Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Background/Objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU). Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations. Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization. Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.     

Psychosomatics: a current overview

The term 'psychosomatic' has typically defined a series of illnesses in which somatic injury breaks out from psychic conflict not recognized as such. Currently, health is considered the only psychosomatic state of integration of mind and soma: an ideal state of integration. Somatic pathology is an effect of mind/body splitting. In the heterogeneous 'field of psychosomatics' interaction between psyche and soma ranges from classical psychosomatic illness to sporadic episodes in which the body has responded to an inability to process mental conflict. The author briefly reviews the development of psychoanalytic thought on psychosomatics in Argentina. He suggests the need to find appropriate conceptual tools to approach the mental structure underlying this pathology. He presents his ideas about the mental functioning of patients with somatization disorders. He introduces the concept of somatic event as a restitution phenomenon through which the subject attempts to re-establish self-integration and links with reality. He also offers some reflections on temporality and on changes in psychoanalytic technique with these patients. A clinical case illustrates his ideas.     

Early psychopathological features in Spanish adolescents

Schizotypal experiences and depressive symptoms are quite common among adolescents, and have been considered as risk markers for schizophrenia-spectrum and mood disorders. The main goal of the present study was to analyze the relationship between schizotypal experiences and depressive symptoms in a community sample of non-clinical adolescents. The sample comprised a total of 1653 participants, 794 male (48%), with an average age of 15.94 years (SD = 1.23). Results showed that schizotypal traits and depressive symptoms were closely related at a subclinical level. Canonical correlation analysis indicated that the two sets of variables shared approximately 48% of the variance. The study of the dimensionality underlying the subscales of the self-reports revealed the presence of three components, namely: Depressive, Anhedonia and Reality Distortion. These results are convergent with previous studies conducted in both clinical and non-clinical samples, indicating overlap between schizotypal experiences and depressive symptoms.     

Personality differences between alcohol abusers and matched controls: Relation to frontal symptoms and subtypes of addicts

Epidemiological studies usually show a link between personality disorders and addictions. Dimensional models of personality, such as that of Cloninger, are able to diagnose and discriminate between transient dysfunctional behavior styles and relatively more stable traits. Certain brain areas have been proposed, as trait locations, based on their activation. This paper explores differences in personality traits among a sample of alcohol abusers (N= 95) and a control group of non-clinical population (N= 95), matched in sociodemographic variables, using the TCI-R-67 and the FrSBe-Sp. It is hypothesized that such differences are associated with frontal symptomatology. The existence of different subgroups of addicts based on certain combinations of traits is also analyzed. Results showed significant differences in two temperament traits (Novelty Seeking and Harm Avoidance) and a characterial trait (Self-Direction). We also found a correlation with a large effect size between these traits and frontal symptomatology. Cluster analysis classified the participants into several subtypes with different combinations of traits that matched diverse frontal symptomatology. Possible neurobiological explanations of these differences and their importance in the clinical practice are discussed.     

Excessive confidence in visually-based estimates

People exhibit excessive confidence in visually-based estimates, which in turn biases decision making. Three experiments support this assertion. Experiment 1 shows a strong impact of presentation format on estimation of proportions. Experiment 2 shows that people rely on these erroneous estimates to make incentive-compatible decisions even when objective information can be easily obtained. Experiment 3 demonstrates that the biased decisions disappear when confidence in visually-based estimates is called into question by the perceived complexity of the stimulus.     

Body,culture and cognition: avoiding reductionist temptations / Cuerpo,cultura y cognición: sorteando las tentaciones reduccionistas

The article considers two postulates of Piaget’s epistemology (anti-reductionism and developmental perspective) to analyse three influential perspectives on cognition: nativist, sociocultural and situated cognition. Based on this analysis, we propose two cognitive processes (explicitation and implicitation) that can explain cognitive change from the most elementary and embodied knowledge to more sophisticated and cultural ones. Some empirical examples concerning external representations that support this proposal are discussed.     

Can Cognitive‐Behavioral Therapy Be Optimized With Parent Psychoeducation? A Randomized Effectiveness Trial of Adolescents With Major Depression in Puerto Rico

This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive‐behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre‐ to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1‐year follow‐up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT‐alone showed an increase. The implication of these findings is discussed.     

Persistent stress 'deafness': the case of French learners of Spanish

Previous research by Dupoux et al. [Dupoux, E., Pallier, C., Sebastián, N., & Mehler, J. (1997). A destressing "deafness" in French? Journal of Memory Language 36, 406-421; Dupoux, E., Peperkamp, S., & Sebastián-Gallés (2001). A robust method to study stress' deafness. Journal of the Acoustical Society of America 110, 1608-1618.] found that French speakers, as opposed to Spanish ones, are impaired in discrimination tasks with stimuli that vary only in the position of stress. However, what was called stress 'deafness' was only found in tasks that used high phonetic variability and memory load, not in cognitively less demanding tasks such as single token AX discrimination. This raised the possibility that instead of a perceptual problem, monolingual French speakers might simply lack a metalinguistic representation of contrastive stress, which would impair them in memory tasks. We examined a sample of 39 native speakers of French who underwent formal teaching of Spanish after age 10, and varied in degree of practice in this language. Using a sequence recall task, we observed in all our groups of late learners of Spanish the same impairment in short-term memory encoding of stress contrasts that was previously found in French monolinguals. Furthermore, using a speeded lexical decision task with word-nonword minimal pairs that differ only in the position of stress, we found that all late learners had much difficulty in the use of stress to access the lexicon. Our results show that stress 'deafness' is better interpreted as a lasting processing problem resulting from the impossibility for French speakers to encode contrastive stress in their phonological representations. This affects their memory encoding as well as their lexical access in on-line tasks. The generality of such a persistent suprasegmental 'deafness' is discussed in relation to current findings and models on the perception of non-native phonological contrasts.