Mindfulness rasgo y el potencial papel mediador de las estrategias de regulación emocional en el trastorno bipolar.
Resumen
En este estudio transversal se investiga la asociación entre los principales síntomas del Trastorno bipolar (TB) y las dificultades asociadas a las estrategias de regulación emocional (ERE) adaptativas y desadaptativas. Además, este estudio examina los efectos mediadores de las ERE con el mindfulness rasgo y el TB. Método. Veinticuatro adultos con TB completaron la Escala de Conciencia de Atención Plena (MAAS), el Inventario de Depresión de Beck (BDI-II), la Escala de Autoevaluación de Manía de Altman (ARSM), el Inventario de Ansiedad Rasgo (STAI-R), y el Cuestionario de Regulación Emocional Cognitiva (CERQ). Resultados. El análisis de regresión múltiple mostró cómo la depresión se relacionaba significativa y positivamente con la autoculpabilización, mientras que la ansiedad rasgo estaba positivamente asociada con la autoculpabilización y el catastrofismo. En segundo lugar, el análisis de mediación mostró un efecto de mediación significativo para la autoculpabilidad en la relación entre mindfulness y depresión (a*b = -.15; ICB 95% [-.36, -.03]) y entre mindfulness y ansiedad rasgo (a*b = -.09; ICB 95% [-.27, -.01]). Conclusiones. Nuestros resultados informan del papel de la auto-culpabilidad y el catastrofismo en el TB y de cómo éstas podrían mediar significativamente entre el mindfulness rasgo y el TB. Estos resultados sugieren que una práctica de meditación enfocada en el catastrofismo y la autoculpabilidad puede ser especialmente útil para reducir los síntomas en los pacientes bipolares.
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Alloy, L. B., Burke, T. A., O’Garro-Moore, J., & Abramson, L. Y. (2018). Cognitive vulnerability to depression and bipolar disorder. In Science and practice in cognitive therapy: Foundations, mechanisms, and applications. (pp. 105–123). Guilford Press.
Altman, E. G., Hedeker, D., Peterson, J. L., & Davis, J. M. (1997). The Altman self-rating mania scale. Biological Psychiatry, 42(10), 948–955. https://doi.org/https://doi.org/10.1016/S0006-3223(96)00548-3
Alvarez, P. M., Benavent, P. R., García, J. M. V., Livianos, L. A., & Rojo, L. M. (2005). Translation and adaptation in the Spanish environment of the Altman Self-Rating Mania Scale. Actas Espanolas de Psiquiatria, 33(3), 180–187.
Ato, M., López, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología [A classification system for research designs in psychology]. Anales de Psicología, 29(3), 1038–1059. https://doi.org/10.1002/bdm.565
Banfi, J. T., & Randall, J. G. (2022). A meta-analysis of trait mindfulness: Relationships with the big five personality traits, intelligence, and anxiety. Journal of Research in Personality, 104307.
Barajas, S., & Garra, L. (2014). Mindfulness and psychopathology: Adaptation of the Mindful Attention Awareness Scale (MAAS) in a Spanish sample. Clínica y Salud, 25(1), 49–56. https://doi.org/http://dx.doi.org/10.5093/cl2014a4
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. (1996). Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67(3), 588–597. https://doi.org/https://doi.org/10.1207/s15327752jpa6703_13
Bojic, S., & Becerra, R. (2017). Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature. Europe’s Journal of Psychology, 13(3), 573– 598. https://doi.org/10.5964/ejop.v13i3.1138
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of personality and social psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
Buela-Casal, G., & Guillén-Riquelme, A. (2017). Short form of the Spanish adaptation of the State-Trait Anxiety Inventory. International Journal of Clinical and Health Psychology, 17(3), 261-268. https://doi.org/10.1016/j.ijchp.2017.07.003
Burgos‐Julián, F. A., Ruiz‐Íñiguez, R., Peña‐Ibáñez, F., Montero, A. C., & Santed‐ Germán, M. A. (2022). Mindfulness‐based and mindfulness‐informed interventions in bipolar disorder: A meta‐analysis based on Becker's method. Clinical Psychology & Psychotherapy. https://doi.org/10.1002/cpp.2717
Carpenter, J. K., Conroy, K., Gomez, A. F., Curren, L. C., & Hofmann, S. G. (2019). The relationship between trait mindfulness and affective symptoms: A meta-analysis of the Five Facet Mindfulness Questionnaire (FFMQ). Clinical psychology review, 74, 101785.
