Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

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    An Interview Study with Professionals on Shared Decision-Making in Child and Adolescent Mental Health
    (Springer, 2026-04-01) Eiroá Orosa, Francisco José; Roura-Roca, Iona
    Shared Decision-Making (SDM) is a paradigm that involves collaboration between healthcare professionals and service users to reach decisions jointly. This approach is based on the exchange of information, identification of service users’ values and preferences, analysis of treatment options, and consensus on an action plan. The present study aims to explore the beliefs and attitudes of mental health professionals regarding this model, in a context where its implementation has not yet begun in services for children and adolescents but is starting in the adult mental health system. A qualitative investigation was conducted through thematic analysis of semi-structured interviews with eleven mental health professionals including social workers, psychologists and psychiatrists. While SDM offers potential benefits, its implementation entails a series of requirements, limitations, and dilemmas that must be addressed. In the child and adolescent context, it is particularly complex to establish specific ages for applying this model and to determine in which situations it is appropriate. The adoption of SDM would represent a significant advancement that could contribute to improving the experience of service users and align with social work values of empowerment and person-centred care.
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    Sexual exploitation among adolescents in residential care: Prevalence and implications for child protection
    (Elsevier, 2026-06-09) Pereda Beltran, Noemí; Águila Otero, Alba
    Background: Child sexual exploitation (CSE) is a major public health problem that disproportionately affects children and young people involved in the child welfare system. Objective: This study estimated the reported prevalence of CSE among adolescents in residential care facilities in a northern region of Spain and identified associated risk factors. Participants and setting: The sample included 119 adolescents (51.3% male, 45.4% female) aged 14–18 years (M = 15.95), residing in 26 residential care facilities across northern Spain. Methods: An ad hoc online questionnaire assessed (a) sociodemographic characteristics, (b) child protection history, (c) knowledge and perceptions of CSE, and (d) personal experiences of CSE. Results: Overall, 17.6% of participants in this regional sample reported experiencing some form of CSE in the past year. The most prevalent form was sharing sexual images or videos, followed by sexual intercourse and sexual touching. Compared with non-victims, those who experienced CSE were more likely to be female, to have run away from the residential facility, to have received prior CSE education, and to know someone involved in CSE. Conclusions: Findings underscore the urgent need for targeted prevention and intervention strategies addressing CSE among youth in residential care. Comprehensive approaches should include professional training, systematic screening and risk assessment, and direct interventions. These should be implemented through an intersectional framework that acknowledges multiple vulnerabilities and risk factors to better protect young people within the child welfare system.
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    Mapping the subcortical pathways associated with fear in the human brain: multiple thalamo-amygdala connections revealed by high-resolution tractography
    (Elsevier B.V., 2026-07-15) Kosteletou-Kassotaki, Emmanouela; Mengxing, Liu; Cinca-Tomás, Martina T.; Paz-Alonso, Pedro María; Domínguez-Borràs, Judith
    Influential models of emotion have proposed multiple direct subcortical pathways, often referred to as “low roads,” linking the thalamus to the amygdala and implicated in fear processing. While such pathways are anatomically well characterized in non-human animals, they have not yet been mapped in the human brain. Here, building on converging evidence from animal models, we provide a comprehensive anatomical characterization of distinct thalamo-amygdala pathways in 113 human participants. Using an advanced high-resolution tractography protocol, we reconstructed pathways originating from posterior, medial, and intralaminar thalamic nuclei and projecting to the basolateral amygdala (BLA). To evaluate their anatomical plausibility, we assessed test-retest reproducibility across sessions. Within the posterior thalamus, projections from the medial geniculate nucleus and the medial and inferior pulvinar to the BLA emerged as the strongest and most robust pathways. Within the medial thalamus, the mediodorsal nucleus showed a prominent connection to the BLA, characterized by a high number of streamlines and moderate-to-high reproducibility. Finally, projections from intralaminar thalamic nuclei were consistently identified but exhibited greater intersession variability and lower reproducibility. Together, these findings provide a unifying anatomical framework for multiple direct thalamo-amygdala pathways in the human brain contributing to the characterization of evolutionarily conserved systems potentially underlying affective processing. 
