Publications by authors named "Rocío Herrero"

36 Publications

High incidence of asymptomatic phase I IgG seroconversion after acute Q fever episode: implications for chronic Q fever diagnosis.

Clin Infect Dis 2021 Sep 23. Epub 2021 Sep 23.

Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario de Valme. Instituto de Biomedicina de Sevilla (IBiS). Universidad de Sevilla. Sevilla, Spain.

Background: The aim of this study was to describe the natural history of acute Q fever, including its clinical and serological evolution and progression to chronic Q fever.

Methods: Observational cohort study (January 2011-September 2020) performed at Valme University Hospital (Seville, Spain). Inclusion criteria: 1) Patients over the age of eighteen; 2) Acute Q fever diagnosis, defined as suggestive symptoms in the presence of phase II IgG titer > 1:256; 3) At least 6 months follow-up after the acute Q fever episode. The incidence of seroconversion to a chronic Q fever serological pattern, defined as phase I IgG titers ≥ 1:1024 six months after acute Q fever diagnosis, was assessed.

Results: During the study period, 117 patients were included. Thirty-four (29%) patients showed phase I IgG titers ≥ 1:1024 six months after acute Q fever diagnosis. All patients with classic serologic criteria for chronic Q fever diagnosis remained asymptomatic despite no specific treatment, with a median (Q1-Q3) follow-up of 26.5 (14-44) months in this subgroup. No cases of Q fever endocarditis neither other persistent focalized infection forms were observed during the study period.

Conclusions: A significant proportion of acute Q fever patients develops classic serologic criteria for chronic Q fever diagnosis in the absence of additional data of chronic Q fever. Consequently, phase I IgG cutoff titer > 1:800 should not be used as a criterion to consider such a diagnosis. The incidence of persistent focalized infection forms after acute Q fever is extremely low and does not justify the use of prophylaxis strategies.
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http://dx.doi.org/10.1093/cid/ciab843DOI Listing
September 2021

Theoretical adequacy, methodological quality and efficacy of online interventions targeting resilience: a systematic review and meta-analysis.

Eur J Public Health 2021 07;31(31 Suppl 1):i11-i18

CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain.

Background: There is a growing interest in the promotion of mental health, and concepts as resilience are re-emerging and taking relevance. In addition, Information and Communication Technologies can provide potential benefits in the field of mental health, and the treatment of mental disorders in particular. This study aims to synthesize the evidence of internet-based resilience interventions, analyzing the theoretical adequacy, methodological quality and efficacy.

Methods: A systematic search was performed. The eligibility criteria stated for this article were: randomized controlled trials targeted at adults or adolescents and including any psychological intervention focussing on resilience in its rationale or design. Studies with direct (e.g. resilience scales) and proximal resilience measures (e.g. scales on well-being) were included. Risk of bias was assessed for each trial using Cochrane's Collaboration Tool. Two reviewers worked independently in order to identify potential articles. A total of 11 articles were selected. A random-effects pooling model using the Hartung-Knapp-Sidik-Jonkman method based on direct and proximal resilience measures at post-test was used.

Results: The overall effects of online resilience training compared to control groups at post-test were not significant; the effect size concerning the improvement of resilience was g=0.12 (95% CI: -0.14 to 0.38). In addition, a potential association between the type of outcome and the effect size could be revealed.

Conclusions: The results of the present meta-analysis showed that the overall effect of online resilience trainings was not significant. Nonetheless, a tendency for a higher benefit for resilience was found in the studies with a clear assessment theory, indicating some promising effects.

Registration Number: PROSPERO CRD42018083339.
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http://dx.doi.org/10.1093/eurpub/ckaa255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266533PMC
July 2021

Stakeholders' views on online interventions to prevent common mental health disorders in adults implemented into existing healthcare systems in Europe.

Eur J Public Health 2021 07;31(31 Suppl 1):i55-i63

Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt 2700, Austria.

Background: Online preventive interventions can help to reduce the incidence of mental disorders. Whereas knowledge on stakeholders' attitudes and factors relevant for successfully integrating online treatment into existing healthcare systems is available, knowledge is scarce for online prevention.

Methods: Stakeholders from Germany, Switzerland, Austria and Spain were surveyed. Potential facilitators/delivery staff (e.g. psychologists, psychotherapists) completed an online questionnaire (n = 183), policy makers (i.e. from the governing sector or health insurance providers) participated in semi-structured interviews (n = 16) and target groups/potential users of mental illness prevention (n = 49) participated in ten focus groups. Thematic analysis was used to identify their experiences with and attitudes and needs regarding online programmes to prevent mental disorders. Additionally, it was examined which groups they consider underserved and which factors they consider as fostering and hindering for reach, adoption, implementation and maintenance (cf. RE-AIM model) when integrating online prevention into existing healthcare systems.

Results: Main advantages of online mental illness prevention are perceived in low structural and psychological barriers. Lack of personal contact, security, privacy and trust concerns were discussed as disadvantages. Relevant needs are high usability and target group appropriateness, evidence for effectiveness and the use of motivational tools.

Conclusions: Positive attitudes among stakeholders are the key for successful integration of online mental illness prevention into existing healthcare systems. Potential facilitators/delivery staff must receive training and support to implement these programmes; the programmes must be attractive and continuously evaluated, updated and promoted to ensure ongoing reach; and existing infrastructure and contextual factors must be considered.
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http://dx.doi.org/10.1093/eurpub/ckab043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495679PMC
July 2021

Online interventions to prevent mental health problems implemented in school settings: the perspectives from key stakeholders in Austria and Spain.

Eur J Public Health 2021 07;31(31 Suppl 1):i71-i79

Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria.

Background: Schools are key settings for delivering mental illness prevention in adolescents. Data on stakeholders' attitudes and factors relevant for the implementation of Internet-based prevention programmes are scarce.

Methods: Stakeholders in the school setting from Austria and Spain were consulted. Potential facilitators (e.g. teachers and school psychologists) completed an online questionnaire (N=50), policy makers (e.g. representatives of the ministry of education and health professional associations) participated in semi-structured interviews (N=9) and pupils (N=29, 14-19 years) participated in focus groups. Thematic analysis was used to identify experiences with, attitudes and needs towards Internet-based prevention programmes, underserved groups, as well as barriers and facilitators for reach, adoption, implementation and maintenance.

Results: Experiences with Internet-based prevention programmes were low across all stakeholder groups. Better reach of the target groups was seen as main advantage whereas lack of personal contact, privacy concerns, risk for misuse and potential stigmatization when implemented during school hours were regarded as disadvantages. Relevant needs towards Internet-based programmes involved attributes of the development process, general requirements for safety and performance, presentation of content, media/tools and contact options of online programmes. Positive attitudes of school staff, low effort for schools and compatibility to schools' curriculum were seen as key factors for successful adoption and implementation. A sound implementation of the programme in the school routine and continued improvement could facilitate maintenance of online prevention initiatives in schools.