Carruthers, S. P., Rossell, S. L., Murray, G., Karantonis, J., Furlong, L. S., & Van Rheenen, T. E. (2022). Mindfulness, mood symptom tendencies and quality of life in bipolar disorder: an examination of the mediating influence of emotion regulation difficulties. Journal of Affective Disorders, 298, 166-172. https://doi.org/ 10.1016/j.jad.2021.10.107
Chan, S. M., Chan, S. K., & Kwok, W. W. (2015). Ruminative and catastrophizing cognitive styles mediate the association between daily hassles and high anxiety in Hong Kong adolescents. Child psychiatry and human development, 46(1), 57–66. https://doi.org/10.1007/s10578-014-0451-9
Chamizo Nieto, M. T., Rey Peña, L., & Sánchez Álvarez, N. (2020). Validation of the Spanish version of the Cognitive Emotion Regulation Questionnaire in adolescents. Psicothema.
De Prisco, M., Oliva, V., Fico, G., Fornaro, M., De Bartolomeis, A., Serretti, A., ... & Murru, A. (2022). Defining clinical characteristics of emotion dysregulation in bipolar disorder: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 104914.
Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mindfulness and emotion regulation in depression and anxiety: Common and distinct mechanisms of action. Depression and Anxiety, 30(7), 654–661. https://doi.org/https:/doi.org/10.1002/da.22124
Dodd, A., Lockwood, E., Mansell, W., & Palmier-Claus, J. (2019). Emotion regulation strategies in bipolar disorder: A systematic and critical review. Journal of affective disorders, 246, 262–284. https://doi.org/10.1016/j.jad.2018.12.026
Eisner, L., Eddie, D., Harley, R., Jacobo, M., Nierenberg, A. A., & Deckersbach, T. (2017). Dialectical Behavior Therapy Group Skills Training for Bipolar Disorder. Behavior Therapy, 48(4), 557–566. https://doi.org/10.1016/j.beth.2016.12.006
Fairchild, A. J., & McDaniel, H. L. (2017). Best (but oft-forgotten) practices: mediation analysis. The American journal of clinical nutrition, 105(6), 1259–1271. https://doi.org/10.3945/ajcn.117.152546
Ferrando, L., Bobes, J., Gibert, J., Soto, M., & Soto, O. (1 de agosto de 2015). MINI Entrevista Neuropsiquiátrica Internacional [International Neuropsychiatric Interview]. Instituto IAP. http://www.iiap.es/files/mini.pdf
Garcia-blanco, A. C. (2016). A new approach to emotional dysregulation in bipolar disorder. Bipolar Disorder: Open Access, 1(1), 10–11. https://doi.org/10.4172/2472-1077.1000e103
García-Blanco, A. C., Perea, M., & Salmerón, L. (2013). Attention orienting and inhibitory control across the different mood states in bipolar disorder: An emotional antisaccade task. Biological Psychology, 94(3), 556–561. https://doi.org/10.1016/j.biopsycho.2013.10.005
Garland, E. L., Farb, N. A., R. Goldin, P., & Fredrickson, B. L. (2015). Mindfulness Broadens Awareness and Builds Eudaimonic Meaning: A Process Model of Mindful Positive Emotion Regulation. Psychological Inquiry, 26(4), 293–314. https://doi.org/10.1080/1047840X.2015.1064294
Garnefski, N., & Kraaij, V. (2007). The cognitive emotion regulation questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 23(3), 141–149. https://doi.org/10.1027/1015-5759.23.3.141
Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events , cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 1311–1327. https://doi.org/10.1016/S0191-8869(00)00113-6
Garnefski, N., Van Den Kommer, T., Kraaij, V., Teerds, J., Legerstee, J., & Onstein, E. (2002). The relationship between cognitive emotion regulation strategies and emotional problems: Comparison between a clinical and a non-clinical sample. European Journal of Personality, 16(5), 403–420. https://doi.org/10.1002/per.458
Gilbert, K., & Gruber, J. (2014). Emotion regulation of goals in bipolar disorder and major depression: A comparison of rumination and mindfulness. Cognitive Therapy and Research, 38(4), 375-388. https://doi.org/ 10.1007/s10608-014- 9602-3
Green, M. J., Lino, B. J., Hwang, E. J., Sparks, A., James, C., & Mitchell, P. B. (2011). Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives. Acta Psychiatrica Scandinavica, 124(4), 307–316. https://doi.org/https:/doi.org/10.1111/j.1600-0447.2011.01718.x
Hanssen, I., Huijbers, M. J., Lochmann-van Bennekom, M., Regeer, E. J., Stevens, A., Evers, S., Wensing, M., Kupka, R. W., & Speckens, A. (2019). Study protocol of a multicenter randomized controlled trial of mindfulness-based cognitive therapy and treatment as usual in bipolar disorder. BMC psychiatry, 19(1), 130. https://doi.org/10.1186/s12888-019-2115-6
Hanssen, I., Huijbers, M. J., Lochmann-Van Bennekom, M. W. H., Regeer, E. J., Stevens, A. W. M. M., Evers, S. M. A. A., Wensing, M., Kupka, R. W., & Speckens, A. E. M. (2019). Study protocol of a multicenter randomized controlled trial of mindfulness-based cognitive therapy and treatment as usual in bipolar disorder. BMC Psychiatry, 19(1). https://doi.org/10.1186/s12888-019-2115-6
Hassani, J., & Kia, E. A. (2016). Cognitive emotion regulation strategies, anxiety and impulsivity in bipolar disorder with and without comorbid obsessive-compulsive disorder. Iranian Journal of Psychiatry and Clinical Psychology, 22(1), 39–49.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press.