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    Psychometric properties of the Spanish version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)
    (Springer Science + Business Media, 2021-12-01) Calderón Garrido, Caterina; Ferrando Piera, Pere Joan; Lorenzo Seva, Urbano; Ferreira García, Estrella; Lee, Eun Mi; Oporto Alonso, Marta; Obispo, Berta M.; Mihic-Góngora, Luka; Rodríguez-González, Adán; Jiménez Fonseca, Paula
    Purpose The aim of this study was to analyze the internal structure of the EORTC QLQ-C30, to examine the validity and normative data for cancer patients. Method Exploratory and Confirmatory factor analyses were conducted to explore the scale’s dimensionality and test for strong measurement invariance across sex and tumor site. All the analyses were based on a multicenter cohort of 931 patients who completed the Brief Symptom Inventory (BSI-18) and the EORTC QLQ-C30. Results Our findings indicate that the EORTC QLQ-C30 has acceptable psychometric properties and an internal structure that is well accounted for a bifactor model: a general factor that evaluates quality of life and a group factor that would analyze physical health that would be defined by physical function, role function, and fatigue. The result of the multi-group CFA revealed a strong invariance according to sex, tumor, and over time. Reliability of the EORTC exceeding 0.86 and the simple sum of the items of the scale was a good indicator of oncology patients’ quality of life. Both factors correlate closely with depression, anxiety, and psychological distress and are sensitive to change, especially the quality of life, with a significant decrease in the post-test. Conclusion The Spanish version of the EORTC QLQ-C30 proved to be a valid, reliable instrument to appraise quality of life in cancer patients. The normative data collected from this study may be useful for the early detection of initial symptoms of deterioration of quality of life in oncology patients.
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    Seasonal longitudinal effects of winter birth on psychopathology, cognition, and functioning in schizophrenia-spectrum and affective disorders: Findings from the PsyCourse Study
    (Elsevier B.V., 2026-09-01) Pérez Ramos, Anaid; Budde, Monika; Adorjan, Kristina; Amoretti Guadall, Silvia; Anghelescu, Ion-George; Arolt, Volker; Baune, Bernhard T.; Dannlowski, Udo; Dietrich, Detlef E.; Fallgatter, Andreas J.; Figge, Christian; Garriga, Marina; García Rizo, Clemente; Guasch Capella, Nora; Heilbronner, Maria; Lang, Fabian U.; Juckel, Georg; Kohshour, Mojtaba Oraki; Konrad, Carsten; Martínez-Arán, Anabel, 1971-; Mezquida Mateos, Gisela; Navarro Flores, Alba; Reich-Erkelenz, Daniela; Reimer, Jens; Reininghaus, Eva Z.; Senner, Fanny; Schmauß, Max; Schmitt, Andrea; Schulte, Eva C.; Spitzer, Carsten; Vieta i Pascual, Eduard, 1963-; Wiltfang, Jens; Falkai, Peter; Schulze, Thomas G.; Papiol, Sergi; Torrent Font, Carla; Heilbronner, Urs
    Aims Winter birth (WB) is a replicated risk factor for mental health conditions, potentially due to third-trimester Vitamin D deficiency and maternal viral infections. Beyond diagnosis, WB is associated with psychopathology, cognition, and functionality as epiphenomena. We analysed these outcomes in psychosis and affective disorders, considering illness duration and sex-specific effects. Methods We included 535 individuals with schizophrenia-spectrum and 667 with affective disorders from the PsyCourse Study, evaluated at four time points over 18 months. Participants were stratified by the birth season: winter vs. other seasons and by duration of illness (</≥5 years). Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS) for psychosis, Inventory of Depressive Symptomatology (IDS-C30) and Young Mania Rating Scale (YMRS) for affective disorders, functionality with the Global Assessment of Functioning Scale (GAF), and cognitive performance with Trail Making Tests A (TMT-A) and B (TMT-B), Verbal Digit Span, and Digit Symbol Test (DST). Linear mixed models adjusted for covariates were applied. Results No interaction effects between WB and diagnostic group or time remained significant after correction for multiple comparisons. In sex-stratified models, a significant WB × time interaction emerged for DST in females, with WB participants showing improvements over time in schizophrenia-spectrum disorders, and a crossover pattern in affective disorders. Conclusions WB has no robust effect on long-term outcomes on schizophrenia-spectrum or affective disorders. Subtle, sex-dependent effects on cognition were observed in females, with divergent longitudinal patterns between diagnostic groups, suggesting a possible early-life influence that attenuates over the course of illness.
