) on their children, we
mention the need to seek methodologies to see accurately the effects of this on the behavior of
individuals
El simposio pretende mostrar las diferentes perspectivas desde las que se ha abordado el
minfulness, los elementos implicados en ste y los debates actuales alrededor del tema, con

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respecto a su componentes y la pertinencia de los conceptos con los que se ha identificado (i.e.
las cinco facetas del mindfulness). Se presenta la importancia de realizar investigaciones
traslacionales para establecer los mecanismos explicativos del mindfulness, con el fin de
relacionar los desarrollos en psicologa bsica con aplicada. Finalmente se presentan los
resultados de una investigacin en las que se observ el efecto del mindfulness sobre el control
parental de madres (con bajos recurso econmicos) sobre sus hijos, sealando la necesidad de
buscar metodologas que permitan ver de manera precisa los efectos de sta sobre el
comportamiento de los individuos.
Mindfulness: Process or Skill? Mindfulness: proceso o habilidad?
In the last decades behavioral therapies have incorporated mindfulness procedures into their
technological amamentum. Currently, there are several definitions that come from different
epistemological fronts. Some authors have operationalized mindfulness as a skill that implies
observing, describing and acting with awareness to the present moment and different stimuli.
Other authors, however, have operationalized mindfulness as change strategies that require
practicing some awareness and meditative exercises (e.g., Baer, 2003). In addition, some
authors have defined mindfulness as a process that facilitates the emission of some behaviors,
whereas other authors define mindfulness as a condition that facilitates the occurrence of other
behaviors. The aim of this talk is to present the differences among the therapeutic models
regarding the definition of mindfulness. Additionally, the current developments, research and
conceptual efforts towards a proper definition of mindfulness will be presented.
En los ltimos aos las terapias conductuales han incorporado como uno de los elementos
fundamentales en su trabajo al mindfulness o conciencia plena. Sin embargo, la delimitacin
acerca de lo que implica este elemento an no es clara, algunos de los autores han abordado
los elementos relacionados con el mindfulness como una habilidad que implica observar,
describir y actuar de manera atenta en momentos especficos y ante diferentes clases de
estmulo, mientras otros autores la definen como estrategias de cambio que refiere a ejercicios
(i.e. Baer, 2003). Otros autores refieren que ste es un proceso que facilita la emisin de
comportamientos y otros lo refieren como una condicin facilitadora para otras conductas.
Con respecto a ello esta presentacin pretende mostrar los diferentes puntos de vista desde los
que se ha abordado el mindfulness, los desarrollos en stas y algunas propuestas para su
conceptualizacin e investigacin
Assessing Basic Processes in Mindfulness Strategies. Evaluando Procesos Bsicos en
las Estrategias de Mindfulness
The third way therapies have in common many different therapeutic methods; among them
one of the most widely used is mindfulness. Although there are many therapies that use this
particular procedure, the basic research that provides empirical supports to these procedures is
very limited. The aim of this talk is to evaluate both conceptually and empirically some of the
studies that have evaluated mindfulness processes in basic research. This review will be focus
on the mindfulness strategies as used in Dialectical Behavior Therapy (DBT) and Acceptance
and Commitment Therapy (ACT). A review of empirical studies in mindfulness and basic
processes will be presented; data from those studies will be analyzed emphasizing the support
that provides to mindfulness techniques. Finally, data from a study conducted in basic
behavioral processes in mindfulness at the Konrad Lorenz University will be presented.
Actualmente las Terapias de Tercera Generacin tienen en comn varios procedimientos de
intervencin, uno de ellos son las estrategias de mindfulness o atencin centrada. Aunque
son varias las terapias que hacen uso de este procedimiento, es muy poco lo que se conoce
sobre los mecanismos bsicos de accin que subyacen a estos procedimientos. El objetivo de
esta presentacin es evaluar y presentar, tanto conceptual como metodolgicamente, varios de

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los estudios que han investigado los procesos bsicos en las estrategias de mindfulness. La
revisin se centrara particularmente en las estrategias de mindfulness como se implementan
tanto en la Terapia Dialctica Conductual (DBT) y la Terapia de Aceptacin y Compromiso
(ACT). Se realizara una revisin emprica de los estudios mas relevantes, haciendo nfasis
particularmente en los aportes conceptuales y metodolgicos que estos estudios ofrecen a la
investigacin en mindfulness. Finalmente se presentara brevemente una investigacin
realizada en la Fundacin Universitaria Konrad Lorenz sobre los procesos bsicos en
mindfulness.
Factor analysis of five facets of mindfulness: relevance of these on its conceptualization
and assessment. Anlisis factorial de las las cinco Facetas del Mindfulness: relevancia
de esto para su conceptualizacin y evaluacin
We present the outcomes of a construct analysis of mindfulness (Baer, 2010) which allows to
conclude based on the regression analysis that the facets within the definition of mindfulness
are not sufficient to predict the total level of mindfulness, measured with FFMQ. Additionally, we
present the results of a factor analysis which identified that the facets are not correlated with
each other, this result is similar to that reported by Mola-Gubbins (2009) whom reports a lack of
correlation between the facets of mindfulness.
Regarding the relationship between the facets of mindfulness, it was established that between
observation and experience without judgment the relationship is confusing and should be
clarified, because mindfulness definition includes observation as a prerequisite for the
experience without judgment of events private. Additionally, the regression models pre and post
intervention in the sample, and the analysis of factors lead to the conclusion that despite the
attempt to integrate mindfulness conceptualizations that is represented in the FFMQ, still
missing delimit some aspects in this issue
Se presentan los resultados de un anlisis del constructo de mindfulness (Baer, 2010) que
permite concluir con base en el anlisis de regresin, que las facetas incluidas en la definicin
de mindfulness no son suficientes para la prediccin del nivel total de mindfulness, medido con
el FFMQ. Adicionalmente, se presentan los resultados de un anlisis factorial que permiti
identificar que las facetas no estn correlacionadas entre s; este resultado es similar al
reportado por Mola-Gubbins (2009) quien refiere falta de correlacin entre las facetas del
mindfulness.
Con respecto a la relacin entre las facetas del mindfulness, se estableci que entre la
observacin y la experiencia sin juicio la relacin es confusa y debe aclararse, ya que la
definicin del mindfulness incluye la observacin como un prerrequisito para la experiencia sin
juicio de los eventos privados. Adicionalmente, los modelos de regresin pre y post intervencin
en la muestra analizada, as como el anlisis de factores permiten concluir que a pesar del
intento de integracin de conceptualizaciones de mindfulness que est representado en el
FFMQ an faltan aspectos por delimitar en este tema.
Relation between control parental locus and the five facets of mindfulness with mothers
who have low incomes. Relacin entre el locus de control parental y las cinco facetas de
mindfulness en madres de nios que viven con bajos ingresos
We carried out an exploratory pre-experimental design to identify the relationship between pre
and post measurements of the variables of parental locus of control and mindfulness skills in a
sample of ten mothers of preschool children.The instruments were: Parenting Locus of Control
Short Form (PLOC-SF) and Five Facet Mindfulness Questionnaire (FFMQ). Mothers received
intensive training in four sessions Mindfulnes between measurements. The results show
changes in pre and post measures of the two variables and find a relationship between locus of
control and the facet of the ability to describe in mindfulness.However, the results should be
undertaken with caution given the methodological limitations that the study represents.

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Se llev a cabo un estudio exploratorio de diseo preexperimental con el fin de identificar las
relaciones existentes entre las mediciones pre y post de las variables de locus de control
parental y habilidades de mindfulness, en una muestra de diez madres de nios en edad
preescolar. Los instrumentos utilizados fueron Parenting Locus of Control Short Form (PLOCSF) y Five Facet Mindfulness Questionnaire (FFMQ). Las madres recibieron un entrenamiento
de cuatro sesiones intensivas en Mindfulnes entre las mediciones. Los resultados permitieron
ver cambios en las medidas pre y post de las dos variables y encontrar relacin entre el locus
de control y la faceta de la habilidad de describir en mindfulness. Los resultados deben
asumirse con precaucin dadas las limitaciones metodolgicas que el estudio representa.
Cognitive Behavior Therapy with Support via a Computer and an iPad
Kristoffer Mnsson1, Erica Skagius Ruiz1, Elisabet Gervind1, Mats Dahlin2, Gerhard Andersson1,
3
.
1. Department of Behavioural Sciences, Linkping University, Linkping, Sweden, 2.
Psykologpartners, Linkping, Sweden, 3. Karolinska Institutet, Stockholm, Sweden.
Cognitive Behavior Therapy delivered face-to-face (CBT) or via the Internet with therapist
guidance (iCBT), has been evaluated in several randomized controlled trials. Some advantages
when delivering treatment via the Internet can be noted, such as availability in time and space
and standardized interventions. These benefits would be interesting to use and blend with a
traditional CBT. A web-based platform, accessible via a computer and an Apple iPad, was
created. Standard CBT content such as agenda setting, treatment goals and educative
information, was included. The platform also contained an encrypted message system, allowing
for contact between sessions, or contact replacing a therapy session due to impediment or
illness. A total of 15 participants fulfilling any criteria for anxiety or depression according to
DSM-IV, were included in the study. 8 psychologists, during their last term of education,
volunteered as therapists. Therapy outcome measures that was used: Beck Anxiety Inventory
(BAI), Montgomery Asberg Depression Rating Scale - Self Rated version (MADRS-S), Patient
Health Questionnaire (PHQ 9), Generalized Anxiety Disorder Screener (GAD 7), Quality Of Life
Inventory (QOLI). Qualitative interviews have been conducted to examine the experience of
using the support of Internet, both with patients and psychologists. Statistical significant (all p's
< .001) main effects were obtained for all clinical outcome measures. Large within-group effect
sizes (Cohen's d) were observed on all measures. Measures regarding depression showed
symptom reduction; MADRS-S, t(14) = 7.25, d = 2.43, CI 95% 1.12 to 3.74; PHQ 9, t(14) = 4.71,
d = 1.62, CI 95% 0.59 to 2.66. In addition, measures of anxiety showed reductions; BAI, t(14) =
4.73, d = 1.67, CI 95% 0.60 to 2.74; GAD 7, t(14) = 4.91, d = 1.80, CI 95% 0.64 to 2.97.
Furthermore, experienced quality of life, QOLI t(14) = 4.30, d = 1.26, CI 95% 0.49 to 2.02,
increased. Clinical significant change was observed in a majority of the patients, ranging from
60% to 100% between measures. This study had no missing data nor any drop outs from
treatment. Quantitative analysis yielded promising results. A qualitative evaluation will be
discussed. These results highlights the significance of utilizing modern information technology in
supporting CBT delivered face-to-face. This study applied no randomization or control condition
why it should be interpreted with caution.
Evaluation of new recording form designed to help students to focus on patients
cognition and emotion on clinical training in psychiatric nursing
Kazuya Norikane, Ikuo Kawazoe, Shizuka Kurauchi, Shimako Ono.
Hirosaki University Graduate School of Health Sciences, Hirosaki-city, Japan.

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This study aimed to evaluate a new recording form designed to help students to focus on
patients cognition and emotion, to use when introducing cognitive behavioral therapy in clinical
training of psychiatric nursing, and to investigate ways to guide students in the training.
Students were instructed to underline patients statements that indicate his/her cognition and
emotion, and to make the best use of the observations when formulating and implementing a
nursing plan. Analysis of data obtained from a questionnaire survey (n=70) after completion of
clinical training revealed that 60% or more of students found it difficult to underline statements
indicating cognition, and 67% and 48% responded that it was difficult to discern cognition and
emotion, respectively, through listening to patients. These results suggest necessity of
exercises of the Socratic Method to grasp patients cognition. The group whose view to patients
feeling was completed was more significantly different about focus on patients cognition and
nursing practice with focus on patients cognition and emotion than the group whose view to
patients feeling was not completed(p<.05). It is therefore suggested that the focus on patients'
emotion encourages students to focus on cognition, and thus is useful in promoting their
involvement with patients.
The Provision of Cognitive-Behavior Therapy Through a Nationalized Program of Access
to Evidence-Based Psychological Treatments: The Australian Experience
Monica O'Kelly3, 1, Michael Kyrios2, Arthur Freeman7, Monica O'Kelly3, 1, Kathryn Gilson3, 1,
James Collard3, 8, Joanne Griffith3, Tania Pietrzak3, Peter Smith3, Leigh Morgan3, Ana Torres3,
Chris Mackey6, Megan Henderson6, Laura Capitanio6, Rachael Murrihy5, Antony Kidman5,
Danielle Ellis5, D. Fitzgerald5, Anna Dedousis-Wallace@uts.edu.au5, Michael Kyrios2, Richard
Moulding2, Julia Reynolds4.
1. Psychology and Psychiatry, Monash University, Clayton, VIC, Australia, 2. Swinburne
University of Technology, Hawthorn, VIC, Australia, 3. CBT Australia, Mentone, VIC, Australia,
4. Australian National University, Canberra, ACT, Australia, 5. University of Technology,
Sydney, NSW, Australia, 6. Chris Mackey and Associates, Geelong, VIC, Australia, 7. Midwest
University, Wentzville, MO, USA, 8. Cairnmillar Institute, Camberwell, VIC, Australia.
A national program targeting mental health within the Australian universal healthcare system
was introduced in 2006 giving the public access to substantially rebated psychological
treatment. Specifically, the program allows primary care physicians with specific training to
charge substantial rebates for mental health assessments and plans, to undertake long
consultations that include counseling, and to refer on for psychiatric and evidence-based
psychological care (Pirkis et al., 2011). Two levels of rebate are specified for psychologist, one
tier of rebate for registered generalist psychologists and a second tier of rebate for clinical
psychologists. The program specifies that psychologists administer focused psychological
treatments with specific reference to cognitive and behavioral therapies. Rebates are set by a
federal body and influence what patients are actually charged. Most patients are charged no
additional fees or relatively low extra fees over-and-above the rebatable amount. Recent
evaluations indicate that the program has high uptake, including amongst disadvantaged
community groups, and is associated with significant reductions in distress, depression, anxiety
and stress, and greater collaborative care amongst mental health care providers (Pirkis et al.,
2011a; Pirkis et al., 2011b). Significantly, although the prevalence of mental health problems
does not appear to have decreased, there is evidence that use of psychotropic medications,
particularly antidepressants, has decreased (Atlantis et al., 2012). Limitations of this system
include the lack of psychologists in rural and remote areas and the role of primary care
physicians as gatekeepers. Furthermore, primary care physicians (particularly those who have
not undertaken specific training and therefore cannot charge the special fees) may offer
inconsistent care by choosing not to refer patients for evidence-based psychological treatments

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or by relying solely on psychopharmacological interventions. This symposium will present recent


examples of psychological practice and training following the advent of this national program of
access to evidence-based psychological treatments. The first two papers in this symposium will
report evaluation studies of evidenced-based treatments delivered in community based private
practices. The third and fourth papers report on the delivery of services in university based
research settings, one of them also with a focus on training psychologists. The final paper
reports the outcome of research on e-mental health programs. The delivery of services reported
in all the papers was supported by government funding.
Is Treatment of Clients Using CBT in Private Psychology Practice Under GovernmentFunded Initiatives Efficacious?
Mental illness is a major burden on the Australian community, costing the economy $20 billion
every year in terms of lost productivity and labour force participation (Australian Bureau of
Statistics, 2010). It has been projected that mental illness will be the leading cause of healthy
years of life lost due to disability (ABS, 2003) and in particular, depression has been projected
to be the second largest cause of suffering next to heart disease (World Health Organisation,
2011). There are a number of Australian Government initiatives under which individuals are
eligible to receive psychological therapy for mental illness. Government funded initiatives have
improved public accessibility to psychological services and psychological interventions has been
linked to perceived consumer improvement. However, we know very little about whether such
government programs are actually efficacious. This study seeks to evaluate whether treatment
of clients using cognitive behaviour therapy (CBT) in private psychology practice under
government-funded initiatives is efficacious using measures of treatment outcomes including the
the Depression Anxiety and Stress Scale (DASS 42), Children's Behaviour Checklist (CBCL),
Strengths and Difficulties Questionnaire (SDQ) and the Arnold Parenting Questionnaire. The
study discusses whether government funded programs in private psychology practice actually
work or are they a waste of funding.
Psychological Treatment Evaluation Outcomes for Clients Seen in Private Practice
This paper reports on the effectiveness of psychological therapy for anxiety and depressive
symptoms offered to over 1000 adult clients seen through the Better Access (national health
rebate) scheme in a specialist private psychology group practice in Geelong, Australia. Clients
were offered a range of psychological interventions consistent with a cognitive-behavioural
treatment approach. A range of outcome measures was used with therapy clients across the
whole practice to evaluate not only changes in anxiety and depressive symptoms, but also
therapeutic alliance and positive psychological health and wellbeing. Outcome measures
included the Outcome Rating Scale (ORS) and Session Rating Scale (SRS), Beck Anxiety
Inventory (BAI) and Beck Depression Inventory (BDI), the Positive and Negative Affect Scale
(PANAS) and the Satisfaction with Life Scale (SWLS). These measures were typically
administered at sessions 1, 5, 10 and the final session enabling observations about the rate as
well as the amount of clinical change. In addition to overall findings based on the above
measures, data will be presented on the treatment progress and outcomes of over 400 clients
treated with Major Depressive Disorder treated both with and without medication.
Help Seeking in Adolescents: Have New Government Mental Health Initiatives in
Australia Improved Treatment Access and Response for this Critically Under-Serviced
Population?
Three-quarters of mental health problems commence in adolescence and the disability arising
from these conditions develops significantly over the next few years (Birchwood et al., 1998;
Kessler et al., 2005). Thus, adolescence represents a critical period for intervention that may (a)
halt the progression of the illness, and (b) reduce ongoing suffering and functional disability

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(Orygen Youth Health Research Centre, 2011). Although early intervention is recognised as
important, treatment uptake in the early stages of mental illness has been far from optimal. In
Australia, 75 percent of adolescents with serious mental health problems had not sought
professional help (Australian Bureau of Statistics, 2007). This may be due to worry about
financial costs, a lack of established relationships with mental health workers and a preference
for confiding in friends over professionals (Rickwood, Wilson & Deane, 2006). However, since
2004 the mental health landscape has changed markedly in Australia with the introduction of an
initiative intended to increase access to psychological care, particularly for underserviced
populations (Better Outcomes in Mental Health Care initiative; Department of Health and
Ageing, 2004). Through this scheme the general population have been able to access
individual, evidence-based therapy (generally CBT) from eligible private psychologists and
social workers for minimal to no cost. Eight years into this initiative we consider the impact on
Australian youth mental health. Are more adolescents accessing treatment for mental illness
and if so what conclusions can be reached regarding the success of early intervention?
The Use of a Nationalized Program of Subsidized Access to Cognitive-Behavior Therapy
in Postgraduate Psychology Training.
Postgraduate psychology training programs in Australia are under pressure to provide
placement experiences that will ensure the development of professional competencies in
student trainees and that will facilitate the development of core knowledge about the Australian
universal healthcare system. University-based training clinics comprise an essential component
of training programs, and one recent successful strategy has used the nationalized program of
access to psychological treatments to expedite placement experiences for trainee students. The
distinctive characteristic of this strategy is the running of structured therapy groups as a key part
of training. Patients are referred to the groups by primary care physicians based on the
reputation of leading staff as experts in particular problem areas. Swinburne focuses on a range
of cognitive-behavior therapy groups. This paper reports on the Compulsive Hoarding and
Acquisition Group (CHAG) program which runs with a minimum of 6 and a maximum of 12
patients. Patients consult their primary care physician who organizes a referral to the expert
psychologist. Once a referral is made, patients are able to access substantial rebates for the
group CBT programs from the universal healthcare system. Patients are offered a 12 session
group program, with session running around 90 minutes. Each group session is lead by the
expert psychologist, with one or two student therapists as co-therapists. The academic expert
psychologist leads the group and provides training and supervision of the student co-therapists.
Student co-therapists write assessment reports, maintain progress notes, and draft letters back
to referring physicians. Results indicate that the CHAG program is effective in ameliorating
patient symptoms, and is associated with high satisfaction ratings amongst patients and trainee
students. Students are able to build core knowledge about the national program of access to
subsidized CBT, while they are learning specialized CBT skills. The paper presents details of
outcomes, and discusses the utility of embedding training within nationalized funding models.
e-Mental Health Programs in Australia
In recent years, Australian governments have made significant investments in electronically
delivered therapies for mental health. This has resulted in the development of a wide range of
online programs and many of these are based on Cognitive Behaviour Therapies. Programs
have been shaped by contributions from consumers, government, researchers and clinicians.
Many of these programs have been subject to high quality research and are now funded as
mental health online services. This paper will provide an overview of key Australian e-mental
health programs and key government funding streams in this area. It will also provide outcome
data for selected programs across a range of clinical populations. Future directions and

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developments will also be explored including challenges of disseminating the programs and
integrating them with more traditional service structures.
Efectos de una Intervencin Cognitivo Conductual en Mujeres con Cncer de Mama en
Radioterapia: Estudio Piloto
Rosa Ornelas-Mejorada, Vite Ariel, Mnica Tufio, Olivia Tena, Juan Jos Snchez-Sosa.
University of Mexico, Mexico, Mexico.
Abstract Central: El someterse a radiaciones y el experimentar los efectos secundarios del
tratamiento puede resultar una experiencia que genera distrs psicolgico. En las mujeres con
cncer de mama la radioterapia es un tratamiento comnmente empleado en cualquier etapa
de la enfermedad. El propsito del presente estudio fue analizar los efectos de una intervencin
cognitivo-conductual de cinco sesiones con tres componentes teraputicos (psicoeducacin,
reestructuracin cognitiva y relajacin) sobre la sintomatologa ansiosa, depresiva, fatiga y las
respuestas de afrontamiento en ocho mujeres con cncer de mama durante la radioterapia. Se
utiliz un diseo N=1 de medidas repetidas. Se aplicaron las versiones validadas en castellano
para esta poblacin de las escalas The Hospital Anxiety and Depression Scale (HADS), FACITFatigue y COPE Breve-17. Los datos se analizaron con el estadstico de varianza bifactorial por
rangos de Friedman. El decremento de la sintomatologa ansiosa (X2 = 11.308, gl.2, p.004), y
fatiga (X2 = 20.000, gl.2, p.001) result estadsticamente significativo. Tambin se observaron
cambios significativos en las respuestas de planeacin (X2 = 13.613, gl.2, p.001), apoyo social
(X2 = 6.414, gl.2, p.040) y autoinculpacin (X2 = 7.053, gl.2, p.029). La disminucin en la
sintomatologa depresiva no result estadsticamente significativa. Posibles explicaciones y las
implicaciones prcticas son discutidas. Undergoing radiation and experiencing the side effects
of treatment can be an experience that produces psychological distress. In women with breast
cancer radiotherapy is a treatment commonly used in any stage of the disease. The purpose of
this study was to analyze the effects of a cognitive behavioral intervention for five sessions with
three therapeutic components (psychoeducation, cognitive restructuring and relaxation) on the
symptoms of anxiety, depression, fatigue, and coping responses in eight women with breast
cancer during radiotherapy. We used a N = 1 repeated measures. Validated versions in Spanish
were applied to this population of The Hospital Anxiety and Depression Scale (HADS), FACITFatigue and Brief COPE-17. Data were analyzed with the statistical variance by Friedman test.
The decrease of anxiety symptoms (X2 = 11,308, gl.2, p.004), and fatigue (X2 = 20.000, gl.2,
P.001) was statistically significant. There were also significant changes in planning responses
(X2 = 13,613, gl.2, P.001), social support (X2 = 6,414, gl.2, p.040) and self-blame (X2 = 7053,
gl.2, p.029). The decrease in depressive symptoms was not statistically significant. Possible
explanations and practical implications are discussed.
Intervencion cognitivo conductual en fobia social
Luz Orozco Ramirez.
Universidad Autonoma de Tamaulipas, Victoria, Mexico.
La fobia social es un trastorno grave y ampliamente difundido, que ocasiona angustia y
discapacidad significativa en un amplio espectro de grupos demogrficos. Se la considera la
tercera enfermedad psiquitrica en importancia. (Liebowitz, Barlow y Davidsom ,2000; Toro y
Yepes, 2001) Parece ser mas prevalente en individuos solteros, divorciados y separados
(medina Mora; Borges y Lara, 2003). Los factores de riesgo para ste trastorno son difciles de
identificar, aunque la separacin temprana de los padres, antecedentes familiares del trastorno
y una enfermedad psiquitrica materna parecen ser elementos predisponentes.(Davidson,
1993; Merikangas, Fogel , Schiffer, 1993) El paciente reconoce que el temor es irracional, pero

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escapa a su voluntad poder controlarlo, provocando interferencias en su rutina habitual


(actividades laborales, acadmicas, sociales) y un grado significativo de sufrimiento. Cuando el
individuo sabe o presiente que el estmulo fobgeno se encuentra prximo, comienza a
presentar sntomas de ansiedad (Ansiedad Anticipatoria) que ceden bruscamente cuando el
objeto, vivido absurdamente como peligroso, desaparece, apareciendo entonces la Ansiedad
Remanente o posterior a la reaccin fbica. Por lo tanto las fobias no son trastornos en los que
la ansiedad es el sntoma exclusivo o excluyente. Se presenta un estudio de caso de una mujer
de 28 aos que presenta un cuadro clnico de fobia social, su madre con un trastorno de
ansiedad, se procede a aplicar la evaluacin correspondiente para corroborar el diagnostico y
se le elabora un mapa clnico de patognesis y un mapa de alcance de metas (Nez, Nez Y
Lombardo, 2006) lo anterior ayudo a determinar la necesidad de un tratamiento psicolgico que
tuviese validez emprica, siendo el elegido el enfoque cognitivo conductual, desarrollndose 10
sesiones con tcnicas de psicoeducacin, relajacin, reestructuracion cognitiva, exposicin,
desensibilizacin sistemtica, entrenamiento en habilidades sociales. La evaluacin prepostratamiento permiti comprobar la eficacia de la intervencin en este padecimiento
obteniendo remisin total de los sntomas e incluso que la paciente tuviese un trabajo,
mantenindose los resultados favorables a los 3 y 6 meses de seguimiento
Study of the Evolution of Self-Reported Knowledge, Skills and Representations of the
Ideal Cognitive Behavioural Therapist Through a Two-Year CBT Training
Diana Ortega, Valentino Pomini.
University of Lausanne, Lausanne, Switzerland.
Introduction The assessment of a CBT training course can be done through various methods.
These usually include self-reports of satisfaction scales or evaluations of competence at the end
of the course (e.g. competence scales completed by supervisors, exams or formal assessment
of written case studies). Measuring changes in self-reports of personal knowledge and skills, or
in the personal representations of the CBT-therapist characteristics, are also interesting and
complementary ways to lead such an assessment. Aims We evaluate the self-reported
knowledge and competences, as well as the representation of the ideal cognitive-behavioural
therapist in a sample of candidates before and after a two-year CBT training (Certificate of
Advanced Studies). The capacity of candidates to recognize interventions as specific to CBT or
related to other approaches has also been assessed as a more objective variable of knowledge.
Method This study focuses on 30 participants, who began a CBT psychotherapy training in
Lausanne, Switzerland. The instrument assessing self-reported competences is composed of a
list of 40 CBT concepts or intervention methods. The candidates level of perceived knowledge
and practical skills are scored on an ordinal scale (1=weakly to 4=high). The more objective
knowledge was assessed with the MULTI (McCarthy & Jacques Barber, 2009). This
questionnaire consists of 60 items describing diverse theoretical therapeutic interventions. The
version used was translated in French by Pomini & Reicherts and adapted in order to assess to
which extent each item represents a typical CBT intervention. The representation of the ideal
CB-therapist was measured with the IPIC questionnaire, developed by Pomini, Velardi and
Reicherts. It consists of a list of 70 adjectives that the candidates should assess on a five points
Likert-scale. Results Preliminary statistics carried out on the self-assessment of competences
questionnaires show an increase in the global means of theoretical knowledge and practical
skills. The global mean of the competence level was 1.6 (sd = .4) before the training and 2.3 (sd
= .5) at the end. Paired-sample t-test revealed a significant difference between pre and post
measures (t = 11.9; p <.001). Conclusion The changes reflect a subjective increase of selfefficacy as a cognitive-behavior therapist where candidates are evolving from a relatively weak
to a moderate level of competence. This outcome indicates that a two-year CBT course is not

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sufficient to take candidates to a level where they perceive themselves to be competent


psychotherapists. In Switzerland, the CAS in CBT represent the 40% of the required standard to
obtain the accreditation of cognitive and behavior therapist.
Interpersonal Problems and cognitive behavioural therapy for emotional disorders
Andrew Page2, Andrew Page2, Peter McEvoy1, 2, Melissa Burgess2, Bruce Campbell1, Paula
Nathan1, 2, Anthea Fursland1, Peter McEvoy1, 2, Melissa Burgess2, Paula Nathan1, 2, Melissa
Burgess2, Peter McEvoy1, 2, Paula Nathan1, Bruce Campbell1.
1. Centre for Clinical Interventions, Perth, WA, Australia, 2. University of Western Australia,
Perth, WA, Australia.
Interpersonal functioning is intrinsically linked to psychological well-being, and interpersonal
problems (IPs) are common among clients with emotional disorders presenting at mental health
clinics. This symposium examines reliable, valid, and clinically meaningful ways of assessing
IPs, and explores how this knowledge can be used to optimise treatment outcomes for clinical
samples with depression, anxiety, and eating disorders. The first paper takes a transdiagnostic
approach to evaluating the psychometric properties of a measure of interpersonal problems, the
Inventory of Interpersonal Problems-32 (IIP-32), across anxiety, depressive, and eating
disorders. The IIP-32 is a relatively brief measure of IPs that contains eight subscales that can
be easily scored and interpreted within clinical settings. The second paper examines the
relationships between pre-treatment IPs, treatment attrition and outcomes from cognitive
behavioural group therapy (CBGT) for major depression. The third paper examines the
differential impact of IPs on therapeutic alliance, treatment attrition and outcome during
individual and group cognitive behavior therapy (CBT). It might be expected that problematic
interpersonal styles will have a greater impact on alliance and outcomes for group therapy,
given the need to interact with other clients rather than a single therapist who has specialist
training in working with a range of challenging interpersonal styles. Interpersonal problems are
often neglected in cognitive behavioural theory and treatment outcome research. Increasing our
understanding of interpersonal styles that are most strongly associated with psychopathology,
and that have the greatest impact on treatment retention and outcome, can guide theoretical
developments, inform clinicians about prognosis, and ultimately optimise treatment outcomes.
Interpersonal problems across anxiety, depression, and eating disorders: A
transdiagnostic examination
OBJECTIVES: Integrative models of psychopathology suggest that quality of interpersonal
relationships is a key determinant of psychological well-being. However, there is a relative
paucity of research evaluating the association between interpersonal problems and
psychopathology within cognitive behavioural therapy. Partly, this may be due to lack of brief,
well-validated, and easily interpretable measures of interpersonal problems that can be used
within clinical settings. The aim of the present study was to evaluate the psychometric
properties, factor invariance, and external validity of the Inventory of Interpersonal Problems 32
(IIP-32) across anxiety, depression, and eating disorders. METHODS: Two treatment-seeking
samples with principal anxiety and depressive disorders (AD sample, N=504) and eating
disorders (ED sample, N=339) completed the IIP-32 along with measures of anxiety,
depression, and eating disorder symptoms, as well as quality of life. RESULTS: The previously
established eight factor structure of the IIP-32 provided the best fit for both the AD and ED
groups, and was robustly invariant across the two samples. The IIP-32 also demonstrated
excellent external validity against well validated measures of anxiety, depression, and eating
disorder symptoms, as well as quality of life. CONCLUSION: The IIP-32 provides a clinically
useful measure of interpersonal problems across emotional and eating disorders.

