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Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

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    Sex differences in psychosocial functioning and neurocognition in bipolar disorder: A systematic review and meta-analysis
    (Cambridge University Press (CUP), 2025-03-05) Serra Navarro, Maria; Clougher, Derek; Oliva, Vincenzo; Valenzuela-Pascual, Clàudia; De Prisco, Michele; Forte, Maria Florencia; Garriga, Marina; Solé Cabezuelo, Brisa; Sánchez-Moreno, José; Verdolini, Norma; Menculini, Giulia; Tortorella, Alfonso; Bernardo Arroyo, Miquel; Ramos-Quiroga, Josep Antoni; Martínez-Arán, Anabel, 1971-; Vieta i Pascual, Eduard, 1963-; Amoretti Guadall, Silvia; Torrent Font, Carla
    Introduction: Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD demonstrate differences in psychosocial functioning and NC performance. Methods: The Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases were systematically searched from inception until November 20, 2023. Results: Twenty studies published between 2005 and 2023 with a total sample size of 2286 patients with BD were included. A random effects meta-analysis revealed a statistically significant result with a small effect (SMD = 0.313) for sex differences in verbal learning and memory as well as visual learning and memory (SMD = 0.263). Females outperformed males in both domains. No significant sex differences were observed for any other NC outcome or psychosocial functioning. High heterogeneity and differences in assessment scales used should be considered when interpreting these findings, given their potential impact on results. Conclusions: Future research should adopt a more homogenous, standardized approach using longitudinal designs to gain a clearer insight nto sex differences in this population. This approach so may increase the use of preventative therapeutic options to address the difficult clinical challenge of reaching cognitive and functional recovery.
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    The scope of religious related child sexual abuse in Spain: A prevalence study
    (Taylor & Francis, 2025-07-30) Pereda Beltran, Noemí; Tamarit Sumalla, Josep M. (Josep Maria); Suárez-Soto, Elizabeth
    Background and Objectives: Research on the prevalence of child sexual abuse within the Catholic Church has been limited in Europe. The aim of this study was to estimate the prevalence and characteristics of religious-related sexual abuse in a broad sample of the Spanish population, placing it within the broader context of sexual violence against children and adolescents. Participants and Setting: Among the survey respondents, 52.3% were women (n = 4,188) and 47.7% were men (n = 3,825). Participants ranged in age from 18 to 100 years (M = 51.5, SD = 17.6), with the majority (n = 7,154; 89.5%) born in Spain. Results: The results indicated that 11.7% of respondents were victims of child sexual abuse, with a higher prevalence among women (8.6%) compared to men (3.1%). A total of 1.1% of respondents reported having experienced religious-related sexual abuse, primarily in religious educational institutions or churches, with 0.6% identifying a Catholic clergyman as the perpetrator. The majority of ecclesiastical abuse involved physical contact, and in many cases, the abuse was recurrent. Victims of religious-related abuse reported more significant spiritual consequences compared to those abused in other contexts. Conclusion: The findings highlight patterns of sexual abuse similar to those observed in other countries, with a notable prevalence of abuse in male Catholic schools during the Franco dictatorship era.
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    Group cohesion in online and in-person psychotherapy in a randomized control trial for cancer survivors
    (Elsevier España, 2025-10-15) Arizu-Onassis, Alejandra; Medina Alcaraz, Juan Carlos; Lleras de Frutos, María; Flix-Valle, Aida; Serra Blasco, María; Ciria Suárez, Laura ; Ochoa Arnedo, Cristian
    Objective: To explore the role of group cohesion (GC) in-person positive group psychotherapy (PPPC) and online positive group psychotherapy (OPPC). Method: A sample of 126 female cancer survivors experiencing emotional distress following primary oncological treatment was randomized to PPPC or OPPC. Measures of emotional distress, post-traumatic stress, and post-traumatic growth were taken at pre-treatment, post-treatment (after 12 weeks), and 3-month follow-up (from post-treatment), with GC assessed at post-treatment for this secondary analysis. Results: There were no significant differences in GC levels between the PPPC and OPPC groups. Higher GC was associated with greater reductions in depressive symptoms (b= -0.80, CI(95 %)= -1.18 – -0.42, p< 0.001) and post-traumatic stress (b= -1.38, CI(95 %)= -2.42 – -0.34, p< 0.010) in both modalities. Participants with higher GC reported immediate post-traumatic growth at post-treatment, while those with lower GC achieved similar growth levels by 3-month follow-up. No specific sociodemographic or clinical variables were associated with higher GC. Conclusions: In group psychotherapy for cancer survivors, GC is associated with a more pronounced reduction of depressive symptoms and post-traumatic stress, and with earlier post-traumatic growth in both OPPC and PPPC. Findings suggest that all cancer survivors have equal potential to develop GC, regardless of clinical or sociodemographic characteristics.