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    A meta-synthesis of qualitative studies on citizenship and mental health
    (Cambridge University Press (CUP), 2026-03) Ball, Cassidy M.; Eiroá Orosa, Francisco José
    Background: Citizenship, as conceptualized by Rowe and colleagues, emphasizes the significance of relationships and community membership, encapsulated by the ‘5Rs’– rights, responsibilities, roles, resources, and relationships. Methods: A meta-synthesis of 20 qualitative studies on citizenship and mental health was conducted. Results: We identified four central themes: Autonomy and Empowerment, Social Inclusion and Relationships, Social Exclusion, and Non-Relational Resources and Supports. Service users’ experiences illuminate the challenges ofachieving full citizenship, negotiating societal norms, and accessing non-relational resources. Conclusions: This synthesis contributes to our understanding of Citizenship and its relationship with mental health, highlighting its role in fostering social inclusion and empowerment as well as informing potential implications for mental health interventions and policies.
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    ℛSCZ: A Riemannian schizophrenia diagnosis framework based on the multiplexity of EEG-based dynamic functional connectivity patterns
    (Elsevier Ltd., 2024-09-01) Stavros, Dimiatriadis
    Abnormal electrophysiological (EEG) activity has been largely reported in schizophrenia (SCZ). In the last decade, research has focused to the automatic diagnosis of SCZ via the investigation of an EEG aberrant activity and connectivity linked to this mental disorder. These studies followed various preprocessing steps of EEG activity focusing on frequency-dependent functional connectivity brain network (FCBN) construction disregarding the topological dependency among edges. FCBN belongs to a family of symmetric positive definite (SPD) matrices forming the Riemannian manifold. Due to its unique geometric properties, the whole analysis of FCBN can be performed on the Riemannian geometry of the SPD space. The advantage of the analysis of FCBN on the SPD space is that it takes into account all the pairwise interdependencies as a whole. However, only a few studies have adopted a FCBN analysis on the SPD manifold, while no study exists on the analysis of dynamic FCBN (dFCBN) tailored to SCZ. In the present study, I analyzed two open EEG-SCZ datasets under a Riemannian geometry of SPD matrices for the dFCBN analysis proposing also a multiplexity index that quantifies the associations of multi-frequency brainwave patterns. I adopted a machine learning procedure employing a leave-one-subject-out cross-validation (LOSO-CV) using snapshots of dFCBN from (N-1) subjects to train a battery of classifiers. Each classifier operated in the inter-subject dFCBN distances of sample covariance matrices (SCMs) following a rhythm-dependent decision and a multiplex-dependent one. The proposed ℛSCZ decoder supported both the Riemannian geometry of SPD and the multiplexity index DC reaching an absolute accuracy (100 %) in both datasets in the virtual default mode network (DMN) source space.
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    Predictors of the impact of rights- and recovery-oriented training for mental health professionals
    (American Psychological Association, 2026-05-06) Eiroá Orosa, Francisco José; Seibel, Carolin
    Objective: This study examines the factors influencing the effectiveness of a rights- and recovery-based training program for mental health professionals. Methods: From an initial pool of 643 professionals providing informed consent, 218 (33.9%) attended the training activity and completed the first follow-up assessment. Effectiveness was evaluated using a scale measuring beliefs and attitudes toward service users. Potential predictors included gender, age, experience, ideological orientation, education, profession type, personal or close experience with mental distress, and training satisfaction. Results: Interactions showed that profession type and personal experience moderated changes in coercion, with social professionals showing a sharper initial reduction that stabilized, clinical professionals a slower but more continuous decrease, and those without personal experience demonstrating greater overall reductions. Ideology moderated changes in paternalism, with left-leaning professionals showing a consistent decline and right-leaning professionals an initial decrease followed by an increase. Conclusions and Implications for Practice: These findings highlight the training’s broad impact on beliefs and attitudes and the role of key professional characteristics in shaping specific outcomes, suggesting strategies for tailoring recovery-oriented education to diverse professional profiles. Further research should refine study designs, improve assessment tools, and explore behavioral outcomes to deepen our understanding of the mechanisms underlying training effectiveness.
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    The Evaluation of a Nursing Care Model for Breast Cancer: What Are Women's Priorities?