Hayes, A. F., & Rockwood, N. J. (2019). Conditional process analysis: Concepts, computation, and advances in the modeling of the contingencies of mechanisms. American Behavioral Scientist, 64(1), 19–54. https://doi.org/10.1177/0002764219859633
Howells, F. M., Ives-Deliperi, V. L., Horn, N. R., & Stein, D. J. (2012). Mindfulness based cognitive therapy improves frontal control in bipolar disorder: A pilot EEG study. BMC Psychiatry, 12(1), 15. https://doi.org/10.1186/1471-244X-12-15
Howells, F. M., Laurie Rauch, H. G., Ives-Deliperi, V. L., Horn, N. R., & Stein, D. J. (2014). Mindfulness based cognitive therapy may improve emotional processing in bipolar disorder: Pilot ERP and HRV study. Metabolic Brain Disease, 29(2), 367–375. https://doi.org/10.1007/s11011-013-9462-7
Kabat-Zinn, J. (1990). Mindfulness-based stress reduction. Using the wisdom of your body and mind to face stress, pain, and illness, 467.
Kabat-Zinn, J. (2021). The liberative potential of mindfulness. Mindfulness, 12(6), 1555-1563.
Ives-Deliperi, V. L., Howells, F., Stein, D. J., Meintjes, E. M., & Horn, N. (2013). The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: A controlled functional MRI investigation. Journal of Affective Disorders, 150(3), 1152–1157. https://doi.org/10.1016/j.jad.2013.05.074
Garfefski, S. L., Tharp, J. A., Peckham, A. D., & McMaster, K. J. (2016). Emotion in bipolar I disorder: Implications for functional and symptom outcomes. Journal of Abnormal Psychology, 125(1), 40–52. https://doi.org/10.1037/abn0000116
Germer, C., & Neff, K. (2019). Mindful self-compassion (MSC). Handbook of mindfulness-based programmes: Routledge, 357-67.
Kishi, T., Ikuta, T., Matsuda, Y., Sakuma, K., Okuya, M., Mishima, K., & Iwata, N. (2021). Mood stabilizers and/or antipsychotics for bipolar disorder in the maintenance phase: a systematic review and network meta-analysis of randomized controlled trials. Molecular psychiatry, 26(8), 4146-4157.
Miola, A., Cattarinussi, G., Antiga, G., Caiolo, S., Solmi, M., & Sambataro, F. (2022). Difficulties in emotion regulation in bipolar disorder: a systematic review and meta-analysis. Journal of Affective Disorders, 302, 352-360.