Conclusions: Attitudes towards Internet-based mental illness prevention programmes in school settings are positive across all stakeholder groups. However, especially safety concerns have to be considered.
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http://dx.doi.org/10.1093/eurpub/ckab039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266540PMC
July 2021

Online prevention programmes for university students: stakeholder perspectives from six European countries.

Eur J Public Health 2021 07;31(31 Suppl 1):i64-i70

King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

Background: Students beginning university are at a heightened risk for developing mental health disorders. Online prevention and early intervention programmes targeting mental health have the potential to reduce this risk, however, previous research has shown uptake to be rather poor. Understanding university stakeholders' (e.g. governing level and delivery staff [DS] and students) views and attitudes towards such online prevention programmes could help with their development, implementation and dissemination within university settings.

Methods: Semi-structured interviews, focus groups and online surveys were completed with staff at a governing level, university students and DS (i.e. student health or teaching staff) from six European countries. They were asked about their experiences with, and needs and attitudes towards, online prevention programmes, as well as the factors that influence the translation of these programmes into real-world settings. Results were analyzed using thematic analysis.

Results: Participating stakeholders knew little about online prevention programmes for university settings; however, they viewed them as acceptable. The main themes to emerge were the basic conditions and content of the programmes, the awareness and engagement, the resources needed, the usability and the responsibility and ongoing efforts to increase reach.

Conclusions: Overall, although these stakeholders had little knowledge about online prevention programmes, they were open to the idea of introducing them. They could see the potential benefits that these programmes might bring to a university setting as a whole and the individual students and staff members.
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http://dx.doi.org/10.1093/eurpub/ckab040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495721PMC
July 2021

Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Adults with Prolonged Grief Disorder (PGD): A Study Protocol for a Randomized Feasibility Trial.

BMJ Open 2021 07 6;11(7):e046477. Epub 2021 Jul 6.

Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain

Introduction: Grief is an emotional reaction to the loss of a loved one with a natural recovery. Approximately 10% of people who lose a loved one develop prolonged grief disorder (PGD). Internet-based and computer-based interventions (ie, internet-delivered cognitive-behavioural therapy, iCBT) are a cost-effective alternative that makes it possible to reach more people with PGD. The main aim of this study is to assess the feasibility of a new iCBT-called GROw-for PGD. As a secondary objective, the potential effectiveness of GROw will be explored.

Methods And Analysis: This study is a two-arm feasibility randomised trial. A total of 48 adults with PGD who meet the eligibility criteria will be randomised to the experimental group (iCBT: GROw) or the active control group (face-to-face CBT treatment). The treatment is organised sequentially in eight modules in the iCBT format and 8-10 sessions in the face-to-face format, and both formats have the same therapeutic components. There will be five assessment points with qualitative and quantitative evaluations: screening, baseline, after the intervention, 3-month follow-up and 12-month follow-up. Consistent with the objectives, the measures are related to the feasibility outcomes for the main aim of the study (participant adherence, expectations and satisfaction with the treatment, preferences, alliance and utility) and psychological and mental health outcomes for secondary analyses (symptoms of grief, symptoms of depression, symptoms of anxiety, affectivity, quality of life, work and social adaptation, post-traumatic growth, purpose in life, mindfulness and compassion).

Ethics And Dissemination: The Ethics Committee of the Universitat Jaume I (Castellón, Spain) granted approval for the study (CD/002/2019). Dissemination will include publications and presentations at national and international conferences.

Trial Registration Number: NCT04462146.
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http://dx.doi.org/10.1136/bmjopen-2020-046477DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261880PMC
July 2021

The impact of strict and forced confinement due to the COVID-19 pandemic on positive functioning variables, emotional distress, and posttraumatic growth in a Spanish sample.

Eur J Psychotraumatol 2021 Jun 9;12(1):1918900. Epub 2021 Jun 9.

Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.

: The adverse consequences of the COVID-19 pandemic on mental health have been widely studied in recent months. However, few studies have examined the protective psychological factors that may explain how individuals are coping with the COVID-19 pandemic and its forced confinements. : This study analyzes the impact of confinement due to the COVID-19 pandemic on positive functioning variables (resilience, meaning of life, gratitude, compassion, life satisfaction), emotional distress (depression, anxiety, perceived stress, affect), and posttraumatic growth (PTG). The impact was measured during and after the first month of strict and obligatory confinement in Spain. : The sample was composed of 438 Spanish residents (78.3% women) between the ages of 18 and 68 ( = 35.68; = 13.19) during the first stage (first two weeks) of confinement. The sample was reduced to 197 participants during the second stage (fifth week) of confinement. Several online self-reported questionnaires were administered to assess positive functioning variables, emotional distress, and PTG. : Women, youths, individuals without a partner, with lower monetary incomes, or diagnosed with a mental disorder or chronic illness experienced lower scores in positive functioning variables and greater emotional distress during the first stage of confinement. Linear mixed models showed that scores on positive functioning variables, emotional distress, and PTG worsened in the second stage of confinement. Nevertheless, a structural equations model showed that increases in positive functioning variables in the second stage were associated with increases in life satisfaction (= .450) and related to decreases in emotional distress (= .186), leading in turn to increases in PTG (= .061). : Individuals could experience PTG during strict and mandatory confinement. The increase in PTG during this adverse event was indirectly associated with increases in positive functioning variables (i.e. gratitude, presence of meaning, resilience), through improvements in life satisfaction and emotional distress.
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http://dx.doi.org/10.1080/20008198.2021.1918900DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205045PMC
June 2021

The relationship between social media use, anxiety and burden caused by coronavirus (COVID-19) in Spain.

Curr Psychol 2021 May 22:1-7. Epub 2021 May 22.

Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.

The outbreak of COVID-19 and national restrictions to slow down its spread have significantly changed people's everyday lives. Many people engage in intensive social media use (SMU) to stay up-to-date about the pandemic. The present study investigated the extent of SMU as source of COVID-19 information, and its relationship with anxiety and the experienced burden caused by the pandemic in Spain. Of the 221 participants, 52.5% reported to frequently use SM as information source. The use of other information sources such as print and online newspaper reports, television reports, and official governmental online sites was not associated with anxiety and burden caused by the current COVID-19 situation. However, SMU was significantly positively linked to both variables. Moreover, anxiety significantly mediated the relationship between SMU and the experienced burden. The findings show the potential negative effect of SMU on individual emotional state and behavior during the pandemic. They emphasize the significance of an accurate and conscious use of SM specifically during extraordinary circumstances such as the COVID-19 outbreak.
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http://dx.doi.org/10.1007/s12144-021-01802-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140743PMC
May 2021

Assessing self-criticism and self-reassurance: Examining psychometric properties and clinical usefulness of the Short-Form of the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS-SF) in Spanish sample.

