Sonreír es Divertido, una intervención online para la prevención y el tratamiento de los trastornos emocionales
Resumen
Los trastornos emocionales representan una problemática en Salud Mental que conlleva un elevado costo personal y social, por lo que diseñar herramientas para su tratamiento y prevención es uno de los desafíos actuales de la psicología clínica. El programa Sonreír es Divertido es un sistema online diseñado bajo la perspectiva transdiagnóstica y el protocolo unificado de Barlow. En este trabajo se presenta una descripción del programa y datos preliminares de su eficacia, obtenidos en un estudio piloto llevado a cabo en España. El programa se muestra capaz de disminuir la sintomatología depresiva y ansiosa, así como de mejorar el afecto positivo y negativo de los participantes. Estos datos preliminares nos muestran el potencial de este tipo de intervenciones que se encuentran con gran desarrollo en muchos de países de Europa, en Norteamérica y Australia. Sonreír es Divertido es el primer programa en español que posee datos de eficacia. En Latinoamérica hay muy pocos trabajos publicados con estas características, pero ya hay investigadores que están trabajando en la región, por lo tanto se espera que los desarrollos bajo esta línea de investigación crezcan en los próximos años.
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Andrews, G., Davies, M., & Titov, N. (2011). Effectiveness randomized controlled trial of face to face versus Internet cognitive behaviour therapy for social phobia. Australian and New Zealand Journal of Psychiatry, 45(4), 337–340. http://dx.doi.org/10.3109/00048674.2010.538840
Andrews, G. & Titov, N. (2009). Hit and miss: Innovation and dissemination of evidence based psychological treatments. Behaviour Research and Therapy, 47, 974–979. http://dx.doi.org/10.1016/j.brat.2009.07.007
Andrews, G. & Titov, N. (2010). Is Internet treatment ready for prime time? Medical Journal of Australia, 192(11), 45–47.
Andersson, G. (2009). Using the Internet to provide cognitive behaviour therapy. Behaviour Research and Therapy, 47, 175–180. http://dx.doi.org/10.1016/j. brat.2009.01.010
Andersson, G. (2016). Internet–Delivered Psychological Treatments. Annual Review of Clinical Psychology, 12, 157–79. http://dx.doi.org/10.1146/annurev– clinpsy–021815–093006
Antony, M. M. & Stein, M. B. (2009). Oxford handbook of anxiety and related disorders. New York, NY, US: Oxford University Press.
Aydos, L., Titov, N. & Andrews, G. (2009). Shyness 5: The clinical effectiveness of Internet–based clinician–assisted treatment of social phobia. Australasian Psychiatry, 17(6), 488–492. http://dx.doi.org/10.1080/10398560903284943
Barlow, D. H., Raffa, S. D., & Cohen, E. M. (2002). Psychosocial treatments for panic disorder, phobias, and generalized anxiety disorder. En P. E. Nathan & M. J. Gorman (2a ed.), A guide to treatments that works. New York: Oxford University Press.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corp.
Bentley, K. H., Gallagher, M. W., Carl, J. R., & Barlow, D. H. (2014). Development and validation of the Overall Depression Severity and Impairment Scale. Psychological Assessment, 26(3), 815–830. http://dx.doi.org/10.1037/a0036216
Borkovec, T. D. & Nau. S. D. (1972). Credibility of analogue therapy rationales. Journal of Behaviour Therapy and Experimental Psychiatry, 3, 257–260. http://dx.doi.org/10.1016/0005–7916(72)90045–6
Botella, C., Gallego, M. J., Garcia–Palacios, A., Guillen, V., Baños, R. M., Quero, S., & Alcañiz, M. (2010). An Internet–Based Self–Help Treatment for Fear of Public Speaking: A Controlled Trial. Cyberpsychology Behavior, and Social Networking, 13, 407–421. http://dx.doi.org/10.1089/cyber.2009.0224
Botella, C., Hofmann, S. G., & Moscovitz, D. A. (2004). A self–applied Internet– based intervention for fear of public speaking. Journal of Clinical Psychology In Session, 60, 1–10. http://dx.doi.org/10.1002/jclp.20040
Botella, C., Mira, A., Garcia–Palacios, A., Quero, S., Navarro, M. V., Riera López del Amo, A., ...Baños, R. M. (2012). Smiling is Fun: A coping with stress and emotion regulation program. Annual review of cybertherapy and telemedicine, 181, 123–127. doi: 10.3233/978–1–61499–121–2–123
Botella, C., Mira, A., Moragrega, I., García–Palacios, A., Bretón–López, J., Castilla, D., ... Baños, R. M. (2015). An Internet–based program for depression using activity and physiological sensors: efficacy, expectations, satisfaction and ease of use. Neuropsychiatric Disease and Treatment, 12, 393–406. http:// dx.doi.org/10.2147/NDT.S93315
Botella, C., Mira, A., Herrero, R., García–Palacios, A., & Baños, R. (2015). Un programa de intervención autoaplicado a través de Internet para el tratamiento de la depresión: Sonreír es divertido. Revista de Psicologia, Ciències de l’Educació i de l’Esport, 33(2), 39–48.
