Despersonalización en una muestra comunitaria y en personas con trastornos de ansiedad: el rol de las interpretaciones catastróficas y de la evitación experiencial

Rafael Kichic

doi:10.18682/pd.v15i2.535

Rafael Kichic Clínica de Ansiedad y Trauma, Instituto de Neurología Cognitiva (INECO)

DOI: https://doi.org/10.18682/pd.v15i2.535

Palabras clave: despersonalización, trastornos de ansiedad, interpretaciones catastróficas, evitación experiencial,

Resumen

Este estudio exploró la relación entre interpretaciones catastróficas, evitación experiencial y los diferentes subtipos de despersonalización (DP) en 70 participantes de la comunidad y 70 pacientes con trastornos de ansiedad. Los pacientes completaron instrumentos que medían interpretaciones catastróficas, evitación experiencial y DP. Las interpretaciones catastróficas predijeron la intensidad global de la DP y los subtipos experiencias corporales anómalas, experiencias anómalas del recordar, y desrealización. Contrariamente, la evitación experiencial no apareció como un predictor de DP. Los resultados son discutidos a la luz de los últimos avances en la conceptualización de la DP.

Descargas

La descarga de datos todavía no está disponible.

Citas

Abramowitz, J. S., Lackey, G. R., & Wheaton, M. G. (2009). Obsessive– compulsive symptoms: The contribution of obsessional beliefs and experiential avoidance. Journal of Anxiety Disorders, 23(2), 160-166.

http://dx.doi.org/10.1016/j.janxdis.2008.06.003

American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.

Baker, D., Earle, M., Medford, N., Sierra, M., Towell, A., & David, A. (2007). Illness perceptions in depersonalization disorder: testing an illness attribution model. Clinical Psychology & Psychotherapy, 14(2), 105-116. http://dx.doi.org/10.1002/cpp.518

Baker, D., Hunter, E., Lawrence, E., Medford, N., Patel, M., Senior., & David, A. S. (2003). Depersonalisation disorder: clinical features of 204 cases. The British Journal of Psychiatry, 182(5), 428-433. http://dx.doi.org/10.1192/bjp.182.5.428

Barlow, D. H., Vermilyea, J., Blanchard, E. B., Vermilyea, B. B., Di Nardo, P. A., & Cerny, J. A. (1985). The phenomenon of panic. Journal of Abnormal Psychology, 94(3), 320. http://dx.doi.org/10.1037/0021-843X.94.3.320

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory – Manual. San Antonio, TX: The Psychological Corporation.

Berman, N. C., Wheaton, M. G., McGrath, P., & Abramowitz, J. S. (2010). Predicting anxiety: The role of experiential avoidance and anxiety sensitivity. Journal of Anxiety Disorders, 24(1), 109-113. http://dx.doi.org/10.1016/j.janxdis.2009.09.005

Block-Lerner, J., Salters-Pedneault, K., & Tull, M. T. (2005). Assessing mindfulness and experiential acceptance. En S. M. Orsillo & L. Roemer (Eds). Acceptance and mindfulness-based approaches to anxiety (pp. 71-99). Springer US. http://dx.doi.org/10.1007/0-387-25989-9_3

Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of consulting and clinical psychology, 52(6), 1090. http://dx.doi.org/10.1037/0022-006X.52.6.1090

Cohen, J., Cohen, P., & Stephen, G. West, and Leona S. Aiken. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Erlbaum.

Cox, B. J., & Swinson, R. P. (2002). Instrument to assess depersonalization‐ derealization in panic disorder. Depression and anxiety, 15(4), 172-175. http://dx.doi.org/10.1002/da.10051

First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). User’s guide for the Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version. New York: Biometrics Research, New York State Psychiatric Institute.

First, M. B., Spitzer, R. L., Gibbon, M. & Williams, J. B. W. (1998). Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Patient Edition with Psychotic Screen (SCID-I/P W/PSY SCREEN). New York: Biometrics Research, New York State Psychiatric Institute.

Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences. Oxford: Oxford University Press.