PLoS One 2021 24;16(5):e0252089. Epub 2021 May 24.

Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.

The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) was designed to measure self-criticism (SC) through Inadequate Self (IS) and Hated Self (HS) factors, as well as self-reassurance (RS). However, its long and short forms have yet to be validated in the Spanish Population. The present study examines the psychometric properties of the short form (FSCRS-SF) and its clinical usefulness in a sample of 576 adult individuals, 77 with psychiatric disorders and 499 without. Non-clinical participants were split according to their previous experience with meditation (active meditators, n = 133; non-active meditators, n = 41; and non-meditators, n = 325) and differences between these subgroups were explored. Additionally, a subsample of 20 non-clinical participants took part in a mindfulness- and compassion- based intervention (MCBI) to assess the usefulness of the scale as an outcome measure. Results confirmed the original three-factorial structure, good internal consistency, acceptable test-retest reliability, and a pattern of correlations consistent with previous literature. Regarding differences between groups, the clinical subsample showed significant higher SC and lower RS levels than non-clinical participants and active meditators had significant lower IS and higher RS levels than non-meditators. Participants who participated in the MCBI showed significant RS improvement and a decrease in IS and HS levels. Moreover, a hierarchical multiple regression showed that RS made a significant predictive contribution to distress at three months' time. In conclusion, results show that the Spanish version of the FSCRS-SF is a reliable and valid measure of SC and RS in non-clinical populations and an adequate instrument to detect changes after MCBIs.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252089PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143420PMC
October 2021

Efficacy of an Internet-Based Intervention to Promote a Healthy Lifestyle on the Reproductive Parameters of Overweight and Obese Women: Study Protocol for a Randomised Controlled Trial.

Int J Environ Res Public Health 2020 11 10;17(22). Epub 2020 Nov 10.

CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Carlos III Health Institute, 28029 Madrid, Spain.

Infertility is estimated to affect 15% of couples of reproductive age. Weight management problems (being obese or overweight) are among the problems that produce infertility, both in women seeking spontaneous pregnancy and in those undergoing assisted reproduction techniques. Over the last few decades, the prevalence of obesity has increased alarmingly in our society and is now considered one of the most important public health problems. The combination of diet and exercise to achieve weight loss are currently considered an effective intervention for the improvement of reproductive parameters in overweight or obese infertile women. In other population groups, it has been shown that Internet-based interventions are just as effective as traditional ones, and these cover a larger population with a good cost-benefit ratio. However, to the best of our knowledge, no studies so far have analysed any specific online interventions for this group of infertile women. Thus, the objective of this project will be to evaluate the effectiveness of an online program to promote a healthy lifestyle among women who are overweight or obese who also have a diagnosis of infertility and are on the waiting list for in vitro fertilisation treatment. : This will be a randomised controlled clinical trial conducted in 94 women which will compare a self-administered Internet-based intervention promoting a healthy lifestyle in terms of diet and exercise ( = 47) to a control group that will receive standard medical care. The online program will comprise nine modules, will last for 3 months, and will be monitored every 3 months after the intervention until the final follow-up at 12 months. The main outcome will be the spontaneous pregnancy rate. Secondary outcomes will include changes in body composition, dietary and physical exercise habits, glycaemic profiles, lipid profiles, hormonal profiles, and patient quality of life related to their fertility problems. The data analysis will be done on an intention-to-treat basis. : The aim of this study is to increase our knowledge of the effectiveness of online interventions specifically adapted to infertile women who are overweight or obese in the promotion of healthy lifestyles.
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http://dx.doi.org/10.3390/ijerph17228312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696477PMC
November 2020

Understanding the Influence of Eating Patterns on Binge Drinking: A Mediation Model.

Int J Environ Res Public Health 2020 12 17;17(24). Epub 2020 Dec 17.

Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain.

Background: Binge drinking is an important health problem, and it has been related to binge eating and fat intake in animal models, but this relationship has not been tested in humans. The first objective of this study was to analyze whether binge eating and fat intake are related to binge drinking in a youth sample. The second objective was to analyze whether binge eating and fat intake mediate the relationship between individual factors associated with binge eating and fat intake (sex, body mass index (BMI), drive for thinness, body dissatisfaction, eating styles, impulsivity, and food addiction) and binge drinking.

Methods: A sample of 428 undergraduate students filled out several questionnaires on binge drinking, binge eating, fat intake, drive for thinness, body dissatisfaction, eating styles, food addiction, and impulsivity.

Results: Results showed an excellent model fit: (25) = 30.342 ( = 0.212), comparative fit index (CFI) = 0.992, root mean squared error of approximation (RMSEA) = 0.022 [90% CI = 0.000, 0.047]. Binge eating and fat intake were positively related to binge drinking. Furthermore, emotional eating, external eating, and food addiction showed positive and statistically significant indirect relationships with binge drinking, whereas the relationship with restrained eating was negative.

Conclusions: These findings point to the need to use a broader approach in understanding and preventing binge drinking in the youth population by showing the influence of the eating pattern on this problem. This information could be helpful in preventing future behaviors and improving interventions that address health risk behaviors.
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http://dx.doi.org/10.3390/ijerph17249451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766311PMC
December 2020

Cultural adaptation of the ing program for the treatment of depression in the Ecuadorian public health care system: A study protocol for a randomized controlled trial.

Internet Interv 2021 Mar 28;23:100352. Epub 2020 Nov 28.

Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain.

Background: Depression is one of the world's major health problems. Due to its high prevalence, it constitutes the first cause of disability among the Americas, where only a very low percentage of the population receives the adequate evidence-based psychological treatment. Internet-Based Interventions (IBIs) are a great alternative to reduce the treatment gap for mental disorders. Although there are several studies in low-and middle-income countries proving IBIs' feasibility and acceptability, there is still little evidence of the effectiveness in diverse social and cultural contexts such as Latin America.

