The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance

Objectives Evidence suggests the efficacy of mindfulness-based cognitive therapy (MBCT) to prevent depression relapse and decrease depressive symptoms during the acute phase. However, the effectiveness of MBCT in real-world heterogeneous samples treated in clinical health settings, including primary care, has received little attention. This study had two aims: (1) to evaluate the effectiveness of MBCT delivered in primary care considering pre-treatment depression scores and (2) to explore the role of participants’ characteristics on symptom improvement. Methods Data were obtained from 433 individuals who received MBCT. Participants completed the Personality Inventory for ICD-11 (PiCD) pretreatment and the Beck Depression Inventory (BDI-II) pre- and post-treatment. Results Sixty percent presented moderate-to-severe depression according to scores on the BDI-II, 18.1% presented mild depression, and 21.7% were in the non-depressed range. The severity of pre-treatment depressive symptoms was associated with outcomes. Most individuals who lacked depressive symptoms at baseline remained in the non-clinical range after the treatment. Those in the severe group benefited the most from the intervention, since 35.6% were considered recovered. Rates of deterioration ranged from 2.1 to 2.7%, depending on the depression-baseline scores. Depression severity at the entrance, attendance, and age, but not personality traits, appear to be related to symptom improvement. Conclusions According to our results, MBCT can be effectively and safely delivered in primary care.

The Moderating Effect of Alcohol Use Disorder on Intimate Partner Violence Intervention Outcomes in Veterans

BackgroundVeterans report relatively high rates of intimate partner violence (IPV) due to high trauma exposure. Alcohol use disorder (AUD), which is more prevalent among veterans, is a risk factor for IPV use and recidivism following IPV intervention. Using data from a prior randomized control trial of a trauma-informed IPV intervention, we examined the moderating effect of AUD on treatment outcomes among veterans.MethodsParticipants were 61 male veterans (M age = 37.18, SD = 13.23; 82% White; 18% met criteria for AUD) who participated in the Strength at Home (SAH) IPV intervention. Generalized mixed modelling was used to examine the effects of AUD and treatment attendance on posttreatment reductions in IPV.ResultsA significant threeway interaction between time, AUD, and session attendance was observed with respect to reductions in psychological IPV. Specifically, psychological IPV decreased significantly over time, but to a lesser extent among individuals with AUD, regardless of treatment attendance.DiscussionResults indicate that participants with AUD receive less benefit from treatment with regard to coercive and controlling abusive behaviors. Findings speak to the need for adapting IPV intervention in order to address problematic alcohol use and related externalizing psychopathology.

Model Adherence to Treatment of Diseases Acquired by Asymmetries Between Job Demands and Self-Control

Background: Psychological studies of adherence to treatment have established; 1) indicators models -frequency of medical consultation, prevalence of medication intake over any other treatment, attendance at therapeutic and rehabilitation sessions-; 2) determining models -sex, age, income, level of instruction, reading comprehension, interpersonal relationships-; 3) mediating models-beliefs, attitudes, knowledge, intentions, and strategies. Objective: Specify a model of the organizational and subjective determinants of adherence to treatment in cases of injured or sick workers due to their work activity, climate of relationships and task climate. Method: Documentary study with a selection of indexed sources in repositories of Latin America -Dialnet, Latindex, Publindex, Redalyc and Scieloconsidering the variables reported in the state of the art. Results: The specification of the model included four explanatory hypotheses of the trajectories of dependency relationships among the six variables - demands, social support, control, effort, reward and adhesion - taken from the literature review. Discussion: In relation to the models of indicators, the determinant models and the models of mediation, it is recommended to include the variables of work culture, quality of life and subjective well-being in the specified model to study the process that goes from the labor culture and it would culminate with the reinsertion of accident and disease cases. Conclusion: The new specification of the model would include explanatory hypotheses of the trajectories of correlations between the variables used in the present work with the purpose of establishing differences between the organizations that provide social security with respect to the companies managed from labor flexibility, as well as their effects on the occupational health of its workers