Botella, C., Moragrega, I., Baños, R., & García–Palacios, A. (2011). Online predictive tools for intervention in mental illness: The OPTIMI project. En J.D. Westwood et al. (Eds.). Medicine Meets Virtual Reality (pp. 86–94). Amsterdam: IOS Press.
Bulacio, J. M., Vieyra, M. C., Alvarez Daneri, C. Benatuil, D., & Mongiello, E. (2004). Índice de calidad de vida: Validación de una muestra argentina. ALCMEON, 11, 333–336.
Campo, A., Bustos, G. & Romero, A. (2009). Consistencia interna y dimensionalidad de la Escala de estrés percibido (EEP–10 y EEP–14) en una muestra de universitarias de Bogotá, Colombia Aquichan. Red de Revistas Científicas de América Latina, el Caribe, España y Portugal, 9, 271–280.
Carrasco, Á. E. (2016). Acceptability of an adventure video game in the treatment of female adolescents with symptoms of depression. Research in Psychotherapy: Psychopathology, Process and Outcome, 19(1), 10–18. http:// dx.doi.org/10.4081/ripppo.2016.182
Cavanagh, K. & Shapiro, D. (2004). Computer Treatment for Common Mental. Health Problems. Journal of clinical psychology, 60(3), 239–251. http://dx.doi. org/10.1002/jclp.10261
Crawford, J. R. & Henry, J. D. (2004). The Positive and Negative Affect Schedule (PANAS): Construct validity, measurement properties and normative data in a large non clinical sample. British Journal of Clinical Psychology, 43(3), 245–265. http://dx.doi.org/10.1348/0144665031752934
Cuijpers, P., van Straten, A., van Oppen, P., & Andersson, G. (2008). Are psychological and pharmacological interventions equally effective in the treatment of adult depressive disorders? A meta–analysis of comparative studies. Journal of Clinical Psychiatry, 69, 1675–1685. http://dx.doi. org/10.4088/JCP.v69n1102
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 386–396. http://dx.doi. org/10.2307/2136404
Cohen, S. & Williamson, G. M. (1988). Perceived stress in a probability sample of the United States. En S. Spacapan y S. Oskamp (Eds.), The social psychology of health (pp. 31–67). Newbury Park: Sage.
Cova, F., Alvial, W., Aro, M., Bonifetti, A., Hernández, M., & Rodríguez, C. (2007). Problemas de salud mental en estudiantes de la Universidad de Concepción [Mental Health Problems in Students at The University of Conception]. Terapia Psicológica, 25, 105–112. http://dx.doi.org/10.4067/ S0718– 48082007000200001
Espinosa, H. D., Carrasco, A., Moessner, M., Cáceres, C. Gloger, S., Rojas, G., ... Krause, M. (2015). Acceptability Study of ‘‘Ascenso’’: An Online Program for Monitoring and Supporting Patients with Depression in Chile. Telemedicine and e–Health, 22(7), 577–83. http://dx.doi.org/10.1089/tmj.2015.0124
EU high–level conference (2008). European Pact for Mental Health and Wellbeing. Brussels: Together for metal health and wellbeig.