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The relationship between interpersonal problems, negative cognitions, and outcomes


from cognitive behavioural group therapy for depression
OBJECTIVES: Interpersonal functioning is a key determinant of psychological well-being, and
interpersonal problems (IPs) are common among individuals with psychiatric disorders.
However, IPs are rarely assessed within cognitive behavior therapy research trials as predictors
of treatment attrition and outcome. The main aim of this study was to investigate the relationship
between IPs, depressogenic cognitions, and treatment outcome in a large clinical sample
receiving cognitive behavioral group therapy (CBGT) for depression in a community clinic.
METHODS: Patients (N = 144) referred for treatment completed measures of IPs, negative
cognitions, depression symptoms, and quality of life (QoL) in the first and final sessions of a 12week manualised CBGT protocol. RESULTS: Two IPs at pre-treatment, finding it hard to be
supportive of others and not being open about problems, were associated with higher attrition.
Pre-treatment IPs also predicted post-treatment depression symptoms (but not QoL) after
controlling for pre-treatment symptoms, negative cognitions, demographics, and comorbidity. In
particular, difficulty being assertive and a tendency to subjugate ones needs were associated
with higher post-treatment depression symptoms. Changes in IPs did not predict post-treatment
depression symptoms or QoL when controlling for changes in negative cognitions, pre-treatment
symptoms, demographics, and comorbidity. CONCLUSIONS: Pre-treatment IPs may increase
risk of dropout and predict poorer outcomes, but changes in negative cognitions during
treatment were most strongly associated with improvement in symptoms and QoL during CBGT.
The relationship between interpersonal problems, therapeutic alliance, and outcomes
following individual and group cognitive behavior therapy
OBJECTIVE: Previous research suggests that interpersonal problems (IPs), treatment format
(group vs individual), and therapeutic alliance may interact to influence treatment attrition and
outcomes. However, no study to date has examined these factors together. The main aim of this
study was to investigate the relationship between IPs, therapeutic alliance, and outcome in
individual and group cognitive behavioral group therapy for anxiety and depression in a
community clinic. METHODS: Patients received either manualised group therapy (n = 105) or
formulation-driven individual therapy (n = 77) for anxiety or depressive disorders. Patients
completed measures of IPs, therapeutic alliance, and symptoms (depression and anxiety) in the
first and final sessions of treatment. A subsample also completed the alliance and symptom
measures at mid-treatment (session 6). RESULTS: For those receiving individual treatment, a
weaker therapeutic alliance (but not symptom severity and IPs) was associated with treatment
attrition, whereas for those receiving group therapy more severe symptoms and more IPs (but
not alliance) were associated with attrition. Pre-treatment IPs were associated with more severe
symptoms for those receiving both treatment formats, but more severe pre-treatment symptoms
were only significantly and negatively associated with poorer alliance for those receiving
individual therapy. There was little evidence that early alliance predicted changes in symptoms
in either treatment format. However, improving alliance across treatment was associated with
greater symptom reductions for individual but not group therapy. CONCLUSIONS: Therapeutic
alliance may be an important predictor of retention in individual therapy, whereas symptom
severity and pre-existing IPs may be more important predictors of retention in group therapy.
Alliance may be less important within group than individual therapy in terms of symptom
reduction.
Therapeutic Orientation and the Practitioners Use of Fundamental Cognitive Behaviour
Therapy Interventions
Alexandra Petrik, Nikolaos Kazantzis.
Cognitive Behavior Therapy Research Unit, La Trobe University, Melbourne, VIC, Australia.

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Abstract Central: Cognitive Behaviour Therapy (CBT; Beck, Rush, Shaw, & Emery, 1979) is
considered an effective therapy for depression and a range of anxiety and other disorders (Epp
& Dobson, 2010). The extent to which CBT interventions are used in general clinical practice, as
well as the manner with which they are incorporated into treatment has important implications
for the appropriate dissemination and application of CBT. This is particularly important because
existing data suggest that a large percentage of practitioners integrate a range of therapeutic
modalities into their clinical practice (Norcross & Karpiak, 2012; Rnnestad & Skovholt, 2003).
The CBT model is now taught to therapists from diverse training backgrounds (Department of
Health, 2008), and the interventions of CBT have been transported into other therapies
(Kazantzis, Lampropoulos, & Deane, 2005), and in some cases, evolved into service models in
themselves (e.g., Martell, Dimidjian, & Herman-Dunn, 2010). The present paper reports data
from a sample of 1,982 mental health practitioners in Australia who were involved in an on-line
CBT training program designed by the Australian Psychological Society (APS) including
assessment, cognitive case conceptualisation, and a comprehensive coverage of CBT
interventions. The APS program had been subject to peer review and endorsement by Dr.
Aaron T. Beck. Practitioners were registered psychologists, occupational therapists, social
workers, and psychiatric nurses, and had been asked to comment on which CBT interventions
they utilised within their clinical practice as part of the course requirements. Analyses are
reported in order to explore the relationship between therapeutic orientation and professional
field on (1) commonly used CBT interventions, (2) the context in which interventions are
integrated, and (3) how the interventions are reportedly adapted into these contexts. Findings
from this research are presented, and implications for professional development and training in
CBT are discussed.
Projeto de Extenso em Assistncia Psicolgica ao Acadmico em Enfoque CognitivoComportamental: Relato de Um Caso Clnico
Marilene Pilon2, 1, Regina Rondina1, 2.
1. Universidade Estadual Paulista (Unesp), Marlia, Brazil, 2. Universidade de Marlia
(UNIMAR), Marilia, Brazil.
Atualmente, as psicoterapias em enfoque cognitivo-comportamental (TCCs) apresentam
comprovada eficcia no tratamento de problemas relacionados ao desajustamento conjugal, na
remisso de sintomas relacionados a transtornos psicolgicos, como transtornos de ansiedade
em geral, transtornos de humor, transtornos de controle dos impulsos, abuso e dependncia de
substncia, entre outros problemas. Esse enfoque terico integra intervenes de natureza
cognitiva e tcnicas de modificao do comportamento. As tcnicas de reestruturao cognitiva
englobam um conjunto de aspectos, como a identificao e o controle dos pensamentos
negativos, o exame de evidncias favorveis e contrrias aos pensamentos distorcidos, alm
promover interpretaes dos eventos cotidianos calcadas na realidade. No mbito
comportamental, esse enfoque terico engloba, entre outros aspectos, o treinamento de
habilidades destinadas a promover melhorias no relacionamento interpessoal. Durante o
processo psicoterpico, cliente preparado para eventuais recadas. O objetivo a
antecipao de provveis quedas, como a retomada de padres de comportamento mal
adaptativos, por exemplo. Objetivo: Este trabalho apresenta resultados parciais obtidos em um
atendimento clinico em enfoque cognitivo-comportamental, em andamento junto ao Projeto de
Extenso em Assistncia Psicolgica ao Acadmico (PROAPA) da Universidade Estadual
Paulista Julio Mesquita Filho (UNESP, Marlia). O estudo tenta avaliar o grau de eficcia desse
enfoque teraputico no tratamento problemas relacionados ao funcionamento conjugal.
Mtodo: M. 25 anos, sexo feminino, acadmica de graduao, buscou atendimento junto ao

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PROAPA. Nas primeiras entrevistas, M. apresentou um conjunto de queixas, como sentimentos


de depresso, baixa auto-estima e conflitos em relacionamentos interpessoais, alm de
dificuldades no relacionamento conjugal. Atravs do processo de avaliao cognitivocomportamental, foi efetuada uma conceitualizao cognitiva preliminar e a formulao inicial
do caso clnico de M. A avaliao permitiu elaborar hipteses iniciais. Com base na formulao,
optou-se por enfocar o desenvolvimento de habilidades sociais e a reestruturao cognitiva de
M.. Resultados Parciais: At o momento, foram realizadas 38 sesses de atendimento
psicoterpico. A anlise de situaes relatadas por M. atravs de estratgias como o Registro
Dirio dos Pensamentos Disfuncionais (Rang, 2011), possibilitou a identificao de
pensamentos automticos como sou culpada, sou incapaz, no sou uma boa me e nem boa
esposa; identificou ainda emoes negativas associadas aos pensamentos automticos e
comportamentos direcionados principalmente busca de aprovao alheia. Foram constatadas
crenas de desvalorizao pessoal. O trabalho psicoterpico foi planejado e direcionado
principalmente, a promover melhorias no relacionamento conjugal. M. vem relatando que est
conseguindo desenvolver habilidades de comunicao, como pensar antes de falar e
aguardar momentos propcios para expor seus pensamentos e sentimentos. Julga tambm que
suas interpretaes acerca dos eventos do dia a dia esto mais coerentes e que o
relacionamento conjugal est melhorando. Discusso: Foi observado o desenvolvimento de
habilidades sociais; em especial, no tocante comunicao de M. com o cnjuge. A paciente
tem relatado melhorias em seu estado de humor e apresenta comportamentos relacionados a
auto cuidados e aparncia, o que possivelmente seja um reflexo de maior auto-estima e
disposio para atividades cotidianas. Referencias Range, Bernard e col. (2011). Psicoterapias
Cognitivo-Comportamentais: um dilogo com a psiquiatria.2ed. Porto Alegre:Artmed.
Therapy at your Fingertips: A Randomized Controlled Trial of an Interactive, Tailored
Mobile Phone and Internet intervention for Depression, Anxiety, and Stress
Judith Proudfoot1, 2, Gordon Parker1, 2, Dusan Hadzi-Pavlovic1, 2, Vijaya Manicavasagar1, 2, Alexis
Whitton1, 2.
1. Black Dog Institute, Sydney, NSW, Australia, 2. University of New South Wales, Sydney,
NSW, Australia.
Abstract Central: More than half of individuals with mental health conditions do not access
mental health services, with many instead turning to self-care management strategies. Common
barriers to the use of mental health services include cost, accessibility and perceptions of
stigma associated with seeking treatment. One way to increase access to mental health support
is through the electronic delivery of evidence-based interventions. However, while electronic
interventions have been used in behavioral and physical health settings, their role in monitoring
and managing mental health is just emerging. Mobile phones are location independent, usually
switched on and carried with the owner, providing an ideal platform for the delivery of real-time
mental health information, strategies and support. Additionally, the increased functionality and
low cost of mobile communication devices makes them ideally suited for the delivery of selfmanagement interventions. In light of this, researchers at the Black Dog Institute in Australia
have developed myCompass - a tailored, interactive self-monitoring and self-management
program for depression, stress, and anxiety delivered via the Internet on users mobile phones
and computers. It allows the user to monitor moods, events, medication and lifestyle behaviors
in real time, and presents graphical feedback incorporating situational information so that users
may identify triggers and patterns to their symptoms. Self-monitoring is tailored to factors
identified by the user, and SMS reminders can be enabled to serve as memory prompts to
assist monitoring compliance. The program also provides brief self-help modules based on
cognitive-behavioral therapy, interpersonal therapy and positive psychology techniques. The

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current randomized controlled trial aimed to evaluate the effects of the myCompass program on
symptoms of depression, stress, anxiety, psychological distress and daily functioning in
individuals with mild to moderate mood and anxiety symptoms. 727 individuals with mild to
moderate depression, anxiety and/or stress were randomized to one of three conditions over a
period of 7 weeks: (1) the myCompass program, (2) a limited version of the program (attention
control) or (3) a waitlist control. Mental health symptoms, functional impairment, psychological
distress and mental health self-efficacy were measured using online questionnaires at baseline,
post intervention (8 weeks) and 3-month follow-up. Individuals who received the myCompass
program showed significant improvements on a number of symptom domains, as well as overall
psychological distress and day-to-day functioning. The current presentation will provide an
overview of the myCompass program, as well as the outcomes from our randomized controlled
trial of the programs efficacy in people with mild-to-moderate depression, stress and anxiety.
Dialectical Behavior Therapy Followed by Prolonged Exposure in Spanish for the
Treatment of BPD and PTSD: A Case Study
Ulises Ramirez1, Lizbeth Gaona1, Suhadee Henriquez1, Aurora Farias1, Lynn McFarr2.
1. Harbor-UCLA Medical Center, Torrance, CA, USA, 2. UCLA David Geffen School of
Medicine, Los Angeles, CA, USA.
Dialectical Behavior Therapy (DBT) has been shown to be an effective treatment modality for
patients diagnosed with Borderline Personality Disorder (BPD) (Linehan, 1993; Linehan et al.,
2006; Harned, M., et al., 2012). In the treatment of Post Traumatic Stress Disorder (PTSD),
implementing Prolonged Exposure (PE), the literature reports the existence of only one PE
study with Spanish speaking patients, which indicated a favorable outcome (Vera, M., et al.,
2011). Additionally, only one published clinical study indicates favorable outcomes using an
integrated DBT PE protocol. This study was conducted, during Stage I of DBT, with English
speaking women, diagnosed with a co-occurring diagnosis of (PTSD) and BPD (Harned, M., et
al., 2012). The aforementioned study found favorable outcomes in the integration DBT and PE
in which 71.4% of the participants no longer met criteria for PTSD upon treatment completion.
Nevertheless, this empirical evidence has mainly come from English speaking clients from the
mainstream culture. Unfortunately, literature shows no studies that have evaluated treatment
outcomes using a DBT PE model for Spanish speaking patients with co-occurring disorders
such as BPD, PTSD and Polysubstance Abuse. In this project, a case study is presented to
illustrate the implementation of a DBT PE model in Spanish. The patient participated in a 12
month standard DBT Spanish speaking program followed by PE in Spanish using the PE
Spanish manual (Foa, E.B. et al., 2008). The PTSD Symptom Scale Self -Report (PSS-SR) and
Beck Depression Inventory (BDI) were administered at baseline and six months post treatment
to assess PTSD and Depression symptom severity. The results of this case study yielded
favorable outcomes of the integration of a DBT PE protocol in Spanish. Additionally, this case
study hopes to underscore/highlight the importance and the need for further research in working
with Spanish speaking, dual diagnosis patients with BPD and PTSD, while using the integration
of DBT PE modalities.
Cognitive Conceptualization of Chronic Pain Patient-Case Study of Lady A
Jaroslava Raudenska, Alena Javurkova.
University hospital Motol adn 2nd Medical Scholl, Prague, Czech Republic.
Cognitive case conceptualization is an integrated picture of the patient's pain problems given
his/ her historical and cultural context. It is the cognitive therapist's view of the general picture of

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the patient's chronic pain problems, i.e. how they developed and are maintained. The therapist
identifies the patient's automatic thoughts, intermediate and core beliefs related to chronic pain
problems and significant environmental, cultural, and social influences. We describing case
conceptualization on the case study: 1.Relevant patient s information Lady A. was a 40-yearsold married woman with 3 children. She worked at home as an free lance designer. 2 Patient's
presenting pain problems and history. She suffered from low back pain one year, 6 months ago
underwent back surgery to fix her disc . It did not help her decrease her pain intenzity, she
became depressed. Till now she undergo treatment in Pain Centre, cognitive psychoterapy
included. 3. Automatic thoughts , intermediate beliefs, and core beliefs One of typical
problematic situation is: How to deal with chronic pain. Typical automatic thought, pain. mood,
and behaviors in this situation are: I am overwhelmed by my pain. It's ruining my life. >
throbbing, sore, and numbing pain in low back pain > depressed social withdrawal, cries.
Intermediate belief: -Rules (shoulds/musts applied to self/others): Life should be fair. The
surgery should have worked. -Attitudes (awful/horrible nature of events): This pain is awful and
unbearable. -Conditional assumptions (positive and negative): If I can't stop the pain, then I am
doomed to a miserable life. If I can get this pain out of my life, then I will feel happier. Core
Beliefs: I am pain-ridden.I am out of control. 4. Family and social history, education and work
history. She was born and raised in Prague as an oldest daughter of 4 younger brothers. Her
parents were very busy project engineers, were often out of home. She has had duties to take
care of siblings and home. She graduated from Academy of Art in Prague 15 years ago.
Immediately after graduation she has married her boyfriend, school-mate from Academy. She
worked at home as an free lance designer. 5.Psychiatric/psychological history. She did not have
any psychiatric/psychological history in the past. 6. Goals for therapy, treatment plan. Lady A.
wished to be pain-free She wants to deal with her pain problems as quickly as possible. Goals
she had was: 1. learn pain management skills, 2. learn how to cope with depression. Therapist's
goals were: 1. Teach her pain management skills, 2. teach her how to cope with her pain and
depression via activity scheduling and pacing as well as cognitive restructuring techniques, 3.
learn to set realistic goals for self . Conclusion: case conceptualization is an important skill that
all therapists must acquire in order to assist their patients. Reference 1. Morrison J. The first
interview. New York: Guilford Press,1996. 2. Winterowd C, Beck AT, Gruener D. Cognitive
Therapy with Chronic Pain Patients. New York: Springer Publishing Co, 2003. Supported by the
project (Ministry of health, Czech Republic) for conceptual development of research
organization 00064203 (University Hospital Motol, Prague,Czech Republic)
Quality of Life After Group Cognitive-Behavioral Therapy in Chronic Nonmalignant Pain
Patients
Jaroslava Raudenska.
Clinical Psychology, University hospital Motol and 2nd Medical School, Prague 5, Czech
Republic.
Aim. The aim of the study was first, to find out differences in quality of life after cognitivebehavioral therapy (CBT) in two groups of patients (chronic nonmalignant low back pain and
chronic nonmalignant headache), second, to use different outcomes for structure of CBT for
separate groups of patients. Methods. The setting of the study was: 1. CB assessment, 2. CB
group therapy (60 out-patient patients: 32 with chronic nonmalignant low back pain and 28 with
chronic headache), 3.CB assessment one week after CBT. Pharmacotherapy was stable during
of CBT. The setting of CBT: one day sessions a week (9am-16pm) in group of 4 patients for the
duration of 5 weeks. Structure: exposure, pacing of physiotherapy, education, relaxation, back
school, stretching exercises, individual session. Results. That outcomes were similar in both of
groups: pain intensity was less by 20%, suffering and pain mystery by 35-50%, but the

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catastrophiazation was higher (half of standard deviation) and the level of activity was several
times higher then before CBT. Group of headache patients had better outcomes in depression
and anxiety (set up to the norm). Conclusion. The quality of life was for both groups of patients
better. Setting of CBT for both groups has to be different probably because of different character
of the pain (intensity and time duration) and social and working status. References 1.
McCracken L. Contextual Cognitive-Behavioral Therapy for Chronic Pain. Seattle: IASP Press,
2005. 2. Sharp T. Chronic pain: a reformulation of the CB model. Behaviour Research and
Therapy, 2001; 39: 787-800. 3. Winterowd C, Beck AT, Gruener D. Cognitive Therapy with
Chronic Pain Patients. New York: Springer Publishing Co, 2003. "Supported by the project
(Ministry of health, Czech Republic) for conceptual development of research organization
00064203 (University Hospital Motol, Prague,Czech Republic)"
La Psicoterapia Frente al Coaching, Amenaza o Oportunidad?
Pedro Reyes Mispireta.
ITRE, Lima, Peru.
Abstract Central: En las ltimas dcadas junto al saludable desarrollo y consolidacin de la
psicoterapia cognitiva un nuevo fenmeno ha surgido en la cultura de la ayuda interpersonal : el
coaching , de formato similar al couseling y con races comunes con este, posee sin embargo
notables diferencias en su evolucin y, sorprendentemente, en su organizacin y difusin. El
coaching ya posee tres confederaciones de acreditacin a nivel mundial, requisitos de
acreditacin y exigencia de formacin. Sus asociaciones estn muy activas tanto en
publicaciones como en actividades tales como congresos y simposios. Son cada vez ms los
ttulos publicados sobre el tema, y obviamente cada vez es ms pblico el que acude a solicitar
sus servicios. Aunque su presentacin inicial aparece como un producto nuevo de la cultura y
ha sido percibido como derivado menor de la psicoterapia por los psicoterapeutas, tambin es
cierto que son muchos los movimientos psicoteraputicos que estn presentado su propia
versin del Coaching, y es obvio a la revisin experta que sus temas y propuestas no son
extraas a las propuestas de la psicoterapia moderna. Qu conocemos de este fenmeno y si
est la psicoterapia cognitiva preparada para lidiar con l? Estamos frente a una amenaza?
Frente a una oportunidad de de ampliar nuestro desarrollo? lo cierto que el desarrollo y
difusin del coaching es ya demasiado notable para ignorarlo y conviene conocerlo y estudiarlo
ya que en muchos aspectos se dirige a una poblacin por lo menos similar a la que usa la
psicoterapia. La presentacin expone la situacin del coaching , sus caractersticas , evolucin
y situacin actual y revisa los posibles peligros y propone ciertas posiciones frente a este.
Supervisin en el entrenamiento de Terapeutas Cognitivos Conductuales
Pedro Reyes Mispireta1, Eduardo Keegan2, Agnieszka Popiel3.
1. ITRE - Instituto de Terapia Racional Emotiva, Lima, Peru, 2. Facultad de Psicologa,
Universidad de Buenos Aires, Buenos Aires, Argentina, 3. Programa de Entrenamiento en
Terapia Cognitivo Conductual, Universidad SWPS, Sopot, Poland.
La supervisin ocupa un lugar central en el entrenamiento y desarrollo de terapeutas, sin
embargo su investigacin emprica es relativamente reciente. Si bien el avance en el campo ha
sido significativo , an hay bastante discrepancia respecto de las competencias bsicas que
debe dominar un terapeuta cognitivo-conductual. La supervisin ha dejado de ser un arte en
manos de expertos inspirados para pasar a ser una tarea que demanda un entrenamiento
estructurado que tiende a ser una formalizacin creciente. El desarrollo relativamente tardo de
la Terapia cognitivo conductual en Latinoamrica ha determinado que el proceso de

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formalizacin de la supervisin sea relativamente reciente, y en gran medida , un proceso en un


curso muy dinmico. El desarrollo de la supervisin enfrenta una serie de desafos en la regin:
el nmero pequeo de supervisores calificados respecto a la cantidad de personas interesadas
en formarse como terapeutas cognitivos conductuales, el carcter reciente de las normas de
supervisin para la certificacin de terapeutas, as como la inexistencia de una obligacin
estatal de cumplir con estas normas de certificacin. En nuestra exposicin presentaremos una
sinopsis de los criterios que empleamos en nuestro entrenamiento, as como los lineamientos
generales que exige al presente, las diversas asociaciones representadas por los expositores.
Por ltimo indicaremos similitudes y diferencias con el proceso de diseminacin de la TCC y
sus supervisin en Latinoamrica y Europa
ASPAC!!!: Material Ldico para Trabalhar RPD
Luciana Rizo.
Luciana Rizo, Rio de Janeiro, Brazil.
Abstract Central: A utilizao de material ldico em psicoterapia com crianas fundamental
para a melhor adeso desse pblico terapia. Na Terapia Cognitivo-Comportamental, o
Registro de Pensamentos Disfuncionais (RPD) uma ferramenta poderosa no processo
teraputico, pois auxilia o indivduo na monitoria de seus comportamentos, sentimentos e
pensamentos, a partir dos acontecimentos e, ainda, fornece material para que seja realizado o
questionamento do pensamento disfuncional, contribuindo para o processo de enfraquecimento
das crenas centrais negativas sobre si, tornando o indivduo mais saudvel psicologicamente.
O jogo utilizado neste trabalho uma adaptao de um jogo comercial muito utilizado por
crianas, cujo objetivo principal construir, em um tabuleiro, uma linha com quatro peas. Essa
linha pode ser formada na horizontal, na vertical ou na diagonal. No jogo original, vencer
aquele que completar a linha com as quatro fichas primeiro. A adaptao realizada, tambm
tem o objetivo de ligar quatro peas ou na vertical, ou na horizontal, ou na diagonal, porm as
quatro peas tem frases escritas que correspondem aos elementos do modelo cognitivo:
acontecimento, sentimento, pensamento automtico e comportamento. Ligando a seqncia, a
criana sedimentar o conhecimento da relao entre esses elementos facilitando os registros
de pensamentos a serem realizados durante a prxima etapa do jogo e no desenrolar da
terapia. O jogo constitudo de 44 peas: 11 peas com acontecimentos, 11 peas com
sentimentos, 11 peas com pensamentos e 11 peas com comportamentos. Foram construdos
11 acontecimentos e seus desdobramentos em sentimentos, pensamentos e comportamentos.
Assim, na primeira etapa, o jogo pode ter duas fases: a primeira fase na qual pode-se formar
uma linha com qualquer seqncia, sem a necessidade de coordenar o acontecimento com o
sentimento pertinente, seu pensamento e comportamento; e a segunda fase quando
necessrio alinhar o acontecimento ao pensamento correspondente e assim por diante. um
jogo colaborativo. Cada jogador recebe suas 22 peas aleatoriamente e ambos colaboram na
criao das seqncias. Ou seja, se eu tenho a pea sentimento que se corresponde com a
pea acontecimento colocada por meu parceiro, eu continuo a seqncia colaborando para
completarmos a fileira. Assim, so formadas todas as fileiras com a colaborao e
comemorao de todas as jogadas. Sempre que uma seqncia for completada, os dois
jogadores falam em voz alta: ASPAC!!!!. Dessa forma, criamos um acrnimo que ajuda a
criana a lembrar do modelo cognitivo (A- acontecimento; S - sentimento; PA - pensamento
automtico e C- comportamento). No segundo momento do jogo, acontece a criao de novas
peas pela criana com seus prprios acontecimentos, sentimentos, pensamentos e
comportamentos. Nessa etapa, incentivamos criana a realizar registros de acontecimentos,
sentimentos, pensamentos e comportamentos que sero utilizados na construo do seu jogo
pessoal. Atingimos nesse momento 3 objetivos: psicoeducao sobre modelo cognitivo,

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discriminao dos componentes do modelo pela criana e incentivo da realizao do registro


de pensamentos - ferramenta fundamental da terapia cognitiva.
Costs and Benefits of the Therapist's Participation in Internet Delivered Psychological
Treatments
Pei-Chun Shih1, Ana Calero-Elvira1, Montserrat Montao-Fidalgo2, Alejandra Montoro1.
1. Universidad Autonoma de Madrid, Madrid, Spain, 2. Centro de Psicologa Alava Reyes,
Madrid, Spain.
Abstract Central: There is a clear consensus about the relevance of the therapeutic
relationship in face-to-face psychological treatments, but the therapist's role in e-health
programs is not as clear as in face-to-face treatments. Andersson (2009) highlighted that in online psychological treatments it is necessary that a therapist guides participants and gives them
feedback in order to obtain good results and adherence to treatments. The aim of this work is to
analyze the costs and benefits that the therapist's participation has on the efficacy and
adherence to internet delivered psychological treatments. We designed and applied three online programs about weight control, smoking cessation and insomnia at the Center of Applied
Psychology (Universidad Autnoma de Madrid, Spain). In every program there was an active
guidance, supervision and feedback for the participants made by clinical psychologists that were
expert in on-line treatments. The efficacy of the programs and the adherence to treatments were
similar to other on-line programs for weight control, smoking cessation and insomnia.
Specifically, dropout rates were 25% for weight control, 87% for smoking cessation, and 70% for
insomnia. In spite of this dropout rate, the satisfaction of the participants who finished the
programs was notably high. The active participation of the therapist in on-line treatment has
both costs and benefits. On the one hand, the main cost is that an active participation is a very
time-consuming activity for the therapist. On the other hand, active participation seems to
increase participants' satisfaction with the program. We have to clarify the relevance of the
therapist's participation in e-health programs and estimate the amount of participation that is
necessary to achieve optimal results in on-line therapy. Reference: Andersson, G. (2009). Using
the Internet to provide cognitive behaviour therapy. Behaviour Research and Therapy, 47, 175180.
Patients' Self-Esteem as a Moderator of Response to Feedback About Progress in
Psychotherapy
Adelln Sng1, Geoff Hooke2, Elizabeth Newnham3, 1, Andrew Page1, 2.
1. The University of Western Australia, Perth, WA, Australia, 2. Perth Clinic, Perth, WA,
Australia, 3. Franois-Xavier Bagnoud Center for Health and Human Rights, Harvard School of
Public Health, Boston, MA, USA.
Aim: Providing feedback about progress in psychotherapy has been shown to improve
treatment outcomes particularly for patients who are not doing well (e.g. Lambert et al., 2001;
Newnham, Hooke, & Page, 2010). However, a substantial proportion of patients continue to do
poorly and appear not to reap these feedback benefits. As self-esteem has been implicated to
influence response to feedback, the current study investigated whether patients self-esteem
moderated the effect of progress feedback on treatment outcomes. Method: Patients completed
a 10-item wellbeing and symptom measure daily throughout an intensive 10-day group
cognitive-behavioural therapy (CBT) program. Self-esteem was also measured at pre- and posttreatment. A cohort of patients completed the measure but did not receive feedback, while a
second consecutive cohort received feedback on Day 5 of the program. Results: While

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providing progress feedback did not appear to influence overall treatment outcomes, response
to feedback varied with levels of self-esteem for patients who were identified as not doing well
on Day 5 of treatment. When no feedback was provided, patients with higher self-esteem had
lower post-treatment symptom scores than patients with lower self-esteem. Interestingly, when
feedback was provided, patients with higher self-esteem had equivalent post-treatment
symptom scores to patients with lower self-esteem. Discussion: The direction of findings in the
current study was inconsistent with self-esteem effects observed in previous studies, and
possible explanations for this discrepancy will be explored. Implications for delivering progress
feedback to patients will also be discussed, with a view of improving effectiveness of therapeutic
feedback systems.
Core Beliefs as Starting Points Across Different Diagnoses in Cognitive Behavior
Therapy
Wolfgang Strauss, Johanna Strauss.
Psychiatric clinic, University of Duesseldorf, Duesseldorf, Germany.
Core beliefs are part of the cognitive model of cognitive behavior therapy. Little is known about
how many patients with different diagnoses report such core beliefs at the begin of
psychotherapy spontaneously.124 consecutive reports of 24 different therapists, which has to
be written in Germany after two or three anamnestic sessions and which are then sent to an
expert of the health insurance-company as request for therapy, were looked through whether in
these first reports core beliefs were reported spontaneously by the patients. In 88% of these
reports core beliefs were directly reported. No specific patterns of core beliefs were found for
the different diagnoses (anxiety disorders, OCD, depression, schizophrenia, personality
disorders, eating disorders). The role of core beliefs as starting point across different diagnoses
in CBT is discussed.
Intervencin cognitivo-conductual en conductas antisociales
Isela Guadalupe Suataita Torres1, Flor de Mara Erari Gil-Bernal2, Luz Orozco Ramirez2.
1. Psicologia, Universidad Autonoma de Tamaulipas, Victoria, Mexico, 2. Psicologia,
Universidad Iberoamericana, Mexico, D.F., Mexico.
El trastorno antisocial de la personalidad tal como lo sostienen Kamarovskaya, Lpez y Warren
(2007) est claramente vinculado al rol de impulsividad en donde en muchos de los casos la
inestabilidad afectiva y determinadas respuestas emocionales favorecen la desinhibicin de
conductas antisociales. Dentro de la prisin, los reclusos se encuentran en un ambiente
caracterizado por el aislamiento de la afectividad. Son sujetos a vigilancia permanente,
mantienen una escaza intimidad, una vida rutinaria, un alto nivel de frustracin constante as
como de una escala de valores que es completamente nueva para ellos. Probablemente estas
condiciones se reflejarn en la desconfianza y la agresividad en las relaciones interpersonales
que logren establecer (Arroyo, 2009). Las conductas antisociales entorpecen el proceso de
adaptacin al reclusorio y por ende una inadecuada reinsercin a la sociedad (Nieto, et al.,
2007). El presente estudio tuvo la finalidad de desarrollar un tratamiento psicolgico eficaz para
el manejo de las conductas antisociales en los delincuentes recluidos en prisin. El estudio de
caso se llev a cabo con un recluso del CEDES Victoria (Cd. Victoria, Tamaulipas) de 24 aos
de edad, soltero, con nivel de escolaridad de primaria terminada y que se encuentra aun
cumpliendo una pena legal que consta de dos procesos uno por robo y el segundo por
lesiones, con una condena de 6 aos 8 meses de prisin, de la cual ya ha purgado en reclusin
tres aos. Se llev a cabo una evaluacin de las reas cognitiva, conductual y emocional

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tomando en cuenta para esto las ideas irracionales y las distorsiones cognitivas del interno. Se
elabor el mapa clnico de patognesis y el mapa de alcance de metas propuesto por Nezu,
Nezu y Lombardo (2006) para la formulacin de casos y diseo de tratamiento. Se decidi
llevar a cabo una intervencin cognitivo conductual basada en la aportacin de Caballo (2008)
para el trastorno antisocial y en donde se seala que es ms factible el tratamiento de los
sujetos con un trastorno antisocial de la personalidad que estn recluidos en algn tipo de
institucin debido a que, en gran medida, el ambiente puede controlarse ms y utilizarse como
una estrategia teraputica.. De acuerdo a la revisin de la literatura, se sabe que es de gran
utilidad agregar a la intervencin, tcnicas de entrenamiento en conductas pro sociales, control
de la ira y de los impulsos y entrenamiento en solucin de problemas (Echebura & Corral,
1999). Derivado de lo anterior, el plan de tratamiento const de 12 sesiones, ms las sesiones
de seguimiento. Las tcnicas que se incluyeron fueron la restructuracin cognitiva, el
entrenamiento en relajacin, la solucin de problemas, la distraccin de pensamiento, las auto
instrucciones positivas y el juego de roles. Posterior al tratamiento, se logr que el paciente
identificara sus emociones y pensamientos negativos y que los modificara. Adems se logr
que estableciera relaciones interpersonales adecuadas con el resto de la poblacin interna y
las autoridades del centro. Con lo anterior se concluye que el tratamiento cognitivo conductual
fue eficaz en la disminucin de las conductas antisociales del interno.
Terapia Cognitivo-Comportamental Como Ferramenta No Tratamento De Depresso:
Estudo De Caso
Julia Tavares, Leopoldo Barbosa.
NAAP - Ncleo de Avaliao e Acompanhamento Psicolgico, Campina Grande - PB, Brazil.
A terapia cognitivo comportamental integra tcnicas e conceitos advindos de duas principais
abordagens. A cognitiva se utiliza do conceito biopsicossocial na compreenso de fenmenos
relativos psicologia humana e mantm o seu foco sobre os fatores cognitivos da
psicopatologia, ou seja, como se realiza o processamento de informaes at que lhe sejam
atribudos significados funcionais ou disfuncionais. A comportamental busca identificar como os
comportamentos, voluntrios ou involuntrios, so resultantes aos estmulos do ambiente
(Bahls e Navolar, 2005). Essa juno nos permite compreender as desordens psicolgicas a
partir da integrao de um sistema comportamental, cognitivo/afetivo e fisiolgico,
apresentando, assim, diversas aplicaes que favorecem a readaptao do indivduo ao meio.
A depresso uma doena que compromete o fsico, o humor e, em consequncia, o
pensamento, alterando a forma com a pessoa v o mundo e sente a realidade. O estudo se
restringe a analisar um caso clnico e prever possveis reas de atuao dentro do modelo
comportamental-cognitivo, bem como sugerir formas de interveno com a finalidade de
provocar mudanas em benefcio da qualidade de vida do cliente. Foi realizada anamnese com
paciente, acompanhante e a partir dos atendimentos construda a conceitualizao do caso e
plano teraputico direcionado para remisso dos sintomas, partindo da modificao de crenas
nucleares negativas. Portanto, a utilizao de estratgias teraputicas permite a compreenso
de todas as variveis que podem contribuir na anlise dos casos atendidos, alm de poder
desenvolver procedimentos eficazes na modificao dos comportamentos inadequados e
crenas disfuncionais, que auxiliam a distorcer a viso racional que o homem tem dos eventos
de vida.
Relao Teraputica como Ferramenta de Mudana Comportamental: Um Estudo de
Caso de Disfuno Sexual Masculina
Catarina Teixeira.