Methods: Two studies will be described: Study 1 is focused on the cultural adaptation of a cognitive-behavioral IBI (Botella et al. 2012, 2015) for Ecuadorian population with depression based on the procedure by Salamanca-Sanabria et al. (2018). Study 2 describes the design of a randomized controlled trial to test the preliminary efficacy of the culturally adapted intervention in a Public Health Care setting. A total of 153 patients with mild to moderate degree of depression as assessed with the Mini-International Neuropsychiatric Interview (M.I.N.I.) and the Patient Health Questionnaire-9 (PHQ-9) will be randomly assigned to either an IBI group using only automated support by the system; an IBI group including also minimal human support; or a waiting list group. The primary outcome (depression) and secondary outcomes (e.g., anxiety, affect, quality of life) will be collected at baseline, 3, 6 and 12 months. Mixed-model analyses with no ad hoc imputations will be conducted.

Discussion: This paper is pioneering in exploring the role of an Internet-based culturally adapted intervention for depression in a public care context in Ecuador. Results obtained will offer new insights into the viability and effectiveness of digital technologies for the psychological treatment of mental illnesses in developing countries.
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http://dx.doi.org/10.1016/j.invent.2020.100352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733006PMC
March 2021

The association between depression symptoms, psychological burden caused by Covid-19 and physical activity: An investigation in Germany, Italy, Russia, and Spain.

Psychiatry Res 2021 01 26;295:113596. Epub 2020 Nov 26.

Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany. Electronic address:

The outbreak of Covid-19 required the re-organization of everyday life. While some people accepted this challenge, other experienced the current situation as a heavy burden that impedes the adaptation to the new life conditions. The present study investigated factors that can impact the level of burden caused by Covid-19. Burden, depression symptoms and frequency of physical activity (e.g., jogging, cycling) were assessed via online surveys in overall 1,931 people from four countries (Germany: N = 625; Italy: N = 936; Russia: N = 230; Spain: N = 140). Similar result patterns were found in all country-specific samples. Burden by Covid-19 was significantly positively associated with depression symptoms, while it was significantly negatively linked to physical activity. Moreover, physical activity buffered the association between depression symptoms and burden. The present cross-national findings emphasize the protective effect of physical activity specifically in times of Covid-19. This issue should be addressed in governmental programs to longitudinally protect mental and physical health and to enhance the willingness to adhere to the anti-Covid-19 measures among the population.
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http://dx.doi.org/10.1016/j.psychres.2020.113596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688416PMC
January 2021

Working Alliance Inventory for Online Interventions-Short Form (WAI-TECH-SF): The Role of the Therapeutic Alliance between Patient and Online Program in Therapeutic Outcomes.

Int J Environ Res Public Health 2020 08 25;17(17). Epub 2020 Aug 25.

Polibienestar Research Institute, University of Valencia, 46022 Valencia, Spain.

Background: Therapeutic alliance (TA) between the patient and therapist has been related to positive therapeutic outcomes. Because Internet-based interventions are increasingly being implemented, a tool is needed to measure the TA with Internet-based self-guided programs. The Working Alliance Inventory for online interventions (WAI-TECH-SF) was adapted based on the WAI Short Form (Hatcher & Gillaspy, 2006). The objectives of this study were: (1) to analyse the psychometric properties of the WAI-TECH-SF; (2) to explore the differences in the WAI-TECH-SF scores according to different categories of the sample; and (3) to analyse whether the WAI-TECH-SF can predict therapeutic outcomes and satisfaction with the treatment.

Methods: 193 patients diagnosed with depression were included and received blended Cognitive-Behavioural Therapy. Measures of preferences, satisfaction, and credibility about the treatment, TA with the online program, depressive symptoms, and satisfaction with the treatment were administered.

Results: An exploratory factor analysis revealed a one-dimensional structure with adequate internal consistency. Linear regression analyses showed that the WAI-TECH-SF predicted changes in depressive symptoms and satisfaction with the treatment.

Conclusions: WAI-TECH-SF is a reliable questionnaire to assess the TA between the patient and the online program, which is associated with positive therapeutic outcomes and satisfaction with the treatment.
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http://dx.doi.org/10.3390/ijerph17176169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503297PMC
August 2020

Virtual Reality as a Medium to Elicit Empathy: A Meta-Analysis.

Cyberpsychol Behav Soc Netw 2020 Oct 30;23(10):667-676. Epub 2020 Jul 30.

Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.

The current meta-analysis aims to investigate and clarify existing research on virtual reality (VR) as a medium to elicit empathy. An exhaustive literature search (updated to February 29, 2020) enabled us to locate seven published articles, yielding a total of nine independent samples. The results reveal statistically significant positive changes in perspective-taking outcomes after VR exposure ( = 0.51 [95 percent CI: 0.15-0.88]) but they did not note in empathy ( = 0.21 [95 percent confidence interval, CI: -0.37-0.79]). A potential limitation of this work is the low number of studies included. Implications and directions for theoretical development and empirical research are also discussed.
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http://dx.doi.org/10.1089/cyber.2019.0681DOI Listing
October 2020

Efficacy of a self-applied online program to promote resilience and coping skills in university students in four Spanish-speaking countries: study protocol for a randomized controlled trial.

BMC Psychiatry 2020 04 5;20(1):148. Epub 2020 Apr 5.

Universitat Jaume I, Castellón, Spain.

Background: There is evidence of a high prevalence of depression and anxiety in university students. Therefore, college time is a key period where prevention of mental disorders through interventions that promote resilience and mental health can be relevant. Currently, there are interventions available, but these are insufficient for those who need them. Online interventions are tools that can facilitate global accessibility and are easy for young people to use. CORE (Cultivating Our Resilience) is a self-administered online program, based on Ryff's psychological well-being model, to promote resilience and coping skills in university students at risk of developing symptoms of depression or anxiety. The objective is to evaluate the effectiveness of this intervention protocol in comparison with an active control condition targeting healthy lifestyle, and a waiting list control condition. The study will be conducted in four populations of Spanish-speaking university students (Spain, Argentina, Colombia, and Mexico).

Methods: The study design is a randomized controlled trial (RCT). At least 324 university students will be randomly assigned to three conditions: 1) CORE, a 6-week training program to improve resilience; 2) HLP, a 6-week training to promote a healthy lifestyle; and 3) WL, waiting list control condition. The primary outcome measure will be the Connor-Davidson resilience scale. Additionally, measures of anxiety, depression, quality of life and socio-demographic variables (age, sex, incomes, marital status, among others) will be collected. Participants will be evaluated at pre-treatment, after each module, 6 weeks after allocation, and at 3-month follow-up. Intention-to-treat and per-protocol analyses will be performed.

Discussion: The results of this study will contribute to research on Internet-administered interventions and the implementation of a protocol that includes a series of components designed to improve resilience and coping skills, increase psychological well-being, and prevent depression and anxiety disorders in Spanish-speaking university students. In addition, avenues will be opened up for new research on the effectiveness of these interventions focused on the prevention and promotion of mental health in Spanish-speaking countries.