Foa, E. B., Riggs, D., & Gershuny, B. (1995). Arousal, numbing, and intrusion. American Journal of Psychiatry, 152, 116-120. http://dx.doi.org/10.1176/ajp.152.1.116

Goff, D. C., Olin, J. A., Jenike, M. A., Baer, L., & Buttolph, M. L. (1992). Dissociative symptoms in patients with obsessive-compulsive disorder. The Journal of nervous and mental disease, 180(5), 332-337. http://dx.doi.org/10.1097/00005053-199205000-00008

Graves, R. E. (2000). Accuracy of regression equation prediction across the range of estimated premorbid IQ. Journal of clinical and experimental neuropsychology, 22(3), 316-324. http://dx.doi.org/10.1076/1380-3395(200006)22:3;1-V;FT316

Harvey, A. G., & Bryant, R. A. (1999). Dissociative symptoms in acute stress disorder. Journal of traumatic stress, 12(4), 673-680. http://dx.doi.org/10.1023/A:1024773202939

Hayes, S. C. (2004). Acceptance and Commitment Therapy and the New Behavior Therapies: Mindfulness, Acceptance, and Relationship. En S. C. Hayes, V. M. Follete, & M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive behavioral tradition (pp. 1-29). New York: Guilford. http://dx.doi.org/10.1016/S0005-7894(04)80013-3

Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of consulting and clinical psychology, 64(6), 1152. http://dx.doi.org/10.1037/0022-006X.64.6.1152

Holmes, E. A., Brown, R. J., Mansell, W., Fearon, R. P., Hunter, E. C., Frasquilho, F., & Oakley, D. A. (2005). Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical psychology review, 25(1), 1-23. http://dx.doi.org/10.1016/j.cpr.2004.08.006

Hoyer, J., Braeuer, D., Crawcour, S., Klumbies, E., & Kirschbaum, C. (2013). Depersonalization/derealization during acute social st ress in social phobia. Journal of anxiety disorders, 27(2), 178-187. http://dx.doi.org/10.1016/j.janxdis.2013.01.002

Hunter, E. C. M., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: a cognitive–behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451-1467. http://dx.doi.org/10.1016/S0005-7967(03)00066-4

Hunter, E. C., Salkovskis, P. M., & David, A. S. (2014). Attributions, appraisals and attention for symptoms in depersonalisation disorder. Behaviour research and therapy, 53, 20-29. http://dx.doi.org/10.1016/j.brat.2013.11.005

Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. Social psychiatry and psychiatric epidemiology, 39(1), 9-18. http://dx.doi.org/10.1007/s00127-004-0701-4

Jaycox, L. H., & Foa, E. B. (1999). Obstacles in implementing exposure therapy for PTSD: Case discussions and practical solution. Clinical psychology and Psychotherapy, 3, 176-184.

Lickel, J., Nelson, E., Hayes, A., & Deacon, B. (2008). Interoceptive exposure exercises for evoking depersonalization and derealization: A pilot study. Journal of Cognitive Psychotherapy, 22, 321-330. http://dx.doi.org/10.1891/0889-8391.22.4.321

Litz, B. T., Litz, B. T., & Gray, M. J. (2002). Emotional numbing in posttraumatic stress disorder: Current and future research directions. Australian and New Zealand Journal of Psychiatry, 36(2), 198-204. http://dx.doi.org/10.1046/j.1440-1614.2002.01002.x

Mahaffey, B. L., Wheaton, M. G., Fabricant, L. E., Berman, N. C., & Abramowitz, J. S. (2013). The contribution of experiential avoidance and social cognitions in the prediction of social anxiety. Behavioural and cognitive psychotherapy, 41(01), 52-65. http://dx.doi.org/10.1017/S1352465812000367

Manos, R. C., Cahill, S. P., Wetterneck, C. T., Conelea, C. A., Ross, A. R., & Riemann, B. C. (2010). The impact of experiential avoidance and obsessive beliefs on obsessive-compulsive symptoms in a severe clinical sample. Journal of anxiety disorders, 24(7), 700-708. http://dx.doi.org/10.1016/j.janxdis.2010.05.001