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1. Universidade Federal de So Carlos, So Carlos, Brazil, 2. Universidade Federal Maranho,


So Luis, Brazil.
Abstract Central: O estabelecimento de uma relao teraputica reforadora entre cliente e
terapeuta tem sido apontado por autores de diferentes modalidades psicoterpicas como uma
varivel que aumenta a eficcia do processo teraputico, principalmente diante de queixas que
se caracterizam como difceis de serem verbalizadas pelos clientes durante as sesses, como
o caso das disfunes sexuais. Portanto, discute-se neste trabalho a importncia de se
analisar funcionalmente a relao terapeuta-cliente considerando ser esta uma poderosa
ferramenta de mudana comportamental. Neste estudo apresenta-se o caso de um cliente cuja
queixa era disfuno ertil. Durante os atendimentos o mesmo tinha 54 anos de idade e
trabalhava como engenheiro em uma empresa multinacional. Foram realizadas 15 sesses (05
de avaliao, 01 de devoluo/discusso e 09 de interveno) sob o enfoque analticocomportamental. No programa de interveno utilizou-se: anlise funcional, biblioterapia,
tcnica foco sensorial e treino assertivo. De acordo com o relato do cliente, mudanas
comportamentais foram identificadas a partir da primeira sesso de interveno, e nas sesses
finais seu desempenho sexual encontrava-se restabelecido
O Impacto da Terapia Cognitivo-Comportamental no Tratamento com Deficiente Visual:
Relato de Caso
Carina Todesco1, Giedre Costa1, 2.
1. Instituto de Psicoterapia Cognitivo-Comportamental, So Jos do Rio Preto, Brazil, 2.
UNIVERSIDADE PAULISTA-UNIP, SAO JOS DO RIO PRETO, Brazil.
Abstract Central: O objetivo desse estudo verificar o impacto da terapia cognitivocomportamental no tratamento com deficientes visuais. Foi sujeito desse relato um paciente do
sexo masculino, de 36 anos, divorciado, tcnico administrativo, escolaridade de nvel superior
completo com graduao em Letras e com deficincia visual congnita. A queixa inicial
apresentada pelo paciente se concentrou nas dificuldades interpessoais relacionadas sua
sexualidade, devido uma experincia homossexual. Foram realizadas 19 sesses, das quais
duas foram faltadas. Utilizou-se tcnicas referentes abordagem e adequaes das mesmas a
dificuldade do paciente como, por exemplo, inflexes expressivas no tom de voz, tarefas de
casa adaptadas devido a excelente memria do paciente, escalas Beck de depresso e
ansiedade aplicadas oralmente. Durante todo o processo, o paciente foi colaborativo e aderiu
ao tratamento com propriedade, fato este que se deve ao perodo de tempo despendido ao
estabelecimento de rapport, bem como a responsividade e empatia da terapeuta ao caso. O
processo teraputico mostrou-se positivo na melhora dos sintomas depressivos e ansiosos e
na compreenso de sua sexualidade. As adequaes s tcnicas da abordagem, assim como
manejo das habilidades teraputicas desenvolvidas pelo profissional, contriburam de forma
eficaz para a realizao do vnculo, na colaborao e na participao do paciente, o que
propiciou a remisso total da queixa.
Avaliao do Tratamento Cognitivo-Comportamental Estruturado para Grupo de
Pacientes com Tricotilomania
Edson Toledo, Enilde Muniz, Hermano Tavares.
Psiquiatria, Universidade de So Paulo, So Paulo, Brazil.
Tricotilomania (TTM) um transtorno prevalente e incapacitante caracterizado pelo repetitivo
arrancar de cabelo, sendo classificada como um transtorno do controle de impulso. Diversos

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estudos foram apresentados na literatura clnica, sugerindo que a TTM mais comum do que
se acreditava e vrias propostas de tratamento foram apresentadas. As pesquisas do
comportamento em pacientes com TTM tm focalizado seus fatores mantenedores. Entretanto,
devemos considerar o potencial papel das cognies que podem operar junto com variveis de
comportamento, na etiologia e manuteno da TTM. Exceto por trs estudos controlados para
Terapia de Reverso de Hbito, at o momento no foram publicados estudos controlados
sobre o uso de Terapia Cognitivo-comportamental (TCC) em TTM; apenas relatos e sries de
casos. O presente estudo teve como objetivo testar um programa manualizado de TCC em
Grupo (TCC-G) para portadores de TTM, diagnosticados de acordo com o Manual Diagnstico
e Estatstico de Doenas Mentais - Quarta edio Edio (DSM-IV). Os pacientes com TTM
foram alocados aleatoriamente em um dos dois grupos, sendo que um grupo experimental
(n=22) participou de TCC-G e o outro grupo controle (n=22) participou de Terapia de Apoio em
Grupo (TA-G). Durante o estudo, os participantes do grupo experimental participaram de vinte e
duas sesses de um programa de TCC-G manualizado. A principal varivel de desfecho foi a
Massachusetts General Hospital Hair Pulling Scale (MGH-HPS), demais variveis secundrias
de desfecho foram: Inventrio de Depresso de Beck (Beck Depression Inventory - BDI),
Inventrio de Ansiedade de Beck (Beck Anxiety Inventory - BAI) Escala Adequao Social
(EAS). Os grupos experimental e controle foram comparados em dois momentos, no incio e no
final da interveno, utilizando-se anlise de varincia (ANOVA) para medidas repetidas.
Ambos os grupos apresentaram melhora significativa dos sintomas de TTM e depresso ao
longo do tratamento (p<0,001). Sintomas ansiosos e ajustamento social no apresentaram
variao significativa. O grupo experimental mostrou uma reduo significativamente maior dos
sintomas de TTM em comparao com o grupo controle (p=0,019) ao fim do tratamento.
Conclui-se que a TCC-G um mtodo vlido para o tratamento da TTM. Revises futuras e
ampliaes deste modelo devem ser realizadas para que o mesmo possa abarcar de forma
mais eficaz a sintomatologia concorrente, em especial ansiedade, e o ajustamento social.
Cognitive Behavioral Therapies in Different Settings and Cultures
Mehmet Turkcapar1, Mustafa Sayar2, Kadir Ozdel4, Fatih Yavuz3, Mehmet Turkcapar1.
1. Psychology, H. Kalyoncu University, Ankara, Turkey, 2. Marmara University, Istanbul, Turkey,
3. Bakirkoy Mental health Hospital, Istanbul, Turkey, 4. Diskapi Yildirim Beyazit Hospital,
Ankara, Turkey.
Cognitive behavioral therapy, as an empirically supported therapy modality, is sometimes
criticized for being so rigid in its structured nature. Although cognitive behavior therapists
provide great deal of flexibility in their practice, cognitive behavior therapy applications in
different settings in terms of culture, age and educational status are in still ongoing debate. As
we face the so called third wave of behavioral therapies in which the focus of psychotherapy
switches from analyzing western style to observing/accepting eastern style we, cognitive
therapists, keep seeking benefits for our clients unsatisfied needs.
To this end we are (Turkcapar MH, Ozdel K, Sayar K, Yavuz FK) planning to perform a panel
discussion in which we try stimulate fruitful debate on the application of CBT across different
population, culture and ages.
Sufi Psychotherapy: Can the eastern wisdom heal the western wound?
Sufism is the wisdom imbued from the islamic heritage of knowledge and spirituality. It has a set
of psychological principles that help individuals to find relief. Some of these psychological
principles are in consent with todays operating psychotherapy systems. On the other hand it is
widely discussed that western psychotherapies lack spirituality and sometimes can not fulfill
human beings needs for transcendence and spirituality.

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A psychotherapy based on sufi ideals of personal growth has many common themes with
acceptence and commitment therapies. The authors discuss whether such resemblance can
give way to a new mode of thinking in psychotherapy. They discuss the shared assumptions of
traditional and modern view on human nature and also draw attention on the differences.
Paralels between Acceptance and Commitment Therapy and Eastern Cultural Tradition
Some concepts of Acceptance and Commitment Therapy has some similarities with the middle
east's cultural and religous tradition. In this presentation this concepts will be presented and
also some clinical implications will be discussed.
Cognitive Therapy In Different Populations
Cognitive behavior therapy can be modified according to clients culture, needs, age, cognitive
developmental level. In this presantations this modifications will be presented in a clinical
context. After a theoretical discussion, various clinical examples will be presented.
Implications of Piaegetian Theory into Cognitive Therapy
Piaget developed a new theaory based on his child observations. He rejected the behavioral
model of cognitive development and propose a new stage theory of cognitive development. In
cognitive therapy setting clinicians have to consider clients cognitive maturational level. This
aspect of therapy endevaur will be discussed in this presentation. Clinical and research
examples will be presented.
Relacin entre Experiencia Profesional y Actitud de los Profesores de Aula Frente a la
Integracin Escolar de Nios con Necesidades Educativas Especiales
Viviana Vallejos Garcias, Marcela Torres Matamala, Ximena Quiroz Lagos.
Universidad Andrs Bello, Concepcion, Chile.
Abstract Central: Relacin entre Experiencia Profesional y Actitud de los Profesores de aula
frente a la Integracin Escolar de nios con Necesidades Educativas Especiales. Autores:
Ximena Quiroz Lagos - Marcela Torres Matamla - Viviana Vallejos Garcas RESUMEN La
presente investigacin trata sobre la experiencia profesional y la actitud de los profesores de
educacin bsica en aula comn ante la integracin escolar de nios y nias con Necesidades
Educativas Especiales en los establecimientos educacionales de la comuna de Santa Brbara.
En este marco, se tiene como finalidad determinar la relacin entre la experiencia laboral y la
actitud de los profesores de aula comn ante la Integracin Escolar en instituciones educativas
de dicha comuna. Para ello, se abordaron diversas fuentes bibliogrficas concernientes a la
historia de la Educacin Especial, la Integracin Escolar, las Necesidades Educativas
Especiales y la Actitud de los profesores frente a la Integracin Escolar. En tanto, el tipo de
metodologa es de carcter cuantitativo, pues se miden las variables experiencia profesional y
las actitudes ante la Integracin Escolar. Consecuente con ello, se adopta un Diseo no
experimental transeccional de tipo descriptivo. El instrumento para recopilar informacin acorde
a la problemtica fue el cuestionario de escalamiento tipo Likert, la cual se aplic a los
profesores de aula comn, que atienden a nios con NEE. Los resultados obtenidos tras la
aplicacin del cuestionario muestran que los profesores con mayor experiencia profesional
tienen una actitud ms favorable frente a los nios que se encuentran en un proyecto de
Integracin Escolar. A partir de la temtica expuesta se hace necesario investigar: Existe
relacin entre la experiencia profesional y la actitud de los profesores de educacin bsica en
aula comn ante la integracin escolar de nios y nias con Necesidades Educativas
Especiales en los establecimientos educacionales de la comuna de Santa Brbara? Para lo
cual se plantea el siguiente Objetivo General de Investigacin: Determinar la relacin entre la
experiencia profesional y la actitud de los profesores de aula comn frente a la Integracin

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Escolar de nios con Necesidades Educativas Especiales en instituciones educativas regulares


pertenecientes a la comuna de Santa Brbara.
Uncovering Therapist Schemas: Psychometric Properties of Leahys (2009) Therapists
Schema Questionnaire
Mei Wah Williams.
School of Psychology, Massey University, Auckland, New Zealand.
Abstract Central: Treatment failure is frequently considered a failure of the client; the clients
characterological deficiency, failure to comply with treatment, or resistance and lack of
commitment to behavioral change. The concept of clients schema has been significant to
understanding the development and maintenance of psychological problems, but also its
function in client resistance within the therapeutic exchange. As therapy is intrinsically an
interpersonal discourse, the role of therapist schema in affecting the process and outcome of
therapy should also be investigated. Leahy (2009) proposed a number of therapists schemas
that may be activated when working with particular clients, and developed the Therapists
Schema Questionnaire. Despite this, few investigations have been carried out in this area. The
research investigated the psychometric properties of Leahys questionnaire and to identify the
particular schemas that therapist adhere to.
Los Trastornos de Ansiedad y sus recadas. Anxiety disorders and relapse
Ruth Wilner1, 2, Liliana Arostegui1, 2.
1. Centro de Terapia Cognitiva, Buenos Aires, Argentina, 2. ALAPCO, Buenos Aires, Argentina.
Los Tratamientos de Ansiedad suelen mejorar significativamente con las tcnicas cognitivo
conductuales. El trabajo con los sntomas fisiolgicos, los pensamientos automticos y las
emociones disfuncionales cosechan buena respuesta al tratamiento y si se implementan
tcnicas de auto asistencia como la respiracin, la relajacin y las visualizaciones se
desarrollan recursos poderosos para la prevencin de recadas. Muchas veces con esto no
alcanza y frente a alguna crisis vital suele haber re consultas. El escollo con el que solemos
encontrarnos es que el paciente desea que los sntomas desaparezcan y jams regresen y es
la vida misma quien pone en jaque semejante pretensin. La realidad del diario vivir y los
avatares de la vida cotidiana enfrentan a todo ser humano con situaciones ansigenas de
diverso calibre. El puente que he experimentado para prevenir las recadas consiste en una
integracin entre diversas tcnicas de la Terapia Cognitivo Conductual y la e intervenciones
basadas en Mindfulness como la aceptacin y compromiso (ACT). En el abordaje se incorporan
adems textos de filsofos y escritores tanto como anlisis de personajes de libros y pelculas.
La intencin de brindar mltiples miradas al padecimiento. Se busca generar flexibilidad y
recursos que sintonicen con cada paciente y su sentido nico y personal de mirar la vida. Poder
darle un significado diferente a la vulnerabilidad y a la incertidumbre que caracteriza a los
Trastornos de Ansiedad.
Personalidades Disfuncionales: Rutas acertadas o desacertadas en el recorrido
teraputico en bsqueda de la funcionalidad extraviada. Dysfunctional personalities:
right or wrong paths in the therapeutic road to seeking the functionality missed
Ruth Wilner1, 2, Lydia Tineo1, 2.
1. Centro de Terapia Cognitiva, Buenos Aires, Argentina, 2. ALAPCO, Buenos Aires, Argentina.

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Si revisamos el trasfondo en el que estos trastornos se consolidan, no resulta difcil comprender


las razones que llevan a los pacientes a abandonar los tratamientos, cuando lo hacemos desde
las perspectivas actuales calificadas como modelos de avanzada en el tratamiento de
trastornos de la personalidad. Entre estos la Terapia de Esquemas de Jeffrey Young, propone
un tratamiento integrativo que enraizado en la Terapia Cognitiva, la teora del aprendizaje y la
psicologa evolutiva y del desarrollo, incorpora en su terapia estrategias cognitivas,
conductuales y emocionales en congruencia teraputica de probada eficacia. Entiende a los
trastornos de personalidad, como disfunciones resultantes de los reiterados aprendizajes
condicionantes que consolida el infante durante su desarrollo evolutivo en su entorno
ambiental. Siendo aprendizajes especficos sistemticamente reforzados en ese medio,
mantienen su vigencia mientras se conjugan con el crecimiento y la evolucin de capacidades
en sincrona con la maduracin neurobiolgica, integrndose en los sucesivos procesos de
asimilacin y adaptacin de experiencias internas y externas, multiplicando los aprendizajes a
procesar e integrar a su estructura de identidad. Son procesamientos complejos de
experiencias vividas que nutren la identidad del individuo. Su incorporacin a la estructura de
identidad, tiende a respetar la vital necesidad de toda estructura en evolucin: mantener el nivel
de coherencia interna suficiente para garantizar la integridad estructural en progreso. Las
experiencias durante el desarrollo evolutivo no siempre se suceden de modo que resulten
congruentes con esa necesidad vital, propiciando en muchos casos incoherencias que se
manifiestan como disfuncionalidad. Cuando en los procesos teraputicos erramos el camino
con el que pretendemos recobrar su funcionalidad reforzamos lo opuesto.
Implementacin de recursos narrativos y experienciales en psicoterapia cognitivoconductual. Alcances y limitaciones. Implementing Narrative and experiential resources
in Cognitive-Behavioral Psychotherapy: Scope and Limitations
Ruth Wilner1, 2, Fany Kauderer1, 2.
1. Centro de Terapia Cognitiva, Buenos Aires, Argentina, 2. ALAPCO, Buenos Aires, Argentina.
Esta presentacin tiene como presupuesto plantear diversas alternativas que se encuentran
como recursos a los cuales acudir en nuestra prctica profesional y que nos llevan a una
lectura que se acerca al tema de la integracin en psicoterapia. Partimos de aquello que tan
frecuentemente nos encontramos en nuestra labor como seria el preguntarnos de cuando es
necesario combinar, frente a determinados casos clnicos ms de un modelo de intervencin en
psicoterapia, nuestra experiencia nos va dando seales muy particulares que determinadas
tcnicas se enriquecen en comunin con otras siempre que tengamos claro que estamos
haciendo, cuando, cmo y con quin. El recurso narrativo genera la posibilidad de ponernos en
el centro del paradigma del paciente a travs de sus relatos entreteje con determinados
recursos conductuales una interesante combinacin, si consideramos que las emociones
juegan un papel indiscutible de disposicin a la accin; emocin que ocupara un rol protagnico
en los relatos del paciente y que tendr un realce importante en el marco de sus conductas. En
cada caso en particular es necesario evaluar los alcances y limitaciones de la utilizacin de
tcnicas narrativas y experienciales. Esto da lugar a un enriquecedor aprendizaje de nuestro rol
como terapeuta.
Translational Psychology/ Investigacin Transcultural/ Pesquisa Cross-Cultural
The Anomalous Adolescent: Insights into Fear Learning and Inhibition during the
Wonder Years
Miriam Den, Rick Richardson.

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University of New South Wales, Sydney, NSW, Australia.


Abstract Central: Although most anxiety disorders emerge during adolescence, there is a
paucity of research examining factors that contribute to the storm and stress of this period.
Preclinical work on emotional learning provides one approach for understanding why
adolescence is marked by such vulnerability. Rodent models of fear learning and extinction (the
processes by which fear is acquired and inhibited) have provided the cornerstone for developing
psychological treatments for anxiety such as exposure therapy. However, these models are
largely based on studies using adults, leaving open whether differences exist in the way
adolescents 1) learn fearful associations and 2) extinguish fearful associations. The studies in
this talk provide unique insights into these questions, which may ultimately indicate the need for
tailoring current treatments to optimally target the underlying dysfunctions that mediate anxiety
in adolescence. Fear Learning: To examine developmental differences in learning fearful
associations, juvenile (postnatal day 23; P23), adolescent (P35), and adult (P90) rats were
trained on a fear conditioning procedure, involving pairing a neutral conditioned stimulus (CS;
white noise) with an aversive unconditioned stimulus (US; footshock). If the CS and US
overlapped in time, all age groups acquired similar levels of fear. However, if a stimulus-free
trace interval of 20 or 40s separated CS offset and US onset, then only the adolescents
exhibited learning. In the next experiment, administration of the stress hormone corticosterone
(200g/ml), via the drinking water for 1 week prior to training, disrupted fear learning in
adolescent rats trained with the 20s trace interval. Together, these findings demonstrate that
adolescents show a heightened propensity to learn fearful associations, and that this is
disrupted with prior exposure to corticosterone. Fear Extinction: Adolescent rats exhibit greater
fear recovery following extinction training (where the CS is repeatedly presented by itself)
compared to juveniles and adults. The current study replicated this finding, however, adolescent
rats given double the amount of extinction training showed improved extinction retention when
tested 24 hrs later. In a follow-up experiment, adolescents exposed to corticosterone for one
week showed impaired extinction retention despite receiving double the amount of extinction
training. Therefore, whilst administering longer extinction training can rescue the deficits
observed in extinction retention during adolescence, these deficits re-emerge with prior
exposure to a stress hormone. Taken together, these experiments show that fear learning is
enhanced, whereas extinction is impaired, in adolescence. These two types of learning are
impacted, albeit in different ways, by exposure to a stress hormone in early adolescence. Thus,
compared to adults, adolescent humans may be more susceptible to learning remote fearful
associations, require lengthier treatment sessions to reduce fear, and might fail to respond to
treatment when stressed. These results are discussed in relation to a long-term focus on the
prevention and treatment of anxiety disorders in adolescence.
Bienestar Psicolgico en Nios Migrantes de Retorno en una Escuela Primaria de
Guadalupe, Zacatecas, Mxico
Ricardo Escobar-Gamboa, Oliva Luis-Delgado.
Universidad Autnoma de Zacatecas, Zacatecas, Mexico.
Abstract Central: En los ltimos aos, la crisis econmica de Estados Unidos ha repercutido
en una creciente disminucin de empleos, lo que ha generado incertidumbre y diversos
temores en los migrantes mexicanos y sus familias. Motivo por el cual en Mxico se ha
presentado un retorno masivo de familias migrantes (Alarcn et al., 2008). Al mes de Marzo
de 2012, se haban inscrito alrededor de 8,700 nios migrantes de retorno en las escuelas
primarias de Zacatecas; la Secretara de Educacin y Cultura desarroll programas para
atender las necesidades educativas de esta poblacin, pero no se han hecho estudios para

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conocer el estado afectivo-emocional de los nios. Objetivo: conocer el bienestar psicolgico de


los nios migrantes de retorno de una escuela primaria en Guadalupe, Zacatecas.
Participantes: la poblacin total de nios migrantes, entre 7 y 12 aos de edad, de una escuela
primaria en Guadalupe, Zacatecas; ms catorce nios de caractersticas similares como grupo
control. Mtodo: se realiz una investigacin mixta, de corte transversal no experimental. En la
fase cuantitativa se aplic la escala BIEPS (Casullo, 2002) a los nios migrantes de una
escuela primaria en Guadalupe, Zacatecas, as como a un grupo control con caractersticas
similares. La fase cualitativa se llev a cabo en tres sesiones de juego diagnstico con cada
uno de los nios migrantes de la misma escuela. Resultados: los nios migrantes de retorno
presentaron sentimientos de enojo, duelo y tristeza que interfieren con su bienestar psicolgico,
especialmente en la dimensin Proyectos. El grupo control present mayor bienestar
psicolgico, aunque la diferencia no fue significativa. Conclusiones: el cambio de ambiente al
momento de trasladarse de Estados Unidos a Mxico crea sentimientos de enojo, duelo y
tristeza que afectan el bienestar psicolgico de los nios migrantes de retorno. Este cambio, a
su vez, genera incertidumbre en relacin al futuro, lo cual se ve reflejado en la falta de
proyectos de vida en los nios.
Reconocimiento Facial de Emociones como Funcin de la Diferencia en las Categoras
Eemocionales de la Prueba JACFEE: Un Estudio Comparativo en Mexicanos
Said Jimnez-Pacheco1, 2, Juan Jos Snchez-Sosa1, 2.
1. UNAM, Mexico City, Mexico, 2. Faculty of Psychology, Mexico City, Mexico.
Abstract Central: El estudio de la expresin y el reconocimiento facial de emociones es,
probablemente, una de las reas ms prolficas de investigacin en las ltimas dcadas. Tan
slo una de las principales ventajas de este estudio es la demostracin sistemtica de que
ciertas expresiones se reconocen universalmente entre las culturas humanas. Un ejemplo son
los notables porcentajes de acuerdo en el nivel de reconocimiento entre personas de pases
como Japn, Estados Unidos, Hungra, Polonia, Indonesia y Vietnam, entre otros. El caso de
Mxico no difiere sustancialmente de los anteriores, pero slo existe un estudio que indica que
las emociones bsicas: enojo, sorpresa, felicidad, disgusto, temor y tristeza se reconocen con
consistencia estadsticamente significativa. En ese estudio los porcentajes de reconocimiento
resultan ser menores a los reportados para otros pases, particularmente para emociones
bsicas negativas como disgusto, temor o tristeza. Se sugiere que estas diferencias en el
porcentaje de reconocimiento se pueden deber a la desigualdad de categoras semnticas y los
significados afectivos asociados con la categora emocional. Esta sugerencia, aunque
tentadora, no ha recibido una revisin exhaustiva de los trminos que representaran las
categoras emocionales para la poblacin mexicana en particular, con posibilidades de
aplicacin a otros pases de Latinoamrica. Tambin, las diferencias en el porcentaje de
reconocimiento del estudio comentado pueden deberse a una tendencia en la seleccin de los
participantes, ya que el nmero de mujeres fue muy superior al nmero de hombres en el
grupo. As, el presente estudio se propuso hacer un anlisis a profundidad sobre los trminos
que mejor representan las categoras emocionales bsicas (enojo, sorpresa, felicidad, disgusto,
temor y tristeza) y comparar el porcentaje de reconocimiento con los reportados en otros
estudios con datos para Mxico y otros pases. Se utilizaron estmulos faciales que suelen
representar de forma confiable y vlida las emociones bsicas: el Japanese and Caucasian
Facial Expression of Emotion (JACFEE) de Matsumoto y Ekman. Se trata del nico material
que rene tales criterios y se utilizaron las categoras emocionales propuestas por Matsumoto
en espaol y en ingls. Despus de una traduccin cuidadosa de las categoras emocionales y
sus significados en ambos idiomas, se instrument un proceso de validacin por jueces
mexicanos expertos sobre la traduccin para definir las categoras emocionales culturalmente

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ms relevantes y se aplic en poblacin mexicana. Los resultados revelan notoriamente mayor


porcentaje de reconocimiento en comparacin con otros estudios, lo que arroja luz sobre la
importancia del uso de los mejores descriptores de las categoras emocionales para
comparaciones adecuadas y contribuir de modo efectivo a la evidencia sobre la universalidad
de las emociones.
El uso de tecnologa para ayudar al mayor nmero de personas posible/ Using
technology to help as many people as possible
Ricardo Muoz1, Ricardo Munoz1, Ma. Asuncin Lara2, Marcela Tiburcio2, Araceli Aguilar2,
Marcela Tiburcio2, Ma. Asuncin Lara2, Araceli Aguilar2, Maria Lucia Souza-Formigoni5, M.
Ramos5, Y. Moura5, D. DeMicheli5, E. Silva5, A. Carneiro5, P. Duarte6, Telmo Ronzani4,
Henrique Gomide4, Leonardo Martins4, Eduardo Bunge3.
1. Palo Alto University, Palo Alto, CA, USA, 2. Instituto Nacional de Psiquiatra Ramn de la
Fuente Muiz, Mexico, Mxico City, Mexico, 3. Fundacin ETCI, Buenos Aires, Argentina, 4.
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil, 5. Universidade Federal de So
Paulo, So Paulo, Brazil, 6. Secretaria Nacional de Polticas sobre Drogas, Braslia, Brazil.
Para hacer llegar intervenciones basadas en evidencia al mayor nmero de personas posible,
sistemas de salud deben de ir ms all de intervenciones que se consumen al usarlas. La gran
mayora de intervenciones dependen del uso de medicamentos, tal como el parche de nicotina,
que, despus de ser usado por un da se desecha, o de tratamientos que se administran frente
a frente, y por lo tanto requieren que el profesional dedique gran parte de su tiempo con un
pequeo nmero de pacientes. Una vez que una sesin teraputica termina, la hora que ha
pasado nunca brindar beneficio a ningn otro paciente. El hecho que el sistema de salud
depende tanto en esta clase de intervenciones dificulta el establecimiento de clnicas en todas
las comunidades que las necesitan, y muchas veces resulta en que cierren tales clnicas por
falta de recursos.
Este simposio explicar como se podra utilizar un mtodo alternativo para reducir las
disparidades en servicios de salud a travs de pases y a travs del mundo. Este mtodo
consiste en desarrollar y evaluar intervenciones en lnea de auto-ayuda automatizadas, que se
pueden compartir con cualquier persona que tenga acceso a Internet. Presentaremos proyectos
para dejar de fumar que han estado vigentes for mas de diez aos, y proyectos mas recientes
enfocados en la depresin.
El propsito de este simposio es informar colegas hispanoparlantes quienes desean brindar
acceso a programas cognitivos conductuales a las personas que mas los necesitan que existen
mtodos para llegar al mayor nmero de personas posible. Nosotros estamos convencidos que
intervenciones Internet deberan de ser diseminadas como un nivel bsico de intervenciones de
salud. Comunidades que tengan los recursos para brindar servicios frente a frente podran
aadir tales servicios al servicio bsico por Internet. Comunidades que no tengan los recursos
para contratar a profesionales de salud podran informar a sus ciudadanos que estos recursos
existen por lo menos por Internet. Este mtodo podra beneficiar a personas que viven lejos de
servicios tradicionales. Tambin contribuira a los esfuerzos para que servicios de salud se
consideren derechos humanos universales.
Proyectos internacionales en linea enfocados a ayudar a personas a dejar de fumar y
controlar la depresin./International Internet projects for smoking cessation and
depression
Propsito: Compartir las experiencias de un pequeo equipo de San Francisco, California, que
se ha dedicado a desarrollar y evaluar intervenciones de auto-ayuda automatizadas y
presentadas por Internet. Las intervenciones estn enfocadas en ayudar a personas a dejar de

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fumar y controlar su estado de nimo. Las intervenciones se han probado con participantes que
hablan ingls o espaol de todas partes del mundo.
Mtodo: Participantes para estudios Internet enfocados en dejar de fumar y depresin se
reclutaron utilizando avisos de Google en espaol e ingls. La primera pgina del sitio les
informaba que se trataba de un estudio de investigacin y los invitaba a completar una
encuesta de elegibilidad. A los que llenaban criterio de ser elegibles se les ofreca el
documento de consentimiento para participar en los estudios. A los que llenaran consentimiento
se les ofrecan las intervenciones en lnea y se les haca seguimiento al mes, 3 meses, 6
meses, y un ao.
Resultados: Desde el ao 2000, ms de un milln de personas de ms de 200 pases y
territorios han visitado nuestras pginas Internet, ms de cien mil han llenado las encuestas de
elegibilidad, y muchos de ellos han firmado los documentos de consentimiento informado.
Nuestros resultados demuestran que las intervenciones en lnea para dejar de fumar ayudan a
fumadores a dejar de fumar a niveles parecidos a los que utilizan parches de nicotina.
Esperamos que nuestras pginas Internet enfocadas a la depresin tambin sern eficaces.
Discusin: Se ha demostrado que intervenciones Internet pueden reducir problemas de salud
mayores, como el fumar y la depresin. Este mtodo podr expandir el alcance de
profesionales de la salud en maneras que no hubieran sido posibles antes del invento de la
Internet. Dada la gran penetracin de telfonos celulares y smartphones hasta en pases
pobres, la siguiente generacin de intervenciones tecnolgicas debern de ser construidas para
que sean accesibles por medio de dispositivos mviles. Presentaremos recomendaciones
acerca de cmo profesionales que desean ayudar al mayor nmero de personas posible
podran contribuir a estas iniciativas.
Lecciones aprendidas de una intervencin en lnea para depresin en Mxico/
Lessons learned from a web-based intervention for depression in Mexico
El internet se ha incorporado a la atencin de salud como un recurso para ofrecer tratamiento
psicolgico. Sin embargo, no hemos encontrado publicaciones sobre el desarrollo y evaluacin
de este tipo de intervenciones en Latinoamrica. Ayuda para Depresin (ADep) es un programa
de auto-ayuda para la depresin en internet que integra mltiples componentes desarrollado en
Mxico.
Objetivo. Explorar el uso de HDep en hispanoparlantes durante 40 meses.
Mtodo. Se colect informacin socio-demogrfica de los usuarios registrados de marzo 2009septiembre 2012. Se realizaron anlisis cuantitativos/cualitativos en una submuestra (N=708)
sobre: a) uso de ADep, b) contenido de los foros en el programa, y c) la percepcin sobre la
utilidad y satisfaccin de los usuarios con ADep.
Resultados. Durante el periodo, 13,617 personas se registraron: 85% mujeres y 15% hombres,
no obstante ADep estar dirigido a mujeres. Los resultados de la submuestra sealan que 87%
de mujeres y 66% de hombres presentaron sintomtologa depresiva (CES-D>24). Los foros
fueron usados por 284 usuarios en donde hubo un intercambio abierto de experiencias de
forma positiva y emptica. La mayora de los posts hicieron referencia a: Reflexiones sobre el
conocimiento derivado de experiencias personales, contenido del programa y de los otros
participantes (834 posts; Revelacin de sentimientos, deseos y comportamientos (502); y
Apoyo Emocional, en trminos de comentaros que animan a los otros (330). Menos de 25%
respondi sobre la percepcin de utilidad: las puntuaciones fueron de 3.6-4.6 (en escala de 15). Diecinueve hicieron la evaluacin final: 90% consider que le intervencin mejor su estado
de nimo.
Conclusiones: Los hallazgos sugieren que los mexicanos utilizan una intervencin en lnea.
ADep tiene el potencial para detectar la depresin no tratada y de brindar apoyo social.