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    Attributions of blame among victims of child sexual abuse: Findings from a community sample
    (Taylor & Francis, 2018-11) Okur, Pinar; Pereda Beltran, Noemí; Van der Knaap, Leontien M.; Bogaerts, Stefan
    According to the attribution theory, negative outcomes of child sexual abuse (CSA) are thought to vary depending on whether CSA victims attribute the abuse to internal or external factors, respectively, self-blame and perpetrator-blame. Therefore, the purpose of this study was to identify abuse characteristics and attitudes that influence blame attributions among CSA victims from a community sample. Data from respondents with a history of CSA (N = 1,496) have been used in predicting blame attributions; perpetrator-blame, self-blame, or both. Results from a multinomial logistic regression analysis showed that attitudes toward gender roles had a significant effect on blame: victims were more likely to blame themselves when they endorsed more conservative gender attitudes than victims with more liberal attitudes. Implications for this finding are discussed.
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    Extended reality (XR) in psychosocial and forensic interventions for child and adolescent sexual abuse: a systematic review of current applications and future directions
    (Frontiers Media, 2025-11-20) Leiva, Varinia; Pereda Beltran, Noemí; Cenzano, Nicolás
    The integration of extended reality (XR) technologies—virtual (VR) and augmented (AR)—into child sexual abuse (CSA) interventions has grown over the past decade. This systematic review explores the application, efficacy, and ethical implications of XR tools in psychosocial, forensic, preventive, and therapeutic approaches addressing CSA. Following PRISMA guidelines, a comprehensive search was conducted across Scopus, Web of Science, and PubMed, identifying 11 empirical studies published between 2014 and 2024. Three main intervention categories emerged: (1) professional training, (2) prevention, and (3) therapeutic treatment. Most studies focused on enhancing forensic interviewing skills through avatar-based simulations and immersive training, demonstrating increased use of relevant questions and improved selfefficacy among professionals. Preventive interventions used VR and serious games in school settings to promote body safety awareness and protective behaviors in children. Despite their promise, only one study addressed therapeutic applications directly, highlighting the use of a nonverbal digital tool and serious game to facilitate trauma narration in children with CSA experiences, based on trauma-focused cognitive-behavioral therapy (TF-CBT). The findings emphasize XR’s potential to foster engagement, realism, and emotional safety in highly sensitive contexts, specifically in CSA interventions. However, challenges include limited longitudinal evidence, lack of culturally diverse studies, and ethical concerns about exposure, re-victimization, and emotional risks for minors. This review underscores the need for more ethically rigorous research to determine the impact of XR-based interventions in child sexual victimization management.
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    The Role of Cognitive Functioning in the ICF Framework: A Systematic Review of Its Influence on Activities and Participation and Environmental Factors in People with Cerebral Palsy
    (MDPI, 2025-09-10) Carracedo-Martín, María; Moral‑Salicrú, Paula; Blasco, Montse; Fernández Andújar, Marina; Pueyo Benito, Roser; Ballester Plané, Júlia
    Background/Objectives: Cerebral palsy (CP) is the most common cause of motor disability in childhood and is frequently associated with cognitive impairments that limit autonomy and participation. While motor function is a known predictor of functional outcomes, the specific contribution of cognitive domains within the International Classification of Functioning, Disability and Health (ICF) framework remains unexplored. This systematic review examines the relationship between cognitive domains and the ICF components of Activities and Participation, and Environmental Factors in people with CP. Methods: Following PRISMA guidelines, a systematic search was conducted across six databases (PubMed, PsycINFO, CENTRAL, CINAHL, ERIC, and WOS) for studies published between 2002 and 2025. Eligible studies included participants with CP (n = 3056) and analyzed associations between cognitive functions and ICF domains using standardized tools and statistical methods. Risk of bias was evaluated using the Oxford Centre for Evidence-Based Medicine criteria. Results: Forty-four studies met inclusion criteria, involving mostly children and adolescents with spastic CP and mild to moderate motor impairment. General intellectual functioning, language, and visual perception were the most studied domains, showing consistent associations with ICF chapters such as Learning and applying knowledge, Communication, and Mobility. Although fewer studies examined Environmental Factors, relevant associations emerged with support systems, attitudes, and services. Heterogeneity in assessment methods and participant profiles was observed, and adult representation was limited. Conclusions: Cognitive functioning is significantly associated with multiple ICF domains in CP. Environmental Factors remain insufficiently addressed. Further research should consider CP heterogeneity and promote standardized assessments to support ICF-based intervention planning.