Trial Registration: Registered at ClinicalTrials.gov NCT03903978 on April 2, 2019.
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http://dx.doi.org/10.1186/s12888-020-02536-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133009PMC
April 2020

Binge Eating and Binge Drinking: A Two-Way Road? An Integrative Review.

Curr Pharm Des 2020 ;26(20):2402-2415

Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.

Unhealthy diet and alcohol are serious health problems, especially in adolescents and young adults. "Binge" is defined as the excessive and uncontrolled consumption of food (binge eating) and alcohol (binge drinking). Both behaviors are frequent among young people and have a highly negative impact on health and quality of life. Several studies have explored the causes and risk factors of both behaviors, and the evidence concludes that there is a relationship between the two behaviors. In addition, some research postulates that binge eating is a precipitating factor in the onset and escalation of excessive alcohol consumption, while other studies suggest that alcohol consumption leads to excessive and uncontrollable food consumption. Given that no review has yet been published regarding the directionality between the two behaviors, we have set out to provide an upto- date overview of binge eating and binge drinking problems, analyzing their commonalities and differences, and their uni- and bidirectional associations. In addition, we explore the reasons why young people tend to engage in both behaviors and consider directions for future research and clinical implications.
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http://dx.doi.org/10.2174/1381612826666200316153317DOI Listing
December 2020

Putting Oneself in the Body of Others: A Pilot Study on the Efficacy of an Embodied Virtual Reality System to Generate Self-Compassion.

Front Psychol 2019 2;10:1521. Epub 2019 Jul 2.

Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain.

Compassion-based interventions (CBIs) have been shown to be effective for increasing empathy and compassion, and reducing stress, anxiety, and depression. CBIs are based on constructive meditations where imagery abilities are essential. One of the major difficulties that participants report during the training is the difficulty related to imagery abilities. Virtual reality (VR) can be a useful tool to overcome this limitation because it can facilitate the construction and sustainment of mental images. The machine to be another (TMTBA) uses multi-sensory stimulation to induce a body swap illusion. This system allows participants to see themselves from a third perspective and have the illusion of touching themselves from outside. The main objective of the present study was to analyze the efficacy of a self-compassion meditation procedure based on the TMTBA system versus the usual meditation procedure (CAU) in increasing positive affect states, mindful self-care, and adherence to the practice, and explore the influence of imagery abilities as moderators of the effects of the condition on adherence. A sample of 16 participants were randomly assigned to two conditions: TMTBA-VR and CAU. All participants had to listen to an audio meditation about self-compassion and answer questionnaires before and after the training. The TMTBA-VR condition also had a body swap experience at the end of the meditation while listening to self-compassionate messages. Afterward, they were invited to practice this meditation for 2 weeks and then measured again. After the compassion practice, both conditions significantly increased positive qualities toward self/others, decreased negative qualities toward self, and increased awareness and attention to mental events and bodily sensations, with no differences between the conditions. After 2 weeks, both conditions showed a similar frequency of meditation practice and increases in specific types of self-care behaviors, with the frequency of clinical self-care behaviors being significantly higher in TMTBA. Finally, lower imagery ability in the visual and cutaneous modality were moderators of the efficacy of the TMTBA (vs. CAU) condition in increasing adherence to the practice. Embodied VR could be an interesting tool to facilitate and increase the efficacy of CBIs by facilitating the construction of positive and powerful mental images.
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http://dx.doi.org/10.3389/fpsyg.2019.01521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626917PMC
July 2019

Healthy Teens @ School: Evaluating and disseminating transdiagnostic preventive interventions for eating disorders and obesity for adolescents in school settings.

Internet Interv 2019 Apr 27;16:65-75. Epub 2018 Feb 27.

FernFH Distance Learning University of Applied Sciences, Wiener Neustadt, Austria.

Background: The worldwide prevalence of overweight and obesity is at alarming levels. Nearly one in three children in Europe is overweight or obese. Disordered eating and body image concerns are equally widespread and increase risk for more chronic and severe weight-related problems. Research has shown that online interventions that address both healthy weight regulation and body image can reduce risk for eating disorders and obesity simultaneously and are feasible to implement in school settings. To date, evaluation and dissemination of such programs in Europe is scant.

Methods: The study is a multi-country cluster-randomized controlled trial (RCT) comparing the effectiveness of an unguided, online, multi-level intervention for promoting a healthy lifestyle and reducing problematic eating behavior, eating disorder and obesity risk among students aged 14 to 19 years with control condition. As part of the Horizon 2020 funded project ICare (GA No. 634757) the trial is conducted in Austria and Spain. Cluster randomization by school is used. The intervention is an adapted version of an evidence-based program developed in the USA (StayingFit). Participants of the intervention group are assigned to one of two possible program tracks based on the results of the initial online-assessment: Overweight adolescents are assigned to the "Weight Management" track emphasizing balanced eating and exercise for weight maintenance, and all other individuals are assigned to the "Healthy Habits" track which aims at promoting healthy habits related to e.g., nutrition, physical activity, sleep. The participants of both tracks work on ten modules (one 20-30 min module per week) during school hours and/or at home. Assessments are conducted at pre- and post-intervention, and at 6- and 12-months after baseline assessment. The primary outcome is intuitive eating, secondary outcomes are eating disorder symptomatology, body image concerns, body mass index, food intake, physical activity, self-esteem, stress coping, depression, and anxiety. Following the initial assessment, individuals in the control group do not have access to the prevention program but continue as normal and are only prompted to the assessments at all time points. At the end of the 12-month study they will get access to the program.

Discussion: The results from this study will add to the understanding of how to address eating and weight related problems in adolescents and will shed light on the feasibility of implementing online prevention programs in school routine in Austria and Spain. As part of the larger ICare project this RCT will determine how an adapted version of StayingFit is disseminated within Europe.
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http://dx.doi.org/10.1016/j.invent.2018.02.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364512PMC
April 2019

Efficacy and cost-effectiveness of guided and unguided internet- and mobile-based indicated transdiagnostic prevention of depression and anxiety (ICare Prevent): A three-armed randomized controlled trial in four European countries.

Internet Interv 2019 Apr 15;16:52-64. Epub 2018 Apr 15.

Department of Clinical Psychology and Psychotherapy, Nägelsbachstraße 25a, Germany.