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Intervenciones en lnea para la atencin de problemas de abuso de sustancias en Mxico


Providing online resources for substance abuse problems in Mexico
Propsito: Documentar el desarrollo y adaptacin de dos programas e-Health en Mxico. El
primero, Bebermenos, es un programa de autoayuda que busca ayudar a los consumidores de
alcohol a reducir su consumo a travs de tcnicas de la Terapia Cognitivo Conductual (TCC).
Es parte de un proyecto internacional de la Organizacin Mundial de la Salud. El Segundo, ,
Programa de Ayuda para Abuso de Drogas y Depresin (PAADD) est basado en una
intervencin TCC cara a cara e incluye un mdulo sobre depresin derivado de otro programa
en lnea que ya existe en Mxico. El PAADD es una intervencin en lnea que inlcuye un nivel
bajo de monitoreo por parte de un orientador que gua a los usuarios a travs del programa y
refuerza su motivacin para cambiar.
Mtodo: La factibilidad de BeberMenos se explor a travs de: a) grupo focal con bebedores
excesivos (n=13) que respondieron un cuestionario sobre sus actitudes hacia las
intervenciones en lnea; b) se obtuvo informacin adicional a travs de pruebas de usabilidad
(n=10). Se realizaron pruebas de factibilidad y usabilidad del PAADD con un grupo de usuarios
de drogas que estaban en algn programa de tratamiento (n=20) y profesionales de la salud
(n=9).
Resultados: En ambos casos, los participantes mostraron actitudes positivas hacia las
intervenciones en lnea y mencionaron que s las usuaran. En cuanto a la usabilidad,
comentaron que las aplicaciones eran fciles de emplear pero que preferiran tener
instrucciones detalladas, en oposicin a la navegacin libre que se oberva en pases
desarrollados. Los profesionales de la salud expresaron ms barreras para el uso de
intervenciones en lnea que los usuarios potenciales y tienden a favorecer la terapia en lnea
sobre los programas d auto-ayuda.
Discusin: La informacin cualitativa sugiere que para incrementar la posibilidad de que los
profesionales de la salud usen y recomienden los programas en lnea es necesario que
conozcan las ventajas que esta modalidad puede ofrecer a los usuarios, para ello se requiere
sensibilizarlos. Las intervenciones en lnea pueden contribuir a cerrar la brecha de tratamiento
al incrementar la disponibilidad, reducir el estigma, acortar las distancias y reducir los costos de
la atencin.
El Uso de Cursos a Distancia para Difundir las Tcnicas de Deteccin y de Intervencin
Breve en Brasil/Use of Distance Learning Courses to disseminate Screening and Brief
Intervention techniques in Brazil
Introduccin - Aunque la deteccin y las Intervenciones Breves en usuarios en riesgo de
alcohol y otras drogas han sido difundidas a travs de entrenamientos cara a cara, la velocidad
de la capacitacin de los profesionales de la salud en Brasil que utilizan este mtodo tradicional
no es suficiente para satisfacer las necesidades del sistema de salud Brasileo. Brasil es un
pas grande con importantes limitaciones de transporte hacia las ciudades que estn lejos de
las grandes ciudades, donde estn disponibles los recursos humanos y los materiales para el
entrenamiento. Teniendo en cuenta esto y la necesidad de crear una red, que incluya a los
profesionales de la salud, a los trabajadores sociales y a lderes comunitarios, para hacer frente
a los problemas relacionados con el consumo de alcohol y de otras drogas, la Secretara
Nacional de Polticas de Drogas (SENAD), en colaboracin con la Universidad Federal de So
Paulo (UNIFESP) desarrollaron dos cursos de aprendizaje a distancia. El primero, SUPERA
(acrnimo en portugus que significa: Sistema de deteccin de uso abusivo y dependencia a
sustancias psicoactivas: Intervencin Breve, reinsercin social y seguimiento), se ofreci a
20,000 profesionales de la salud, de trabajo social y de reas educativas. El segundo, "F na
Preveno" (Fe en la prevencin) se ofreci a 10,000 lderes religiosos y comunitarios.
Objetivos - Evaluar el efecto del curso en los conceptos, el conocimiento especfico y las
actitudes de los participantes con respecto a la aplicacin del DIB (Deteccin e Intervencin

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Breve) en sus lugares de trabajo.


Mtodos - Ambos cursos fueron ofrecidos a los participantes de forma gratuita, cuyos costos
fueron cubiertos por la SENAD y la UNIFESP. El material de los cursos consisti en un sitio de
Internet con actividades, pruebas de evaluacin y foros de discusin, libros y CDs con videos
sobre el uso prctico de los procedimientos de Deteccin y de Intervencin Breve.
Resultados - Ambos cursos ofrecieron 5,000 lugares en cada edicin. Un gran nmero de
participantes completaron los cursos: alrededor de 16,000 en el SUPERA (en cuatro ediciones)
y 8,000 en dos ediciones de F na Preveno. Los participantes informaron haber cambiado
sus conceptos y mejorado sus conocimientos sobre los problemas de consumo de alcohol y
otras drogas, as como de sus actividades prcticas dirigidas a hacer frente a los usuarios en
riesgo de alcohol y otras drogas.
Conclusin - Observamos una muy buena aceptabilidad de los cursos de aprendizaje a
distancia y concluimos que esta metodologa puede ser til en la difusin y capacitacin en
tcnicas de DIB, con una buena relacin costo-efectividad.
Disponibilidad de sitios Internet para reducir el uso de alcohol en la lengua
portuguesa/Availability of web-based interventions for alcohol use reduction in
Portuguese
7.4 millones de muertes ocurren mundialmente por ao debido al uso del alcohol y tabaco. En
Brazil las substancia mas usada es el alcohol; se estima que el 74.6% de la poblacin lo ha
usado y el 12.3% de la populacin depende del alcohol. Intervenciones por internet son unas
de las estrategias basadas en evidencia para reducir al dao causado por abuso de
substancias. Durante los ltimos diez aos la internet ha estado creciendo exponencialmente
en Latinoamrica (1,111.1%). Brazil cuenta con el 67.5% del uso de internet en Latinoamrica,
correspondiendo a 80 millones de usuarios. Estudios sugieren que el 20% de los usuarios de
internet en Brazil buscan informacin para la salud.
Objetivo: Identificar y evaluar el contenido disponible en portugus por medio de intervenciones
por internet para trastornos relacionados con el alcohol y para reducir el riesgo de problemas
con alcohol.
Mtodos: Google Adwords fue utilizado para identificar las palabras claves mas buscadas por
los usuarios de internet. Una vez identificadas estas palabras, 3 motores de bsqueda fueron
consultados (Google, Yahoo, y Bing). Ciento ochenta y cinco sitios web fueron encontrados y
clasificados usando un protocolo adaptado de Bock (2004). Los sitios web identificados en la
bsqueda inicial fueron clasificados segn su contenido. Los sitios web que proporcionaron
servicios de apoyo a las enfermedades relacionadas con el alcohol y el riesgo de problemas
con alcohol fueron analizados por tres investigadores independientemente usando la gua
clnica del NIAAA como referencia para evaluar el contenido y la cobertura.
Resultados: De 185 sitios web seleccionados, 17 cumplieron los criterios de intervenciones por
internet; 9 fueron clasificados como sitios Web basados en evidencia y 8 como supersticiones,
segn su contenido y evaluacin de calidad.
Conclusiones: La mayora del contenido de intervenciones por internet disponible en portugus
no est basado en la evidencia. Se necesita desarrollar intervenciones por internet basadas en
la evidencia, enfocadas en usuarios que desean cambiar su manera de beber o aquellos que
necesitan ser referidos a servicios de salud.
Trauma, PTSD, & Grief/ Trauma, Trastorno de Estrs Postraumtico y Duelo/ Trauma,
PTSD e luto
Traos de Personalidade de Pacientes com Transtorno de Estresse Ps Traumtico
Paula De Vitto.
Amban, IPQ, So Paulo, Brazil.

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O transtorno de Estresse Ps Traumtico (TEPT) um estado debilitador, que envolve


sintomas ansiosos, e depressivos como esquiva social, embotamento afetivo, irritabilidade e reexperincia do evento traumtico via flashbacks, pesadelos ou pensamentos intrusivos. A
personalidade um tpico em crescente discusso entre os profissionais da sade, sendo
ainda controverso o impacto real dos traos de personalidade no risco de desenvolver
transtornos ansiosos. A literatura revela que alguns traos de personalidade em pessoas com
TEPT podem indicar pior resposta ao tratamento medicamentoso e psicoterpico. Objetivo:
Avaliar e descrever os traos de personalidade em pacientes com TEPT. Mtodo: 30 pacientes
com diagnstico de Transtorno de Estresse Ps-Traumtico, tratados no Programa de
Ansiedade do Instituto de Psiquiatria do Hospital das Clnicas e que concordaram em participar
da pesquisa, responderam o Inventrio de Personalidade Neo Revisado (NEO PI-R).
Resultados e Discusso: Os resultados demonstram que os Traos de personalidade
denominados de "Neuroticismo" e "conscienciosidade" no teste NEO -PI - R so mais
frequentes que os traos descritos como "extroverso", " amabilidade" e "abertura para
experincia" em pacientes com Transtorno de Estresse Ps -Traumtico. Conclui-se que
algumas diferenas individuais de personalidade podem influenciar o modo como o sujeito
experincia e processa emocionalmente o trauma, assim como sua resposta ao tratamento
psicoterpico e farmacolgico.
Trastorno por Estrs Postraumtico en las Vctimas de la Violencia Escolar
Paloma Albuquerque, Lcia Williams.
Psicologia, Universidade Federal de So Carlos, So Carlos, Brazil.
Abstract Central: El trauma es la causa de las dificultades emocionales, cognitivos y fsicos
que estn directamente relacionados con las experiencias aversivas, e incluso puede favorecer
la aparicin de problemas psiquitricos, como trastorno por estrs postraumtico (TEPT). A
medida que la literatura indica que las experiencias coercitivas escolares tambin pueden
causar dao emocional a los seres humanos, el objetivo de este estudio fue investigar el
impacto de eventos traumticos en la escuela para los estudiantes, especialmente el desarrollo
de los sntomas del trastorno por estrs postraumtico y la persistencia de tales sntomas. Para
ello, 691 estudiantes de una universidad pblica en el estado de So Paulo respondi
versiones traducidas y adaptadas a Brasil de la Escala de Trauma e Alienao Estudantil Revisada (SATS-R), instrumento retrospectivo para evaluar los eventos traumticos en la
escuela y el desarrollo de trastorno por estrs postraumtico y Post-traumatic Stress Disorder
Checklist - Civilian Version (PCL-C), utilizado para evaluar los sntomas actuales del TEPT. Los
estudiantes pertenecan a 34 de los cursos presenciales universitarios, con un promedio 21,1
aos, 54,8% mujeres y 45,2% hombres. Los principales resultados muestran que de las diez
experiencias aversivas ms citados por los participantes, cinco pertenecan a la categora de
"violencia relacional", dos a la "violencia verbal", dos a la "violencia fsica" y una a la "disciplina
injusta". La mayora de los participantes, 80,2%, inform que su peor experiencia implic un
alumno como el autor de la violencia; 28,6% inform haber sido vctima de un maestro, 5,8%
tenan experiencias con la participacin de director, subdirector o coordinador y 1,7% inform
de la participacin de los funcionarios. En cuanto al sexo del agresor, 53,4% eran hombres,
43,4% mujeres y 12,6% report la participacin de los agresores de ambos sexos. La edad de
inicio de la "peor experiencia escolar fue en promedio de 12,3 aos, que van desde 4 a 20
aos y por la duracin de la experiencia escolar, 32,1% dijo que slo dur "un da", 19,4% "das
o semanas", 22,6% meses, 8,4% seal un ao y 10,5% inform haber sufrido "aos".
Sobre el grado de malestar de la peor experiencia, la mayora, 55,4%, dijo que estaba "muy
molestado", 35,6% estaba "un poco molestado" y 6,8% no se preocup. Adems, el 45,3%

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dijo que tena algo bueno o positivo de la experiencia, sealando algunos factores de
proteccin, como las buenas relaciones con el personal de la escuela, apoyo a la familia y las
amistades. En cuanto a los sntomas desarrollados inmediatamente despus de la experiencia,
7,8% mostr indicios de trastorno por estrs postraumtico; 4,8% con resultados clnicamente
significativos para el transtorno, 2% con alta indicacin para el trastorno y 1% con indicacin
extrema para tal diagnstico. Por otra parte, 10,8% tenan niveles por encima de la media. En
el caso de los sntomas actuales de TEPT (PCL-C) 10,4% tenan indicacin de tal trastorno. De
los participantes que tenan sntomas de TEPT en el pasado, 42,6% estaban tambin en la
edad adulta. Est claro, pues, que algunos individuos expuestos a la victimizacin escolar
pueden tener una mayor vulnerabilidad a los sntomas de TEPT durante la vida.
A Neuroimaging Study of Inhibitory Control as a Predictor of PTSD response to CBT
Adrian Allen1, Erin Falconer1, Kim Felmingham2, Richard Bryant1.
1. School of Psychology, University of New South Wales, Killara, NSW, Australia, 2. University
of Tasmania, Hobart, TAS, Australia.
Abstract Central: Despite the effectiveness of cognitive behavior therapy (CBT) in treating
posttraumatic stress disorder (PTSD), approximately 30% to 50% of patients do not show
significant symptom reduction (Bradley et al., 2005). Disturbed neural networks of inhibitory
control may contribute to this limited response rate by reducing patients ability to engage in
CBT. In this study thirteen PTSD patients underwent pre-treatment functional magnetic
resonance imaging (fMRI) while performing a Go/NoGo task of response inhibition. They then
received eight sessions of weekly CBT comprising cognitive restructuring and imaginal and in
vivo exposure. PTSD symptoms were measured before and six months following treatment.
Depressive symptoms were measured at pre-treatment. Regression analyses were conducted
between post-treatment PTSD symptom level and fMRI blood oxygenation level dependent
(BOLD) signal on a whole-brain basis. Analyses controlled for pre-treatment depressive and
PTSD symptom levels. Better PTSD response to CBT was associated with greater activation of
a localized left dorsal striatal and frontal network during inhibitory control. However, poorer
treatment response was associated with activation of a more distributed fronto-parieto-striatal
and cerebellar network during inhibitory control. Findings support the hypothesis that increased
efficiency of inhibitory control in PTSD may predict better treatment outcome. These findings
may have implications for the conduct of CBT in order to enhance treatment response rates.
The Role of Mastery in Adjusting to Trauma and Enhancing Treatment
Richard Bryant1, Fiona Maccallum1, Laurie Monier1, Lisa Hancock1, Amy Joscelyne2, Richard
Bryant1.
1. University of New South Wales, Sydney, NSW, Australia, 2. New York University, New York,
NY, USA.
Although cognitive behavior therapy is a frontline treatment for PTSD, many people do not
respond optimally to CBT. Accordingly, there is an important need to identify mechanisms that
can facilitate adaptation to trauma, and evaluate how these mechanisms can augment current
CBT protocols to improve treatment response for PTSD patients. Perceiving that one has
mastery over an aversive experience can have a range of psychological benefits. Evidence from
animal and human research points to the advantages of perceiving control and heightening
ones sense of efficacy. The four presentations in this symposium outline studies that address
the mechanisms of how perceived control can enhance psychological adjustment to adversity,
and how these factors can be implemented to advance CBT for traumatic stress disorders. The

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initial paper presents two studies that focus on the impact of believing that one has control over
adversity on subsequent memory patterns; being able to retrieve specific memories of ones
past has been shown to strongly predict PTSD development and maintenance. The second
presentation focuses on the impact of sexual assault on the capacity of people to benefit from
the effects of perceiving mastery over unpleasant experiences, and highlights the distinctive
impact of rape-related PTSD on ones capacity to have mastery. Turning to treatment, the third
study reports a proof-of-concept trial in which troops returning from the Middle East with PTSD
were provided with either a mastery or no-mastery induction to elevate their sense of esteem,
and assessed on core psychological functions, including ones expected outcomes in the future.
Finally, a controlled trial is presented in which CBT for civilian PTSD is reported that provided
half the patients with standard CBT and half were prepared with brief training in mastery and
distress tolerance. Taken together, these studies highlight the important role of perceiving
mastery in adapting to trauma and point to the potential for enhancing mastery as a means of
improving treatment response.
Perceived Mastery and Psychological Functioning
The belief that one has control over aversive experiences, even in the absence of actual control,
has previously been shown to result in reduced distress during confrontation of aversive
experiences. This paper extends this literature by examining the impact of perceiving one has
control over psychological responses subsequent to the experience of believing one has control.
These studies examined the effects of perceived control on psychological processes relevant to
posttraumatic adjustment, including retrieving personal memories and tolerating subsequent
distress. In Study 1, participants (N = 40) watched aversive images and half the participants
(mistakenly) believed they could terminate the presentation by pressing a button. Participants
who perceived control rated subsequently retrieved personal memories more specifically than
those who perceived no control. Study 2 adopted a similar paradigm and participants (N = 32)
additionally completed a subsequent stressor task. Participants in the control condition again
reported more specific personal memories and also tolerated the subsequent stressor better
than those in the no-control condition. These findings provide human evidence that parallels
animal research, and indicates that adaptive responses observed following trauma can be
facilitated by perceiving that one has control.
The Impact of Believing One Has Control on Rape Survivors
A core feature of the experience of sexual assault is the knowledge that one does not have
control over the event. Lacking control has been shown to be a key factor in PTSD, however
there is no evidence pertaining to the effects of sexual assault on ongoing ability to experience
control over aversive experiences. This study investigated in sexual assault survivors with and
without PTSD and non-sexual assault trauma survivors with and without PTSD (N = 160) the
extent to which they were capable of benefiting from the documented advantages of perceived
control. Participants watched aversive images and half were instructed that they could terminate
the image, although the timing of presentations was constant across control and no-control
conditions. Participants subsequently watched additional aversive images and their length of
time they watched the images was assessed as a measure of distress tolerance. Participants
also completed an anticipatory anxiety task in which they indicated the level of distressing
stories they would read in a subsequent task. Sexual assault survivors with PTSD were
characterized by reduced capacity to tolerate distress subsequent to believing they had control.
These findings are discussed in terms of the need to address persistent deficits in perceived
mastery in people with PTSD following sexual assault.
Enhancing Mastery in Troops with PTSD

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Many studies indicate that large numbers of troops returning from deployment to the Middle
East suffer PTSD. Further, current evidence indicates that military populations have traditionally
been non-responsive to CBT. The benefits of enhancing mastery may assist military personnel
following deployment. Accordingly, this study investigated the extent to which enhancing a
sense of mastery and efficacy could facilitate the capacity of troops following deployment to
tolerate distress and envisage a better future. Troops returning from Afghanistan were randomly
allocated to receive an efficacy or no-efficacy induction which required them to focus on
experiences in their past in which they succeeded and indicated that they had strength, skills,
and positive qualities. Participants subsequently completed a range of tasks required for
successful adaptation to trauma, including a distress tolerance task in response to aversive
images, a social problem task, and a future imagining task. Across these tasks, receiving an
efficacy induction resulted in troops being able to engage in psychological functioning indicative
of enhanced mental health. These findings are discussed in terms of potential strategies for
clinical interventions for troops following deployment.
Augmenting Cognitive Behavior Therapy for PTSD by Enhancing Mastery and Distress
Tolerance
Although cognitive behavior therapy (CBT) is the treatment of choice for PTSD, almost half of
PTSD people do not respond adequately to CBT. Accordingly, there is a need to augment CBT
to improve treatment response. This paper reports on an controlled trial that aims to augment
CBT by preparing PTSD participants with skills to tolerate distress and enhance their sense of
mastery. This randomized controlled trial evaluates the extent to which preparing patients with
emotion regulation skills prior to CBT enhances treatment outcome. Seventy adult civilian
patients with PTSD were randomized to 12 sessions of either CBT (supportive counselling
followed by CBT) or CBT/Skills (emotion regulation training followed by CBT). CBT/Skills
resulted in fewer treatment drop outs and less PTSD, anxiety, and negative appraisals at six
months follow-up than CBT. Between condition effect size was moderate for PTSD severity [.43
(95% CI: -0.04-0.90)]. More CBT/Skills (31%) patients achieved high end-state functioning at
follow-up than patients in CBT (12%). This evidence suggests that response to CBT may be
enhanced in PTSD patients by preparing them with emotion regulation skills.
The Effect of Early-Life Stress on Critical Periods of Emotional Learning: Targeting the
Gut to Modulate Behaviour
Bridget Callaghan1, 2, Caitlin Cowan1, 2, Rick Richardson1, 2.
1. Psychology, University of New South Wales, Sydney, NSW, Australia, 2. University of New
South Wales, Sydney, NSW, Australia.
Abstract Central: Early-life experiences are generally poorly remembered (a phenomenon
known as infantile amnesia). In addition, fear inhibition procedures (such as extinction) are
particularly effective in infancy, leading to a loss of fear that is resistant to relapse. However,
early-life experiences (particularly those of adversity) have a long-lasting impact on emotional
functioning. It is unclear though how these early-life experiences can have such a profound
impact on emotional responding in the absence of explicit memory for those events. Using an
animal model of early-life adversity, we have recently shown that maternal-separation stress
causes an early emergence of adult-like forms of fear and extinction learning in infant offspring,
causing these rats to remember fearful associations for longer and exhibit greater levels of fear
relapse after those memories have been extinguished. That is, stress appears to predispose
young animals at risk to respond cautiously to ambiguous cues in their environment, a common
feature seen in individuals with anxiety. Because early-life adversity is known to increase the
risk of psychopathology, and because persistent expression of fear is characteristic of anxiety
disorders, the next important question relates to how the infant behavioural phenotype can be

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saved following maternal-separation. One potential solution to this problem comes, perhaps
unexpectedly, from the field of gastroenterology. In two experiments we show that treating the
mother with a probiotic during the separation procedure ameliorated the effect of that stress on
her infants fear learning and extinction behaviour. That is, maternally-separated infants that
suckled from a probiotic-treated mother behaved more like typical infant rats than like the
maternally-separated infants that suckled from a mother on normal drinking water. Implications
of the effect of gut manipulations in the mother on the brains and behaviour of her infant rats are
discussed.
Incidncia de Transtorno de Estresse Ps-Traumtico em Mulheres Mastectomizadas:
Uma Demanda Para Psicologia
Jackeline Caporossi, Luiz Stoppiglia, Tiago Morinigo, Hudson Ribeiro, Aline Banshee.
Psychology, Universidade Federal de Mato Grosso, Cuiab, Brazil.
Abstract Central: A incidncia de Transtorno de Estresse Ps-Traumtico (TEPT) um tema
ainda pouco abordado pela literatura cientfica no Brasil, principalmente relacionado a doenas
traumticas como cncer de mama. Este estudo, foi realizado com 20 mulheres
mastectomizadas, e revelou a incidncia de TEPT em 20% desta amostra, atravs da escala
CAPS (Clinician Administered PTSD Scale), a IES ( Impact of Events Scale) e a SOS
(Significant Other Scale), foi realizada tambm uma entrevista semi-estruturada para verificar o
histrico da doena e seu impacto fsico e social. A famlia foi relatada como principal rede de
apoio social, seguido do parceiro, amigos, igreja e profissionais da sade. A assistncia
psicolgia se apresenta de forma majoritria no perodo ps-operatrio. Observou-se ento
uma grande lacuna a ser trabalhada pelo profissional psiclogo de maneira preventiva com
relao ao trauma gerado pelo cncer de mama que segundo o ministrio da sade o tipo de
cncer de maior incidncia nas mulheres brasileiras.
Aspectos Positivos do Trauma em Mulheres Mastectomizadas: Uma Mudana de Foco
Para Psicologia
Jackeline Caporossi, Luiz Stoppiglia.
Psychology, Universidade Federal de Mato Grosso, Cuiab, Brazil.
Abstract Central: Apesar de j existirem estudos sobre o lado positivo da exposio a eventos
traumticos, a psicologia ainda se encontra majoritariamente focada nos transtornos
psicopatolgicos como TEPT (Transtorno de Estresse Ps-Traumtico) advindos desta
exposio. Mas neste estudo com 20 mulheres com cncer de mama seguido da mastectomia,
como outros estudos, revela que existem aspectos positivos relacionados a estas experincias
traumticas, que vai depender da vulnerabilidade ou resilincia da pessoa, que envolvem
fatores psicolgicos, biolgicos e sociais. A experincia de risco de morte provoca luta contra a
doena e valorizao da vida em aspectos antes menosprezados e alterao de valores e
crenas. A busca pela sade e qualidade de vida desenvolve tambm a averso ao sofrimento.
Este foco reflete o contexto social mundial onde todos tem obrigao de ser e estar em uma
felicidade constante, qualquer sofrimento considerado predisposto a patologias como
depresso, angstia, isolamento social, esquecendo-se que o sofrimento ou o trauma
tambm constitutivo para promoo do crescimento do prprio indivduo desde o seu
nascimento no processo de adaptao e fortalecimento na superao de situaes adversas.
A Estrutura Latente da Verso Portuguesa da PTSD Checklist-Militar Version (PCL-M)

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Teresa Carvalho1, 2, Marina Cunha1, 2, Jos Pinto-Gouveia1.


1. Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal, 2.
Higher Institute Miguel Torga, Coimbra, Portugal.
A PTSD Checklist-Military Version (PCL-M) um instrumento breve de auto-resposta
frequentemente utilizado para avaliar, em veteranos de guerra, a sintomatologia da
Perturbao Ps-stresse Traumtico (PTSD) de acordo com o DSM-IV. Objectivos: o presente
estudo teve como objectivos traduzir e adaptar para a lngua Portuguesa a verso original da
PCL-M e explorar a sua estrutura latente. Participantes e Mtodo: A PCL-M foi traduzida e
adaptada para a lngua Portuguesa atravs do mtodo de traduo-retroverso. A escala foi
subsequentemente administrada a 660 sujeitos pertencentes populao geral de veteranos
da Guerra Colonial Portuguesa. Resultados: os resultados da Anlise Factorial Confirmatria
confirmam a estrutura de sintomas da PCL-M de acordo com os critrios de diagnstico do
DSM-IV. Os modelos de primeira e de segunda ordem rectificados possuem o mesmo
ajustamento global (2/gl = 4.95; GFI = .90; TLI = .95; CFI = .96; RMSEA = .08; PCFI = .79) e
uma validade factorial similar (R2 .47). Perante estes resultados, consideramos o modelo de
segunda ordem como teoricamente mais apropriado por apresentar uma estrutura composta
por ts factores de primeira ordem (sub-escalas), unificados num factor de ordem superior
(escala global). Discusso: Este estudo examinou a estrutura latente da verso Portuguesa da
PCL-M. Os seus resultados, pioneiros em Portugal, sugerem que este instrumento de autoresposta uma medida vlida para avaliar a sintomatologia da PTSD de acordo DSM-IV. A sua
aplicao populao de veteranos da Guerra Colonial Portuguesa permite identificar
facilmente possveis casos de PTSD, promove um planeamento mais adequado do tratamento
e facilita a monitorizao dos resultados teraputicos.
Lifetime Stressful Events and Appraisal of Involuntary Memory as an Emotion Regulation
Strategy
Grazia Ceschi, Melissa Hearn, Stphane With.
University of Geneva, Geneva, Switzerland.
Abstract Central: Recent studies conducted with nonclinical participants show that intrusive
autobiographical memories are generally rated as positive and that an intense emotional
reaction accompanies their retrieval (Berntsen & Rubin, 2008). Studies also show that
posttraumatic stress disorder (PTSD) symptoms are associated with more negative and more
intense evaluations of their involuntary memories. Despite this growing body of cognitive
evidence, research has not yet clarified how an accumulation of lifetime stressful events affects
evaluations of involuntary memories. The main aim of the current study was to examine whether
the appraisal of recurring involuntary memories (in terms of their intensity and valence) differed
with respect to stressful life event history. One hundred forty-nine members of the Geneva,
Switzerland, community (50% female; Mean Age=24.64, SD=3.55) volunteered to complete a
series of validated self-reported measures of Involuntary Memory (recurrence, valence,
intensity), Exposure to stressful life event during their life, Depression, and Anxiety. Hierarchical
multiple regressions analysis indicated that recurrence of involuntary memories was predicted
by lifetime stressful events, and intensity and valence appraisal of recent intrusive memories. As
expected, recurrent involuntary memories were generally rated as positive and intense. Lifetime
stressful events did not moderate the relationship between valence and involuntary memory
recurrence however, a greater accumulation of lifetime stressful events was associated with
recurrent involuntary memories evaluated as less emotionally intense. In sum, consistent with
recent cognitive model of involuntary autobiographical memory, our main effects showed that
recurrent involuntary memories were primarily rated as positive and intense. The lifetime

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exposure to stressful events did not moderate the relationship between valence and involuntary
memory recurrence, although it did moderate the relationship between intensity and memory
recurrence. Interestingly, a greater lifetime accumulation of stressful events was associated with
recurrent involuntary memories evaluated as less, rather than more, emotionally intense. This
later counterintuitive result suggests that arousal intensity and negative valence of involuntary
memories currently described in relation to post-traumatic stress symptoms do not directly apply
to the context of cumulative lifetime stressful events. On the other hand, this same result might
also be discussed in line with the argument that a greater accumulation of lifetime stressful
events can be associated with recurrent involuntary memories evaluated as less affective. This
might suggest that with the passage of time and the increase exposure to lifetime stressful
events, cognitive suppression processes underlying emotion regulation may become less
flexible and indiscriminately inhibit all emotion perceived to be intense. Reference: Berntsen, D.,
& Rubin, D. C. (2008). The reappearance hypothesis revisited: Recurrent involuntary memories
after traumatic events and in everyday life. Memory & Cognition, 36, 449-460.
Post-Traumatic Stress Disorder and Depression and Dementia in HIV patients:
Similarities
Joo da Costa Chaves Jr.1, Nelson Filho1, Carmem Fourier2.
1. Psicologia Clnica, Universidade Estadual Paulista, Assis, Brazil, 2. Berlin University, Berlin,
Germany.
Abstract Central: The definition of PTSD in DSM-5 varies from the older version (DSM-4) in
some parts which are mainly additions to DSM-4. Since the data analyzed further in this review
is based on the definition in DSM-4, a comparison between the PTSD definitions in DSM-5 and
DSM-4 might be relevant. The level of TNF- is significantly higher in patients with PTSD than in
trauma controls (TC) without PTSD or non-traumatized controls (NTC). The TNF- level in TC
are slightly but not significantly higher than in NTC (Gill et al., 2008; Von Kaenel et al., 2007).
The level of IL-2 in PTSD patients is significantly lower when compared to TC and NTC.
However, the IL-2 levels in TC are also significantly lower than in NTC (Song et al., 2007).
There are significantly lower levels of IL-8 in PTSD patients compared to TC and NTC whereas
the IL-8 level in TC is slightly but not significantly lower than in NTC (Song et al., 2007).
Theoretically these changes are related to stronger inflammatory immune activities, but also to a
decrease in T cell growth, in discrimination between self and non-self and decrease in
stimulation of macrophage movement. The IL-6 level in PTSD patients is significantly higher
than in TC or NTC. On the other hand, the level of IL-6 in TC is also significantly higher than in
NTC (Gill et al., 2008; Rohleder et al. 2004; Maes et al., 1999). IL-6 contributes to both, humoral
and cell-mediated, immune responses, but also plays a role in inhibiting TNF-, concluding that
the high IL-6 levels might be associated with the high TNF- levels. There were no differences
found in the level of IL-10, which contributes to the humoral immune response, when comparing
PTSD patients with NTC (Von Kaenel et al., 2007; De Kloet et al., 2007). Generally the cytokine
levels in PTSD patients differ significantly from TC, and NTC respectively, although in some
parts the TC show a similar tendency like PTSD patients when compared to NTC. Trauma
controls, just like PTSD patients, have lower IL-2 levels and higher IL-6 levels. Other cytokine
levels in TC did not differ significantly from normal controls. In conclusion the data suggest that
people who experienced a traumatic event are exposed to a higher risk of autoimmunity
regarding the low IL-2 levels and to stress due to higher levels of pro-inflammatory cytokines
like IL-6 compared to NTC. However, some cytokine levels in PTSD patients differ much more
drastically from NTC, so it seems that the risk of immune dysfunction is more severe. We
studied the relationships among the emotional behavior and immune function of HIV patients
with physichiatric disorders, like depression and dementia (HDD) and pointed out that this

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persons exhibits some cytokines characteristic patterns associated to a different steps of the
disease. Literature dates suggest that there are important similarities among the immune
functioning of the post-traumatic stress disorder (PTSD) and HDD patients. Both have high
levels of necrosis tumoral factor (TNF-) and interleukin 6 (IL-6) .
Cuando Falta la Palabra: Trabajo Psicoteraputico con Procesos Psicolgicos
Ricardo Cordoba Otaduy.
Asociacin de Medicina del Estrs de Crdoba, Crdoba, Argentina.
Abstract Central: Se define a la Programacin Neuro Lingstica como una psicotecnologa
psicoteraputica basada en el trabajo con procesoso psicolgicos, capaz de prescindir del
contenido de la queja del paciente. Esto le permite superar la dificultad que presentan los
pacientes adultos que por razones emocionales no pueden hablar acerca de la situacin objeto
de la consulta a la que concurren. La Programacin Neuro Lingstica puede trabajar sin el
contenido de la queja, sin perder eficacia por ello. Se aclara que no se alienta el trabajo sin
contenido, sino que se aporta una alternativa para superar aquella dificultad. Se presenta un
caso clnico para ilustrar la intervencin sin el contenido. Si el tiempo de la exposicin lo
permite, se har una demostracin didctica con un voluntario de los asistentes. Se receptarn
preguntas de los participantes y se entregar un dossier de la exposicin y del protocolo de
intervencin empleado.
Post Traumatic Stress Disorder After Several Terrifying Events: Clinical and
Neuropsychological Features, Clinical Outcome in a Case Study
Romina Cortizo Vidal, Maria Barba, Maria Mas, Maria Cruz, Ana Cascales, Angela Navarro,
Belen Daz, Juan Ramn Castao, Antoni Bulbena, Patricia Garnier.
INAD. Parc de salut mar, Barcelona, Spain.
Introduction: We report a case study of a 60 years old train driver who developed PTSD after
faint caused by arrhytmia while driving. This event triggered reexperience episodes of this and
other past threating events like two suicides at rails, one attemp, and pickpocket s death
electrocuted by high-voltage cable at station . Patient also began reexperiencing traumatic
events speaked by other train drivers. Methods: We report follow up data evaluating mild and
long-term outcomes of combined trauma focused therapy plus antidepressant, antipsicotic and
benzodiazepine pharmacological treatment assesed by Clinician Administered PTSD
Scale(CAPS), intrusive thoughts daily record and anxiety graphic reports during exposition
trials. Results: We find not only a significant decreased of anxiety intensity during intrusive
memories and flashbacks (from 8 to 4 using anxiety subjective scale ) but also mood
improvement at posttreatment. Less autonomic symptoms and avoidance was seen during
exposure treatment. No significant changes in reexperience frecuency, insomnia and
dissociative symptoms was observeded. Conclusions: Number of traumatic events seems to be
a pronostic factor in treatment response in PTSD.
Evidencia Clnica de las Aportaciones del DSM V al Trastorno de Estrs Postraumtico
Maria Crespo, Mar Gomez.
Complutense University of Madrid, Madrid, Spain.
Abstract Central: Desde su inclusin en las clasificaciones diagnsticas el Trastorno de Estrs
Postraumtico (TEPT) ha sido objeto de mltiples investigaciones que han pretendido estudiar

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la idoneidad de la definicin de acontecimiento traumtico y la caracterizacin clnica del


cuadro. Las evidencias ofrecidas por estas investigaciones han redundado en las
modificaciones que se proponen para el TEPT cara a la edicin V del DSM. En este trabajo se
pretende analizar y comparar la presencia de sintomatologa postraumtica y diagnstico de
TEPT, segn criterios DSM IV-TR y DSM V, en una muestra espaola de personas que han
sufrido diferentes acontecimientos traumticos. Para ello se evalu a 175 personas mayores de
18 aos que haban experimentado al menos un acontecimiento traumtico, que haba tenido
lugar al menos un mes antes de la evaluacin. En la batera de evaluacin, entre otros
instrumentos, se inclua la escala de Evaluacin Global de Estrs Postraumtico-EGEP
(Crespo y Gmez, 2012). Esta escala incluye tres secciones: caracterizacin del
acontecimiento traumtico, sntomas postraumticos y dificultades de funcionamiento. Esta
escala, permite valorar la sintomatologa y diagnstico de TEPT segn criterios DSM V ya que
en el desarrollo de la EGEP se tuvieron en cuenta otros sntomas (denominados sntomas
clnicos subjetivos) no recogidos en la clasificacin DSM IV-TR, pero que se consideraron
relevantes incluir para la comprensin de la problemtica del TEPT. Y estos sntomas han sido
incluidos en el borrador propuesto para el TEPT en el DSM V. Los datos a presentar sern el
resultado de analizar el grado de acuerdo (DSM IV-TR y DSM V) entre el cumplimiento de los
diferentes grupos de sntomas y del diagnstico de TEPT (DSM IVTR y DSM V). Adems, se
analizarn aquellos casos en los que no exista correspondencia entre ambos diagnsticos.
Patients profile of the Center of Studies and Research on Trauma and Stress in Southern
Brazil
Julia Donat, Gustavo Silva, Thiago Silva, Beatriz Lobo, Ninna Mnego, Rodrigo Grassi de
Oliveira, Christian Kristensen.
PUCRS, Porto Alegre, Brazil.
Background: Psychological services and centers for posttraumatic mental health usually
emphasize the interventions on the impact of violence or trauma and individuals life,
development and health. In Brazil, there is a lack of specialized centers for these populations,
and despite the high rates of violence in the country, there is no studies that describe the
Brazilian traumatized population. Aims: The purpose of this study was to draw a clinical profile
of patients treated at the Center of Studies and Research on Trauma and Stress, a center for
psychological treatment of stress-related disorders in the south region of Brazil. The goal was to
describe the samples social-demographic data, medication use, posttraumatic symptoms
intensity and comorbidities. Method: This retrospective study was conducted by collecting data
from 67 patients evaluated from April 2011 to October 2012. Data were acquired through a
social-demographic questionnaire, the Structured Clinical Interview for DSM-IV Axis I Disorders
(SCID-I), the Screen for Posttraumatic Stress Symptoms (SPTSS), the Beck Depression (BDI)
and Anxiety (BAI) inventories and a semi-structured interview about the trauma itself. Results:
The sample was composed by 50 women (74,6%). Median age was 39 years, and the
education levels were Elementary school (8; 11,9%), High school (33; 49,25%), Undergraduate
(21; 31,34%) and graduate (4; 5,97%). Median individual income was R$1100 and median
familiar income was R$2000. 38,8% (n=26) were single, 35,8% (n=24) were married, 9%(n=6)
were divorced, 7,5% (n=5) were in a stable union and 3% (n=2) were separated. The types of
trauma were assault/robbery 18,4% (n=13), vehicle accident 16,4% (n=11), sexual violence
14,9% (n=10), physical aggression 24% (n=14) and the fact of had witnessed the death of
someone emotionally related 10,4% (n=7). 14 people (17,5%) reported other traumatic
situations. 31 patients (46,15%) were taking psychiatric medication. The most frequent classes
of drugs were antidepressants (25,5%, n=24), anxiolytics (19,15%, n=18) and antihypertensives
(16%, n=15). Screening instruments for symptomatology showed that the patients had high

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posttraumatic symptoms (5,81 2,17) on SPTSS, depressive symptoms on BDI (26,23 12,15)
and anxiety symptoms on BAI (22,20 13,39). Accordingly, 67% and 47,7% had Posttraumatic
Stress Disorder and Depressive disorder respectively. 32,8% of the patients had the two
diagnoses in comorbidity. Conclusions: our patients have different posttraumatic reactions and
symptomatology, and also an assorted socio-economic status and education levels.
Interpersonal trauma and violence seem to be the most common type of related traumatic
events. Treatment strategies in social politics should attend to the specificities of this population,
willing of finding the best treatment choice.
Effectiveness of Trial-Based Therapy in Post-Traumatic Stress Disorder
rica Duran, Francisco Lotufo Neto.
Psiquiatria, Universidade de So Paulo, So Paulo, Brazil.
Introduction: Post-traumatic Stress Disorder (PTSD) can be an incapacitating disease.
According to Yehuda and Davidson (2000), studies have shown that PTSD is the fourth most
common psychiatric disorder, affecting around 10.3% of men and 18.3% of women at some
time in their lives. Among the psychological therapies directed at the treatment of this disorder,
Cognitive-Behavioral Therapy has featured in literature. It works well with Automatic Negative
Thoughts, but there are still doubts about its effectiveness for treating cognitive schemas. More
recently, Oliveira (2011) developed a treatment named "Trial-Based Therapy" (TBT), cognitive
therapy based on Beck, which proposes a new way for addressing schemes. The TBT has its
name because of the main techniques used which simulates a trial and is inspired by Franz
Kafkas literary work, named "The Process". Objective: To evaluate the efficacy of the Therapy
Procedure in the treatment of patients with Post-Traumatic Stress Disorder. Method: 10 patients
who were diagnosed with PTSD were randomized and treated by psychologists trained in TBT
and Exposure Therapy (1999). The duration of treatment was three months and one week and
the follow-up was carried out having elapsed three months from the end of the treatment. The
therapy was performed on a weekly basis for the first eleven weeks and the two remaining
sessions were carried out on a week in - week out basis, totaling thirteen sessions. The duration
of the psychotherapy sessions were one hour. The Beck Anxiety Inventory (BAI), Beck
Depression Inventory (BDI), Davidson Trauma Scale (DTS), Quality of Life Questionnaire
(SF36) and Automatic Thoughts Questionnaire (QPA) were used before and after the treatment
in order to evaluate its effectiveness. Results and Discussion: The results demonstrate that
patients who went through TBT showed a drop in scores of Scales BAI, BDI, DTS, SF36 and
QPA, thus presenting an overall improvement in the framework of disorder and in the quality of
life. The results confirm the effectiveness of TBT, thus representing a new feature in the
treatment of these patients.
Trauma Narratives: State of Research and Clinical Implications
Violeta Fernndez-Lansac, Maria Crespo.
Psicologia Clnica, Facultad de Psicologa. Universidad Complutense de Madrid, Madrid, Spain.
One of the keys to understand Posttraumatic Stress Disorder (PTSD) is to know how traumatic
event is represented on individual memory. Analysis of the narrative that the person elaborates
to tell what happened provides access to his/her autobiographical memory. So, several studies
have employed linguistic procedures to assess structural and content aspects of traumatic
narratives. This paper reports the main findings of narrative research on PTSD (as result of an
extended bibliographical search), outlining future lines of study and their applications to clinical
practice. What is know: evidence suggest that traumatic narratives of PTSD patients are

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fragmented and disorganized; contain a lot of elements regarding to sensorial, perceptual and
emotional experiences; show a lack of self-referential processing; are constructed in present
tense; and reflect the impact that stressful situation has been on individual beliefs about the
world, the others and oneself. These characteristics are susceptible to socio-cultural
considerations. Outcomes support cognitive models of PTSD, which propose that traumatic
narratives appear in form of dissociated sensorial or emotional elements that represent nonintegrated aspects of stressful situation. What still needs to know: future studies must clarify: (a)
the role of some aspects of narratives (i.e. extension, cognitive words, narrative coherence) that
up to date have offered contradictories outcomes; (b) the role of metacognitive beliefs, rumiation
processes and other factors that could moderate the relationship between fragmentated
narratives and the development of posttraumatic symptoms; and (c) the causal link between
fragmentation and PTSD. Clinical implications: narrative studies emphasize the importance of
conscious elaboration about traumatic event. Since language is essential to organize the recall;
changes on language will lead changes on trauma representation. Therefore, narrative therapy
would be a useful alternative to treatment of PTSD and future efforts should focus on
developing new programs that incorporate the latest advances in narrative research.
Entrenamiento a Nios Abusados Sexualmente que Deben Declarar en Juicios Orales:
Aportes de la Terapia Cognitivo Conductual
Cristbal Guerra2, 1, Pamela Canessa2, Blanca Calvo2, Cecilia Ramirez2, Marcela Viveros2.
1. Pontificia Universidad Catlica de Chile, Santiago, Chile, 2. Corporacin de Asistencia
Judicial, Valparaso, Chile.
Abstract Central: Existe evidencia de que nios vctimas de delitos sexuales que enfrentan
procesos judiciales pueden sufrir victimizacin secundaria. Por esta razn se dise un
programa de apoyo a los nios que deben declarar en juicios orales complementario a la
psicoterapia. El programa, de orientacin cognitivo conductual, utiliza la psicoeducacin,
inoculacin de estrs, debate cognitivo y autoisntrucciones. Se describen los resultados
cualitativos y cuantitativos de la aplicacin piloto del programa a 10 nios. Adems, se
comparan estos resultados con el reporte de nios que no han participado del programa. Los
resultados preliminares indican que el programa es efectivo ya que evita la victimizacin
secundaria y favorece el proceso de restructuracin cognitiva. Dado que el presente estudio
corresponde a una aplicacin piloto del programa, se hace necesario continuar investigando el
tema. (There are evidence that child who were victims of sexual offenses suffer secondary
victimization in criminal trials. For this reason we designed a Cognitive Behavioral program to
support children who must testify in oral hearings, complementary to psychotherapy. The
program uses psychoeducation, stress inoculation, cognitive discussion, and self instructions.
We describe the qualitative and quantitative results of the pilot program to 10 children.
Furthermore, these results are compared with the report of children who have not participated in
the program. Preliminary results indicate that the program is effective because it prevents
secondary victimization and enhance the process of cognitive restructuring. Since this study is
an pilot implementation of the program, it is necessary to further investigate the issue)
Terapia Cognitivo-Conductual en un Caso de Violacin Infantil
Cristbal Guerra1, 2, Hugo Plaza3.
1. Pontificia Universidad Catlica de Chile, Santiago, Chile, 2. Corporacin de Asistencia
Judicial de la Region de Valparaso, Via del Mar, Chile, 3. Corporacin de Apoyo a la Infancia
Paicabi, Via del Mar, Chile.

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Abstract Central: En este estudio se describe el tratamiento de una nia con estrs
postraumtico producto de una violacin. Este tratamiento integra; desensibilizacin
sistemtica, relajacin, control del pensamiento, y psicoeducacin. Se pretendi reducir los
sntomas intrusivos, evitativos y de aumento de la activacin fisiolgica propios de este
trastorno. Para medir los efectos de la intervencin, se registraron los niveles de ansiedad de la
nia mediante la Escala de unidades subjetivas de ansiedad (SUDS; Wolpe, 1958). Los
resultados indican una disminucin gradual de la sintomatologa hasta llegar a niveles mnimos
en 9 semanas. Estos resultados se mantienen en el seguimiento realizado semanas, meses y 2
aos despus de finalizado el tratamiento. Finalmente se discuten las implicancias tericas y
clnicas de estos resultados This article describes the treatment of a female child with
posttraumatic stress disorder as a result of rape. This treatment integrates systematic
desensitization, relaxation, control of thought, and psychoeducation. This treatment attempted
to reduce intrusive, avoidant and increasing physiological activation symptoms, which are
characteristics of this disorder. To measure the effects of this intervention, the anxiety levels of
the female child were registered using the Scale of subjective anxiety units (SUDS; Wolpe,
1958). The results indicate a gradual reduction of symptoms reaching minimum levels after 9
weeks. These results are maintained in the follow-up weeks, months and after 2 years the
treatment was finished. Finally, the theoretical and clinical implications of these results are
discussed.
Trauma-Focused Cognitive Behavioral Therapy for Traumatized Youth - Mediators for
Treatment Outcome
Tonje Holt2, Tine Jensen1, 2, Silje Ormhaug2.
1. Department of Psychology, University of Oslo, Oslo, Norway, 2. Norwegian centre for
violence and traumatic stress studies, Oslo, Norway.
Abstract Central: Although the evidence for trauma-focused cognitive behavioral therapy (TFCBT) for children is documented in several studies, little is known about what mediates
treatment outcome. Since some studies have shown that negative trauma-related cognitions are
a significant factor in the maintenance of post-traumatic stress reactions, we wanted to examine
whether treatment effects are mediated through changes in negative cognitions. We also
wanted to examine what role changes in parent distress and depression had on child treatment
outcomes. Data from a randomized clinical effectiveness study that compared TF-CBT (n= 79)
with treatment as usual (n=77) in 8 mental health clinics in Norway will be presented. Inclusion
criteria were children between ages 10-18 that had experienced trauma and had severe
posttraumatic stress reactions. The child and at least one parent had to speak Norwegian and
128 parents participated in the study. Exclusion criteria were psychosis, suicidal behavior or
mental retardation. The main outcome measures were post-traumatic stress, depression and
anxiety. Negative trauma-related cognitions were measured using the Childrens Posttraumatic
Cognitions Inventory. Changes in parent distress were measured using PERQ (parental
emotional reaction questionaire) and parent depression was assessed using CES-D (Center for
Epidemiologic Studies Depression Scale). This presentation will present findings regarding the
effectiveness of TF-CBT and the possible mediating role that changes in negative traumarelated cognitions and changes in parental distress and depression may have for treatment
outcome. The implication of these findings for clinicians working with traumatized children and
their families will be discussed.
El Terapeuta Cognitivo Conductual Resiliente
Jacinto Inbar.

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1. Bar Ilan University, Jerusalem, Israel, 2. Center for Integrative Cognitive Behavior and
Positive Therapy, Jerusalem, Israel.
Abstract Central: La profesin teraputica requiere una entrega constante y una empata
clnica efectiva y sensible con la que involucrarse profundamente, como en el caso de las crisis
masivas, eventos de terrorismo, duelo, crisis, incertidumbre, enfermedades crnicas, prdidas,
desocupacin, etc. Es conocido que el apoyo y el tratamiento psicolgico de los individuos
afectados por esos eventos, puede crear potencialmente en los terapeutas expresiones y
sntomas similares, como el Estrs Traumtico Secundario, la Traumatizacin Vicaria, el
desgaste psicolgico/burnout, y el Desgaste por Compasin. Objetivos de la Comunicacin
Libre Presentar y analizar un acercamiento integrativo multi-dimensional centrado en la Terapia
Breve Enfocada en las Soluciones, la Psicoterapia Positiva y la Terapia Cognitiva Conductual,
para el aumento de las fortalezas y los recursos de afrontamiento, la resiliencia psicolgica y la
prevencin en situaciones normativas, como el burnout y la fatiga por compasin entre los
terapeutas cognitivos conductuales. Abordar distintos acercamientos teraputicos basados en
evidencias relacionados con el crecimiento, la Flow, la Esperanza, el Optimismo, la Compasin
y la Auto-Compasin en el tratamiento del CBT y su aplicacin en el fomento de la resiliencia
psicolgica para la consecucin de los objetivos teraputicos y la prosperidad en los pacientes
y en los terapeutas. En la ponencia sern presentados distintos modelos aplicativos para la
consecucin de los objetivos citados anteriormente y analizaremos las implicaciones
relacionadas con la prosperidad en el tratamiento y sern mencionadas Intervenciones
Cognitivas Conductuales de Baja Intensidad e intervenciones y multi - dimensionales que han
demostrado su efectividad.
Lessons in Trauma and Commonsense
Derek Indoe.
The Bath Clinic, Bath, United Kingdom.
Abstract Central: This paper describes how patients who have suffered trauma can be further
traumatized by medical staff to whom they go for help. Drawing on a range of case studies
using qualitative methodology the paper highlights the importance of concepts that are
commonsense but not given prominence in modern cognitive behavioural therapy. The paper
draws attention to the need for joined-up thinking in accessing the world of the patient rather
than a compartmental prescriptive view of that world. The paper argues for more research into
the early stages of treatment when a patient is faced with death and issues of responsibility, self
worth, safety and choice.
Can Activation of Secure Attachment Representation Reduce PTSD Symptoms - Lessons
from Basic Research and Group Treatment Combining Trauma-Focused CBT and
Interpersonal Therapy (IPT)
Anke Karl1, Gizem Arikan2, Luke Norman1, Kathy Carnelley2, Lusia Stopa2, Natalia Lawrence1,
Alexander Haslam3, Catherine Haslam3, Heather O'Mahen1.
1. University of Exeter, Exeter, United Kingdom, 2. University of Southampton, Southampton,
United Kingdom, 3. University of Queensland, St Lucia, QLD, Australia.
Abstract Central: The protective role of social support for the recovery from trauma is well
documented. However, it is not well understood how social support exerts its protective effect
and why some individuals struggle to receive social support or benefit from it. PTSD is a
disorder of intrusive recollections of the traumatic experiences, pervasive feelings of current

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threat, cognitive and behavioural avoidance and dysregulated physiological arousal, but it is
also accompanied by altered social functioning. We propose that understanding the
neurobiology of adult attachment may help one understand mechanisms of action that buffer
posttraumatic stress and facilitate its treatment. In a series of proof-of-concept studies we found
that the experimental activation of a secure attachment representation via priming was
accompanied by reduced physiological arousal (reduced skin conductance and heart rate and
increased heart rate variability), reduced amydgala activation to facial and verbal threat cues
and reduced number of stressful intrusions after exposure to trauma films. In addition, we
evaluated the feasibility and acceptability of a group treatment that combined TF-CBT and IPT.
In particular, we were interested in investigating whether individuals self-reported session-bysession perceived group fit and attachment security preceded PTSD symptom reduction. We
integrate our findings into current aetiological models of PTSD and extend these by
incorporating how secure attachment protects from PTSD intrusions, avoidance and
hyperarousal.
Advances in Cognitive-Behavioral Therapy for Posttraumatic Stress Disorder: Treatment
Protocols and Softwares
Christian Kristensen1, Renato Caminha2, Eduardo Guimares1, 2, Trcio Soares2.
1. Psychology, Pontifcia Universidade Catlica do Rio Grande do Sul, Porto Alegre, Brazil, 2.
Instituto da Famlia de Porto Alegre, Porto Alegre, Brazil.
Posttraumatic Stress Disorder (PTSD) is a complex, often chronic and debilitating mental
disorder that develops after exposure to a traumatic event such as sexual assault, interpersonal
violence, natural disasters, and other extreme stressors. This picture is further complicated by
associated features, such as comorbid disorders, dissociation, shame and guilt. PTSD can
disrupt many aspects of normal functioning, including dimensions such as cognition, affect,
social and neurobiological. Therefore, it imposes a large social cost, impacting individuals,
families and society. Psychosocial treatment for PTSD is well established, with evidence-based
literature supporting cognitive-behavioral (CBT) interventions. Even if CBT has strong empirical
support, in order to ensure its dissemination in a growing number of countries, it is crucial that
cultural aspects be taken into account, both in terms of how clinical conditions - such as PTSD manifest and to enable adaptation of interventions. Furthermore, in very culturally and ethnically
diverse countries, the heterogeneity of patients, complaints, and beliefs (many of which are
culturally mediated) require specific knowledge and techniques. The main goal of this clinical
roundtable is to present three CBT based interventions developed in southern Brazil to the
treatment of PTSD. The first intervention, presented by Renato Caminha, is the Box of Memory
(BM), software developed to aid the cognitive restructuring of traumatic memory in children 8-12
years suffering from PTSD. This software operates with the desensitization of traumatic
memories by means of pairing these memories with positive ones and enabling the child to
control the involuntary memories. Christian Kristensen will present the second intervention, the
Virtual Bank, which is a virtual environment used in virtual reality exposure (VRE-CBT) for
victims of bank attacks (bank employees, clients) suffering from PTSD. Some of the advantages
of the VRE-CBT includes (a) ease the viewing for patients who have difficulty visualizing the
traumatic event; (b) the opportunity of the therapist to visualize what the patient actually sees;
(c) that virtual exposure is more realistic than exposure based on mental imagery; and (d) the
VRE-CBT seems to increase the engagement of the patients on the treatment more than on
imagery exposure. Specific cultural aspects are considered in order to increase the sense of
presence in the virtual environment. The third intervention, presented by Eduardo Guimares, is
a treatment protocol for the dissociative subtype of PTSD (as proposed for the DSM-5), which is
a condition characterized by depersonalization and derealization with a distinctive pattern of

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limbic over modulation. Specific emotion regulation techniques and grounding exercises are
proposed to help individuals suffering from this condition. All three interventions will be
presented along with preliminary data from ongoing studies. Cultural specificities of these
interventions are highlighted as potential mediators to therapeutic effectiveness.
Impact of PTSD on Quality of Life among Victims of a Workplace Trauma: A Systematic
Review
Sophie Lacerte1, 2, Sarah Bruyninx1, 3, Delphine-milie Bourdon1, 2, Andre Marchand1, 2.
1. Trauma Studies Center, Montreal, QC, Canada, 2. Psychology, University of Quebec in
Montreal, Montreal, QC, Canada, 3. University of Sherbrooke, Sherbrooke, QC, Canada.
Being exposed to a traumatic event in the workplace is relatively frequent. Each year,
approximately 350 000 cases of workplace violence are declared, and near 106 000 workplace
accidents are confirmed in Canada. The most associate mental disease developed after
experiencing a trauma is Posttraumatic Stress Disorder (PTSD). The development of this
disorder can have important consequences on a victims quality of life. The association between
workplace trauma, PTSD and quality of life has been studied for more than a decade, but no
review were done in order to draw conclusions and suggest new directions for future
researches. Thus, a systematic review was conducted, following Cochranes recommendations.
Literature search was effectuated on three reliable databases (PsycNet, PubMed, Pilots) with
specific keywords. Dissertations were included. Additional studies were found by reference list
of selected articles. In total, 1 202 articles were extracted from database searching or reference
list. Selection criteria were predetermined. Systematic selection of relevant articles was made
by two independent raters who screened studies by title, then abstracts and full-reading. Data
from the selected articles were then rate independently by the same two researchers following a
form adapted for the review. An inter-rater agreement on selection of articles and data
extraction was made at each step. Nineteen articles were finally selected, and include one
thesis, are mainly effectuated in USA and have a prospective design. Despite the various
assessments of quality of life among studies, limiting comparison of results, this review confirms
the negative impact that PTSD has on multiple domains of quality of life among victims of a
workplace trauma. Global quality of life significantly differed from control groups (no-PTSD,
partial PTSD). Victims suffering of PTSD are up to 8 times more likely to have a diminished
quality of life than people who do not develop PTSD. Although few studies have included a
measure of prediction, age, severity of PTSD and presence of psychological comorbidities seem
to predict the degree of quality of life among this population. Future studies should define
precisely the concept of quality of life being measured, use validated instruments, include a
comparison group, and design longitudinal studies to evaluate the evolution of quality of life.
Moreover, predictors of the degree of quality of life experienced after being exposed to a
workplace trauma should be more often explored and evaluated, in order to be able to identify
people at risk and develop preventive interventions. Also, results from these studies help
professionals to have a better understanding of implications of PTSD in a victims life, so they
can incorporate it in their treatment and be more efficacious in the recovery process.
Efficacy of Cognitive-Behaviour Therapies for Nightmares Compared to
Pharmacotherapy (Prazosin) for Adults with PTSD: a Meta-Analysis
Katia Levrier1, 2, Carolyn Leathead1, Delphine-milie Bourdon1, 2, Sophie Lacerte1, 2, Genevive
Belleville3, Andre Marchand1, 2.
1. Psychology, UQAM, Montreal, QC, Canada, 2. Trauma Studies Centre, Montreal, QC,
Canada, 3. Universit Laval, Quebec, QC, Canada.