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    ALCO-VR Project: A randomized clinical trial evaluating virtual reality cue-exposure Therapy for Treatment-Resistant Alcohol Use Disorder patients
    (Sociedad Científica Española de Estudios sobre el Alcohol, el Alcoholismo y las otras Toxicomanías, 2025-09-22) Ghiţă, Alexandra; Hernández Serrano, Olga; Ruiz, Jolanda F. (Fernandez Ruiz); Gacto-Sánchez, Mariano; Monras Arnau, Miquel; Gual, Antoni; Porras-García, Bruno; Ferrer, Marta (Ferrer García); Gutiérrez Maldonado, José
    The management of “treatment-resistant” alcohol use disorder (AUD) often presents significant challenges. Virtual reality (VR) applications, specifically VR cue exposure therapy (VR-CET), offer a potentially complementary approach to the standard treatment (TAU). This randomized clinical trial (RCT) aimed to assess VR-CET’s effectiveness when added to TAU, compared to TAU alone, in reducing alcohol craving and anxiety among individuals with treatment-resistant AUD. The study also sought to determine anxiety and craving levels during VR-CET sessions and to explore long-term effects. Eighty-five AUD patients from the Clinic Hospital of Barcelona participated. They were randomly assigned to either an experimental group (EG), receiving VR-CET plus TAU, or a control group (CG), receiving TAU alone. The EG completed six VR-CET sessions alongside TAU, while the CG continued with only TAU. Alcohol craving and anxiety were assessed before and after treatment for both groups, and during VR-CET sessions for the EG. Relapses were monitored at 3-, 6-, and 12-months post-treatment. Results indicated no significant main effects of “type of treatment” (EG vs. CG) on craving or anxiety. However, a significant “time” factor was observed, showing reductions in craving and anxiety from pre-test to post-test, regardless of the treatment type. Within VR-CET sessions, EG participants reported minimal anxiety and craving by the end of the therapy. Importantly, no statistically significant differences in relapse rates were found between the EG and CG at any follow-up period (3, 6, 12 months). The clinical implications of the study, limitations, and research directions are further discussed. 
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    The role of baseline and persistent depression in adjuvant cancer therapy: impact on toxicity and quality of life
    (Elsevier España, 2025-10-19) Obispo, Berta M.; Calderón Garrido, Caterina; Carmona Bayonas, Alberto; Ghanem, Ismael; Cano-Cano, Juana Maria; Jiménez Fonseca, Paula
    Introduction: Depression is common among cancer patients, adversely affecting treatment adherence, toxicity, and quality of life (QoL). However, its course during adjuvant therapy and its impact on outcomes in resected cancer remain poorly understood. This study evaluated changes in depression from treatment initiation (T1) to six months later (T2) and examined associations with demographic, clinical, and psychological factors, treatment-related toxicities, and QoL. Methods: In this multicenter, prospective observational study, 927 patients with resected, non-metastatic cancer receiving adjuvant treatment were enrolled. Depressive symptoms were measured using the Brief Symptom Inventory-18 (BSI-18) at T1 and T2. Patients were classified as “never” (no symptoms at T1 or T2), “new-onset” (absent at T1, present at T2), “remission” (present at T1, absent at T2), or “persistent” (present at both time points). Treatment-related toxicities were evaluated according to CTCAE v4.0, and QoL was assessed with the EORTC QLQ-C30. Results: At T2, 50.8% of patients remained asymptomatic, 12.3% experienced remission, 23.4% exhibited persistent depression, and 13.5% developed new-onset depression. Persistent depression was more common among women, younger patients, those without a partner, and breast cancer patients. Patients with persistent symptoms showed significantly higher toxicities—including hematologic, digestive, and neuropathic events, as well as increased asthenia (p < .001)—and poorer functioning with greater symptom burden, resulting in markedly reduced overall QoL. In multivariate analyses, baseline depression and ECOG performance status were the main predictors of depressive symptoms at six months, while age predicted changes over time; other sociodemographic or clinical factors were not significant. Logistic regression confirmed that younger age, female sex, breast cancer, and poorer ECOG were associated with higher odds of persistent depression compared with never-depressed patients. Conclusion: Both baseline depression and functional impairment (ECOG) are independent predictors of depressive symptoms during adjuvant therapy. Persistent depression is significantly associated with increased treatment toxicity and poorer QoL in patients with early-stage resected cancer, highlighting the need for routine screening and early psychological intervention during adjuvant treatment.