    (John Wiley & Sons, 2025-04-26) Rodriguez Ortega, Ana; Ferro, Tàrsila; Ochoa Arnedo, Cristian; Campos, Gloria; Valverde, Yolanda; Medina, Joan Carles; Borràs Andrés, Josep Maria
    Aim: To assess patient satisfaction with the breast care nurse (BCN) model and its adequacy in meeting patients’ needs for information and support. Background: The BCN is a core multidisciplinary member of the breast cancer team. The evaluation of care models is necessary to detect gaps and improve the quality of care. Material and Methods: This cross-sectional descriptive study took place in a breast pathology unit and included patients with early breast cancer seen between 1 July 2016 and 30 June 2017 after finishing their treatment. Between July and December 2018, sociodemographic and clinical variables were collected from the clinical history, and satisfaction was measured using a questionnaire sent to the patients. Results: Of the 139 patients included, 99.3% reported that the BCN provided information correctly, 96.2% reported that she provided adequate information on self-care at home (96.2%), and 97.8% reported that the words of the BCN helped them feel better. However, some patients were unsure whether the BCN would have been willing to discuss alternative therapies (41%). Conclusions: Patients were satisfied with the BCN, including her role in meeting information and support needs. However, some issues needed to be sufficiently addressed. Comprehensive, continuous assessment is required to understand patient needs. Training and specific studies on topics that are of interest to patients can help respond to these needs. Implications for Nursing Management: BCN functions are being developed in some countries. BCN results make it easier for healthcare managers to commit to this role and for nurses to develop all their competencies. BCN models must respond to international guidelines but are also determined by organizational resources. The evaluation of these models is essential and must be considered by users. Advanced practice nursing roles, including the BCN, are well established in some countries but developing in others. BCN results make it easier for healthcare managers to commit to this role and for nurses to develop all their skills. BCN models must respond to the elements determined by organizations that work to improve the quality of care for patients with breast cancer. However, they are also determined by organizational resources. The evaluation of these models is essential to correct deficiencies and improve the quality of care. An important part of the evaluation must take into account the user who receives the care, in terms of satisfaction and the form of patient-reported outcome measures (PROMs).
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    Virtual reality body exposure and attentional bias modification in the treatment of adolescents with anorexia nervosa
    (John Wiley & Sons, 2026-04-14) Ascione, Mariarca; Carulla-Roig, Marta; Meschberger-Annweiler, Franck-Alexandre; Serrano Troncoso, Eduardo; Blasco Martínez, Anna; Guerrero Álvarez, Fernando; Miquel, Helena; Mendoza-Medialdea, María Teresa; Porras-García, Bruno; Ferrer, Marta (Ferrer García); Moreno Sánchez, Manuel; Gutiérrez Maldonado, José
    Anorexia nervosa (AN) is a severe psychiatric disorder characterized by intense fear of gaining weight and persistent body image disturbance. Virtual reality–based mirror exposure therapy (VR-MET) may reduce body-related fear through embodied exposure, while attentional bias modification training (ABMT) may enhance exposure learning by promoting balanced attentional allocation. This controlled clinical study tested the hypothesis that adjunctive VR-MET would improve clinical outcomes beyond treatment as usual (TAU) alone, and that preceding VR-MET with ABMT would produce additional benefits in adolescent females with AN. Seventy-five female adolescents with AN were allocated to TAU, TAU+VR-MET or TAU+ABMT+VR-MET. Assessments were conducted pre- and post-intervention. Outcomes included eye-tracking indices of attentional bias (number of fixations, complete fixation time), state anxiety and fear of gaining weight, BMI and eating disorder–related measures. Compared with TAU alone, both VR-based conditions showed greater reductions in state anxiety and fear of gaining weight. State body dissatisfaction decreased significantly only in the TAU+VR-MET group. No significant changes were observed for BMI or most trait-level eating disorder measures. ABMT did not enhance clinical outcomes beyond VR-MET. Within the short-term assessment window, adjunctive VR-MET was associated with reductions in state-dependent emotional responses in adolescents with AN. Effects on trait-level symptoms were limited, and ABMT did not confer additional benefit in this unselected sample. Fully randomized studies with larger samples, extended exposure protocols, and follow-up assessments are needed to determine durability and broader clinical impact.