Background: Depression and anxiety are highly prevalent and often co-occur. Several studies indicate the potential of disorder-specific psychological interventions for the prevention of each of these disorders. To treat comorbidity, transdiagnostic treatment concepts seem to be a promising approach, however, evidence for transdiagnostic concepts of prevention remains inconclusive. Internet- and mobile-based interventions (IMIs) may be an effective means to deliver psychological interventions on a large scale for the prevention of common mental disorders (CMDs) such as depression and anxiety. IMIs have been shown to be effective in treating CMDs, e.g. in reducing symptoms of depression and anxiety. However, there is a lack of studies examining the efficacy of interventions reducing the incidence of CMDs. Moreover, the comparative cost-effectiveness of guided versus unguided IMIs for the prevention of depression and anxiety has not been studied yet. Hence, this study aims at investigating the (cost-) effectiveness of guided and unguided internet- and mobile-based transdiagnostic individually tailored indicated prevention of depression and anxiety.

Methods: A multi-country three-armed randomized controlled trial will be conducted to compare a guided and unguided intervention to treatment as usual (TAU). Both active conditions are based on the same intervention, , and differ only with regard to guidance format. Altogether, 954 individuals with subclinical symptoms of depression (CES-D ≥ 16) and anxiety (GAD-7 ≥ 5) who do not have a full-blown disorder will be recruited in Germany, Switzerland, Spain and the Netherlands, and randomized to one of three conditions (guided intervention, unguided intervention, or TAU). The TAU arm will receive access to the training after a 12-month waiting period. The primary outcome will be time to CMD onset (any depression/anxiety disorder) within a follow-up period of 12 months after baseline. Secondary outcomes will include disorder-specific symptom severity (depression/anxiety) assessed by diagnostic raters blinded to intervention condition at post-intervention, self-reports, acceptability, health related quality of life, and psychosocial variables associated with developing a CMD. Assessments will take place at baseline, mid-intervention (5 weeks into the intervention), post-intervention (8 weeks after randomization) and follow-up (6 and 12 months after randomization). Data will be analyzed on an intention-to-treat basis and per protocol. Cost-effectiveness will be evaluated from a public health and a societal perspective, including both direct and indirect costs.

Discussion: The present study will further enhance the evidence-base for transdiagnostic preventive interventions and provide valuable information about optimal trade-off between treatment outcome and costs.

Trial Registration: German Clinical Trial Registration (DRKS - http://www.drks.de/drks_web/): DRKS00011099.
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http://dx.doi.org/10.1016/j.invent.2018.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364519PMC
April 2019

An Internet based intervention for improving resilience and coping strategies in university students: Study protocol for a randomized controlled trial.

Internet Interv 2019 Apr 22;16:43-51. Epub 2018 Mar 22.

University Jaume, Castellón, Spain.

Background: The literature shows a high prevalence of depression and anxiety in young people. The university represents a change in the lives of students, and is considered a stress factor. Therefore, it is particularly relevant to develop interventions specifically addressed to students and foster supportive environments and resilient communities. As students are "digital natives", online interventions offer several potential advantages in doing this. This study aims to develop and evaluate the efficacy of an Internet-based intervention (CORE: Cultivating our Resilience), based on the Ryff model of well-being, to promote resilience and coping skills, decrease symptoms of depression and anxiety, and increase overall wellbeing in young people confronting a crucial life event (the university). This paper summarizes the study protocol.

Method: The design of the planned study is a randomized controlled trial. A minimum of 464 participants will be randomly assigned to two conditions: 1) an unguided Internet-based intervention to enhance resilience (N = 232); 2) a care-as-usual condition (CAU) (N = 232). The primary outcome will be the Connor-Davidson resilience scale. Secondary outcomes will - among others - include other relevant clinical measures, such as anxiety and depressive symptoms, quality of life, and social support. Outcomes will be assessed 4 and 8 weeks, and 6 and 12-months follow-ups. Intention-to-treat and per-protocol analyses will be performed.

Discussion: The results of this study will contribute to the growing research on Internet-delivered interventions. The expected results may have a major impact on the prevention of mental disorders and possible negative consequences in at-risk populations, such as college students.
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http://dx.doi.org/10.1016/j.invent.2018.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364440PMC
April 2019

Assessing the costs and cost-effectiveness of ICare internet-based interventions (protocol).

Internet Interv 2019 Apr 27;16:12-19. Epub 2018 Feb 27.

TechnischeUniversität Dresden, School of Science, Faculty of Psychology, Chair ofClinical Psychology and E-Mental-Health, 01062 Dresden, Germany.

Background: Mental health problems are common and place a burden on the individual as well as on societal resources. Despite the existence of evidence-based treatments, access to treatment is often prevented or delayed due to insufficient health care resources. Effective internet-based self-help interventions have the potential to reduce the risk for mental health problems, to successfully bridge waiting time for face-to-face treatment and to address inequities in access. However, little is known about the cost-effectiveness of such interventions. This paper describes the study protocol for the economic evaluation of the studies that form the ICare programme of internet-based interventions for the prevention and treatment of a range of mental health problems.

Methods: An overarching work package within the ICare programme was developed to assess the cost-effectiveness of the internet-based interventions alongside the clinical trials. There are two underlying tasks in the ICare economic evaluation. First, to develop schedules that generate equivalent and comparable information on use of services and supports across seven countries taking part in clinical trials of different interventions and second, to estimate unit costs for each service and support used. From these data the cost per person will be estimated by multiplying each participant's use of each service by the unit cost for that service. Additionally, productivity losses will be estimated. This individual level of cost data matches the level of outcome data used in the clinical trials. Following the analyses of service use and costs data, joint analysis of costs and outcomes will be undertaken to provide findings on the relative cost-effectiveness of the interventions, taking both a public sector and a societal perspective. These analyses use a well-established framework, the Production of Welfare approach, and standard methods and techniques underpinned by economic theory.

Discussion/conclusion: Existing research tends to support the effectiveness of internet-based interventions, but there is little information on their cost-effectiveness compared to 'treatment as usual'. The economic evaluation of ICare interventions will add considerably to this evidence base.
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http://dx.doi.org/10.1016/j.invent.2018.02.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364355PMC
April 2019

Efficacy and cost-effectiveness of a blended cognitive behavioral therapy for depression in Spanish primary health care: study protocol for a randomised non-inferiority trial.

BMC Psychiatry 2018 03 23;18(1):74. Epub 2018 Mar 23.

Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain.

Background: Data from primary health care in Spain show a high prevalence of the major depressive disorder. Blended treatment (combination of face-to-face and online components) seems to be a very promising tool for the optimization and dissemination of psychological treatments in a cost-effective form. Although there is growing data that confirm the advantages of blended therapies, few studies have analyzed their application in regular clinical practice. The objective of the present paper is to describe the protocol for a clinical study aimed at exploring the clinical and cost-effectiveness of a blended cognitive behavioral therapy (b-CBT) for depression, compared to treatment as usual (TAU) in a primary health care setting.