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    Fatigue, Physical Symptoms, Psychological Distress, and Use of Integrative Medicine in Patients With Advanced Cancer
    (John Wiley & Sons, 2025-10-15) Calderón Garrido, Caterina; Muñoz, Maria del Mar; Peña-López, Jesús; López-Ceballos, Helena; Fernández Montes, Ana; Asensio Martínez, Elena; Carrillo-Vicente, Raúl; Gustems, Marina; Jiménez Fonseca, Paula
    Fatigue is a significant challenge for cancer patients, substantially affecting their quality of life, physical symptoms, and psychological distress. This study examined the relationship between fatigue in patients with advanced cancer and sociodemographic, clinical, and psychological factors. Conducted across 15 oncology departments in Spain, the study included patients with locally advanced, unresectable, or metastatic cancer eligible for systemic treatment. Participants completed the Fatigue Assessment Scale (FAS), European Organisation for Research and Treatment (EORTC QLQ-C30), Locus of Control (UWBHS), and Brief Symptom Inventory (BSI). A total of 512 patients are participated, classified into low-fatigue (55%) and high-fatigue (45%) groups. High fatigue was associated with lower educational attainment (53% vs. 44%), locally advanced disease (26% vs. 17%), poorer functional status according to ECOG (70% vs. 30%), and shorter expected survival (< 18 months: 51% vs. 37%). Additionally, patients with high fatigue reported greater use of integrative medicine (24% vs. 14%, p = 0.003) and higher prevalence of symptoms such as pain, nausea, and memory problems (p < 0.05). They also exhibited poorer quality of life and higher psychological distress. These findings highlight the need to develop multidimensional strategies that address both physical symptoms and quality of life to enhance the well-being of cancer patients. Clinically, systematic screening for fatigue and psychological distress, alongside tailored supportive interventions, should be embedded in routine care to optimize outcomes in advanced cancer patients.
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    Learning disabilities and adolescent suicidal ideation: Findings from the z-proso cohort study
    (Elsevier B.V., 2026) Codina, Marta; Díaz-Faes, Diego A.; Pereda Beltran, Noemí; Ribeaud, Denis; Eisner, Manuel; Obsuth, Ingrid
    Objective: To investigate suicidal ideation among adolescents with learning disabilities and examine whether learning disabilities and a range of risk and protective factors assessed at age 13 are associated with suicidal ideation at age 15. Methods: Longitudinal data were drawn from a youth population -based cohort (Zurich Project on the Social Development from Childhood to Adulthood [z -proso]; N = 1,675). Modified Poisson regression was used to estimate the relative risk of suicidal ideation at age 15, with learning disabilities along with the other variables as predictors. An additional model included an interaction term between learning disabilities and anxiety/depression symptoms to test whether the association between anxiety/depression and suicidal ideation varied by learning disability status. Average marginal effects were used to estimate absolute differences in predicted probabilities between groups. Results: Adolescents with learning disabilities reported significantly higher rates of suicidal ideation (32.5%) and self-injury (18.4%) compared to peers without learning disabilities. They showed elevated levels of most risk factors and lower levels of protective factors. Significant predictors of increased relative risk of suicidal ideation included female sex, anxiety/depression symptoms, bullying experiences, and learning disabilities, the latter associated with a 40.2% higher risk (RR = 1.402, 95% CI = [1.070, 1.387]). Average marginal effects indicated that anxiety/depression significantly increased suicidal ideation risk among adolescents without learning disabilities but not among those with learning disabilities. Conclusions: Findings suggest that learning disabilities are a significant risk factor for adolescent suicidal ideation, highlighting the need for early identification, tailored assessment, and targeted prevention strategies.