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Nightmares are one symptom of the intrusion/re-experiencing symptoms cluster of posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV-TR). PTSD nightmares are different from "normal" dreams as they are recurrent
frightening dreams of past traumatic events (Phelps, Forbes, & Creamer, 2008) and vary from
19% to 71% in the PTSD cases compared to 2-8% in the general population. Also, one of their
consequences is to be related to PTSD prevalence, severity (Pruiksma, 2011) and maintenance
(Maher, Rego, & Asnis, 2006). The efficacy of cognitive and behavioral therapies (CBT) as a
psychological treatment (Ponniah & Hollon, 2009) and selective serotonin reuptake inhibitors
(SSRIs), as a pharmacological treatment (Stein, Ipser, & Seedat, 2006), to solve PTSD
symptoms in general have often been demonstrated through meta-analyses and systematic
reviews. However, it has appeared PTSD nightmares can be treatment resistant. Therefore,
considering patients complaints due to nightmares consequences on everyday life and the fact
that nightmares may contribute to PTSD symptoms maintenance, new psychological and
pharmacological treatments are tested to directly reduce these nightmares (Aurora et al., 2010).
Imagery Rehearsal Therapy (IRT), Lucid Dreaming Therapy (LDT) and Prazosin, are among the
most common treatments we can encounter in the literature. Nevertheless, their efficacy
compared to each other is not really known yet. Therefore, the aim of this meta-analysis is to
evaluate the impact of CBTs for nightmares (for example, IRT or LDT) compared to Prazosin as
a pharmacotherapy, on PTSD nightmares, on PTSD symptoms in general and on sleep for
adults diagnosed with PTSD. A systematic search of English and French clinical trials of any
CBTs and Prazosin treatments for PTSD nightmares from 1980 to July 2012 was conducted in
PsycINFO, MedLine, PILOTS, and Proquest Dissertations and Theses. The final sample was
composed of 28 studies published in English: 10 studies on Prazosin and 18 studies on CBTs.
The analyses were performed using the random-effects model and the effect sizes (ES) were
computed with Hedgesg. Both treatments had a significant effect on PTSD nightmares
(Prazosin, ES = 2.39 and CBTs, ES = 0.55) and sleep quality (Prazosin, ES = 0.57 and CBTs,
ES = 0.76). A significant effect was also found for CBTs on PTSD symptoms (ES = 0.69) but not
for Prazosin. The type of trauma and questionnaires used to evaluate PTSD nightmares
frequency, PTSD symptoms and sleep substantially differed between the studies and will also
be discussed.
Imagery Rehearsal Treatment (IRT) Combined to a Conventional Cognitive-Behavioral
Treatment (CBT) for Post-Traumatic Stress Disorder: a Pilot Study
Katia Levrier1, 2, Genevive Belleville3, Andre Marchand1, 2.
1. Psychology, UQAM, Montreal, QC, Canada, 2. Trauma Studies Centre, Montreal, QC,
Canada, 3. Universit Laval, Quebec, QC, Canada.
Post-traumatic nightmares are recurrent frightening dreams of past traumatic events (Phelps,
Forbes, & Creamer, 2008) and they vary from 19% to 71% in the PTSD cases compared to 28% in the general population. In the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV-TR), they represent one of the symptoms of the intrusion/re-experiencing symptoms
cluster of post-traumatic stress disorder (PTSD). In this context, it is believed that a
conventional cognitive and behavioral treatment (CBT) for PTSD will solve this symptom.
However, recent studies underline PTSD nightmares can be treatment resistant (Davis et al.,
2003). Some studies explain nightmares would be a normal reaction after a traumatic event at
first and would be, therefore, a PTSD symptom. However, as victims are afraid of their
nightmares content and would avoid them by not going to bed at night for example, nightmares
would become a learned behavior. Thus, nightmares would eventually become an independent
disorder which needs to be directly treated. As a result, new psychological and pharmacological

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treatments are tested to directly reduce these nightmares (Aurora et al., 2010). Imagery
Rehearsal Therapy (IRT) is one treatment gaining more and more empirical support to treat this
problem. The IRT rational is to select a repetitive nightmare, to transform and write it into a new
positive or neutral dream, and finally to rehearse it in imagination. Several studies have tested
IRT to decrease nightmares frequencies (Aurora et al., 2010) but to our knowledge, no studies
have tried to incorporate this specific treatment for nightmares into a conventional CBT for
PTSD. Therefore, the aim of this pilot study is to test through a case study the possibility to
combine both a conventional CBT for PTSD and IRT for nightmares in a 20-week treatment;
and to analyze the results. A structured clinical interview was used to determine subjects
diagnosis at baseline and to gather background information. Results from the interview
indicated that the client was a married 52-years male who met criteria for PTSD after a leisure
accident. Daily self-observation logs were completed starting from 4 weeks before the treatment
and during the whole treatment. Also, several self-report measures were administered at
baseline, at 3 weeks (at the end of the IRT), at 10 weeks and at the end of the whole treatment.
Questionnaires evaluating nightmares such as the Nightmare Distress Questionnaire (NDQ);
PTSD symptoms, such as the PTSD Checklist Scale (PCLS); sleep difficulties (Pittsburg Sleep
Quality Index - PSQI); and comorbidities (Beck Depression Questionnaire - BDI-II) were fulfilled.
Analyses were performed with SPSS. Means of selected variables from the daily sleep activities
log will be presented. T-test analyses (pre, post) and clinically significant changes will be
performed on NDQ, PCLS, PSQI and BDI-II. Complications factors, treatment implications and
recommendations of this case will be discussed.
Eficcia da TCC em Sujeitos com TEPT Aps Desastres Naturais: Uma Reviso
Sistemtica
Alessandra Lopes1, 2, Tnia Macedo1, Livia Wilheim3, Paula Ventura1, 3, Ivan Figueira1.
1. Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de
Janeiro, Brazil, 2. Instituto D Or de Pesquisa e Ensino (IDOr), Rio de Janeiro, Brazil, 3. Instituto
de Psicologia da Universidade Federal do Rio de Janeiro (IP/UFRJ), Rio de Janeiro, Brazil.
Em cada ano cerca de 225 milhes de pessoas no mundo so expostas a desastres naturais.
Destas de 5 a 60% desenvolvem Transtorno de Estresse Ps-traumtico (TEPT), no primeiro
ou segundo ano aps a catstrofe. O TEPT um transtorno de ansiedade que pode ocorrer em
pessoas que passaram, vivenciaram ou tiveram notcias de um trauma, inclusive desastres
naturais. A pessoa que sofre com este transtorno apresenta sintomas de revivescncia,
esquiva e hiperestimulao autonmica. A interveno mais difundida para este tipo de
catstrofe o debriefing psicolgico, porm estudos apontam que esta abordagem no
eficaz, na preveno de psicopatologias relacionadas ao trauma e na reduo dos sintomas de
estresse. Sendo assim, a escassez de estudos que definam o que eficaz em termos de
interveno ps-trauma em populaes afetadas por desastres naturais, motivou este estudo.
So considerados como resultados positivos dos tratamentos a reduo significativa dos
sintomas de TEPT, medida atravs de escalas. O objetivo do presente estudo avaliar a
eficcia do tratamento psicoterpico baseado em Terapia Cognitivo-comportamental (TCC)
para pessoas que desenvolveram TEPT a partir de desastres naturais, atravs de uma reviso
sistemtica. Esta terapia considerada a primeira escolha para o tratamento de TEPT, por isso
foi focado nesta reviso. Foram conduzidas buscas nas bases eletrnicas ISI Web of Science,
PsycINFO, PUBMED, PILOTS e Scopus incluindo todas as lnguas e todos os anos. Foram
includos estudos que utilizaram TCC, entendendo esta abordagem de maneira ampla,
englobando estratgias cognitivas e/ou comportamentais, em estudos randomizados,
controlados ou abertos para indivduos diagnosticados com TEPT, tendo como trauma principal
um desastre natural. Foram excludos artigos de reviso, captulos de livros, dissertaes e

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teses. Assim como estudos sem medida padronizada de eficcia antes e aps a interveno;
estudos de caso; estudos que no tenham um grupo de pacientes que utilize como interveno
apenas a TCC; estudos com modelo animal; e estudos em populao sem diagnstico formal
de TEPT, ou seja, que o diagnstico foi atribudo sem mencionar o uso de entrevistas
diagnsticas estruturadas ou inventrios clnicos padronizados. Dos 800 estudos encontrados,
foram selecionados oito, sendo dois randomizados, dois controlados e quatro ensaios abertos.
A presente reviso constatou a efetividade da TCC para TEPT oriundo de desastres naturais,
tais como terremotos e furaces, tendo-se em vista que sete dos oito estudos selecionados
apontaram reduo significativa dos sintomas de TEPT utilizando tcnicas da TCC. Apesar dos
estudos apresentarem resultados positivos, para se falar em eficcia desta abordagem neste
contexto traumtico, faz-se necessria a conduo de mais estudos controlados e
randomizados, tendo-se em vista a baixa quantidade de estudos encontrados.
Reducing Cognitive Intrusions Following a Laboratory 'Trauma': Therapeutic Value of
Adopting a Concrete Mode of Processing
Alea Losch, Colin MacLeod.
Psychology, The University of Western Australia, Perth, WA, Australia.
Research has suggested that when people encounter events that produce acute emotional
reactions, it can lead to dysfunction through the development of various traumatisation
symptoms, of which intrusions are the hallmark. Intrusions are thoughts or images that come to
mind relating to the traumatic event and produce dysphoria. This same phenomenon can be
observed within a laboratory in which people are exposed to a stressor which induces an
intense negative emotional reaction. This intense negative emotional reaction has been found to
predict the development of intrusions across successive days. The question of interest to the
present study was whether it is possible to ameliorate the degree to which such an acute
negative emotional reaction to a stressor results in subsequent intrusions. The present study
evaluated this question by applying a distinction made by Watkins, Baeyene and Read (2009)
between two modes of information processing: abstract (implicational) versus concrete (nonimplicational) processing. Watkins et al. (2009) found that individuals processing information in
a concrete manner, thinking about what and how the events happened, rather than in an
abstract manner, thinking about the implications of the events, experienced a reduction in
dysfunctional symptomatology. However, to date no research has investigated whether the
adoption of a concrete mode of processing can attenuate the degree to which people
experiencing an intense negative emotional reaction to a stressor develop subsequent
intrusions. The present study examined this hypothesis by getting 72 first year psychology
students to process film clips designed to produce an acute emotional reaction, and measuring
both their emotional reactions to the film clips and the development of intrusions over a seven
day period following the film clips. Half of the students were required to process the film clips in
a concrete manner and the other half were required to process the film clips in an abstract
manner. Results showed that across participants, the intensity of the emotional reaction did
indeed predict the frequency of subsequent intrusions. More importantly, in support of the
hypothesis, the degree to which this was the case was strongly influenced by the way in which
the participants processed the film clips. Specifically, for participants adopting an abstract mode
of processing a normal association was observed in which the emotional reaction predicted the
frequency of intrusions. Whereas for the participants adopting the concrete mode of processing
this association was reduced to non-significance. The implications of these findings will be
discussed.

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Cognitive Intrusions following Laboratory induced trauma: The Moderating Influence of


Processing Mode
Alea Losch, Colin MacLeod.
Psychology, The University of Western Australia, Perth, WA, Australia.
Abstract Central: It has frequently been observed that when people encounter events that
produce traumatic emotional reactions, it can lead to dysfunction through the development of
various symptoms, of which intrusions are the hallmark. Intrusions are defined as thoughts or
images of a negative nature that pop into mind and can produce continuing dysphoria. Analogue
demonstrations of this clinical phenomenon can be observed within a laboratory in which people
are exposed to a stressor which induces an intense negative emotional reaction. This intense
negative emotional reaction has been found to predict the development of intrusions across
subsequent days. The question of interest to the present study was whether it is possible to
ameliorate the degree to which such an acute negative emotional reaction to a stressor results
in subsequent intrusions. Specifically, the prediction assessed was whether the adoption of
what Watkins, Baeyene and Read (2009) have referred to as a concrete mode of processing,
when initially experiencing a stressor, will attenuate the degree to which the acute emotional
reaction will predict the development of intrusions. Following Watkins et al.s (2009) definition,
the adoption of a concrete mode of processing means that the potentially distressing information
is processed while considering what is happening and how it is happening, rather than the
implications of what has happened or could happen (which in contrast would be referred to as
an abstract mode of processing). Whilst Watkins et al. (2009) have observed that concrete
processing can attenuate various types of dysfunctional symptomatology, to date no one has
examined whether it can attenuate the degree to which people experiencing an intense negative
emotional reaction to a stressor develop subsequent intrusions. In the present study, seventytwo first year psychology students were required to process video clips designed to produce an
intense emotional reaction and subsequent measures were taken, not only of the intensity of the
emotional reaction, but also of the development of intrusions across the following seven days
using an online intrusion diary on their mobile phones. Half of these students processed these
video clips while adopting the concrete mode of processing, while the other half adopted an
abstract mode of processing. Results showed that across participants, the intensity of the
emotional reaction to the video clips did indeed predict the frequency of subsequent intrusions.
More importantly, in support of the hypothesis, the degree to which this was the case was
strongly influenced by the mode adopted by participants when processing these video clips. For
the participants who adopted the abstract mode of processing the normal association was
observed, such that the emotional reaction predicted the frequency of intrusions. Whereas, for
those who instead adopted the concrete mode of processing, this association was reduced to
non-significance. The theoretical and applied implications of these findings will be discussed.
Childhood Adversity Is Associated with Psychiatric Disorders, Anxiety Symptoms and
Substance Use
Nancy Low1, Nastasija Lezaic1, Erika Dugas2, Giselle Kraus1, Igor Karp3, Jennifer O'Loughlin3.
1. Psychiatry, McGill University, Montreal, QC, Canada, 2. University of Montreal, Montreal, QC,
Canada, 3. University of Montreal Hospital Centre, Montreal, QC, Canada.
BACKGROUND: Childhood adversity (CA) is associated with mood disorders in adults in clinical
settings. Previous research is limited to clinical samples that examine the association between
few or uncommon childhood events (i.e. violent physical abuse) and a narrow range of mental
health and substance use outcomes. OBJECTIVE: To examine the association between CA and
(a) psychiatric disorders, anxiety symptoms, and substance use; (b) specific psychiatric

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disorders including mood disorders (bipolar, depression) anxiety disorders and alcohol or drug
problems; (c) self-reported symptoms of depression, panic, generalized anxiety disorder (GAD),
social phobia and agoraphobia; (d) use of specific substances. METHODS: A school-based
prospective cohort of 1293 students was followed 22 times over 13 years beginning in grade 7
(age 12-13 years). Data on childhood adversity were collected from 642 parents. Data on
diagnosed psychiatric disorders were collected from cohort participants (n = 880) in cycle 21
(mean age 21 years; 47% male) which also assessed lifetime anxiety symptoms (panic, GAD,
social phobia, agoraphobia) and lifetime use of specific substances. Depression symptoms
across adolescence were collected every 3 months during the five years of secondary school.
The association between number of childhood adversities and number of disorders, substances
and symptoms was examined in linear and logistic regression analyses. RESULTS: The CA
experienced ranged from 2% for death of mother to 68% for death in the family (other than
parent). Number of childhood adversities was associated with number of psychiatric disorders,
anxiety symptoms, and lifetime substance use. In the presence of 3 adversities), there was a
3.5-fold increase in diagnosed mood disorders (depression, bipolar disorder) and a 3-fold
increase in anxiety disorders and alcohol or drug problem. CA was also associated with a 2.5fold increase in self-reported depression, panic, GAD and social phobia symptoms; 2-fold
increase in social phobia symptoms, and lifetime use of specific drugs (marijuana, speed,
ecstasy, cocaine) ranging from a 1.5 to 2-fold increase. CONCLUSION: Childhood adversity is
associated with mental health problems (depressed mood, anxiety) and substance use in
adolescents and young adults. Strategies to detect childhood adversity and intervene to protect
against possible mental health consequences should be developed.
Screening for PTSD in Urban Latino Youth
Louise Macbeth.
Psychiatry, USC Keck School of Medicine, Los Angeles, CA, USA.
There are very few brief, valid and cost-effective instruments available for screening PTSD in
young people. One parent-report measure that has emerged as potentially useful is a 20-item
PTSD subscale that is derived from the 113 items on the Child Behavior Checklist. This derived
scale has been the subject of a number of validity studies with mixed results and no overall
consensus within the field. Another instrument that has been used extensively for self-reported
posttraumatic symptoms in youth is the Trauma Symptom Checklist for Children. This 54-item
instrument has two validity scales and six clinical scales, including a Posttraumatic Stress scale
that measures primarily re-experiencing symptoms. Various studies have shown the overall
TSCC to be reliable with well-established convergent and discriminant validity. A third
instrument, the UCLA PTSD Index, is a 22-item survey of self-reported DSM symptomatology.
Although it is widely used and has undergone a number of revisions, validity studies are still
underway at UCLA. Methods. This study examined the validity of the three measures described
above for a group of 92 urban Latino youth who were participants in a national study of traumaexposed children that was sponsored by SAMHSA. These children received treatment at an
outpatient psychiatric clinic in a large medical center in Los Angeles, and were administered the
instruments prior to beginning therapy. The 45 females and 47 males were from low-income
Latino families and ranged in age from 6 to 17. They were evaluated at intake and diagnosed
with PTSD (24), no PTSD (22), or probable PTSD (46). The CBCL Total T-score was also
included in the analyses as a measure of general psychopathology. Results. Analysis of
variance results showed significant differences among the diagnostic groups for both the TSCC
PTS scale (F=7.82; p<.001) and the UCLA PTSD Index (F=5.58; p<.005), with a clear
progression of scores as predicted. Neither of the CBCL scales showed significant differences
between diagnostic groups. Conclusions. Scores for trauma-exposed children who received a

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diagnosis of PTSD by a clinician were significantly higher on two self-report measures than
those for children without PTSD. These two measures did about equally well in distinguishing
between the above two diagnostic groups. In contrast, the CBCL-PTSD scale was not able to
distinguish between any of the three diagnostic groups. CBCL-PTSD scores were consistently
high as were the Total T scores from the CBCL for all three diagnostic groups, leading to the
conclusion that both measures most likely reflect high levels of behavior problems and overall
psychopathology in this population, rather than PTSD specifically. This study has implications
for the choice of PTSD screening instrument in urban Latino populations that takes into account
the age of the children as well as the type of setting. The CBCL-PTSD scale has been most
effective in community and medical settings where traumatized children are compared to
normals, rather than clinic settings where all of the children have high levels of distress and
psychopathology. With older trauma-exposed children in clinical settings, it may be best to
gather self-report data on instruments such as the TSCC and UCLA Index in order to screen for
possible PTSD.
Cognitive Mechanisms and the Treatment of Prolonged Grief
Fiona Maccallum1, Don Robinaugh2, 4, Richard McNally2, Nicole LeBlanc2, Riva Shah4, Noah
Schwatrz4, Eric Bui4, Naomi Simon4, Fiona Maccallum1, Richard Bryant1, Paul Boelen3, Richard
Bryant1, Amy Joscelyne5.
1. University of New South Wales, Sydney, NSW, Australia, 2. Harvard University, Cambridge,
MA, USA, 3. Utrecht University, Utrecht, Netherlands, 4. Massachusetts General Hospital,
Boston, MA, USA, 5. New York University, New York, NY, USA.
Prolonged grief disorder (PG; also known as complicated grief) is increasingly recognized as a
potential and debilitating consequence of bereavement. Affecting at least 10% of bereaved
individuals, PG is characterized by persistent and distressing yearning for the deceased,
difficulty accepting the reality of loss, loss of meaning and purpose in life and the future,
bitterness, loss of trust, and a difficulty reengaging with life, that extends for at least 6 months
following the loss but can last unabated for years. PG is distinct from bereavement related
depression and anxiety, and is associated with significant functional impairment. The weight of
evidence is such that the major diagnostic systems are planning to introduce grief specific
diagnoses in their forthcoming revisions. PG does not respond to evidence based treatments for
depression. Although there is promising evidence that PG responds to grief specific cognitive
behavioral interventions, up to 50% of people fail to respond. Accordingly there is an urgent
need to better understand the mechanisms underlying the condition. This symposium comprises
4 papers that employ a range of methodologies to investigate the core mechanisms implicated
in PG, with the aim of enhancing treatment outcomes. The way in which an individual engages
with their future has important implications for their mental health. Bereaved adults with PG
exhibit difficulties imagining specific future events. This symposium will explore deficits in future
related thinking and present data examining the boundaries and basis of this dysfunction in PG.
Another key area of debate in the literature is the relative role of approach and avoidance
tendencies in PG. Data will be presented from a study using an experimental paradigm to
examine the extent to which PG is associated with approach or avoidance of loss related
stimuli. The third paper will focus on rumination. Rumination is a behavior observed in
numerous emotional disorders however research on the role of rumination in the development
and maintenance of PG is still relatively sparse. This symposium will present research findings
from prospective and experimental studies on the role of rumination in the development and
maintenance of PG and other emotional problems following loss. Finally the symposium will
present the results of a randomized controlled treatment outcome study investigating a key
question in the literature regarding the importance of exposure in a CBT treatments for PG. The

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findings presented in this symposium significantly advance our understanding of the


mechanisms underlying PG. Discussion will highlight the relevance of each mechanism and
how findings can be applied in the development of novel CBT interventions to improve
outcomes for this population.
Positive future thinking and complicated/prolonged grief symptom severity in bereaved
adults
Bereaved adults with prolonged grief (PG; also known as complicated grief) exhibit difficulty
imagining specific future events (Maccallum & Bryant, 2011; Robinaugh & McNally, under
review). However, the boundaries and basis of this dysfunction remain unclear. To further
evaluate prospection deficits in PG, we examine the association of positive future thinking (PFT)
and negative future thinking (NFT) with PG symptom severity. Bereaved adults with and without
PG completed the Inventory of Complicated Grief (Prigerson et al., 1995) and the Future
Thinking Task (FTT; MacLeod, et al., 1998; 2005). In the FTT, subjects generated future events
occurring over two time periods: next week and next 5-10 years. For each time period, subjects
generated and briefly described as many positive events as they could in 1 minute and as many
negative events as they could in 1 minute. Subjects then rated the perceived likelihood of each
event occurring as well as the emotion they would feel if the event occurred, ranging from very
negative to very positive. In keeping with past research (MacLeod, et al., 2005), the number of
events, perceived likelihood, and anticipated emotion in each condition were combined to create
indices of PFT and NFT. Data among subjects with PG (n = 19) suggest that PG severity may
be negatively correlated with PFT but unrelated to NFT In particular, greater PG severity may be
associated with lower anticipated positive emotion when imagining positive events (r = -.47, p =
.04) and lower perceived likelihood of positive future events (r = - .26, p = .27). Data are limited
by the small sample size and the restricted range of PG severity. However, the findings are
consistent with previous studies in clinical populations showing small to moderate negative
associations between depression severity and PFT, but no association between depression
severity and NFT (e.g., O'Connor et al., 2005). In this symposium, we will present the findings
from a sample including bereaved adults with and without PG, and we will discuss the
implications for our understanding of prospection deficits in PG.
Approach and avoidance tendencies in prolonged grief
There is considerable debate over the extent to which Prolonged Grief (PG; also known as
complicated grief) is characterized by avoidance from or approach to reminders of the loss. The
degree to which PG is associated with a tendency to seek out or avoid loss related information
has important implications for treatment. To date, however, much of our understanding of
approach and avoidance behaviors in PG has come from self-report methodology and findings
are mixed. This study examined approach and avoidance tendencies in a bereaved sample
using an experimental methodology that has been associated with approach and avoidance
behavior in substance use and phobias, respectively. Study 1 investigated general approach
and avoidance tendencies in a sample of 60 bereaved participants. Participants responded to
neutral shapes by either pulling a joystick towards them (approach) or pushing a joystick away
from them (avoidance) according to the color of the shape. Overall participants were quicker to
pull (approach) stimuli regardless of PG level. Study 2 investigated the tendency to approach or
avoid death related stimuli. 50 bereaved participants were required to push or pull a joystick
according to whether the stimuli they saw was a photograph (death related, negative, and
positive) or an abstract design (control). Half of the participants also received a prime designed
to activate their grief prior to the task. Results found that irrespective of prime condition,
participants with high levels of PG were slower to push, but not pull death related slides than
participants with low levels of PG symptoms. There was no difference in responding to non-

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death slides. This finding suggested PG was not associated with avoidance of death related
images. Limitations of the study, and theoretical and treatment implications are discussed.
The role of rumination in complicated/prolonged grief: Recent research and clinical
implications
There is strong evidence that rumination - a passive and repetitive focus on ones symptoms of
distress and the causes and consequences of these symptoms - is a transdiagnostic
mechanism involved in numerous emotional disorders. Research on the role of rumination in the
development and maintenance of prolonged grief disorder (PGD also known as complicated
grief) is still relatively sparse. This talk will focus on the question of how problematic rumination
following loss can be defined. Specifically, the form and content of loss-related rumination, and
how such rumination differs from and overlaps with depressive rumination and rumination
following traumatic events will be discussed. Moreover, existing research on rumination in grief
will briefly be reviewed. In the second part of this talk, recent research findings from prospective
and experimental studies on the role of rumination in the development and maintenance of PGD
and other emotional problems following loss - conducted in Utrecht - will be presented. The final
part of this talk will address the question how rumination can be curbed in the treatment of PGD
using conventional and novel cognitive behavioral interventions.
Treating Prolonged Grief Disorder: Is exposure necessary?
Prolonged Grief Disorder (PGD) is a recently recognized disorder that describes persistent and
impairing grief reactions that do not abate within 6-12 months of the death of a close person.
There is strong evidence from at least two studies that cognitive behavior therapy (CBT) that is
the treatment of choice for this condition. Current treatments are exposure-based, and also
include additional elements that pertain to the needs of goal setting and reorganizing ones
future in the case of the bereaved. Exposure is a strategy normally used in anxiety disorders,
and its role in treating PGD has been questioned. This study reports a controlled trial that
treated PGD patients with CBT with or without exposure to memories of the death and loss.
Seventy-nine patients were randomized, with each condition comprising 10 2-hour sessions.
Intent-to-treat analyses indicated that CBT/Exposure resulted in markedly superior gains in grief
and PTSD symptoms at both posttreatment and 6-month follow-up assessments. Effects sizes
were large at both posttreatment and follow-up assessments for changes in grief severity. This
finding underscores that treatment of PGD is more effective when explicit emotional processing
of the death/loss memories is undertaken.
Complicated Grief and PTSD: Differences and Similarities and Implications to Cognitive
Grief Therapy
Ruth Malkinson.
Colman College, Rishon LeZion, Israel.
Abstract Central: The nature of the relationship between bereavement and trauma is reflected
in the variety of opinions describing it as overlapping, as similar or separate subfields. Both
bereavement and trauma are external events followed by a bio-psychological response with
some resembling symptoms. However, while intrusion and avoidance elements are eventfocused in trauma, they are usually less intense in the case of bereavement and are mostly
deceased- focused (i.e. linked to the relationship with the deceased such as yearning) (Horowitz
et al,1997; Rubin, Malkinson, & Witztum, 2012). Diagnosis of complication in bereavement as
either PTSD or depression as is presently the case, ignores the unique element in
bereavement, that of a relationship to the deceased. Research studies indicate that
complications in bereavement have unique features necessitating distinct interventions. This
distinction is most relevant to therapy following a loss through death of a significant other. The

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presentation will review differences and similarities between complicated grief and PTSD and
the emergence of the link between the two, and the relevancy to assessment and intervention
(Malkinson,2007). Complications in bereavement will be examined from the continuing bonds
perspective and the difficulties in reorganizing inner relationship with the deceased. Specific
CGT strategies will be discussed. References: Horowitz, M. Bonanno, G.A. & Holen, A.
Pathological grief: Diagnosis and explanation. Psychosomatic Medicine, 55 260-273. Malkinson,
R. (2007). Cognitive grief Therapy: Constructing rational meaning to life following loss. Rubin,S.
Malkinson, R. & Witztum, E. (2012). Working with the bereaved: Multiple lenses on loss and
mourning. New York: Routledge.
The Effect of Shame and Shame Memories on Paranoid Ideation and Social Anxiety
Marcela Matos1, Jos Pinto-Gouveia1, Paul Gilbert2.
1. Cognitive and Behavioral Research Centre, University of Coimbra, Coimbra, Portugal, 2.
Mental Health Research Unit, Derby, United Kingdom.
Introduction: Social wariness and anxiety can take different forms. Paranoid anxiety focuses on
the malevolence of others, while social anxiety focuses on the inadequacies in the self in
competing for social position and social acceptance. Objectives and Methodology: This study
investigates whether shame and shame memories are differently associated with paranoid and
social anxieties. Shame, traumatic impact of shame memory, centrality of shame memory,
paranoia and social anxiety were assessed using self-report questionnaires in 328 participants
recruited from the general population. Results: Results from path analyses show that external
shame is specifically associated with paranoid anxiety. In contrast, internal shame is specifically
associated with social anxiety. In addition, shame memories, which function like traumatic
memories, or that are a central reference point to the individuals self-identity and life story, are
significantly associated with paranoid anxiety, even when current external and internal shame
are considered at the same time. Thus, traumatic impact of shame memory and centrality of
shame memory predict paranoia (but not social anxiety) even when considering for current
feelings of shame. Conclusion: Our study supports the evolutionary model suggesting there are
two different types of conspecific anxiety, with different evolutionary histories, functions and
psychological processes. Paranoia, but less so social anxiety, is associated with traumatic
impact and the centrality of shame memories. Researchers and clinicians should distinguish
between types of shame memory, particularly those where the self might have felt vulnerable
and subordinate and perceived others as threatening and hostile, holding malevolent intentions
towards the self. Keywords: Shame; Shame memory; Autobiographical memory; Paranoia;
Social Anxiety; Path analysis
Shame Autobiographical Memory: An Integrative Model for the Relations Among
Autobiographical and Traumatic Shame Memory Properties, Shame Feelings, and
Psychopathology
Marcela Matos, Jos Pinto-Gouveia.
Cognitive and Behavioral Research Centre, University of Coimbra, Coimbra, Portugal.
Introduction: Recent evidence shows that early shame experiences can function as traumatic
memories, eliciting intrusions, hyperarousal symptoms and avoidance and become central to
self-identity and life story. Shame traumatic and central memories have also been found to
increase current shame feelings and vulnerability to psychopathology. Objectives and
Methodology: The present study extended this research by exploring the phenomenological
properties of shame autobiographical memories and how these relate to their traumatic and

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centrality features and to shame and psychopathological symptoms. Participants (N = 412)


recruited from the general population, retrieved a shame memory from childhood or
adolescence and completed a set of self-report questionnaires measuring autobiographical
memory properties, traumatic and centrality memory features, external shame, internal shame
and depression, anxiety and stress symptoms. Results: Results showed that several
autobiographical memory properties were related to traumatic and centrality qualities of the
shame memory, shame feelings and psychopathology. Across analyses strength of recollection,
reliving and similarity of emotions, importance to self and rehearsal autobiographical memory
properties were the best predictors of measures of traumatic and centrality features of shame
memory, external and internal shame and psychopathology. Path analysis results revealed a
complex mediational chain where reliving of emotions, importance to self and rehearsal
properties of shame autobiographical memory indirectly predicted heightened external and
internal shame and elevated symptoms of depression, anxiety and stress through increased
traumatic and centrality qualities of shame memory. Conclusion: These findings offer insight
towards an integrative model of shame autobiographical memory, its traumatic and centrality
qualities, shame feelings and psychopathological symptoms, with implications to current
conceptualizations of shame, traumatic and autobiographical memory, and to clinical work.
Limitations and directions for future research are discussed. Keywords: Traumatic memory;
Autobiographical memory; Shame; Psychopathology; Path analysis
Concurrent Treatment for Posttraumatic Stress and Alcohol Dependence Disorder
Carmen McLean1, Edna Foa1, David Yusko1, Carmen McLean1, Yi-Jen Su1, 2, Elna Yadin1, Patti
Resick3.
1. University of Pennsylvania, Philadephia, PA, USA, 2. National Taiwan University, Taipei,
Taiwan, 3. National Center for PTSD at the Veterans Affairs (VA) Boston Healthcare System,
Boston, MA, USA.
Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) are frequently comorbid.
Individuals with comorbid AD and PTSD present more severe clinical impairment and poorer
treatment prognosis relative to individuals with AD or PTSD alone. While research has identified
effective treatments for each disorder separately, these comorbid patients are often left in a
revolving door of recidivism due to the lack of an effective combined treatment. Dr. David Yusko
will begin this symposium by describing the elements of a combined treatment program that was
developed and tested in a randomized controlled trial with 114 patients diagnosed with
comorbid PTSD/AD. The combined intervention included an evidence-based treatment for
PTSD (prolonged exposure therapy; PE) and an evidence based treatment for AD (naltrexone),
and a counseling program developed specifically for AD (BRENDA). The presentation will briefly
provide an overview of the study design, describing the core elements of PE and BRENDA, and
discuss initial results. Next, Dr. Carmen McLean will present the results of a study that
examined the mechanisms of PE and NAL that underlie symptom reduction among individuals
with PTSD/AD. This study tested the hypotheses that 1) changes in negative trauma-related
cognitions will mediate changes in PTSD severity; and 2) changes in alcohol craving will
mediate changes in drinking frequency; and 3) changes in PTSD symptoms will mediate
changes in alcohol use and craving. Dr. Yi-Jen Su will present data examining differences in
demographic and clinical presentation, and response to intervention by temporal order of onset
of AD or PTSD. Finally, Dr. Elna Yadin will present two case examples that illustrate the use of
the combined treatment protocol. One case is a Vietnam War veteran with a 30 year history of
chronic PTSD and AD, the other is a veteran of Operation Iraqi Freedom with an 8 year history
of chronic PTSD and AD.