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    Spontaneous and perturbation-based EEG cortical excitability markers are associated with plasma p-tau181 concentration in healthy middle-aged adults
    (Elsevier, 2024-12-30) Perellón Alfonso, Ruben; Abellaneda Pérez, Kilian; Pileckyte, Indre; Cabello Toscano, María del Rocío; Mulet Pons, Lídia; Vaqué Alcázar, Lídia; Cattaneo, Gabrielle; Redondo-Camós, María; España Irla, Goretti; Delgado Gallén, Selma; Solana Sánchez, Javier; Zetterberg, Henrik; Tormos, José María; Franzmeier, Nicolai; Pascual Leone, Álvaro, 1961-; Bartrés Faz, David
    In early-stage Alzheimer's disease (AD) amyloid-β (Aβ) deposition can induce neuronal hyperactivity, thereby potentially triggering activity-dependent neuronal secretion of phosphorylated tau (p-tau), ensuing tau aggregation and spread. Therefore, cortical excitability is a candidate biomarker for early AD detection. Moreover, lowering neuronal excitability could potentially complement strategies to reduce Aβ and tau buildup. There is, however, a lack of understanding of the relationship between cortical excitability and p-tau increase in vivo. Therefore, in a sample of 658 healthy middle-aged (between the ages of 40 and 65) participants of the Barcelona Brain Health Initiative cohort study, we examined the relation of blood-based tau, phosphorylated at amino acid 181 (p-tau181), reflecting neuronal p-tau secretion; neurofilament light chain (NfL), as a passively released control for p-tau181; and electroencephalography (EEG) markers of cortical excitability. A subsample of 47 participants also completed a controlled brain perturbation approach via transcranial magnetic stimulation (TMS) with concurrent EEG. Results show that both spontaneous (i.e., resting-state) and perturbation-based TMS-EEG markers, are associated with blood p-tau181, particularly in older individuals. The perturbation-based marker was a significantly more sensitive predictor of p-tau181 concentration than the spontaneous resting state EEG-based marker. The relationships observed are not present for the NfL control. These results show that relationships between p-tau181 and cortical excitability are present in healthy middle-aged subjects and that p-tau181 increases may reflect activity-dependent secretion.
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    From childhood maltreatment to intimate partner violence perpetration: A prospective longitudinal examination of the roles of executive functioning and self-esteem
    (Elsevier Ltd., 2024-05-01) Díaz-Faes, Diego A.; Widom, Cathy Spatz
    Background: Previous research has found that childhood maltreatment predicts increased risk for violence and partner violence and there is some evidence for poorer executive functioning and low self-esteem. To date, there have been no longitudinal studies that have examined the extent to which executive functioning and self-esteem play a role in the relationship between child maltreatment and intimate partner violence (IPV) perpetration. Methods: This study aims to fill this gap by utilizing data from a prospective longitudinal study of children with documented court cases of abuse and neglect (ages 0–11 years) from a metropolitan county area in the Midwest (during the years 1967–1971) and demographically matched controls. Both maltreated individuals and matched controls were followed up and assessed over several waves of the study in young and middle adulthood. At mean age 39 years, inhibition and cognitive control were evaluated, while cognitive flexibility and nonverbal reasoning were assessed at mean age 41. Self-esteem was also assessed at mean age 41. Physical IPV perpetration was evaluated at age 47 using two different scoring strategies in separate models: the number of acts and variety of acts, ensuring avoidance of potential score skewness. Results: Childhood maltreatment predicted lower executive functioning and self-esteem, and both independently predicted intimate partner violence perpetration. Lower executive functioning and self-esteem mediated the relationship between childhood maltreatment and physical IPV perpetration in midlife, irrespective of the scoring method. Conclusion: Findings suggest that executive functioning and self-esteem play a role in the cycle of violence. Implications and suggestions for future directions are discussed.