Methods: A two-arm randomised controlled non-inferiority trial will be carried out, with repeated measures (baseline, 3 months, 6 months, and 12 months) under two conditions: b-CBT and TAU. The b-CBT program will consist in three face-to-face sessions and eight online sessions. The TAU is defined as the routine care delivered by the general practitioner for the treatment of depression in primary care. The primary outcome is a symptomatic change of depressive symptoms on the patient-health questionnaire (PHQ-9). Other secondary outcomes will be considered (e.g., quality of life, treatment preference). All participants must be 18 years of age or older and meet the diagnostic criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental disorders 4th edition. 156 participants will be recruited (78 per arm).

Discussion: It is expected that b-CBT is clinically non-inferior when compared to TAU. This is the first study in Spain to use a b-CBT format in primary and specialized care, and this format could be an efficacious and cost-effective therapeutic strategy for the treatment of depression.

Trial Registration: ClinicalTrials.gov NCT02361684. Registered on 8 January 2015. Currently recruiting participants.
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http://dx.doi.org/10.1186/s12888-018-1638-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865366PMC
March 2018

Effect of a web-based positive psychology intervention on prenatal well-being: A case series study.

Women Birth 2018 Feb 21;31(1):e1-e8. Epub 2017 Jun 21.

University of Valencia, Valencia, Spain; PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO, Valencia, Spain.

Background: Detrimental effects of women's negative feelings during pregnancy have been extensively examined and documented, but research on the influence of positive feelings and protective factors on their prenatal mental health is scarce. Evidence from the positive psychology field has shown that practicing some brief positive exercises, called positive psychology interventions, can maximize well-being by increasing positive emotions, engagement, and meaning.

Aim: The aim of this study is to examine the effect of a positive psychology web-based intervention on indices of women's prenatal well-being.

Methods: Specifically, a case series design was adopted, and data from six women are presented. Participants were involved in a 5-week online positive psychology intervention that includes a set of positive psychology interventions specifically adapted for pregnant women. Measures of women's mental well-being, depression, pregnancy-related anxiety, life satisfaction, and social support were measured at pre- and post-intervention. Compliance with the intervention and exercise preferences were assessed at post-test. Single-item related well-being measures were assessed weekly.

Findings And Discussion: The findings of this case series study indicate potential effects of the intervention on supporting mental well-being and decreasing depressive symptomatology in these pregnant women. Furthermore, this study provides some suggestions for developing future online-based positive interventions addressed to pregnant women. However, these findings are preliminary, and future studies are needed in order to assess the effects of the intervention in a wider population of pregnant women.
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http://dx.doi.org/10.1016/j.wombi.2017.06.005DOI Listing
February 2018

Attitudes towards digital treatment for depression: A European stakeholder survey.

Internet Interv 2017 Jun 25;8:1-9. Epub 2017 Jan 25.

Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.

Background: The integration of digital treatments into national mental health services is on the agenda in the European Union. The E-COMPARED consortium conducted a survey aimed at exploring stakeholders' knowledge, acceptance and expectations of digital treatments for depression, and at identifying factors that might influence their opinions when considering the implementation of these approaches.

Method: An online survey was conducted in eight European countries: France, Germany, Netherlands, Poland, Spain, Sweden, Switzerland and The United Kingdom. Organisations representing government bodies, care providers, service-users, funding/insurance bodies, technical developers and researchers were invited to participate in the survey. The participating countries and organisations reflect the diversity in health care infrastructures and e-health implementation across Europe.

Results: A total of 764 organisations were invited to the survey during the period March-June 2014, with 175 of these organisations participating in our survey. The participating stakeholders reported moderate knowledge of digital treatments and considered cost-effectiveness to be the primary incentive for integration into care services. Low feasibility of delivery within existing care services was considered to be a primary barrier. Digital treatments were regarded more suitable for milder forms of depression. Stakeholders showed greater acceptability towards blended treatment (the integration of face-to-face and internet sessions within the same treatment protocol) compared to standalone internet treatments. Organisations in countries with developed e-health solutions reported greater knowledge and acceptability of digital treatments.

Conclusion: Mental health stakeholders in Europe are aware of the potential benefits of digital interventions. However, there are variations between countries and stakeholders in terms of level of knowledge about such interventions and their feasibility within routine care services. The high acceptance of blended treatments is an interesting finding that indicates a gradual integration of technology into clinical practice may fit the attitudes and needs of stakeholders. The potential of the blended treatment approach, in terms of enhancing acceptance of digital treatment while retaining the benefit of cost-effectiveness in delivery, should be further explored.

Funding: The E-COMPARED project has received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 603098.
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http://dx.doi.org/10.1016/j.invent.2017.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096292PMC
June 2017

Common haplotypes in CD209 promoter and susceptibility to HIV-1 infection in intravenous drug users.

Infect Genet Evol 2016 11 15;45:20-25. Epub 2016 Aug 15.

Immunogenetics Unit, Department of Experimental Biology, University of Jaen, 23071 Jaén, Spain. Electronic address:

Introduction: CD209 is a receptor expressed in the dendritic cells involved in recognition of oligosaccharides present in several pathogens with a relevant impact on human health. SNPs located in the promoter region have been associated with HIV-1 susceptibility, although this finding has not been replicated in other populations. The objective of this study is to evaluate the association of CD209 promoter haplotypes with risk of HIV-1 infection in a cohort of Spanish male intravenous drug users (IDU) infected with hepatitis C virus (HCV) and to characterize the phenotypic effects of the associated variants.

Methods: We genotyped 4 SNPs of CD209 promoter in 295 HCV males exposed to HIV-1 infection by IDU, 165 HIV-1-infected and 130 exposed uninfected (EUI) and 142 healthy controls (HC). We have cloned the promoter variants in a reporter vector and evaluated the promoter activities in a cell culture model. CD209 mRNAs were measured in PBMC.

Results: Single-marker analysis revealed no significant allelic association with the risk of HIV-1 infection by parenteral route. Nevertheless, one haplotype was significantly overrepresented in EUI compared with HIV-1 positive patients and was associated with HIV-1 status (P=0.0008; OR: 0.43). Functional experiments suggested that the protective haplotype displayed lower transcriptional activity in vitro (P<0.05) and this was correlated with lower CD209 mRNA expression in PBMC (P=0.014).

Conclusions: This study suggests that the promoter haplotypes of CD209 influence the risk of HIV-1 acquisition in IDU and that this association is correlated with the mRNA expression level.
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http://dx.doi.org/10.1016/j.meegid.2016.08.014DOI Listing
November 2016

IFNL4 rs368234815 polymorphism is associated with innate resistance to HIV-1 infection.