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    Efficacy and safety of efavirenz in Niemann-Pick disease type C
    (Springer Verlag, 2025-09-01) López de Munain, Adolfo; Rouco, Idoia; Pérez Sousa, Celia; Cerdán, María; Muelas, Nuria; Sevillano, María Dolores; Mir Rivera, P.; Villoria, Jesús; Videla, Sebastià; Gascón-Bayarri, Jordi; Rico, Imma; Sánchez Castañeda, Cristina; Ledesma, María Dolors; Carnaval, Thiago; Bejr-Kasem, Helena; Campdelacreu i Fumadó, Jaume; Ferrer, Anna; Rodríguez Bel, Laura; Cos, Mónica; Lama, Eugenia de
    Introduction In search of disease-modifying treatments for the Niemann-Pick disease type C (NPC), this Phase II single-arm clinical trial evaluated the safety and efficacy of efavirenz, a reverse transcriptase inhibitor that potentially ameliorates neuronal cholesterol turnover, typically impaired in this rare lysosomal storage disorder. Material and methods Patients 14 years of age or older with genetically confirmed NPC received efavirenz 25 mg/day (Weeks 1–26) or 100 mg/day (Weeks 27–52) orally on top of standard care including miglustat. The primary endpoint was the proportion of response, defined as lack of deterioration in a composite outcome of cognitive performance. Secondary endpoints included the quantitative scores of several clinical neuropsychological assessment tools, some relevant neurological signs and symptoms, and imaging and biological specimen-based biomarkers. Measures were taken repeatedly over time and were analyzed using generalized linear mixed models. Results Sixteen patients 15–60 years of age were enrolled. All (100.0 %, 95 % exact confidence interval: 79.4–100.0 %) met the primary endpoint response criterion at Week 52. Quantitative neuropsychological assessments yielded more nuanced results, with relative preservation of learning, memory and executive control, and subtle impairments of verbal fluency, selective and divided attention, and cognitive inhibition. Some patients had better responses than others, allowing us to set two well-differentiated subgroups that differed essentially in the time since symptoms onset. No efavirenz-related or serious adverse events were reported. Conclusion Efavirenz appears to be a safe, easy-to-use, new targeted therapeutic option which slows the rate of NPC progression. The benefits of efavirenz are greater if started earlier.
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    Memoria y epilepsia
    (Viguera Editores SL, 1997) Mataró Serrat, Maria; Junqué i Plaja, Carme, 1955-
    Es tracta d'una revisió on es posa en valor l'exploració neuropsicològica per a detectar alteracions cognitives subtils i la rellevància en contribuir a la indicació del tractament quirúrgic o monitoritzar el tractament farmacològic.
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    Influence of extraneurological insults on ventricular enlargement and neuropsychological functioning after moderate and severe traumatic brain injury
    (Mary Ann Liebert, 2004-07) Ariza González, Mar; Mataró Serrat, Maria; Poca Pastor, María Antonia; Junqué i Plaja, Carme, 1955-; Garnacho, Ángel; Amorós, Sonia; Sahuquillo, Juan
    Extraneurological insults secondary to TBI such as hypotension or hypoxia have been associated with mortality and morbidity. The purpose of this study was to investigate the influence of systemic complications on both neuropsychological outcome and cerebral atrophy. Fifty-seven patients selected from 122 consecutive admissions were studied. Data on the type and severity of injury as well as other systemic insults were collected prior to and during the first 3 days of hospitalization. These data included the presence or absence of a hypoxic episode during the pre-hospital period, the presence and degree of hypoxia, hypercapnia, anemia, hypotension and intracranial hypertension, pupillary reactivity, Glasgow Coma Scale score and coma duration. From the last control CT scan image, performed 6 months post-injury, four different indexes of ventricular dilatation were calculated. Neuropsychological assessment at 6 months included tests of verbal and visual memory, visuoconstructive functions, fine motor speed, and frontal lobe functions. Our results showed that hypoxia and hypotension were related to neuropsychological outcome and long-term ventricular enlargement. Hypoxic episodes prior to hospitalization were related to third ventricle dilatation and to adverse neurological and cognitive outcomes, especially to attention, motor speed, mental flexibility, fluency and verbal memory impairments, suggesting fronto-striatal and hippocampal dysfunction. We conclude that the effect of extraneurological insults on brain structure and function may be as important as the severity of the primary injury.