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    Problematic gaming use and psychological distress among Spanish young adults: A comprehensive study
    (Universidad de Zaragoza, 2025) Suárez Soto, Elizabeth; Peris-de la Hoz, A.; Sánchez-Fernández-Quejo, A.; Rodríguez-Toscano, E.; Lagunas, N.; Reneses, B.; De la Torre Luque, Alejandro
    Background and objectives: This study examined problematic video game use and its sociodemographic and clinical correlates in a sample of 1,410 Spanish video game players (33.6% women; mean age = 21.12 years, SD = 3.29). Methods: The participants completed a comprehensive set of assessment scales to evaluate clinical features: a sociodemographic interview, problematic video gaming (using the GAS-7), emotional symptoms (with the Goldberg Anxiety and Depression scales), suicidal ideation (with the Paykel Suicidal Ideation Scale), loneliness (De Jong Gierveld Loneliness Scale) and impulsivity (UPPS-P scale). Participants were classified based on problematic gaming severity. Differences between groups were explored for the clinical features assessed. Results: As a result, most participants showed a low-risk gaming pattern (88.2%), in comparison to those showing either excessive use of video games (10% of participants) or problematic (pathological) gaming use (almost 2%). Risk groups differed by sex (p < .01), but not age, education, or employment. Game time and frequency varied across risk groups, indicating higher use with greater risk. Clinical correlates were examined, with higher risk groups showing more depressive symptoms (p < .01), anxiety symptoms (p < .01), suicidal ideation (p < .01), and loneliness (p < .01). Impulsiveness dimensions also showed significant group differences, except for sensation seeking. In conclusion, problematic video game use was linked to higher levels of depressive symptoms, anxiety, suicidal ideation, loneliness, and impulsiveness. Conclusion: This study sheds light on the clinical aspects associated with different levels of problematic gaming.
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    WADD-SEPD Consensus on Psychological Treatment of Dual Disorders I: General Recommendations, Most Used Therapies, and Severe Mental Disorders
    (MDPI, 2026-01-16) Benito, Ana; Jimenez Murcia, Susana; Tirado Munoz, Judit; Adan Puig, Ana
    Background/Objectives: The treatment of dual disorders (DDs) must be comprehensive and multidisciplinary. There is evidence supporting the effectiveness of psychotherapy in their treatment. However, clinical guidelines, consensus statements, and reviews on the treatment of DDs typically devote considerably less space to psychological therapy than to pharmacological therapy. Therefore, this work aimed to synthesize the available evidence, recommendations, and clinical experience on the psychological treatment of DDs to reach a consensus. Methods: Two consensus methods were sequentially implemented: the nominal group technique and the Delphi method. Results: The first part of this consensus review encompassed a compilation of general recommendations for the psychological treatment of DDs, evidence on the efficacy of the most frequently used therapies, and recommendations for the psychological treatment of severe dual mental disorders. These disorders include schizophrenia and other psychotic disorders, bipolar disorders, depressive disorders, and obsessive compulsive disorders. Conclusions: (1) Psychological treatment is effective; (2) integrated psychological treatment is more effective; (3) motivational interviewing, cognitive behavioral therapy, and relapse prevention are the psychological interventions with the most supporting evidence; (4) the best alternative is multicomponent strategies; (5) the most frequently studied severe mental disorders are schizophrenia and depression; (6) for dual schizophrenia, motivational interviewing and integrated cognitive behavioral therapy combined with other components are recommended; (7) for dual depression, cognitive behavioral therapy with relapse prevention or motivational interviewing is recommended; (8) for dual bipolar disorder, group therapies with psychoeducation or relapse prevention and inclusion of the family, contingency management, and family intervention are recommended; (9) more empirical evidence is needed, especially for obsessive compulsive and schizoaffective disorders; and (10) more randomized clinical trials are needed to improve current methodological limitations.
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    Understanding and enhancing post-stroke recovery: Insights from a nested qualitative study within the MindFit Project randomized clinical trial
    (Elsevier Ltd., 2024-12) Bermudo-Gallaguet, Adrià; Bielsa-Pascual, Jofre; García-Sierra, Rosa; Feijoo Cid, Maria; Arreciado Marañón, Antonia; Ariza González, Mar; Agudelo, Daniela; Camins-Vila, Neus; Boldó, Maria; Durà Mata, Maria José; García-Molina, Alberto; Torán Monserrat, Pere; Mataró Serrat, Maria
    Background: Stroke survivors experience a wide range of physical, cognitive, and emotional challenges. In the MindFit Project, a randomized clinical trial, 141 chronic stroke patients were divided into three groups: mindfulness-based stress reduction (MBSR) with computerized cognitive training (CCT), physical exercise (PE) with CCT, and CCT alone. The interventions were conducted remotely over 12 weeks, including online group and individual sessions. Objective: This exploratory nested qualitative study aimed to investigate chronic stroke survivors' experiences, opinions, and perceived changes due to the interventions within the MindFit Project. The secondary objective was to describe the broader experience of their recovery journey. Methods: Twenty-seven participants were recruited through purposive sampling and engaged in semi-structured one-on-one interviews. Twelve received MBSR+CCT, nine received PE+CCT, and six received CCT-only. The interviews were recorded, transcribed, and analyzed using thematic analysis. Results: Participants shared insights into their lives after stroke, including emotional and physical challenges, coping mechanisms, and the impact of societal perceptions. The interventions were generally positively valued, with MBSR aiding in emotional regulation, PE enhancing physical capabilities, and CCT improving cognition. The group setting provided valuable peer support and motivation, although some participants noted challenges owing to the heterogeneity. The telematic format was also appreciated for its accessibility, although it posed challenges to personal interaction and intervention supervision. Conclusions: Our study emphasizes the complexity of stroke recovery and the importance of holistic, patient-centered rehabilitation approaches. It also highlights the value of combining physical and non-physical interventions in a group setting, along with the potential of remote platforms to enhance the accessibility of rehabilitation programs. These findings generate hypotheses for future randomized clinical trials aimed at improving post-stroke recovery.
