Propuestas para un enfoque transdiagnóstico de los trastornos mentales y del comportamiento: Evidencia, utilidad y limitaciones = Proposals for a transdiagnostic perspective of mental and behavioural disorders: Evidence, usefulness, and limitations

Fuster, Amparo Belloch

doi:10.5944/rppc.vol.17.num.3.2012.11845

Cited by 33 publications

(15 citation statements)

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“…The findings showed that more than half of the non-clinical community participants had experienced illness-ITs in the past three months, although their frequency was generally low ('occasionally'). Nonetheless, it was noteworthy that the reported frequency was identical to what was observed for intrusive thoughts with obsessional contents in community samples (Belloch, Roncero, & Perpiñ a, 2016), which supports the notion that intrusive thoughts can be viewed as transdiagnostic variables and might be considered vulnerability factors in different disorders (Belloch, 2012;Pascual-Vera & Belloch, 2018a;Pascual-Vera, Roncero, & Belloch, 2017;Romero-Sanchiz et al, 2017).…”

Section: Discussionsupporting

confidence: 61%

Illness‐related intrusive thoughts and illness anxiety disorder

et al. 2020

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Introduction Intrusive thoughts about health threats (illness‐ITs) are a potential cognitive risk factor for the development and maintenance of illness anxiety disorder (IAD). This study analyzes the dimensionality of illness‐ITs from normalcy to psychopathology, and it evaluates whether the appraisals instigated by the Its mediate between these thoughts and IAD symptoms. Methods Two groups of individuals participated in the study and completed the Illness Intrusive Thoughts Inventory and the Whiteley Index. The first group was composed of 446 non‐clinical community participants. Of them, 264 individuals (68.6% women; Mage = 30.03 [SD = 13.83]) reported having experienced an upsetting illness‐IT in the past three months and were then included in the main analyses. The second group included 31 patients with a current main diagnosis of IAD based on DSM‐5 criteria (51.6% women; Mage = 32.74 [SD = 9.69]). Their severity was assessed with the Hypochondriasis Yale‐Brown Obsessive‐Compulsive Scale ‐Modified version, with scores ranging from 15 to 58 (M = 46.12, SD = 9.41). Results Illness‐ITs are common in both non‐clinical individuals and in patients with IAD, and they instigate dysfunctional emotional, cognitive, and behavioral consequences, although with greater intensity in patients than in non‐clinical individuals. The relationship between illness‐ITs and IAD is mediated by overestimation of threat and thought‐action fusion‐probability appraisals. Conclusion Illness‐ITs are a dimensional cognitive experience. The way they are appraised facilitates their escalation into symptoms of IAD. Practitioner points Provides support for the cognitive explanatory model of IAD and its usefulness in clinical practice. Indicates that the way people interpret and react to naturally occurring intrusive thoughts about illness seems to be a vulnerability marker for developing an illness anxiety disorder. Emphasizes that the meaning that patients with IAD ascribe to their intrusive thoughts about illnesses must be a main target in the cognitive‐behavioral treatment of IAD. Suggests that the importance of intrusive thoughts in IAD does not lie in the frequency with which they are experienced, but in the way, they are appraised/interpreted, which is what determines whether they become a clinically significant symptom. Indicates that the relationship between illness intrusive thoughts and IAD symptoms in non‐clinical individuals is based on: overestimating the negative consequences of experiencing an illness intrusive thought; and the appraisal that having such a thought would increase its likelihood of coming true. Shows that the frequency of illness‐related intrusive cognitions is associated with worse cognitive and behavioral consequences.

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Section: Discussionsupporting

confidence: 61%

Illness‐related intrusive thoughts and illness anxiety disorder

et al. 2020

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“…Se pretende con ello solventar algunas de las limitaciones derivadas de los sistemas categoriales, tales como la dificultad para establecer diagnósticos precisos, las altas tasas de comorbilidad (tanto intra-como entre-categorías), la «mutación» de un trastorno en otro, las dificultades para establecer etiopatogenias específicas y diferenciadas, y como consecuencia de todo ello, los problemas para establecer el curso de los distintos trastornos y las pautas más eficaces para su tratamiento. El cumplimiento de estos objetivos deberá por tanto optimizar los recursos y procesos de evaluación, diagnóstico y tratamiento (Aldao y Nolen-Hoeksema, 2010;Barlow et al, 2011;Belloch, 2012;Fairburn, Cooper, y Shafran, 2003;Nolen-Hoeksema y Watkins, 2011).…”

Section: Introductionunclassified

“…17, nº 3). Las intrusiones mentales desagradables y no deseadas (en adelante, IM) se encuentran entre las posibles variables transdiagnósticas de la psicopatología que nuestro grupo viene proponiendo (p.ej., Belloch, 2012). Si bien se ha constatado la relevancia de las IM como análogos y/o pre-síntomas clínicos en el trastorno obsesivo-compulsivo, también se ha mencionado que su aparición y relevancia van más allá de este trastorno.…”

Section: Introductionunclassified

“…En suma, se producen relaciones funcionales entre un producto mental del que la persona es consciente, las IM, y el estado emocional, la calidad de vida, y los comportamientos que suscitan. Desde esta perspectiva, tanto las IM como sus consecuencias funcionales (i.e., malestar, egodistonía, interferencia, valoraciones sesgadas, comportamientos y estrategias de neutralización y control), podrían ser un factor común, con valor transdiagnóstico, en los trastornos mencionados (Belloch, 2012;Blom, Hagestein-de Brujin, de Graaf, ten Have y Denys, 2011), además de estar presentes en otros, como el insomnio (p.ej., Harvey y Payne, 2002;Schubert y Coles, 2013), el trastorno de estrés post-traumático (p.ej., Ehlers et al, 2002;Engelhard, van den Hout, Arntz, y McNally, 2002), la ansiedad generalizada, las adicciones, o la depresión (Clark, 2005(Clark, , 2017.…”

Section: Introductionunclassified

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El carácter transdiagnóstico de las intrusiones mentales: una revisión y una propuesta basada en datos.