Festorazzi Acosta, A., Rodríguez A. L., & Lotero, J. A. (2008). Epidemiologia de los trastornos de ansiedad y depresión en adolescentes de una población rural. Revista de Posgrado de la VIa Cátedra de Medicina, 184(8), 4–9.
Fredrickson, B. L. (2001). The role of positive emotions in positive psychology. The broaden–and–build theory of positive emotions. American Psychologist, 56(3), 218–226. http://dx.doi.org/10.1037/0003–066X.56.3.218
Gega, L., Norman, I. & Marks, I. (2007). Computer–aided vs. tutor–delivered teaching of exposure therapy for phobia/panic: Randomized controlled trial with pre–registration nursing students. International Journal Of Nursing Studies, 44(3), 397–405. http://dx.doi.org/10.1016/j.ijnurstu.2006.02.009
Gómez–Restrepo, C., Bohórquez, A., Pinto–Masis, D., Gil Laverde, J. F. A., Rondón–Sepúlveda, M., & Díaz–Granados, N. (2004). Prevalencia de depresión y factores asociados con ella en la población colombiana. Revista Panamericana de Salud Pública, 16(6), 378–386. http://dx.doi.org/10.1590/ S1020–49892004001200003
González–Robles, A., Mira, A., Riera López del Amo, A., Raya, D., & Botella, C. (2015). Psychometric properties of the Overall Depression Severity and Impairment Scale in Spanish sample. General and Clinical populations. Póster presentado en la European Society for Research on Internet Interventions (ESRII) Conference, Polonia.
Hedman, E., Ljótsson, B., Kaldo, V., Hesser, H., El Alaoui, S., Kraepelien, M., ... Lindefors, N. (2014). Effectiveness of Internet–based cognitive behaviour therapy for depression in routine psychiatric care. Journal of affective disorders, 155, 49–58. http://dx.doi.org/10.1016/j.jad.2013.10.023
Jacobson, N. S. & Truax, P. (1991). Clinical Significance: A Statistical Approach to Defining Meaningful Change in Psychotherapy Research. Journal of Consulting and Chemical Psychology, 59(1), 12–19. http://dx.doi. org/10.1037/0022–006X.59.1.12
Johansson, R. & Andersson, G. (2012). Internet–based psychological treatments for depression. Expert Review of Neurotherapeutics, 12(7), 861–869. http:// dx.doi.org/10.1586/ern.12.63
Kazdin, A. E. & Blase, S. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6(1), 21–37. http://dx.doi.org/10.1177/1745691610393527
Kazdin, A. E. & Rabbitt, S. M. (2013). Novel models for delivering mental health services and reducing the burdens of mental illness. Clinical Psychological Science, 1(2), 170–191. http://dx.doi.org/10.1177/2167702612463566
Kohn, R., Levav, I., Caldas de Almeida, J. M., Vicente, B., Andrade, L., Caraveo–Anduaga, J. J., ...Saraceno, B. (2005). Los trastornos mentales en América Latina y el Caribe: asunto prioritario para la salud pública. Revista Panamericana de Salud Pública, 18(4/5), 229–240. http://dx.doi.org/10.1590/S1020 – 49892005000900002
Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Harnett, S. K., ...Dunbar, G. C. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12(5), 224–231. http://dx.doi. org/10.1016/S0924–9338(97)83296–8
López–del–Hoyo, Y., Olivan, B., Luciano, J. V., Mayoral, F., Roca, M., Gili, M., Andres, E., ...García–Campayo, J. (2013). Low intensity vs. self–guided Internet–delivered psychotherapy for major depression: a multicenter, controlled, randomized study. Bmc Psychiatry, 13(1), 21. http://dx.doi. org/10.1186/1471–244X–13–21
Lorian, C. N., Titov, N., & Grisham, J. R. (2012). Changes in risk–taking over the course of an internet–delivered cognitive behavioral therapy treatment for generalized anxiety disorder. Journal of Anxiety Disorders, 26(1), 140–149. http://dx.doi.org/10.1016/j.janxdis.2011.10.003
Mayo–Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta– analysis. The Lancet Psychiatry, 1(5), 368–376. http://dx.doi.org/10.1016/ S2215–0366(14)70329–3
Mezzich, J. E., Ruipérez, M. A., Pérez, C., Yoon, G., Liu, J., & Mahmud, S. (2000). The Spanish version of the quality of life index: presentation and validation. The Journal of Nervous and Mental Disease, 188(5), 301–305. http://dx.doi. org/10.1097/00005053–200005000 – 00008
Ministerio de Salud de la Nación (2013). Plan Nacional de Salud Mental. Buenos Aires: Dirección Nacional de Salud Mental y Adicciones.