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    Large-scale population data enrichment in mental health research
    (Springer Nature, 2024-10-01) Nees, Frauke; Renner, Paul; Holz, Nathalie E.; Polemiti, Elli; Siehl, Sebastian; Hese, Sören; Schepanski, Kerstin; Schumann, Gunter; The environMENTAL Consortium
    This Comment explores new approaches to enrich large-scale population data, including incorporating macro-environmental and digital health measures.
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    Exploring Metacognition in a Spanish-Speaking Population: Adaptation and Validation of the Metacognition Self-Assessment Scale (MSAS)
    (Universidad Nacional de Educación a Distancia (UNED), 2025) Alabèrnia Segura, Miquel ; Mullins, Danielle; Carulla Flix, Anna ; Feixas i Viaplana, Guillem
    El presente estudio tiene como objetivo adaptar y validar la Escala de Autoevaluación de la Metacognición (MSAS) para población de habla hispana. Empleando un enfoque modular de la metacognición, esta investigación se centra en analizar subfunciones específicas de la metacognición, como la auto-monitorización, la autoevaluación y la selección de estrategias. Una muestra de 138 individuos de habla hispana participó en el estudio, que incluyó tanto la traducción del MSAS, como la realización de pruebas de fiabilidad y validez. Los resultados del análisis factorial confirmatorio apoyan la estructura original del MSAS, que incluye cuatro factores: Autorreflexión, Distancia Crítica, Comprensión de la Mente del Otro y Dominio. Además, se estableció la validez convergente del MSAS con la Escala de Alexitimia de Toronto (TAS-20), demostrando una fuerte correlación negativa entre ambos instrumentos. Esta adaptación y validación de la versión en español del MSAS proporciona un valioso instrumento disponible para fines clínicos y de investigación. Esta contribución sienta las bases para inves
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    Psychosocial functional recovery in patients with bipolar disorder in remission: Which symptoms hold them back?
    (Elsevier B.V., 2026-02-14) Bonnín Roig, Caterina del Mar; Montejo Egido, Laura; Torrent Font, Carla; Sánchez-Moreno, José; Diego-Adeliño, Javier de; Solé Cabezuelo, Brisa; Roca Tutusaus, Xavier; Hidalgo Mazzei, Diego; Borràs, Roger; Clougher, Derek; Valentí Ribas, Marc; Martínez-Arán, Anabel, 1971-; Cardoner, N. (Narcís); Vieta i Pascual, Eduard, 1963-
    Background: Subthreshold depressive symptoms significantly hinder functional recovery in bipolar disorder (BD). While most studies use a global score to assess the impact of these symptoms on functioning, this study examines which specific subthreshold depressive symptoms mostly impede functional recovery in patients with BD in remission. Method: The sample comprised a total of 413 patients with BD. Subthreshold depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D), and psychosocial functioning was measured with the Functioning Assessment Short Test (FAST). Bivariate analyses were performed to identify items from the HAM-D as well as other clinical and demographic variables associated with functional impairment. Multivariate linear regression analyses were conducted including the variables that demonstrated significant associations in the bivariate analyses. Results: The linear regression model for the FAST total score demonstrated that "psychomotor retardation" (item 8) had the strongest association on psychosocial functioning (β = 6,9; p < 0,001), followed by "feelings of guilt" (item 2) (β = 5,75; p < 0,001) "work and activities" (item 7) (β = 5,38; p < 0,001) and "somatic anxiety" (item 11) (β = 3,45; p < 0,001). Other significant clinical variables included antipsychotic use, older age, fewer years of education and male sex. This model explained 39,6% of the variance in the FAST total score (R2 = 0,396; Adjusted R2 = 0,375; F(399,13) = 20,04; p < 0,001). Conclusions: Specific subthreshold symptoms, including psychomotor retardation, apathy, guilt and somatic anxiety significantly influence psychosocial functioning. These findings highlight the importance of specifically targeting these symptoms to achieve functional recovery, even when patients are clinically stable.