Musket, C. W., Hansen, N. S., Welker, K. M., Gilbert, K. E., & Gruber, J. (2021). A pilot investigation of emotional regulation difficulties and mindfulness-based strategies in manic and remitted bipolar I disorder and major depressive disorder. International Journal of Bipolar Disorders, 9(1), 1-8. https://doi.org/10.1186/s40345-020-00206-0
Painter, J. M., Mote, J., Peckham, A. D., Lee, E. H., Campellone, T. R., Pearlstein, J. G., Morgan, S., Kring, A. M., Johnson, S. L., & Moskowitz, J. T. (2019). A positive emotion regulation intervention for bipolar I disorder: Treatment development and initial outcomes. General Hospital Psychiatry, 61, 96–103. https://doi.org/10.1016/j.genhosppsych.2019.07.013
Parmentier, F., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Frontiers in psychology, 10, 506. https://doi.org/10.3389/fpsyg.2019.00506
Radford, S., Eames, C., Brennan, K., Lambert, G., Crane, C., Williams, J. M. G., ... & Barnhofer, T. (2014). Trait mindfulness as a limiting factor for residual depressive symptoms: An explorative study using quantile regression. PLoS One, 9(7), e100022.
Roemer, L., Williston, S. K., & Rollins, L. G. (2015). Mindfulness and emotion regulation. Current Opinion in Psychology, 3, 52–57. https://doi.org/http://dx.doi.org/10.1016/j.copsyc.2015.02.006
Rowland, J. E., Hamilton, M. K., Lino, B. J., Ly, P., Denny, K., Hwang, E. J., Mitchell, P. B., Carr, V. J., & Green, M. J. (2013). Cognitive regulation of negative affect in schizophrenia and bipolar disorder. Psychiatry research, 208(1), 21–28. https://doi.org/10.1016/j.psychres.2013.02.021
Ruiz, F. J. (2014). The relationship between mindfulness skills and pathological worry: The mediating role of psychological inflexibility. Anales de Psicología/Annals of Psychology, 30(3), 887-897. https://doi.org/10.6018/analesps.30.3.150651
Sanz, J., García-Vera, M. P., Espinosa, R., Fortún, M., & Vázquez, C. (2005). Adaptación española del Inventario para la Depresión de Beck-II (BDI-II): Propiedades psicométricas en pacientes con trastornos psicológicos [Spanish adaptation of the Beck Depression Inventory-II (BDI-II): Psychometric properties in patients with psychiatric disorders]. Clínica y Salud, 16(2), 121–142.
Sala, M., Rochefort, C., Lui, P. P., & Baldwin, A. S. (2020). Trait mindfulness and health behaviours: a meta-analysis. Health Psychology Review, 14(3), 345-393.
Segal, Z., Williams, M., & Teasdale, J. (2018). Mindfulness-based cognitive therapy for depression. Guilford publications.
Segovia, S. (2018). Mindfulness y el contexto budista. In S. Segovia & M. A. Santed (Eds.), Mindfulness: Fundamentos y aplicaciones (pp. 1–20). Paraninfo Universidad.
Sheehan, D., Lecrubier, Y., Sheehan, K., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G. (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(20), 22–33. https://www.psychiatrist.com/wpcontent/uploads/2021/02/15175_mini -international-neuropsychiatric-interview mini.pdf
Sørensen, L., Osnes, B., Visted, E., Svendsen, J. L., Adolfsdottir, S., Binder, P. E., & Schanche, E. (2018). Dispositional mindfulness and attentional control: The specific association between the mindfulness facets of non-judgment and describing with flexibility of early operating orienting in conflict detection. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.02359
Spielberger, C. D., Cubero, N. S., Gorsuch, R. L., & Lushene, R. E. (1982). Manual del cuestionario de ansiedad estado/rasgo (STAI). TEA Ediciones.
Teper, R., & Inzlicht, M. (2013). Meditation, mindfulness and executive control: The importance of emotional acceptance and brain-based performance monitoring. Social Cognitive and Affective Neuroscience, 8(1), 85–92. https://doi.org/10.1093/scan/nss045
Van Rheenen, T. E., Murray, G., & Rossell, S. L. (2015). Emotion regulation in bipolar disorder: Profile and utility in predicting trait mania and depression propensity. Psychiatry research, 225(3), 425-432. https://doi.org/ 10.1016/j.psychres.2014.12.001
Wolkenstein, L., Zwick, J. C., Hautzinger, M., & Joormann, J. (2014). Cognitive emotion regulation in euthymic bipolar disorder. Journal of Affective Disorders, 160, 92– 97. https://doi.org/https://doi.org/10.1016/j.jad.2013.12.022
Zahn, R., Lythe, K. E., Gethin, J. A., Green, S., Deakin, J. F. W., Young, A. H., & Moll, J. (2015). The role of self-blame and worthlessness in the psychopathology of major depressive disorder. Journal of Affective Disorders, 186, 337–341. https://doi.org/10.1016/j.jad.2015.08.001
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