Mira, A. (2014). Eficacia diferencial de un programa de intervención auto– aplicado a través de Internet para la prevención y el tratamiento de la depresión leve o moderada con apoyo y sin apoyo por parte del terapeuta. Tesis Doctoral. Universitat Jaume I.
Mira, A., Botella, C., García–Palacios, A., Riera López del Amo, A., Quero, S., Alcañiz, M., & Baños. R. M. (2012). An Internet–based program to cope with regulating stress and emotion: An example of positive technology. Cybertherapy & Rehabilitation, 2(1), 22–23.
Mira, A., González, A., Botella, C., Bretón–López, J., García–Palacios, A., Riera López del Amo, A., & Baños, R. M. (2015). Psychometric properties of the Overall Anxiety Severity and Impairment Scale in Spanish sample. Clinical and general populations. Póster presentado en el 49th Annual ABCT Convention, Chicago.
Norman, S. B., Cissell, S. H., Means–Christensen, A. J., & Stein, M. B (2006). Development and validation of an overall anxiety severity and impairment scale (OASIS). Depression & Anxiety, 23, 245–249. http://dx.doi.org/10.1002/da.20182
Nogueira, L. A., Neto, R. F., & Macedo, P. C. M. (2004). The mental health of graduate students at the Federal University of Sao Paulo: A preliminary report. Brazilian Journal of Medical and Biological Research, 37(10), 1519–1524. http://dx.doi.org/10.1590/S0100– 879×2004001000011
Organización Mundial de la Salud (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association, 291(21), 2581–2590. http://dx.doi.org/10.1001/jama.291.21.2581
Organización Panamericana de la Salud (2011). Marco de Referencia para la Implementación de la Estrategia Regional en Salud Mental. Washington, D. C.: OPS.
Osornio, L. & Palomino, L. (2009). Depresión en estudiantes universitarios [Depression in University Students]. Archivos en Medicina Familiar, 11(1), 1–2.
Perini, S., Titov, N., & Andrews, G. (2009). Clinician–assisted Internet–based treatment is effective for depression: randomized controlled trial. The Australian and New Zealand Journal of Psychiatry, 43(6), 571–578. http:// dx.doi.org/10.1080/00048670902873722
Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D., Mann, A., Tylee, A., ...Gray, J. (2004). Clinical efficacy of computerised cognitive behavioural therapy for anxiety and depression in primary care. British Journal of Psychiatry, 185, 46–54. http://dx.doi.org/10.1192/bjp.185.1.46
Remor, E. (2006). Psychometric properties of a European Spanish version of the Perceived stress scale (PSS). The Spanish Journal of Psychology, 9(1), 86–93.
Richards, D. (2011). Prevalence and clinical course of depression: A review. Clinical Psychology Review, 31(7), 1117–1125. http://dx.doi.org/10.1016/j.cpr.2011.07.004
Richards, D. & Salamanca Sanabria, A. (2014). Point–Prevalence of Depression and Associated Risk Factors. The Journal of Psychology, 148(3), 305–326. http://dx.doi.org/10.1080/00223980.2013.800831
Robles,Y., Saavedra, J. E., Mezzich, J. E., Sanez, Y., Padilla, M., & Mejía, O. (2010). Índice de calidad de vida: validación en una muestra peruana. Anales de Salud Mental, 26(2), 33–43. http://dx.doi.org/10.1192/bjp.185.1.46
Rochlen, A. B., Zack, J. S., & Speyer, C. (2004). Online Therapy: Review of Relevant Definitions, Debates, and Current Empirical Support. Journal of Clinical Psychology, 60(3), 269–283. http://dx.doi.org/10.1002/jclp.10263
Rodríguez, J. J., Kohn, R., & Aguilar–Gaxiola, S. (2010). Epidemiología de los trastornos mentales en América Latina y el Caribe. Revista Facultad Nacional de Salud Pública, 28(2).