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Posttraumatic Stress Disorder and Alcohol Dependence Combined Treatment: Study


Overview and Preliminary Outcomes
The prevalence of comorbid posttraumatic stress disorder (PTSD) and alcohol dependence
(AD) is relatively high in general psychiatric clinics, and particularly in clinics specializing in
either disorder. Therefore, many clinicians are in search of efficacious treatments that address
both disorders. While research has identified effective treatments for each disorder separately,
these comorbid patients are often left in a revolving door of recidivism due to the lack of an
effective combined treatment. In this presentation a combined treatment program for patients
with comorbid PTSD/AD will be discussed. The program delivers prolonged exposure therapy
(PE) for PTSD and a counseling program developed specifically for AD (BRENDA). The
presentation will briefly provide an overview of the study design, describing the core elements of
PE and BRENDA, and discuss initial results.
Effects of Order of Onset for Comorbid Posttraumatic Stress Disorder and Alcohol
Dependence.
Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) frequently co-occur, but
there may be important differences depending upon which disorder develops first. Examining
the temporal order of onset of AD and PTSD may provide clues about the etiology of these
conditions and improve our understanding of how best to treat this comorbid population. The
current study examined differences in demographic presentation, clinical presentation, and
response to intervention by order of onset. The sample consisted of 165 individuals with dually
diagnosed PTSD and AD that received integrated treatment for comorbid PTSD and AD. Of
these participants, 64 met criteria for primary AD (AD occurred before onset of PTSD) and 73
met criteria for primary PTSD (PTSD occurred before onset of AD). The findings revealed that
no significant gender difference was observed between primary AD and primary PTSD groups.
Individuals with primary AD were more likely to report less income, have current antisocial
personality disorder, consume more drinks per drinking day than individuals with primary PTSD.
With regard to PTSD-related trauma, primary AD group reported more physical assault and
other trauma, but primary PTSD group reported more sexual assault and combat-related
trauma. No significant group differences were noted in total PTSD, re-experiencing, avoidance,
and depressive symptoms except hyperarousal symptoms. Despite this, primary AD group were
more likely to make more internal attribution for trauma, assign more self-blame, and blame for
one's behavior more than primary PTSD group. Considering response to treatment, no
significant group differences were observed in main outcome variables, including PTSD
symptoms, percent days drinking, and alcohol craving. The current investigation also attempted
to replicate Back et al's (2005) findings by incorporating gender effect into analysis. Only part of
their findings were replicated and most were pertinent to treatment response. Our unique finding
was that males with primary AD consumed more drinks per drinking day than males with
primary PTSD. Overall, the current findings suggest that order of onset of AD vs. PTSD may
warrant to be considered in elucidating clinical profile and developing treatment plan for
comorbid PTSD and AD.
Mechanisms of Symptom Reduction in a Combined Treatment for Comorbid
Posttraumatic Stress Disorder and Alcohol Dependence
Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) are frequently comorbid
(Brown, Recupero, & Stout, 1995) and there is evidence that PTSD patients abuse alcohol, in
part, to self-medicate (e.g., Leeies et al, 2010; Nishith, Resick, & Mueser, 2001). Because
alcohols anxiolytic effects decrease with tolerance to alcohol (Lipscomb et al., 1980), a vicious
cycle can develop in which PTSD symptoms elicit drinking and drinking perpetuates PTSD
symptoms (Stewart, 1996; Chilcoat & Brislau, 1998). Thus, an intervention that combines an
evidence-based treatment for PTSD (prolonged exposure; PE) with an evidence-based

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treatment for AD (naltrexone; NAL) may be the best approach to interrupt this vicious cycle. The
current study examined the mechanisms of PE and NAL that underlie symptom reduction
among individuals with comorbid PTSD and AD. Data from a RCT trial was used to test the
hypotheses that 1) changes in cognitions will mediate changes in PTSD severity for those
receiving PE, but not for those receiving supporting counseling (SC) only; and 2) changes in
craving will mediate changes in drinking frequency for those receiving NAL, but not for those
receiving placebo pill (PBO) and 3) changes in PTSD symptoms will mediate changes in alcohol
use and craving. Participants were 114 individuals meeting the DSM-IV diagnosis of PTSD and
AD randomly assigned to either PE or no-PE and to either NAL or PBO. All participants received
SC. The results indicated that, as hypothesized, the effect of PE on reductions in PTSD
symptoms was fully mediated by reductions in negative cognitions. The hypothesis that changes
in craving will mediate the effect of NAL on drinking was not well supported. There was an effect
of craving on drinking and NAL was superior to PBO in reducing craving, but no significant
effect of NAL on drinking. Finally, we found that change in PTSD symptoms was significantly
related to change in craving and there was a trend for PE to be more effective than no-PE in
reducing alcohol craving. Mediation analyses showed significant indirect effects indicating that
the effect of PE on craving was fully mediated by change in PTSD symptoms. The results
suggest that the effect of the combined treatment was due to the influence of PE on craving,
(via reductions in PTSD symptoms) and that decreased craving leads to decreased drinking.
This study represents an important step in understanding the mechanism of PE and the central
role of PTSD symptoms in the maintenance of alcohol craving in patients with comorbid AD and
PTSD.
Then and Now: Two case examples of treatment in veterans of the Vietnam War and of
Operation Iraqi Freedom presenting with a dual diagnosis of PTSD and alcohol
dependence.
The high prevalence of comorbid post-traumatic stress disorder (PTSD) and alcohol
dependence (AD) has often presented a dilemma to mental health providers about the best
sequence of treatment and a difficulty offering effective treatments that would positively impact
both diagnoses. Two case examples will be presented to demonstrate the use of a combined
treatment protocol utilized in a study addressing the above dual diagnosis. One is a Vietnam
War veteran with a 30 year history of chronic PTSD and alcohol dependence who had tried a
variety of treatments over the years, with only partial success. The other is a veteran of
Operation Iraqi Freedom with an 8 year history of chronic PTSD and alcohol dependence who
had never before sought treatment. Their individual backgrounds and deployment experiences
will be described; the target traumatic events used in their Prolonged Exposure treatment will be
identified as well as some items from their in vivo exposure hierarchies. And, treatment
summaries and outcomes will be highlighted. Short video clips will be shown to illustrate.
Efficacy of Cognitive-Behavioral Therapy and its Individual Components for
Posttraumatic Stress Disorder: a Systematic Review
Patrcia Mello, Gustavo Silva, Julia Donat, Christian Kristensen.
Pontifcia Universidade Catlica do Rio Grande do Sul, Porto Alegre, Brazil.
Background: Posttraumatic Stress Disorder (PTSD) is a response to a traumatic event defined
by intense suffering and symptoms of avoidance, numbing, re-experiencing and increased
arousal. Even though Cognitive-Behavioral Therapy (CBT) is the treatment of choice for PTSD,
it is still unclear which components of its protocol are more important for clinical improvement or
if they can be utilized individually with equally efficacious results. Cognitive (CT) and exposure
(ET) therapies were already compared with CBT in a systematic review released in 2008 that
contained articles published up to 2005. Aims: This review seeks to unite the main findings on

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the efficacy of CBT, CT and ET for PTSD in the past six years, when compared with other wellestablished treatments or conditions without active treatment. Method: The search was
performed in the databases Cochrane, Embase and Medline. Studies were required to be
randomized controlled trials published between 2006 and 2012 comparing CBT, CT or ET with
(1) each other, (2) other active treatments or (3) assessment-only conditions. Trials rated
through the Jadad scale as having poor methodological quality were excluded. The main
outcome measures were diagnostic and symptomatic remission and dropout rates. Results: The
final sample contained 29 articles out of 2350 found on the initial search. CBT and its individual
components were shown to be efficacious treatments individually when compared to
assessment-only conditions. Comparison with other active treatments favored PE, with 7 of 10
studies finding significant improvement in favor of the experimental groups. Only 3 studies out of
6 showed considerable difference in treatment outcomes favoring CBT and none of the 2
studies found favored CT over other active protocols. It should be highlighted that EMDR
generated better results than CBT in both studies that compared them. Results of trials (n=2)
that compared CBT, CT or ET with each other did not favor any of the treatments, even though
they all significantly reduced PTSD symptoms. Conclusions: CBT and its components are
individually efficacious in reducing PTSD symptoms and diagnosis. Outcome measures did not
differ when treatments were compared with each other, what indicates that either treatment is
indicated for treating PTSD. Those results also suggest that ET could be an efficient alternative
to CBTs full protocol, since it is potentially less demanding in terms of time and resources. That
in turn might explain why we found more trials conducted with ET in comparison with CBT and
CT, representing a current refinement of treatment protocols for PTSD. Caution is
recommended regarding that hypothesis however, since some researches show higher dropout
rates in ET groups. Also cognitive restructuring components were already revealed as very
important for maintaining clinical improvement. More studies comparing treatments with each
other are required to clarify which should be the choice for treating PTSD, especially
considering the emerging results of EMDR for PTSD patients.
Prolonged Exposure Therapy for Japanese Patients with PTSD
Naoyasu Motomura, Yasuo Kawabata.
psychiatry, Osaka medical college, takatsuki, Osaka, Japan.
We conducted PE therapy for Japanese PTSD patients and examined the effect. Subjects were
13 patients with PTSD, which was diagnosed by DSM-IV-TR. Subjects were between 18 years
old and 66 years old (4 male, 9 female). We assessed PTSD symptoms and depression by IESR and BDI-II before and after PE therapy. Out of 13 patients 3 female subjects have dropped
out. Ten patients accomplished 10 week program of PE. Two patients conducted PE therapy
without SSRI and 8 patients conducted PE with SSRI. All these 10 patients improved PTSD
symptoms after PE and 6 patients could not diagnose PTSD after treatment. The scores of IESR and BDI-II were reduced after the PE trial. These results suggest that PE therapy is effective
both PTSD symptoms and depressive state and PE therapy is also effective for Japanese PTSD
patients. As the number of subjects is limited in the present study, further examinations are
critical in the near future.
Perda Ambgua em Cuidadoras de Crianas com Autismo: Ela Existe?
Cristiane Oliveira1, 2, Ana Lcia Aiello2, Marcus Vinicius Brito3, Ana Cristina Polycarpo4.
1. Universidade Paulista, So jos do Rio Preto, Brazil, 2. Universidade Federal de So Carlos UFSCar, So Carlos, Brazil, 3. Fundao Padre Albino, Catanduva, Brazil, 4. Universidade
Estadual de Londrina-UEL, Londrona, Brazil.

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Abstract Central: A perda ambgua a incerteza ou falta de informao sobre o paradeiro ou


condio de um ente querido. A ambiguidade congela o processo de luto e impede cognies,
bloqueando processos de enfrentamento e tomada de decises. Segundo esta teoria, ela pode
ser observada tanto na perda em que h falta de informaes sobre um ente querido, como na
percepo conflituosa da famlia sobre que membros so considerados como presentes ou
ausentes no crculo ntimo. Poucos estudos avaliam perda ambgua em famlias com autistas.
Os objetivos deste estudo foram: 1. Identificar e descrever as possveis expresses de
sentimentos decorrentes da perda ambgua em cuidadoras de crianas com autismo; 2.
Verificar quais estratgias de coping so mais comuns nestas cuidadoras; 3. Confrontar as
possveis expresses de identidade ambgua s medidas de estresse e depresso nas
cuidadoras, bem como ao grau de severidade do autismo. Participaram do estudo quatro
cuidadoras de crianas com autismo com a faixa etria entre seis e oito anos de idade. As
cuidadoras foram entrevistadas sobre vrios tpicos relacionados perda ambgua e
responderam a instrumentos sobre estresse, depresso, enfrentamento e severidade do
autismo da criana. Foi realizada a anlise de contedo de entrevistas e as pontuaes dos
instrumentos das quatro participantes. A seguir, foram confrontados os relatos de Identidade
ambgua com as pontuaes de estresse, depresso e nvel de autismo. Foram observadas
trs crianas que se encontravam no nvel de leve a moderadamente autista e uma no nvel
severo. Todas as cuidadoras apresentaram nveis de estresse e depresso, com o predomnio
das estratgias de coping de Suporte social, Resoluo de problemas e Reavaliao Positiva.
Aps a anlise da entrevista semi estruturada de ambiguidade, verificou-se a existncia de
sentimentos relacionados perda ambgua em todas as cuidadoras, com relatos nas seis
categorias e predomnio da categoria Falta de clareza sobre o diagnstico da criana. Os
resultados demonstraram a existncia da relao entre o aumento da freqncia de Identidade
ambgua com os resultados de estresse e a severidade do autismo. Espera-se que a presente
pesquisa, ao identificar a vivncia de perda ambgua em famlias de criana autista, possa
auxiliar os profissionais a oferecerem uma assistncia e apoio mais completo e abrangente a
tais famlias.
Efecto de la reexperimentacin emocional de vivencias traumticas
Wenceslao Peate Castro1, Juan Manuel Bethancourt Prez1, Tasmania Pino - Sedeo1, Silvia
Prez Rodrguez2, Maria Idaly Barreto3, Sonia Zambrano Hernndez3, 1.
1. Universidad de La Laguna, Tenerife, Spain, 2. Fundacin Canaria de Juventud, Tenerife,
Spain, 3. Facultad de Psicologia, Universidad Catlica de Colombia, Bogota, Colombia.
La recuperacin de la antigua catarsis como un recurso teraputico ha tenido un gran
desarrollo a partir de los trabajos de J. Pennebaker. As, hoy tras un periodo de investigacin
experimental y clinica sobre el uso de la escritura como estrategia para llevar a cabo la
reexperimentacin emocional (RE) se puede sostener que es beneficiosa para la salud fsica y
mental. En sntesis, se ha tratado de evocar mediante la escritura la vivencia de traumas,
situaciones estresantes o altamente molestas en el pasado. Su eficacia en diferentes trastornos
y problemas de salud ha permitido desarrollar un protocolo de (RE) que puede ser de utilidad
como una tcnica en la prctica clnica. Los objetivos del simposium sern (1) presentar el
desarrollo de la RE como recurso teraputico; (2) exponer el papel de determinadas variables
contextuales y personales en la eficacia de la RE; (3) la eficacia en funcin de los contenidos
de los escritos; (4) presentar el papel de la RE en adolescentes y adultos que han vivido
situaciones traumticas; (5) proponer el protocolo concreto de actuacin de la RE: escritura de
traumas, tiempo y valoracin de la eficacia. Con ello se pretende recorrer, por un lado, el uso
del RE experimentalmente y cotidianamente y, por otro, hacer un recorrido por distintas

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cohortes de edad. El resultado final es que existen condiciones que hacen til el uso de la RE,
pero su aplicacin debe manejarse bajo determinados parmetros y condiciones sociales y
personales.
Factors Associated with Emotional State in Former Caregivers of People with Dementia
Ana Teresa Piccini, Maria Crespo, Mnica Bernaldo de Quirs, Violeta Fernndez-Lansac.
Complutense University of Madrid, Madrid, Spain.
Introduction: The negatives effects experienced by caregivers of relatives with dementia during
the caregiving period have received considerable attention over the last twenty years. However,
little has been written about how caregivers response to death of the loved one. The current
study have two aims: 1) to examine the emotional state among relatives of people with
dementia after the death of the care recipient; and 2) to analyze the relation with some
characteristics (e.g. caregiving characteristics, patient's death circumstances) that may
influence the emotional outcomes in former caregivers. Method: We have carried out a crosssectional study on 50 informal former caregivers of family member with dementia after the
patient's death. Assessment consisted of a semi-structured interview and standardized
questionnaires. The emotional state was assessed by the Beck depression inventory (BDI-II),
the Anxiety subscale from the hospital anxiety and depression scale (HAD-A), and the Texas
Revised Inventory of Grief (TRIG); their data were correlated with the following variables:
caregiver's characteristics, caregiving context, circumstances surrounding death, appraisal and
resources. Results: Former's caregivers did not present clinically significant levels of anxiety,
depression or grief symptomatology after bereavement. Intense past grief response immediate
after the relative death, the use of emotional focused coping strategies, high levels of burden
during the caregiving period, or the impossibility of saying goodbye to the loved one were
significantly correlated with poorer emotional state in the participants. Conclusions: Intervention
and support targeting to reduce the caregiver's burden may be beneficial to improve the
caregiver's emotional well-being not only during the active caregiving; it may have the potential
to influence their emotional status after the death of their family member. It is very important an
early identification of those caregivers at risk for developing complicated grief after the death of
the loved one, and propose intervention strategies that directly target the early grief response.
Use of Lifeline with Families in Violence Situation
Mariana Poletto1, 2, Christian Kristensen1, 2, Rodrigo Grassi-Oliveira1, 2, Mariana Boeckel1, 2.
1. Pontifcia Universidade Catlica do Rio Grande do Sul, Porto Alegre, Brazil, 2. Ncleo de
Estudos e Pesquisa em Trauma e Estresse, Porto Alegre, Brazil.
A violncia intrafamiliar precoce, crnica e recorrente pode levar ao desenvolvimento de
transtornos mentais, incluindo o Transtorno de Estresse Ps Traumtico (TEPT) e o Trauma
Complexo. Os efeitos da exposio violncia intrafamiliar comumente no so limitados
infncia e adolescncia, podendo impactar o funcionamento psicolgico, social e ocupacional
na vida adulta. As intervenes com maior eficcia para esses casos envolvem psicoterapia
individual (psicoterapia cognitivo comportamental) e psicoterapia familiar (sistmica e cognitivocomportamental). Na abordagem sistmica, a tcnica da linha de vida pode se caracterizar
como uma estratgia til na avaliao do curso temporal da exposio a eventos estressores,
bem como das respostas adaptativas e desadaptativas dos diferentes membros do sistema
familiar. Frente a isso, levanta-se a hiptese sobre a possvel utilizao desta tcnica como
uma estratgia teraputica, para alm do processo de avaliao. O objetivo deste trabalho
apresentar um processo de psicoterapia familiar breve com o uso da tcnica da linha de vida

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em uma famlia exposta a mltiplas situaes de violncia intrafamiliar. A famlia descrita no


presente pster constituda pela me, uma filha biolgica e duas adotivas, e buscou o Ncleo
de Estudos e Pesquisa em Trauma e Estresse (NEPTE) para atendimento psicoterpico da
filha mais nova devido a sintomas de TEPT decorrentes de violncia por parte dos irmos mais
velhos e do pai, alcoolista e falecido h dez anos. A famlia encontra-se sob proteo judicial
devido perseguio por parte dos filhos. A me e as trs filhas apresentam diagnstico de
Transtorno de Humor Bipolar, todas em tratamento farmacolgico, entre outros sintomas
associados s mltiplas exposies a eventos estressores. O uso da tcnica da linha de vida
possibilitou o relato de situaes traumticas sofridas por perpetradores intrafamiliares,
identificao de sentimentos e pensamentos disfuncionais relacionados a comportamentos
evitativos, experincias de revivncia, excitabilidade aumentada e vis atencional orientado a
situaes de violncia. Ainda, a filha biolgica apresenta pensamentos disfuncionais de autoresponsabilizao em relao aos abusos sexuais sofridos pelas irms adotivas. Foram
identificados padres agressivos transgeracionais originrios das famlias de origem, como
abusos fsico, psicolgico e sexual, e negligncia. Alm disso, foram realizadas outras
intervenes, como reparentalizao, fortalecimento de vnculos intrafamiliares, tcnicas de
soluo de problemas, questionamento socrtico e checagem de evidncias sobre a eficcia do
padro de comportamentos e estratgias de relacionamento at ento utilizadas pela famlia.
Observaram-se melhoras na comunicao familiar, ampliao no repertrio de habilidades na
resoluo de problemas, maior definio dos papis familiares e maiores nveis de regulao
emocional. Observa-se a relevncia das intervenes em psicoterapia familiar breve com
famlias em situao de violncia. Trabalhar com todo o sistema familiar, alm de auxiliar na
reestruturao das distores acerca das histrias de violncia, potencializa recursos
individuais e relacionais.
QUEM SO OS FILHOS DE MULHERES ENCARCERADAS? ALGUMAS
CARACTERSTICAS
Gabriela Reyes.
psicologia, UFSCAR, Brazil, Brazil.
A maioria dos adultos homens e mulheres encarcerados pai ou me, embora no exista uma
estimativa especifica mundial sobre de quantas crianas encontram-se separadas de seus pais
e/ou cuidadores por causa do encarceramento. Na literatura brasileira no h dados indicando
quantas crianas encontram-se nessa condio. Na literatura norte-americana estima-se que
mais de dois milhes de crianas sejam filhos de pais encarcerados, sendo que desse nmero,
200.000 so filhos de mes encarceradas. Dentre as principais caractersticas apresentadas
pelas crianas de pais encarcerados, pode-se destacar: o estigma social, a preocupao
gerada pelo questionamento de como ser viver sem o pai ou a me, lembranas do episdio
traumtico da priso do pai ou da me, ansiedade, culpa, baixa auto-estima, solido,
sentimento de abandono emocional por parte dos familiares e amigos, distrbio de alimentao
e sono, distrbios de ateno e comportamento regressivo, agressividade, comportamento antisocial, envolvimento precoce com o crime, entre outros. O presente trabalho teve como objetivo
caracterizar filhos de mulheres encarceradas. Para isto, foi realizada uma entrevista
estruturada com 69 mulheres encarceradas, em 4 cadeias pblicas, no interior do Estado de
So Paulo. Como resultado preliminar constatou-se um total de 184 filhos menores de 12 anos,
sendo a mdia de 2,6 filhos que tais mulheres tinham. Salienta-se, ainda, que 97 das crianas
eram do sexo masculino e 85 do sexo feminino, sendo que para duas crianas no foi descrito
o sexo; 64.13% das crianas residiam com mes na poca do encarceramento e em 27.72%
dos casos as crianas presenciaram a priso da me. No que diz respeito ao sentimento
apresentado pela criana em relao ao encarceramento materno em 56% dos casos as

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crianas ficaram tristes, abatidas, chateadas e/ou depressivos, 14% das crianas chorou muito,
8,15% sentiram raiva e 10.33% apresentaram outros sentimentos. Das crianas que tinham
conhecimento da priso da me, em 54% dos casos os filhos tiveram alguma forma de contato
com suas mes aps a priso. Observou-se, ainda, que em 79.2% dos casos as crianas
precisaram mudar de casa, aps o encarceramento, e desses, os que se encontravam em
idade escolar 7.93% tiveram que mudar de escola. Os dados apontam para possveis efeitos
traumticos do encarceramento materno a seus filhos. Esses resultados servem como
subsdios de implementao de programas preventivos de interveno sistemtica, visando
trabalhar com os possveis problemas futuros de comportamento e diminuir as possveis
consequncias nocivas ao encarceramento materno para o desenvolvimento saudvel dos
filhos e, assim, possibilitar que tais crianas no se tornem a prxima gerao carcerria.
Intervencin Cognitivo-Conductual para Abuso Sexual en una Adolescente
Karen Reyna Rosas, Juan Jimnez, Luz Fores Herrera, Ana Ortiz Olvera.
psicologa, Facultad de Estudios Superiores Zaragoza, Mxico DF, Mexico.
Karen Ilce Reyna Rosas, Ana Laura Ortiz Olvera, Juan Jimnez Flores y Luz Mara Flores
Herrera Facultad de Estudios Superiores Zaragoza, UNAM El abuso sexual es un problema
que causa severos daos y secuelas a las personas que lo han sufrido, es un fenmeno que se
ha notado con gran relevancia. Una gran cantidad de poblacin clnica requiere de atencin
para solucionar el dao provocado por el abuso. Sin embargo, no es fcil que las vctimas lo
externalicen, por cual, no se sabe con certeza la magnitud del problemas. La OMS calcula que
anualmente alrededor de 73 millones de nios y 150 millones de nias menores de 18 aos
sufren algn tipo de violencia sexual en el mundo y que ms de un 20% de las personas
adultas ha experimentado algn tipo de abuso. Se ha observado que frecuentemente el agresor
ha sido un familiar y que el abuso ocurre en forma repetitiva. El abuso sexual se ha definido
como la actividad encaminada a proporcionar placer sexual, estimulacin o gratificacin sexual
a un adulto que utiliza para ello a un nio/a, aprovechando su situacin de superioridad (Deza,
2005). Finkelhor (1984) seala que la gravedad del abuso sexual y del impacto en la victima
depende de la cercana del vnculo entre el nio y el perpetrador, el tipo de abuso (manoseos,
sexo oral, penetracin), la duracin del mismo, el grado de coercin fsica empleada, la
ausencia de cualquier figura alternativa protectora. Los tratamientos referidos para el abuso
sexual en nios y adolescentes son programas de terapia cognitivo-conductual, solos o en
combinacin con intervencin familiar. El objetivo de este trabajo fue disear y evaluar un
programa de intervencin con tcnicas cognitivo-conductuales para modificar pensamientos y
comportamientos derivados del abuso. Para la evaluacin se utiliz una entrevista estructurada,
el Inventario de Depresin Beck II y el Inventario Multifsico de la Personalidad para
Adolescentes. Con esta base se estableci un programa de intervencin para un caso de
abuso sexual, el cual se describe a continuacin. Mtodo Motivo de consulta Se present una
adolescente de 18 aos, remitida por sus profesores a causa de conflictos emocionales
provocados por abuso sexual por parte de su pap durante su niez. Antecedentes Sus padres
viven separados. La madre siempre trabajo y asegur nunca haberse dado cuenta del abuso
que el padre cometa con su hija. La joven senta que era necesario hablar abiertamente de lo
que haba sucedido cuando era nia, sin embargo, tena miedo a lo que pudiera pasar y la
reaccin de su familia y amigos. Instrumentos de evaluacin Entrevista clnica Inventario de
Depresin Beck - II Inventario Multifsico de la Personalidad de Minnesota para Adolescentes
Intervencin Se realiz en 15 sesiones de 1 hora cada una. En las primeras 3 sesiones se
estableci el diagnstico, las sesiones 4 a 11 fueron de entrenamiento con Terapia Racional
Emotiva (para modificar pensamientos de haber quedado marcada), en las siguientes 3
sesiones se aplic la Terapia Cognitiva de la Depresin (tcnica de retribucin para modificar

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pensamientos de culpa). Resultados El tratamiento concluy satisfactoriamente logrando que


enfrentara por si sola a su pap, logr tener una relacin amorosa y tiene un mejor control de
sus emociones y pensamientos negativos.
Virtual Reality Exposure for Posttraumatic Stress Disorder: A Systematic Review
Marcelo Rigoli, Christian Kristensen.
Pontifcia Universidade Catlica do Rio Grande do Sul, Porto Alegre, Brazil.
Abstract Central: Introduction: Posttraumatic Stress Disorder (PTSD) is defined on DSM-IV-TR
as a symptomatic answer to a traumatic event involving recollections, avoidance, numbing and
increased arousal. Cognitive-behavioral therapy (CBT), is a well established treatment for
PTSD. Also the use of exposure alone or as part of a CBT protocol has been shown to be highly
effective. The Virtual Reality Exposure Cognitive-Behavioral Therapy for PTSD is based on the
principles of PE. Despite its novelty, the use of VR as a tool for exposure therapy has shown
promising results with anxiety disorders (. Method: In order to search the electronic databases
the following keywords were used: PTSD, Post-Traumatic Stress Disorder, Posttraumatic Stress
Disorder, Virtual Reality. The databases used for the search were: PsycINFO/PsycLIT,
PubMed/Medline, Ebsco, ProQuest, ISI Web of Science and SciELO/Pepsic. The included
studies should contemplate the following criteria: (a) to have own empirical data; (b) published
from 1999 to 2011; (c) written in English, Spanish or Portuguese languages; (d) sample of
adults with diagnostic criteria for PTSD (e) the intervention should consist of exposure with
virtual reality. Results: A total of 241 publications were found. Afterwards, the retrieved fulltext
publications were assessed by two independent judges and 28 publications were selected for
this review after a consensus meeting. The majority is composed of case studies (n = 11), also
uncontrolled case series (n = 8) and randomized controlled trials (n = 9) were included. The
treatment showed wide range in the number of sessions with VR exposure, ranged between 3
and 22 sessions (M = 9.09, SD = 1.57), and in the techniques used alongside VR exposure,
such as: relaxation training, psychoeducation, meditation, imagistic exposure, attentional
refocusing and cognitive restructuring. Among the case studies the results were promising; all
studies were able to reduce the PTSD symptomatology. As to the uncontrolled case series,
overall they showed promising results. In two studies with combat related PTSD the participants
no longer meet criteria at the end of treatment, whilst the rest presented a significant reduction
in symptomatology. Regarding the randomized clinical trials was found a wide variation
concerning the VRE intervention as well as combined and control intervention. As to the control
group waitlist was the most employed, followed by treatment as usual. The majority of the
studies presented significant results, except two which found modest or nonsignificant results.
Discussion: The findings of this study suggest that the use of virtual reality as a tool for
exposure therapy for PTSD can be an asset. Although, more randomized clinical studies with
different samples and that contemplate control groups with other interventions like imaginal
exposure and in vivo exposure are required.
Factores de Riesgo de Sintomatologa Postraumtica en Vctimas del Terremoto y
Tsunami del 27-F en Poblacin Realojada en Campamentos de Tumbes, Talcahuano,
Chile
Paulina Rincn1, Sonia Panadero2, Jos Juan Vzquez3, Flix Cova1, Claudia Prez1, Pamela
Grandn1, Sandra Saldivia1.
1. Psicologa, Universidad de Concepcin, Concepcin, Chile, 2. Universidad Complutense de
Madrid, Madrid, Spain, 3. Universidad de Alcal, Alcal de Henares, Spain.