Pascual-Vera

Belloch

2018

RPPC

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Abstract. The objective of a transdiagnostic perspective in psychopathology is to better understand the commonalities among clinically different mental disorders on the basis of a set of shared etiopathogenic dimensions and processes. Unwanted intrusive cognitions (UI) and their functional consequences had been proposed as symptom dimensions in Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Hypochondriasis (HYP) and Eating Disorders (EDs). In this article, we review the empirical data about the putative transdiagnostic nature of UI and their functional consequences in the four mentioned disorders. Firstly, the results about the universality and dimensionality of UI with contents of each disorder are reviewed. Secondly, data about UI as common symptom dimensions in OCD and EDs are presented. Finally, we offer information about our current research about the hypothetical transdiagnostic nature of UI with obsessional, dysmorphic, hypochondriac, and eating-disorders contents.Keywords: Mental intrusions; transdiagnostic; obsessive-compulsive disorder; body dysmorphic disorder; hypochondriasis; eating disorders.Resumen. El propósito de adoptar un enfoque transdiagnóstico en psicopatología es comprender las comunalidades entre trastornos mentales clínicamente diferentes sobre la base de un rango de dimensiones y procesos etiopatogénicos compartidos. Las intrusiones mentales no deseadas (IM) y sus consecuencias funcionales se han propuesto como dimensiones de síntomas en el Trastorno Obsesivo-Compulsivo (TOC), el Trastorno Dismórfico Corporal (TDC), la Hipocondría (HIP) y los Trastornos Alimentarios (TA). Este artículo resume y actualiza los datos disponibles sobre el potencial valor transdiagnóstico de las intrusiones mentales y sus consecuencias funcionales en los cuatro trastornos mencionados. Se presentan, primero, los resultados sobre la universalidad y dimensionalidad de IM con contenidos característicos de cada trastorno; segundo, los datos sobre las IM como dimensiones de síntomas comunes en el TOC y los TA; por último, se aporta información sobre una investigación propia cuyo objetivo es poner a prueba la hipótesis del carácter transdiagnóstico de IM obsesivas, dismórficas, hipocondríacas y alimentarias.Palabras clave: Intrusiones mentales; transdiagnóstico; trastorno obsesivo-compulsivo; trastorno dismórfico corporal; hipocondría; trastornos alimentarios. IntroducciónFrente a la caracterización categorial de los trastornos mentales en los sistemas de diagnóstico psiquiátrico, que establecen características únicas y específicas de y para cada trastorno, surge a principios de este siglo el denominado enfoque transdiagnóstico de la psicopatología (Sandín, 2012). Su objetivo es identificar los procesos disfuncionales nucleares que subyacen a trastornos mentales que, aun siendo diferentes en su manifestación clí-nica, mantienen tasas de comorbilidad más elevadas de lo que cabría esperar por azar, se ajustan bien a modelos explicativos similares, y responden a tratamientos a menudo idénticos. U...

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“…One of the main problems of the categorical approach to psychopathology is the high comorbidity among the different mental disorders (Sandín et al, 2012). In last years, a new approach has emerged for the treatment of mental disorders that aims to develop interventions that can be used to treat the common symptoms of various psychological disorders (Belloch, 2012). This approach, known as transdiagnostic, considers that mental disorders share numerous cognitive and behavioral processes that contribute to the development and maintenance of symptoms (Harvey et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Evidence-Based Brief Psychological Treatment for Emotional Disorders in Primary and Specialized Care: Study Protocol of a Randomized Controlled Trial

et al. 2019

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Emotional Disorders (EDs) are very prevalent in Primary Care (PC). However, general practitioners (GPs) have difficulties to make the diagnosis and the treatment of this disorders that are usually treated with drugs. Brief psychological therapies may be a new option to treat EDs in a PC context. This article aims to present a study protocol to evaluate the effectiveness and the efficiency of an adaptation to brief format of the “Unified Protocol (UP) for the transdiagnostic treatment of EDs.” This is a single-blinded RCT among 165 patients with EDs. Patients will be randomly assigned to receive brief psychological treatment based on UP, conventional psychological treatment, conventional psychological treatment plus pharmacological treatment, minimum intervention based on basic psychoeducational information, or pharmacological treatment only. Outcome measure will be the following: GAD-7, STAI, PHQ-9, BDI-II, PHQ-15, PHQ-PD, and BSI-18. Assessments will be carried out by blinded raters at baseline, after the treatment and 6-month follow-up. The findings of this RCT may encourage the implementation of brief therapies in the PC context, what would lead to the decongestion of the public health system, the treatment of a greater number of people with EDs in a shorter time, the reduction of the side effects of pharmacological treatment and a possible economic savings for public purse.Clinical Trial Registration: ClinicalTrial.gov, identifier NCT03286881. Registered September 19, 2017.

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Propuestas para un enfoque transdiagnóstico de los trastornos mentales y del comportamiento: Evidencia, utilidad y limitaciones = Proposals for a transdiagnostic perspective of mental and behavioural disorders: Evidence, usefulness, and limitations

Cited by 33 publications

References 38 publications

Illness‐related intrusive thoughts and illness anxiety disorder

Illness‐related intrusive thoughts and illness anxiety disorder

El carácter transdiagnóstico de las intrusiones mentales: una revisión y una propuesta basada en datos.

Evidence-Based Brief Psychological Treatment for Emotional Disorders in Primary and Specialized Care: Study Protocol of a Randomized Controlled Trial

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