Sandín, B., Chorot, P., Lostao, L., Joiner, T. E., Santed, M. A., & Valiente, R. M. (1999). Escalas Panas de afecto positivo y negativo: Validación factorial y transcultural. Psicothema, 11, 37–51.
Sanz, J., García Vera, M. P., Espinosa, R., Fortin, M., & Vázquez, C. (2005). Adaptación española del inventario para la depresión de Beck– II (BDI–II): 3. Propiedades psicométricas en pacientes con trastornos psicológicos. Clínica y Salud, 16, 121–142.
Schneier, F. R., Heckelman, L. R., Garfinkel, R., Campeas, R., Fallon, B. A., Gitow, A., ...Liebowitz, M. R. (1994). Functional impairment in social phobia. Journal of Clinical Psychiatry, 55, 322–331.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., ...Dunbar, G. C. (1998). The Mini–International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM–IV and ICD–10. The Journal of Clinical Psychiatry, 59, 22–33.
Spek, V., Cuijpers, P., Nyklicek, I., Riper, H., Keyzer, J., & Pop, V. (2007). Internet based cognitive behaviour therapy for symptoms of depression and anxiety: A meta–analysis. Psychological Medicine, 37(3), 319–328. http:// dx.doi.org/10.1017/S0033291706008944
Spence, J., Titov, N., Dear, B. F., Johnston, L., Solley, K., Lorian, C., Wootton, B., ...Schwenke, G. (2011). Randomized controlled trial of Internet–delivered cognitive behavioral therapy for posttraumatic stress disorder. Depression and Anxiety, 28(7), 541–50. http://dx.doi.org/10.1002/da.20835
SUSESO (2008). Licencias tramitadas por problemas de Salud Mental [Sick leave due to mental health problems]. Santiago de Chile: Superintendencia de Seguridad Social.
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Johnston, L. (2009). Randomized controlled trial of web–based treatment of social phobia without clinician guidance. Australian and New Zealand Journal of Psychiatry, 43, 913–919. http://dx.doi.org/10.1080/00048670903179160
Titov, N., Andrews, G., Johnston, L., Robinson, E., & Spence, J. (2010). Transdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial. Behaviour Research and Therapy, 48, 890–899. http://dx.doi. org/10.1016/j.brat.2010.05.014
Titov, N., Andrews, G., Kemp, A., & Robinson, E. (2010). Characteristics of adults with anxiety or depression treated at an Internet clinic: Comparison with a national survey and an outpatient clinic. PLoS ONE , 5(5), 1–5. http:// dx.doi.org/10.1371/journal.pone.0010885
Titov, N., Dear, B. F., Ali, S., Zou, J. B., Lorian, C. N., Johnston, L., ...Fogliati, V. J. (2015). Clinical and Cost–Effectiveness of Therapist–Guided Internet– Delivered Cognitive Behavior Therapy for Older Adults With Symptoms of Depression: A Randomized Controlled Trial. Behavior Therapy, 46(2), 193–205. http://dx.doi.org/10.1016/j.beth.2014.09.008
Vázquez, C. & Hervás, G. (2008). Psicología positiva aplicada. Bilbao: Desclée de Brouwer.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. http://dx.doi. org/10.1037/0022–3514.54.6.1063
Wims, E., Titov, N., Andrews, G., & Choi, I. (2010). Clinician–assisted Internet– based treatment is effective for panic: A randomized controlled trial. Australian and New Zealand Journal of Psychiatry, 44, 599–607. http://dx.doi. org/10.3109/00048671003614171
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