AIDS 2015 Sep;29(14):1895-7

aInfectious Diseases and Microbiology Clinical Unit, Valme Hospital, Seville bImmunogenetics Unit, Department of Experimental Biology, University of Jaen, Jaen cMaimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba dDepartamento de Enfermedades Infecciosas, Hospital Carlos III, Madrid eServicio de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Barcelona fHuman Genetics Unit, Department of Basic Medical Sciences, University of Lleida IRBLleida, Lleida, Catalonia, Spain.

The interferon (IFN)L4 polymorphism rs368234815 is associated with hepatitis C virus (HCV) spontaneous clearance and response to IFN-based treatments. The role of this polymorphism in HIV-1 infection is controversial. We investigated whether genetic variation at IFNL4 is associated to HIV-1 acquisition. The HCV protective allele TT was associated with decreased likelihood of HIV-1 infection in male intravenous drug users [odds ratio (OR): 0.3; P = 0.006], and this association was not modified by the genotype of CCR5. These results suggest that genetic susceptibility to HCV and HIV-1 infection shares common molecular pathways.
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http://dx.doi.org/10.1097/QAD.0000000000000773DOI Listing
September 2015

Integrating virtual reality with activity management for the treatment of fibromyalgia: acceptability and preliminary efficacy.

Clin J Pain 2015 Jun;31(6):564-72

*Department Psicología Básica, Clínica y Psicobiología, Universitat Jaume I (Department of Basic Psychology, Psychobiology and Clinical Psychology, Jaume I University, Castellon) †Ciber Fisiopatología Obesidad y Nutrición (CB06/03 Instituto Salud Carlos III) (Ciber Physiopathology Obsity and Nutrition (CB06/03 Instituto Salud Carlos III Health Institute, Madrid) ‡Hospital General de Castellón, Servicio de Reumatología (Castellon General Hospital, Reumathology Service, Castellon) §Department Personalidad, Universidad de Valencia, Evaluación y Tratamientos Psicológicos, Spain (Department of Personality, Assessment and Psychological Treatments, Valencia University, Valencia).

Objectives: Cognitive-behavioral therapies (CBT) for fibromyalgia syndrome (FMS) are important interventions in the management of this condition. Empirical evidence reports that although the results are promising, further research is needed to respond more appropriately to these patients. This study focuses on exploring the use of Virtual Reality (VR) as an adjunct to the activity management component. The aim of this study is to present the results of a small-sized randomized controlled trial to test the preliminary efficacy and acceptability of this component.

Materials And Methods: The final sample was composed of 61 women diagnosed with FMS according to the American College of Rheumatology. The sample was randomly allocated to 2 conditions: VR treatment and treatment as usual.

Results: Participants in the VR condition achieved significant improvements in the primary outcome: disability measured with the FIQ. The improvement was also significant in secondary outcomes, such as perceived quality of life and some of the coping strategies included in the Chronic Pain Coping Inventory: task persistence and exercise. There were no differences in other secondary outcome measures like pain intensity and interference and depression. Participants reported high satisfaction with the VR component.

Discussion: The effects were related to the psychological aspects targeted in the treatment. The component was well accepted by FMS patients referred from a public hospital. These findings show that the VR component could be useful in the CBT treatment of FMS and encourage us to continue exploring the use of integrating VR with CBT interventions for the treatment of FMS.
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http://dx.doi.org/10.1097/AJP.0000000000000196DOI Listing
June 2015

Virtual reality for the induction of positive emotions in the treatment of fibromyalgia: a pilot study over acceptability, satisfaction, and the effect of virtual reality on mood.

Cyberpsychol Behav Soc Netw 2014 Jun;17(6):379-84

1 Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I , Castelló de la Plana, Spain .

One of the most important aspects of fibromyalgia syndrome (FMS) is its impact on quality of life, increasing negative emotions and dysfunctional coping strategies. One of these strategies is to avoid activities, especially meaningful activities, which reduces positive reinforcement. Commencing significant daily activities could enable chronic patients to experience a more fulfilling life. However, the main difficulty found in FMS patients is their willingness to start those activities. Promoting positive emotions could enhance activity management. The aim of this paper is to present a description of a system along with data regarding the acceptability, satisfaction, and preliminary efficacy of a virtual reality (VR) environment for the promotion of positive emotions. The VR environment was especially designed for chronic pain patients. Results showed significant increases in general mood state, positive emotions, motivation, and self-efficacy. These preliminary findings show the potential of VR as an adjunct to the psychological treatment of such an important health problem as chronic pain.
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http://dx.doi.org/10.1089/cyber.2014.0052DOI Listing
June 2014

IFNL4 ss469415590 variant shows similar performance to rs12979860 as predictor of response to treatment against Hepatitis C Virus genotype 1 or 4 in Caucasians.

PLoS One 2014 18;9(4):e95515. Epub 2014 Apr 18.

Unidad de Inmunogenética, Universidad de Jaén, Jaén, Spain.

Objectives: The rs12979860 variant, linked to IL28B gene, predicts sustained viral response (SVR) to pegylated-interferon/ribavirin (pegIFN/RBV) therapy in Hepatitis C Virus genotype 1 or 4 (HCV-1/4)-infected patients. Recently, a functional variant, ss469415590, in linkage disequilibrium (LD) with rs12979860, has been discovered. Our objective was to assess the value of ss469415590 to predict SVR to pegIFN/RBV in Caucasian HCV-1/4-infected individuals and to compare its performance with that of rs12979860.

Methods: 272 Caucasian HCV-1/4-infected patients who completed a course of pegIFN/RBV were genotyped for both rs12979860 and ss469415590 markers. Logistic regression models including factors with univariate association with SVR and each genetic marker were elaborated. The area under the receiver operating-characteristic curve (AUROC) was calculated for each model and both were compared.

Results: Both markers were in LD (r2 = 0.82). For rs12979860, 66 (64.0%) CC versus 56 (33.1%) T allele carriers achieved SVR (Adjusted OR = 4.156, 95%CI = 2.388-7.232, p = 4.647×10-7). For ss469415590, 66 (66.0%) TT/TT versus 56 (32.5%) -G allele carriers (Adjusted OR = 4.783, 95%CI = 2.714-8.428, p = 6.153×10-8) achieved SVR. The AUROC of the model including rs12979860 was 0.742 (95%CI = 0.672-0.813) and of that based on ss469415590 was 0.756 (95%CI = 0.687-0.826) (p = 0.780).

Conclusions: The ss469415590 variant shows an equivalent performance to predict SVR to pegIFN/RBV than the rs2979860 in Caucasian HCV-1/4-infected patients.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0095515PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991683PMC
May 2015
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