Michal, M., Beutel, M. E., Jordan, J., Zimmermann, M., Wolters, S., & Heidenreich, T. (2007). Depersonalization, mindfulness, and childhood trauma. The Journal of nervous and mental disease, 195(8), 693-696. http://dx.doi.org/10.1097/NMD.0b013e31811f4492

Michal, M., Glaesmer, H., Zwerenz, R., Knebel, A., Wiltink, J., Brähler, E., & Beutel, M. E. (2011). Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population. Journal of affective disorders, 128(1), 106-111. http://dx.doi.org/10.1016/j.jad.2010.06.033

Molina Castillo, F., Molina Castillo, J. J., Martínez de la Iglesia, J., Albert Colomer, C., Berrios, G., Luque Luque, R., & Sierra, A. M. (2006). Adaptación y validación al castellano de la Escala de Despersonalización de Cambridge. Actas Españolas de Psiquiatría, 34(3), 185-192.

Neziroglu, F. & Donnelly, K. (2010). Overcoming Depersonalization Disorder: A mindfulness and acceptance guide to conquering feelings of numbness and unreality. Oakland: New Harbinger Publications.

Noyes, R., & Kletti, R. (1977). Depersonalization in response to life-threatening danger. Comprehensive psychiatry, 18(4), 375-384. http://dx.doi.org/10.1016/0010-440X(77)90010-4

Noyes, R., Woodman, C., Garvey, M. J., Cook, B. L., Suelzer, M., Clancy, J., & Anderson, D. J. (1992). Generalized anxiety disorder vs. panic disorder: Distinguishing characteristics and patterns of comorbidity. The Journal of nervous and mental disease, 180(6), 369-379.

Sanderson, W. C., Rapee, R. M., & Barlow, D. H. (1989). The influence of an illusion of control on panic attacks induced via inhalation of 5.5% carbon dioxide-enriched air. Archives of General Psychiatry, 46(2), 157-162. http://dx.doi.org/10.1001/archpsyc.1989.01810020059010

Sierra, M., Baker, D., Medford, N., & David, A. S. (2005). Unpacking the depersonalization syndrome: an exploratory factor analysis on the Cambridge Depersonalization Scale. Psychological medicine, 35(10), 1523-1532. http://dx.doi.org/10.1017/S0033291705005325

Sierra, M., & Berrios, G. E. (1998). Depersonalization: Neurobiological perspectives. Biological Psychiatry, 44, 898-908. http://dx.doi.org/10.1016/S0006-3223(98)00015-8

Sierra, M., & Berrios, G. E. (2000). The Cambridge Depersonalisation Scale: a new instrument for the measurement of depersonalisation. Psychiatry research,93(2), 153-164. http://dx.doi.org/10.1016/S0165-1781(00)00100-1

Sierra, M., & David, A. S. (2007). Depersonalization and individualism: the effect of culture on symptom profiles in panic disorder. The Journal of nervous and mental disease, 195(12), 989-995. http://dx.doi.org/10.1097/NMD.0b013e31815c19f7

Sierra, M., Medford, N., Wyatt, G., & David, A. S. (2012). Depersonalization disorder and anxiety: a special relationship?. Psychiatry research, 197(1), 123- 127. http://dx.doi.org/10.1016/j.psychres.2011.12.017

Simeon, D. S. & Abugel, J. (2008). Feeling unreal: Depersonalization disorder and the loss of the self. Oxford: Oxford University Press.

Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory STAI. Mountain View, CA: Consulting Psychologists Press.

Stevens, J. P. (1984). Outliers and influential data points in regression analysis. Psychological Bulletin, 95, 334-344. http://dx.doi.org/10.1037/0033-2909.95.2.334

Trueman, D. (1984a). Depersonalization in a nonclinical population. The Journal of psychology, 116(1), 107-112.

Trueman, D. (1984b). Anxiety and depersonalization and derealization experiences. Psychological reports, 54(1), 91-96.