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    Consensus on Subdomains and Measures of Relevance to Affective and Social Cognition Research on Bipolar Disorder (CAS-BD); Outcomes and Recommendations From an International Society for Bipolar Disorders Targeting Cognition Taskforce Study
    (John Wiley & Sons, 2026-03-01) Van Rheenen, Tamsyn E Van; Lewandowski, Kathryn E; Pinkham, Amy; Varo, Cristina; Caruana, Georgia F.; Gruber, J.; Zarp, Jeff; Young, Allan H.; Yatham, Lakshmi N.; Vieta i Pascual, Eduard, 1963-; Torres, Ivan J.; Tsapekos, Dimosthenis; Sumiyoshi, Tomiki; Stokes, Paul R. A.; Schaffer, Ayal; Purdon, Scot E.; Porter, Richard J.; McIntyre, Roger S.; Martínez-Arán, Anabel, 1971-; López Jaramillo, Carlos; Lafer, Beny; Kessing, Lars Vedel; Kjærstad, Hanne Lie; Hasler, Gregor; Gallagher, Peter; Douglas, Katie; Dols, Annemiek; Carvalho, André F.; Burdick, Katherine E.; Bowie, Christopher R.; Bonnín Roig, Caterina del Mar; Balanzá-Martínez, Vicent; Miskowiak, Kamilla W.
    Background The Consensus on subdomains and measures of Affective and Social cognition for research on Bipolar Disorder (CAS-BD) project aimed to formulate preliminary consensus-based recommendations for assessing affective and social cognition in BD. Methods Three sequential surveys administered to experts on affective and social cognition in BD were conducted using the Delphi process. Experts responded to questions regarding affective and social cognition subdomains and rated their importance to research on BD. Experts also nominated measures, rated them for suitability, and ranked them by preference for use. Consensus was defined as ≥ 80% agreement. Results 31 experts completed the initial survey, with 20–23 completing subsequent surveys. Consensus was obtained for the subdomain structure of both affective cognition and social cognition, and the definition of each subdomain within. Explicit emotion regulation was ranked as being of highest priority for further research on affective cognition, and theory of mind as highest priority for further research on social cognition. The top-preferenced measures of all affective cognition subdomains were considered by consensus to be suitable for use in BD research. Agreement that the top-preferenced measures of social cognition were suitable ranged from 71.5% to 95.3%. Discussion Expert consensus on subdomains and measures of affective and social cognition for research on BD was obtained via a staged approach. Prior familiarity may have influenced some experts' rankings, but generally there was a notable lack of consistency in the use of available measures by BD experts. This reaffirms the need for more specific guidance and validated batteries of social and affective cognition to direct the field and allow for more consistency and replication of research in the future.
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    An Exemplary Life? A Personal Construct Analysis of the Autobiography of Rudolf Hoess, Commandant of Auschwitz
    (Taylor & Francis, 2014-08-27) Reed, Nick; Winter, David A., 1950- ; Schulz, Joerg; Aslan, Esther; Soldevilla Alberti, Joan Miquel; Kuzu, Duygu
    This article analyzes the autobiography of Rudolf Hoess, commandant of Auschwitz. Textual grid, ABC, and self-characterization analyses of the autobiography are used to construe Hoess’s writing. The textual grid analysis suggests that Hoess saw his adult self as being different from others but his young self as similar to Jews. Conflicts in self-construing are identified. The ABC analysis indicates that, from his perspective, it made sense for Hoess to choose not to leave the concentration camp service. The self-characterization analysis focuses on whether Hoess experienced Kellyan guilt and it suggests that he did, but in unexpected contexts.