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    Neuropsychological outcome in relation to the traumatic coma data bank classification of computed tomography imaging.
    (Mary Ann Liebert, 2001-09) Mataró Serrat, Maria; Poca Pastor, María Antonia; Sahuquillo, Juan; Pedraza, Salvador; Ariza González, Mar; Amorós, Sonia; Junqué i Plaja, Carme, 1955-
    The Traumatic Coma Data Bank (TCDB) classification of CT (computed tomography) scan hasbeen related to the general outcome and intracranial pressure evolution. Our aim was to analysethe relationship of thisclassification with neuropsychological outcome and late indices of ventriculardilatation. Fifty-seven patientswith a moderate or severe head injury (mean admission GlasgowComa Scale Score, 7.7) were studied from 122 consecutive cases. There were 49 males and 8 females(mean age, 27.7 years). Subjects were classified into TCDB categories on the basis of their most seriousacute CT scan finding. From the last control CT scan image, performed at a mean of 6.12months postinjury, several measures of ventricular dilatation were calculated. Neuropsychologicalassessment at 6-month included tests of verbal and visual memory, visuoconstructive functions, finemotor speed, and frontal lobe functions. Patients with diffuse injury type I showed better neuropsychologicaloutcome than patients with more severe diffuse injuries and those with mass lesions.Within the diffuse injury groups, the degree of diffuse damage was related to measures of verbalmemory and attention and cognitive flexibility. Ventricular enlargement was more evident in patientswith mass lesions and it decreased in the remaining groups as the severity of diffuse injury diminished.
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    Postsurgical Cerebral Perfusion Changes in Idiopathic Normal Pressure Hydrocephalus: A Statistical Parametric Mapping Study of SPECT Images
    (The Society of Nuclear Medicine and Molecular Imaging, 2003-12-01) Mataró Serrat, Maria; Poca Pastor, María Antonia; Salgado-Pineda, Pilar; Castell Conesa, Joan; Sahuquillo, Juan; Díez Castro, María Jesús; Aguadé Bruix, Santiago; Vendrell i Gómez, Pere; Matarín, Mar; Junqué i Plaja, Carme, 1955-
    Our goal was to study cerebral blood flow (CBF) changes after surgery in a group of 15 patients with idiopathic normal pressure hydrocephalus (NPH). Methods: We used hexamethylpropyleneamine oxime SPECT and statistical parametric mapping (SPM), an image analysis method that does not require prior selection of regions of interest. Results: Our study showed areas of significant increase in perfusion in specific regions of both frontal lobes and the right parietal lobe. Regions of increased perfusion were found in the left prefrontal dorsolateral areas (Brodmann’s areas 9 and 45 or 47), right frontal premotor area (Brodmann’s area 44), right medial prefrontal region (Brodmann’s area 10 or 32), right frontal white matter area (superior longitudinalis fasciculus), and right basal ganglia (lenticular nucleus, putamen, and globus pallidus). In the right hemisphere, another region of increased perfusion was found in the inferior parietal lobule (Brodmann’s area 40). The 2 areas most related to clinical improvement were Brodmann’s area 32 and the frontal part of the left lobule of Reil insula. Conclusion: The results obtained with the SPM method of image analysis confirm and expand on previous CBF literature in NPH, with specific CBF regions located in frontal and parietal areas that improve after surgery in idiopathic NPH.