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Abstract Central: Un terremoto de 8,8 grados en escala Richter sacudi a Chile el 27 de


febrero de 2010 y un fuerte tsunami impact la pennsula de Tumbes, Talcahuano. Gran parte
de la poblacin de la caleta Tumbes y la totalidad de la poblacin de tres caletas aledaas fue
reubicada en campamentos. Diez meses despus se desarroll una investigacin para conocer
el impacto psicosocial del evento en dicha poblacin. El objetivo de este trabajo es valorar las
diferencias entre personas que desarrollaron mayor sintomatologa postraumtica y aquellas
que no lo hicieron, aislando las variables que permiten predecir -al menos en esta muestra- el
desarrollo de mayor sintomatologa postraumtica. La poblacin objetivo fueron las personas
del sector de Tumbes que debido al desastre perdieron sus hogares y fueron realojadas en
campamentos. Se entrevist a 162 personas, la mayora mujeres (67,9%), con una edad media
de 46,73 aos (dt=17,37). Se us una entrevista que rene distintos instrumentos y apartados
elaborados de manera ad-hoc: a) Datos sociodemogrficos, situacin durante el suceso y
condiciones de vida actuales; b) Sntomas emocionales generales (General Health
Questionnaire, en su versin de 12 tems); c) Abuso y dependencia del alcohol (Alcohol Use
Disorders Identification Test); d) Sintomatologa postraumtica (Escala de Trauma de
Davidson); e) Conductas de violencia masculina hacia la pareja (tems de la Escala de Tcticas
de Resolucin de Conflictos de Gelles y Straus); y f) Apoyo social (Escala Multidimensional de
Percepcin de Apoyo Social). Se compararon diferentes variables entre los participantes con
alta y baja sintomatologa postraumtica, utilizando Chi cuadrado y prueba t de Student. Se
realiz un anlisis discriminante para identificar variables que discriminaran entre quienes
presentaban una elevada sintomatologa postraumtica (sobre percentil 75) y quines no lo
hacan. Se emple el mtodo de inclusin por pasos con el procedimiento Lambda de Wilks. El
inters terico y los resultados de los anlisis univariantes guiaron la seleccin de las variables
independientes. Para el primer anlisis discriminante, se seleccionaron aquellas variables en
las que se haban encontrado diferencias significativas en los anlisis previos: a) Participacin
en el rescate de personas fallecidas o heridas, b) Respuesta emocional experimentada durante
la catstrofe, c) Salud general, d) Apoyo social (tanto de amigos como familiar), e) Sucesos
vitales estresantes experimentados por los participantes, tanto antes de los 18 aos, como a lo
largo de toda su vida. La mejor discriminacin posible entre el grupo que presentaba una
elevada sintomatologa postraumtica y aquellos que no lo hacan, clasificando correctamente
al 82,55% de los casos originales, se dio con: a) Respuesta emocional de miedo intenso, b)
Puntuacin GHQ mayor a 6, c) Problemas de alojamiento en la infancia, d) Separacin o
divorcio del cnyuge, y e) Haber padecido problemas econmicos importantes. Se discute la
relevancia que acontecimientos previos padecidos por las personas pueden tener en el
desarrollo de una mayor sintomatologa postraumtica tras una catstrofe de este tipo, y de
llevar a cabo intervenciones preventivas tempranas en personas que pertenecen a grupos de
mayor riesgo.
Induo e Interveno em Memrias Intrusivas Usando Paradigma Filme-Trauma: Uma
Reviso
Luciana Santos, Raquel Gonalves, Fernando Oliveira, Marcus Pinho, Priscila Fernandes, Ivan
Figueira, Paula Ventura.
Psiquiatria, Universidade FEderal do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract Central: Memrias intrusivas (intruses) so recordaes involuntrias relativas a
eventos que surgem espontaneamente na conscincia e esto presentes no Transtorno de
Estresse Ps-traumtico (TEPT), diferindo de recordao deliberada ou ruminao verbal de
eventos (pensamento circular improdutivo sobre o trauma e/ou suas consequncias). Para
investigar as memrias intrusivas tem-se adotado o paradigma filme-trauma (PFT), uma
ferramenta experimental para investigao anloga dos mecanismos cognitivos subjacentes

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intruso. O objetivo do presente estudo foi depreender a eficcia do PFT, atravs de reviso
sistemtica, sobre induo e interveno em intruses. Buscaram-se artigos nas bases
eletrnicas PILOTS, ISI, PubMed e PsycINFO, buscando-se os termos sobre PFT e sobre
intruso/ruminao. Sobre PFT: watching an aversive film, aversive film, stressful film, stressful
film paradigm, trauma film, trauma-film e laboratory analogue trauma experiences. No outro:
intrusive memories, intrusive cognitions, intrusive images, rumination. Foram encontrados 44
artigos e selecionados 27, os critrios de excluso foram: duplicao (seis), estudos tericos ou
de caso clnico (um), experimental, com interveno ou uso de substncia qumica durante PFT
(oito) ou com amostra clnica (dois). As anlises formaram duas categorias: avaliao s da
induo (sete) e induo e interveno (20). Na primeira identifica-se que intruses so
induzidas com PFT, em experimento comparando alteraes produzidas por filmes neutro e
traumtico observou-se aumento de intruses, de raiva e de humor negativo. As intruses se
relacionam alterao na ansiedade, dissociao ao estado de horror produzidos pelo filme e
memria de trabalho deficitria. Ressalta-se que a condutncia da pele aumenta durante
PFT. Dos resultados da segunda categoria, cinco envolveram tarefas cognitivas, quatro
visuoespaciais, dois supresso, dois ateno, um reavaliao emocional, dois atividade de
imaginao, um informaes contextuais, um avaliando atividade das plpebras e dois
investigando ruminao. Na interveno cognitiva, os processos atencionais sofrem
interferncia do contedo do filme e o processamento informacional orientado est associado a
intruses, tal como informaes contextuais do PFT e fraco controle cognitivo. Maior nmero de
intruses est associado imaginao de cenas traumticas priorizando processamento visual
e tarefa de supresso. Estratgias de evitao mantem intruses. A reduo d com tarefas
cognitivas conceituais, com verbais aprimoradas e duais que empobrecem a memria de
reconhecimento, com tarefas centradas no atendimento em emergncia hospitalar s vtimas
de traumas ou que no afetam a memria voluntria de reconhecimento, assim como com
treino de reavalio positiva e aprendizagem em Spatial Contextual Cuing Task. Tarefas
visuoespaciais reduzem flashbacks. A tcnica Imagery Rescripting influencia a consolidao de
memria em estgios iniciais. Nveis declarados de ruminao na tarefa guiada predizem
intruses subsequentes, conduzem a menor recuperao do humor triste e levam a recordao
de menos detalhes perifricos do trauma. Conclui-se que a utilizao do PFT em amostras noclnicas eficaz para induo de intruses e para estudar suas intervenes.
Induo e Interveno em Memrias Intrusivas Usando Paradigma Filme-Trauma
Luciana Santos, Raquel Gonalves, Fernando Oliveira, Marcus Pinho, Priscila Fernandes, Ivan
Figueira, Paula Ventura.
Psiquiatria, Universidade FEderal do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract Central: Memrias intrusivas (intruses) so recordaes involuntrias relativas a
eventos que surgemespontaneamente na conscincia e esto presentes no Transtorno de
Estresse Ps-traumtico (TEPT),diferindo de recordao deliberada ou ruminao verbal de
eventos (pensamento circular improdutivosobre o trauma e/ou suas consequncias). Para
investigar as memrias intrusivas tem-se adotado o paradigma filme-trauma (PFT), uma
ferramenta experimental para investigao anloga dos mecanismos cognitivos subjacentes
intruso. O objetivo do presente estudo foi depreender a eficcia do PFT, atravs de reviso
sistemtica, sobre induo e interveno em intruses. Buscaram-se artigos nas bases
eletrnicas PILOTS, ISI, PubMed e PsycINFO, buscando-se os termos sobre PFT e sobre
intruso/ruminao. Sobre PFT: watching an aversive film, aversive film, stressful film, stressful
film paradigm, trauma film, trauma-film e laboratory analogue trauma experiences. No outro:
intrusive memories, intrusive cognitions, intrusive images, rumination. Foram encontrados 44
artigos e selecionados 27, os critrios de excluso foram: duplicao (seis), estudos tericos ou

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de caso clnico (um), experimental, com interveno ou uso de substncia qumica durante PFT
(oito) ou com amostra clnica (dois). As anlises formaram duas categorias: avaliao s da
induo (sete) e induo e interveno (20). Na primeira identifica-se que intruses so
induzidas com PFT, em experimento comparando alteraes produzidas por filmes neutro e
traumtico observou-se aumento de intruses, de raiva e de humor negativo. As intruses se
relacionam alterao na ansiedade, dissociao ao estado de horror produzidos pelo filme e
memria de trabalho deficitria. Ressalta-se que a condutncia da pele aumenta durante
PFT. Dos resultados da segunda categoria, cinco envolveram tarefas cognitivas, quatro
visuoespaciais, dois supresso, dois ateno, um reavaliao emocional, dois atividade de
imaginao, um informaes contextuais, um avaliando atividade das plpebras e dois
investigando ruminao. Na interveno cognitiva, os processos atencionais sofrem
interferncia do contedo do filme e o processamento informacional orientado est associado a
intruses, tal como informaes contextuais do PFT e fraco controle cognitivo. Maior nmero de
intruses est associado imaginao de cenas traumticas priorizando processamento visual
e tarefa de supresso. Estratgias de evitao mantem intruses. A reduo d com tarefas
cognitivas conceituais, com verbais aprimoradas e duais que empobrecem a memria de
reconhecimento, com tarefas centradas no atendimento em emergncia hospitalar s vtimas
de traumas ou que no afetam a memria voluntria de reconhecimento, assim como com
treino de reavalio positiva e aprendizagem em Spatial Contextual Cuing Task. Tarefas
visuoespaciais reduzem flashbacks. A tcnica Imagery Rescripting influencia a consolidao de
memria em estgios iniciais. Nveis declarados de ruminao na tarefa guiada predizem
intruses subsequentes, conduzem a menor recuperao do humor triste e levam a recordao
de menos detalhes perifricos do trauma. Conclui-se que a utilizao do PFT em amostras noclnicas eficaz para induo de intruses e para estudar suas intervenes.
Effects of Cognitive-Behavioral Conjoint Therapy for PTSD on Partners Psychological
Functioning
Philippe Shnaider1, Nicole Pukay-Martin1, Steffany Fredman2, 3, Alexandra Macdonald4, 5,
Candice Monson1.
1. Ryerson University, Toronto, ON, Canada, 2. Massachusetts General Hospital, Boston, MA,
USA, 3. Harvard Medical School, Boston, MA, USA, 4. National Center for PTSD, U.S. VA
Boston Healthcare System, Boston, MA, USA, 5. Boston University Medical School, Boston,
MA, USA.
A growing body of literature has consistently documented associations between posttraumatic
stress disorder (PTSD) and intimate relationship discord, as well as general psychological
distress in romantic partners of individuals living with this condition. Yet, existing studies of
couple therapies for PTSD have failed to consistently consider the effects of these treatments
on partners mental health. Furthermore, the trials that have examined partners outcomes have
reported mixed findings. The current study examined the effects of participating in a couple
therapy for PTSD on partners psychological functioning. Forty couples were randomized to
receive cognitive-behavioural conjoint therapy (CBCT) for PTSD or to a waitlist condition in
which they would receive treatment after 3 months. Partners psychological functioning was
assessed pre-, mid-, and post-treatment and at equivalent time points while on the waitlist.
Partners receiving CBCT did not have significant changes in their psychological functioning
compared with waitlist. However, partners who had poorer levels of psychological functioning at
pre-treatment had clinically significant and reliable improvements in their psychological
functioning by post-treatment. There was no significant worsening of partners psychological
functioning. Results of this study demonstrate that distressed partners of individuals with PTSD
may benefit from receiving couple interventions for PTSD. In addition, this study supports the

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notion that trauma-focused couple treatment for PTSD does not pose risks to partners mental
health and may even improve partner's mental health for partner's who were psychologically
distressed prior to treatment.
Effect of Psychoeducation in Posttraumatic Stress Disorder Patients
Thiago Silva, Patricia Mello, Julia Donat, Christian Kristensen.
PUCRS, Porto Alegre, Brazil.
Posttraumatic Stress Disorder (PTSD) is a psychiatric disorder developed after an event
perceived as a threat to the individuals physical or psychological health. PTSD symptoms
include avoidance to stimulus associated with the traumatic event; reexperience of the trauma
though nightmares and flashbacks; and hyperousal. The treatment of choice for PTSD is the
Cognitive-Behavior Therapy (CBT) and its protocols include techniques of psychoeducation,
exposure and cognitive restructuring. Psychoeducation consist in explain to patient how his
disorder operates, what to expect about the treatment and to increase hope about a future
recover. This study aims to evaluate the effect of 5 psychoeducation sessions in PTSD
symptoms. METHOD: 25 patients with PTSD (44% male; 66% female), adults from 19 to 51
years (m=39,2; sd=10,1), that searched treatment in the university mental health clinic. Among
the participants, 48% had witnessed assaults, 12% experienced vehicle accident, 28%
experienced violent situations and 8% witnessed the death of a loved one and 4% have
experienced other traumatic situations. The instruments used were Structured Clinical Interview
for DSM-IV Disorders (SCID-I), Screen for Posttraumatic Stress Symptoms (SPTSS),
Posttraumatic Cognitions Inventory (PTCI), Beck Depression Inventory (BDI) and Beck Anxiety
Inventory (BAI). The patients were evaluated before the treatment and after the 5 sessions of
psychoeducation by trained CBT therapists. The Wilcoxon Analysis was used to compare the
scores before and after intervention. RESULTS: There were 9 dropouts 36%. It was found
reduction of all the scores, such as BDI (r=-.15), BAI (r=-.21), SPTSS (r=-.37), PTCI (r=.32).
Aditionally, statistic significant data was found on the reduction of reexperience symptoms
(r=.52, p<0,5).CONCLUSIONS: It indicates that a few sessions of psychoeducation in the
beginning of therapy can help patients to reduce part of their afflition. Further studies with larger
samples should emphasize the value of psychoeducation in the treatment of trauma population.
The Relationship Between Coping Strategies and Post-Traumatic Stress Symptoms
Thiago Silva, Janaina Carvalho, Julia Donat, Alice Brunnet, Beatriz Lobo, Rodrigo GrassiOliveira, Christian Kristensen.
PUCRS, Porto Alegre, Brazil.
Coping strategies are the resources used by an individual to adapt to adverse or stressful
circumstances, which are seen as an overload to the organism. These responses are classified
by Lazarus`s cognitivist model into two main categories: problem-focused coping and emotionfocused coping. Studies have shown that emotion-focused coping strategies and evitative
coping styles predict post-traumatic symptoms. These studies agree with the dual
representation model of PTSD, which says that the development of the disorder is associated to
an avoidance of emotional processing of the situation. Although studies have investigated the
relationship between coping and PTSD, little is known about the relationship between coping
styles and PTSD symptom subtypes (reexperience, evitation, excitability). In this way, this
work`s objective was to investigate the existence of an association between type of coping
strategy and subgroups of post-traumatic stress symptoms. The sample was 41 people (10 men
and 31 women), aged between 16 and 76 years (M=37, Sd=15). All participants had witnessed

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at least one traumatic event throughout their lives. Patients were evaluated and followed in a
research laboratory specializing in psychological trauma. Types of coping style were evaluated
by the Escala Modos de Enfrentamento de Problemas - EMEP, styles and behaviors related to
coping strategies were evaluated by the scale Brief Cope, and symptoms of post-traumatic
stress were evaluated by Screen for Posttraumatic Stress Symptoms - SPTSS. Descriptive and
association analyses of variables were made using SPSS version 17.0. Results support the
literature, since strong correlations were found between emotion-focused strategies and PTSD
symptoms (r=0,403, p=<0,05), while a negative correlation was found between problem-focused
strategies and PTSD symptoms (r=-0,451, p<0,05). Regarding specific symptoms, there is a
strong association between emotional strategies and reexperience symptoms (r=0,403, p>0,05)
and a negative correlation between a problem-focused strategy and heightened excitability (r=0,409, p>0,05). About coping styles, PTSD symptoms showed strong negative correlations with
active coping (r=0,449, p>0,05) and fact acceptance (r=0,453, p>0,05). Self-blaming styles were
associated with revival symptoms (r=0,424, p>0,05). Therefore, developing active, problemfocused coping strategies and reducing self-blaming by the patient are important objectives to
be sought by the psychotherapeutical process with patients who went through a traumatic
situation. In the same way, preventative measures focused on these coping strategies must be
developed for target groups who commonly undergo potentially traumatic experiences, such as
firefighters, rescue teams, police, etc.).
Cognitive-Behavioral Psychotherapy for Acute Stress Disorder: A Systematic Review
Aline Sponchiado, Cristiane da Silva, Christian Kristensen.
PUCRS, Porto Alegre, Brazil.
Acute Stress Disorder (ASD) is the short-term reactions that occur after exposure to a traumatic
stressor. The major focus of interventions in ASD is to prevent the development of Post
Traumatic Stress Disorder (PTSD), among other disorders, and treat the symptoms of this acute
phase, bringing back the well-being of the patient. Cognitive Behavioral Therapy (CBT) has
been considered the treatment of choice for the treatment of ASD. However, there is no
consensus on the most effective strategies within this approach. This article aims to identify,
through a systematic review of randomized clinical trials, the strategies that have greater
efficacy in the cognitive behavioral approach. Were consulted the databases Scielo, LILACS,
MedLine / PubMed, Web of Science and PsychInfo in June 2012. Initially, 1103 studies were
identified. The searched terms were "acute stress disorder cognitive therapy AND", "acute
stress disorder AND behavioral therapy" and "acute stress disorder AND exposure therapy".
Studies included were randomized controlled trials published between 1994 and 2012,
conducted with individuals diagnosed with ASD according to DSM-IV treated with
psychotherapy, cognitive-behavioral approach. Only studies published in English, Spanish and
Portuguese were evaluated. After the adoption of the inclusion/exclusion criteria, five studies
were included in the review process. Five studies were analyzed, which were characterized by
quasi-experimental methodology, using active conditions (CBT, CBT / hypnosis, cognitive
restructuring, exposure and counseling) and passive (waiting list) for the treatment of ASD. Our
results indicate that CBT, which is already seen as the intervention method elective for many
mental disorders, also presents empirical evidence that make therapeutic choice for ASD.
Controlled studies analyzed confirm the efficacy of CBT, and in particular the technique of
prolonged exposure. Another important finding is that interventions, when used in the first month
after exposure to a traumatic stressor, are effective for the prevention of PTSD. In analyzed
protocols which include exposure therapy, it is observed that exposure significantly aids in
reducing avoidance through confrontation with anxiety stimuli continuously until the anxiety is
reduced. Hypnosis held together with CBT was significantly effective either. The review has also

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indicated that there are few investigations on the effectiveness of strategies focused on the ASD
and need for studies with better methodological quality and broader samples.
Implementing Exposure-based CBT for the Treatment of Hispanics with PTSD: Cultural
Considerations and Challenges
Mildred Vera1, Rafael Kichic2, 3, Suhadee Henriquez4, Aurora Farias4, David Yusko5.
1. Medical Sciences Campus, University of Puerto Rico, San Juan, USA, 2. Anxiety Clinic,
Institute of Cognitive Neurology, Buenos Aires, Argentina, 3. Department of Psychiatry, Institute
of Neurosciences, Favaloro University, Buenos Aires, Argentina, 4. Harbor-UCLA Medical
Center, Los Angeles, CA, USA, 5. Center for the Treatment and Study of Anxiety, University of
Pennsylvania, Philadelphia, PA, USA.
Prolonged exposure (PE) is a first-line evidence-based treatment (EBT) for posttraumatic stress
disorder (PTSD) that has been shown to be effective in a wide range of trauma populations.
However, most of the empirical studies that support the effectiveness of PE for the treatment of
posttraumatic stress disorder (PTSD) have been conducted on white mainstream Englishspeaking populations. Although high PTSD rates have been reported for Hispanics, the
appropriateness of PE for this population remains unclear. The Institute of Medicine committee
on treatment of PTSD noted that even though it could be expected that psychotherapies present
special challenges in different cultural groups, they were unable to comment because the
evidence is mostly silent on the acceptability, efficacy, or generalizability of treatment in ethnic
and cultural minorities. Lack of training and therapists concerns about the safety of exposure to
traumatic memories are common barriers in the use of PE. Also, therapists concerns about the
use of manualized interventions are a common obstacle for the adoption of PE. To overcome
these obstacles and favor the development of a skillful application of EBTs in general and PE in
particular, experts suggest that a combination of didactic training and ongoing supervision while
administering the treatment. However, one of the greatest challenges for the implementation
and dissemination of an EBT in Spanish-speaking countries is the limited availability of training
and supervising clinicians to administer the treatment with expertise. This roundtable will
describe the implementation of PE therapy for the treatment of Hispanics with PTSD in clinical
and research settings. A PE pilot study conducted in Puerto Rico to examine the feasibility of
providing PE therapy will be described. Also, we will discuss details of the challenges faced by
clinicians with limited experience in PE and the training and supervision process. Lastly, we will
describe the implementation of PE in one of the largest Spanish-speaking clinics in the US.
Time will also be allotted for feedback and questions from the audience.
Life after Death: Predicting and treating PTSD linked to death trauma in high risk groups
Jennifer Wild1, 3, Vanessa Cobham2, Patti Resick9, 5, Steve Hollon4, Anke Ehlers1, 3, Jennifer
Wild1, 3, Francine Bear3, Kirsten Smith3, Erin Thompson6, Katherine Dondaville10, Jennifer
Schuster Wachen9, 5, Jim Mintz10, Stacey Young-McCaughan10, Alan Peterson10, Strong Star
Consortium11, Paul Boelen8, Mariette van Denderen7, Jos de Keijser7, Paul Boelen8, Mariken
Spuij8.
1. University of Oxford, Oxford, United Kingdom, 2. University of Queensland, Brisbane, QLD,
Australia, 3. Institute of Psychiatry, Kings College London, London, United Kingdom, 4.
Vanderbilt University, Nashville, TN, USA, 5. Boston University School of Medicine, Boston, MA,
USA, 6. University College London, London, United Kingdom, 7. University of Groningen,
Groningen, Netherlands, 8. Utrecht University, Utrecht, Netherlands, 9. National Center for
PTSD, VA Boston Healthcare System, Boston, MA, USA, 10. University of Texas Health

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Science Center at San Antonio, San Antonio, TX, USA, 11. STRONG STAR Consortium, Texas,
TX, USA.
Death trauma is perhaps the most difficult trauma to overcome and often leads to post-traumatic
stress disorder (PTSD). Following traumatic loss, PTSD can be as high as 39%. National
guidelines in the UK recommend an extension of the suggested 8 to 12 sessions of traumafocused psychological therapy for PTSD when an individual presents with traumatic
bereavement.
This international symposium with speakers from Australia, England, the Netherlands, and the
United States brings an evidence-based approach to investigating the effect of death trauma on
the development and treatment of PTSD and depression in high risk groups. Speakers apply
leading cognitive behavioral models of the maintenance of PTSD to its prediction or treatment in
emergency service workers, children who have survived major natural disasters, adults
bereaved by homicide, and the military. The symposium focuses on two areas for intervention:
PTSD and depression following death trauma.
The first two speakers focus on PTSD linked to death trauma in the military and in emergency
service workers. Professor Patti Resick presents data on those in active military and looks at
whether handling dead bodies influences the development of PTSD and depression and
response to cognitive processing therapy, a leading therapy for the treatment of the disorder.
Dr Jennifer Wild, based at the University of Oxford, presents data from her large-scale
prospective study of PTSD in newly recruited ambulance personnel. The study investigates
established predictors of PTSD as well as key cognitive and behavioral factors that as yet have
only been investigated in relation to the maintenance of PTSD. Dr Wild presents data on
resilience and recovery from ongoing exposure to death trauma in this sample.
Dr Vanessa Cobham from the University of Queensland presents her leading study, conducted
in collaboration with the Australian government following the devastating floods in Queensland
in which over thirty people were killed, leaving some children bereaved. Dr Cobham presents
her trial data which pilots a CBT protocol with grief and loss content for youth experiencing
PTSD. Six and twelve month data will be presented.
Dr Van Denderen based at the University of Groningen in The Netherlands will present her
teams ongoing research programme, which is investigating PTSD amongst the homicidally
bereaved. Dr Van Denderen will present the teams 8 session trauma-focused treatment
programme and data supporting its effectiveness.
Professor Paul Boelen, a leading expert in the research and treatment of complicated grief, will
present findings linked to complicated grief in children, and his teams evidence-based CBT
programme for helping children to overcome the emotional and behavioural distress linked to
the loss of a loved one.
Integrating these findings into existing conceptualizations about the etiology and maintenance of
PTSD provides important refinements to clinical models and concrete indications for
modifications in CBT for PTSD linked to death trauma. Professor Steve Hollon will discuss these
new findings and their application in the CBT treatment of PTSD after death trauma in high risk
groups.
The role of death in PTSD and depression reactions and recovery
In therapy, military Service Members who have returned from combat often express guilt that
they did not or could not do something to prevent the death of friends. Sometimes they express
anger at situations that put their fellow Service Members in positions in which they were killed.
Medics often express great guilt and remorse over the Military Member they could not save. The
purpose of this paper will be to examine whether the deaths of fellow Service Members
produces greater PTSD and depression and more problematic recovery among active duty

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military than traumas that happen to themselves. The sample of this study consists of at least
100 active duty Soldiers who have been deployed to combat at least once, have PTSD, and are
stationed at Ft Hood, Texas. The authors aim to examine if those who experienced death of
friends or witnessed deaths of fellow Soldiers have more severe PTSD and depression than
those who did not, and whether these experiences predict treatment outcome. The data will be
coded from the initial interview prior to starting Cognitive Processing Therapy conducted by the
therapist, in which there are questions asked regarding whether the worst traumatic event
included the death of others (Was anyone killed? [yes or no; if yes, who?]; Did you see other
peoples injury or their death?; Did you attempt to give assistance to save someones life? If
yes, how so?). The Deployment Risk and Resilience Inventory also includes items regarding
death of others and aftermath of battle. We will compare severity of symptoms among Soldiers
with death trauma experiences with those who developed their PTSD another way and will
examine whether it affects treatment outcome. We will also examine guilt cognitions as a
mediator of the relationship between type of trauma and severity of PTSD as well as outcomes.
Predictors of poor outcome in ambulance workers regularly exposed to trauma: The
influence and frequency of exposure to death trauma
Ambulance workers are regularly exposed to trauma and are considered to be a group at risk of
developing post-traumatic stress disorder (PTSD). Previous research has reported rates of
PTSD based on self-report data to be in the range of 20% in this group (i.e., Sterud et al., 2006).
As part of a large prospective study investigating predictors of PTSD, we assessed N=443
newly recruited ambulance workers with self-report questionnaires and with the Structured
Clinical Interview for DSM-IV (SCID; First et al., 1996) during their first week of paramedic
training. Participants completed questionnaires to assess symptoms of PTSD, depression,
social phobia, and alcohol use disorders. They then attended an interview session in which the
SCID was administered. A total of 322 participants have completed two year follow-up. Twelve
per cent of participants suffer PTSD, major depression and other psychiatric problems at two
year follow-up. Key variables at baseline and at one year follow-up distinguish those who will
and who will not suffer a disorder at two year follow-up. Alcohol as a coping factor, rumination
and depressive attributions at baseline predicted poor outcome at follow-up. Sleep problems,
time off due to physical illness, suppression, rumination and dissociation as coping mechanisms
at one year predicted poor outcome at two years. The influence of type of critical incident and
frequency of exposure to death trauma and its link to poor outcome will be presented. The
implications of this for developing CBT early interventions for this at risk group will be discussed.
My Story of the Flood: Piloting a trauma-focused CBT protocol with youth experiencing
PTSD following a natural disaster.
On the 10th of January 2011, what locals describe as a wall of water unexpectedly struck the
small, inland communities of the Lockyer Valley in Queensland, killing over 30 people. Targeted
screening of children and adolescents in the Lockyer Valley was conducted. Twenty-five primary
and high school-aged youth meeting criteria for PTSD and/or a significantly exacerbated mental
health problem following the flood were provided with individual, school-based treatment using a
manualized trauma-focused, cognitive-behavioural protocol (My Story of the Flood; Cobham &
McDermott, 2011). Depending on childrens losses and their responses to these, grief and loss
content was also included in the program. Outcome measures included the PTSD-RI, the
Spence Childrens Anxiety Scale, the Childrens Depression Index, and the Anxiety Disorders
Interview Schedule for Children (child and parent versions). Data from these cases (including 6
and 12-month follow-up) will be presented. In addition, challenges faced and lessons learned
will be discussed.

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Complicated Grief and PTSD following homicidal bereavement: Prevalence and


Treatment
In literature on bereavement, it has been claimed that the loss of a loved one due to homicide is
associated with severe post-traumatic stress disorder (PTSD), depression,
dysfunctional/complicated grief, and other mental health problems. However, only very few
studies have investigated the nature and prevalence of emotional symptoms following homicidal
bereavement. The present authors are conducting a research program in the Netherlands that
aims to enhance knowledge on the prevalence, underlying mechanisms, and treatment of
psychopathology among the homicidally bereaved. In this talk, several findings of this research
are presented. First, data on the prevalence of Complicated Grief and PTSD obtained from this
program will be presented. Secondly, study findings on the role of cognitive behavioural
variables as well as anger and revenge in emotional problems following homicidal loss are
reviewed. Thirdly, we will discuss the treatment study that is part of this research program, in
which the effectiveness of a brief, 8-session, treatment encompassing cognitive behavioural
interventions and eye movement desensitization and reprocessing (EMDR) is examined. The
content of this treatment and preliminary findings on its effectiveness are presented.
Prolonged Grief in Children: Cognitive Behavioral Mechanisms and Treatment
Although most children confronted with the death of a loved one recover well, a small but
significant group of children experience clinically significant psychiatric problems. These
problems include elevated dysphoria, generalized anxiety, posttraumatic stress, behavioral
problems, and symptoms of prolonged grief disorder (PGD). PGD encompasses separation
distress, preoccupation with thoughts about the lost person, a sense of purposelessness about
the future, numbness, bitterness, difficulties accepting the loss, and difficulty moving on with life
without the lost person. There is growing evidence that childhood PGD is distinct from
depression and posttraumatic stress disorder (PTSD) and, if left untreated, associated with
persistent mental and physical health complaints and reduced quality of life. Despite these facts,
effective interventions targeting PGD in children and adolescents bereaved by the loss of a
parent, sibling, or other loved one are not yet available. As part of a larger project on childhood
PGD, we developed a nine-session manualized cognitive behavioral treatment for children with
elevated levels of PGD -- applied in combination with five counseling sessions with the parents.
This treatment focuses on the modification of maladaptive cognitions and coping behaviors that
block adaptation, taking into account the broader context of individual factors (e.g. ongoing
developmental changes) and socio-environmental factors (caretaking environment) that
influence bereavement outcome. In the present talk, the content and theoretical background of
this treatment are introduced. Empirical evidence on the role of maladaptive cognitions and
behaviors in childhood PGD is briefly reviewed. In addition, findings of recent studies designed
to examine the feasibility and efficacy of this new treatment are presented.
Eficacia de Dos Protocolos de Reexperimentacin Emocional en el Bienestar Psicolgico
y Fisico de Jvenes Universitarios
Sonia Zambrano Hernndez1, 2, Wenceslao Peate Castro2.
1. Facultad de Psicologia, Universidad Catlica de Colombia, Bogota, Colombia, 2. Universidad
de La Laguna, Tenerife, Spain.
La vivencia de situaciones estresantes, molestas o traumticas es relativamente frecuente en la
vida de los seres humanos. La expresin de las emociones, especialmente las relacionada con
este tipo de situaciones, se considera normal y saludable. De aqu surge el paradigma de la
reexperimentacin emocional, que implica que los participantes escriban sobre sus
experiencias ms altamente molestas, estresantes o traumticas acompaadas de las
emociones y pensamientos ms profundos. Las sesiones se realizan individualmente, por

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escrito, durante trs o cuatro das consecutivos y con una duracin por sesin de unos 20
minutos. Como propsito de esta investigacin se plantea conocer cmo dos tipos de RE
(tradicional y con instrucciones ACT) en dos condiciones experimentales (narracin del mismo
evento o narracin de diferente trauma) influye sobre el bienestar psicolgico y fsico de los
participantes. Asimismo, se trata de conocer cmo influyen variables personales como la
alexitimia, el optimismo y los sntomas de estrs postraumatico intervienen en el bienestar a
partir de un estudio experimental.
Secondary Traumatic Stress in Mental Health Workers
Ayten Zara.
Bilgi University, Istanbul, Turkey.
The present study investigated the prevalence of secondary traumatic stress in Turkey, impact
of demographic, professional and personal factors on development of secondary traumatic
stress and the relationship between the constructs of secondary traumatic stress and burnout
syndrome. 205 mental health workers, which encompass psychologists, psychiatrists,
psychological counselors and social workers from Marmara, Southeastern, Central Anatolian
and Aegean regions of Turkey with various educational backgrounds, took part in the study. In
order to measure above mentioned variables, a demographical survey, Trauma Attachment
Belief Scale and Maslach Burnout Inventory were applied to participants through mail and online
survey. Level of education, profession, geographical factor, sex, working with trauma, work
setting, work population, personal trauma history and active, problem solving focused, adaptive
coping strategies were found to be significantly related with development of secondary traumatic
stress. The present sample showed high levels of secondary traumatic stress prevalence, in
comparison to other studies.

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