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    Improving Anorexia Nervosa Treatment with Virtual Reality Body Exposure and Attentional Bias Modification: A Single Case Study
    (MDPI, 2024-06-01) Ascione, Mariarca; Serrano Troncoso, Eduardo; Carulla-Roig, Marta; Blasco Martínez, Anna; Guerrero Álvarez, Fernando; Meschberger-Annweiler, Franck-Alexandre; Porras-García, Bruno; Ferrer, Marta (Ferrer García); Gutiérrez Maldonado, José
    This case study explores the potential of integrating attentional bias modification training (ABMT) with mirror exposure therapy (MET), utilizing virtual reality and eye-tracking, for a 14-year-old girl diagnosed with anorexia nervosa (AN). The ABMT-MET intervention was used alongside a standard treatment program called Home Treatment (HoT), which combines cognitive behavioral therapy with family-based therapy. Though the patient began HoT with a 3-week inpatient phase, the ABMT-MET intervention specifically took place during the subsequent Home Treatment sessions. The experimental treatment, comprising five consecutive weekly sessions, was bookended by pre- and post-assessment sessions and included a six-month follow-up. During the sessions, the patient engaged in systematic and hierarchical exposure to a virtual representation of her silhouette, with gradual adjustments made to the avatar’s body mass index (BMI) toward a healthier range. ABMT sessions, conducted before each MET session, aimed to redistribute the patient’s focus evenly across her body, successfully neutralizing her initial attentional bias toward non-weight-related body parts. The patient demonstrated consistent decreases in anxiety and fear of weight gain, effectively progressing through the BMI hierarchy in the virtual setting. Post-treatment assessments indicated significant enhancements in body dissatisfaction, drive for thinness, body-checking behaviors, and body appreciation, with these gains preserved at the six-month follow-up, although the attentional bias returned to pre-treatment levels. Though the single-case design limits definitive conclusions, these findings suggest ABMT-MET may be a promising adjunct therapy for AN, requiring further research for confirmation.
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    Estudio de las secuelas a largo plazo de los traumatismos craneoencefálicos (TCE): evaluación de la memoria declarativa y procedimental y de su sustrato neuroanatómico
    (IMR Press, 2001) Verger Maestre, Katia; Serra y Grabulosa, Josep Ma.; Junqué i Plaja, Carme, 1955-; Álvarez Amador, Alfredo; Bartrés Faz, David; Mercader Sobrequés, José Ma.
    [spa] Introducción y objectivos. Los estudios realizados hasta la actualidad permiten considerar el hipocampo y el estriado como el sustrato neural de las memorias declarativa y procedimental, respectivamente. Si bien ambas estructuras son vulnerables al traumatismo craneoencefálico, y diversos estudios han observado que tanto la memoria declarativa como la procedimental también decaen a consecuencia de traumatismo craneoencefálico, los estudios volumétricos realizados hasta ahora no muestran evidencia de la relación entre la atrofia de ambas estructuras y el grado de alteración de la memoria. El presente estudio se centra en investigar el grado de alteración de las memorias declarativa y procedimental en niños que, de pequeños, sufrieron traumatismo craneoencefálico de moderado a grave. Pacientes y métodos Diecinueve pacientes y sus respectivos controles fueron evaluados en tareas de memoria declarativa y aprendizaje motor. Los resultados mostraron que los sujetos con traumatismo craneoencefálico exhibían un peor rendimiento en ambas tareas. Además, para relacionar el rendimiento neuropsicológico con los datos volumétricos del hipocampo y el estriado, se realizaron análisis de correlaciones. Resultados Se encontraron correlaciones positivas entre el volumen del hipocampo y la memoria para objetos del test ‘objeto-localización’. Por su parte, el volumen del estriado correlacionaba positivamente con el aprendizaje motor y la memoria verbal. Conclusión Los resultados obtenidos sugieren que los mecanismos de plasticidad no compensan completamente los déficit de memoria resultantes de la pérdida neural en el cerebro immaduro.
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    Cambios en la sustancia blanca y rendimiento cognitivo en el envejecimiento
    (IMR Press, 2001) Bartrés Faz, David; Clemente, Immaculada; Junqué i Plaja, Carme, 1955-
    [spa] Objetivo En el presente trabajo se revisan los principales estudios de resonancia magnética dirigidos a evidenciar la posible relación entre los cambios en la sustancia blanca cerebral (CSB) o leucoaraiosis y el perfil neuropsicológico de sujetos envejecidos sin demencia. Desarrollo Los artículos publicados hasta la fecha aportan resultados contradictorios, y en casi la mitad de los casos revisados la relación entre la leucoaraiosis y la conducta no se ha podido establecer claramente. No obstante, con la utilización de pruebas cognitivas sensibles es posible detectar una asociación entre la presencia o el grado de CSB y el declive en las funciones frontales, como la velocidad de procesamiento de la información, la función visuomotora, la fluidez verbal, la categorización o la secuenciación mentales. Otras áreas cognitivas como el lenguaje, la memoria o las funciones visuoespaciales, visuoconstructivas y visuoperceptivas aparecen menos frecuentemente relacionadas con la presencia o intensidad de lesiones en la sustancia blanca cerebral. La localización periventricular de la leucoaraiosis parece más importante desde un punto de vista neuropsicológico en contraposición a la localización subcortical. Conclusiones Las funciones neuropsicológicas más frecuentemente asociadas a la presencia de leucoaraiosis son las dependientes de los lóbulos frontales; el mecanismo fisiopatológico más plausible consiste en una ‘desconexión’ propiciada por la presencia de los CSB. Aunque existe evidencia que señala un efecto genético en la manifestación de los CSB, el estudio de genes asociados al deterioro cognitivo en el envejecimiento normal no ha aportado resultados concluyentes.
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    Alteración cognitiva en el envejecimiento normal: nosología y estado actual
    (IMR Press, 1999-07) Bartrés Faz, David; Clemente, Immaculada; Junqué i Plaja, Carme, 1955-
    [spa] Introducción y objetivos. Durante los últimos 15 años han aparecido diversas clasificaciones diagnósticas con la intención de describir un grupo de población adulta que presenta un grado de afectación cognitiva superior a lo esperable por su edad, pero que no cumple criterios de demencia. En este trabajo se revisan los principales estudios que han utilizado estas categorías y se comparan sus resultados a fin de establecer si definen poblaciones comparables o distintas. Desarrollo Los estudios llevados a cabo con diversas categorías diagnósticas o con distinta utilización de los criterios de inclusión o exclusión hacen que los valores de prevalencia o la evolución de los sujetos hacia demencia sean muy dispares. Los datos genéticos y de neuroimagen contribuyen a reforzar la validez de las clasificaciones propuestas para identificar la pérdida cognitiva asociada a la edad. Conclusiones Los criterios utilizados parecen ser sumamente importantes para la identificación de sujetos con un estado cognitivo más próximo al envejecimiento normal o a la demencia. En este sentido son necesarios más estudios longitudinales y un consenso entre los criterios de las distintas clasificaciones si se pretende identificar de forma fiable la población con función cognitiva inferior a la esperada por su edad, pero distinguible de aquella que representa estados iniciales de demencia
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    Good outcome in patients with normal-pressure hydrocephalus and factors indicating poor prognosis
    (American Association of Neurological Surgeons, 2005) Poca Pastor, María Antonia; Mataró Serrat, Maria; Matarín, Mar; Arikan, Fuat; Junqué i Plaja, Carme, 1955-; Sahuquillo, Juan
    Object The authors set out to describe the outcome in a subgroup of patients with normal-pressure hydrocephalus (NPH) in whom prognostic factors were poor. This subgroup of patients who had received shunts was selected according to strict criteria. Methods From a cohort of 56 patients with NPH in whom shunts were placed, the authors selected a subgroup with four of the factors traditionally considered to indicate poor prognosis: idiopathic type, cortical atrophy, longstanding symptoms, and presence of dementia in addition to old age. Twelve patients met the inclusion criteria. After receiving shunts, 92% of the patients showed clinical improvement on the NPH scale; gait improved in 100% of patients, sphincter control in 90%, and dementia in 33%. Improvement was significant for gait and sphincter control, general NPH score, and most daily life activity scales. No significant differences regarding clinical, cognitive, or functional changes following surgery were found in comparison with the rest of patients (the good prognosis subgroup). Conclusions The clinical condition of patients with NPH who present with traditionally accepted markers of poor prognosis can improve after surgery, especially as regards gait and sphincter control. The authors assert that the presence of these markers should not be considered to be an absolute criterion for ruling out shunt surgery in cases of NPH syndrome.