La regulación emocional como factor transdiagnóstico en psicoterapia: Luces y sombras de un campo en desarrollo
DOI:
https://doi.org/10.33898/rdp.v29i110.245Palabras clave:
regulación emocional, transdiagnóstico, integración en psicoterapiaResumen
La regulación emocional se ha convertido a lo largo de las últimas dos décadas en uno de los constructos más estudiados en el campo de la psicología clínica. En el presente artículo se exponen en una primera sección los conceptos primordiales en torno a los hallazgos psicopatológicos que dan cuenta del papel primordial de la regulación emocional como factor transdiagnóstico. Posteriormente, se describen las nociones centrales que deben ser consideradas para llevar a cabo una mejor articulación entre investigación y práctica clínica. Por último, se presentan algunos de los principales tratamientos existentes que abordan la regulación emocional como eje central, para plantear en último lugar los caminos por los que el campo de la regulación emocional debería transitar como campo específico de estudio en el contexto del desarrollo de la psicoterapia en general.
Descargas
Citas
Abravanel, B. T. y Sinha, R. (2015). Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology. J Psychiatr Res, 61, 89-96. doi:10.1016/j.jpsychires.2014.11.012
Aldao, A., Nolen-Hoeksema, S. y Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clin Psychol Rev, 30(2), 217-237. doi:10.1016/j.cpr.2009.11.004
Andersson, G. (2016). Internet-Delivered Psychological Treatments. Annu Rev Clin Psychol, 12, 157-179. doi:10.1146/annurev-clinpsy-021815-093006
Bardeen, J. R., Tull, M. T., Stevens, E. N. y Gratz, K. L. (2014). Exploring the relationship between positive and negative emotional avoidance and anxiety symptom severity: the moderating role of attentional control. J Behav Ther Exp Psychiatry, 45(3), 415-420. doi:10.1016/j.jbtep.2014.04.006
Barlow, D., Allen, L. B. y Choate, M. L. (2004). Toward a Unified Treatment for Emotional Disorders. Behavior Therapy, 35, 205-230.
Beauchaine, T. P. (2015). Respiratory sinus arrhythmia: a transdiagnostic biomarker of emotion dysregulation and psychopathology. Curr Opin Psychol, 3, 43. doi:10.1016/j.copsyc.2015.01.017
Bebko, G. M., Franconeri, S. L., Ochsner, K. N. y Chiao, J. Y. (2011). Look before you regulate: differential perceptual strategies underlying expressive suppression and cognitive reappraisal. Emotion, 11(4), 732-742. doi:10.1037/a0024009
Berking, M. y Schwartz, J. (2014). Affect regulation training. En J. J. Gross (ed.), Handbook of emotion regulation (2 ed., pp. 529 – 547). Nueva York, NY: Guilford Press.
Beyderman, I. y Young, M. A. (2016). Rumination and overgeneral autobiographical memory as mediators of the relationship between attachment and depression. Personality and Individual Differences, 98, 37-41. doi:10.1016/j.paid.2016.03.077
Black, H. S. (1977). Inventing the negative feedback amplifier: Six years of persistent search helped the author conceive the idea “in a flash” aboard the old Lackawanna Ferry. Spectrum, IEEE, 14, 55–60. doi:dx.doi.org/10.1109/MSPEC.1977.6501721
Borkovec, T. D. (2004). Research in Training Clinics and Practice Research Networks: A Route to the Integration of Science and Practice. Clinical Psychology: Science and Practice, 11(2), 196-210. doi:10.1093/clipsy/bph073
Botella, C., Baños, R. M., García-Palacios, A. y Quero, S. (2017). Chapter 22 - Virtual Reality and Other Realities A2 - Hofmann, Stefan G. En G. J. G. Asmundson (Ed.), The Science of Cognitive Behavioral Therapy (pp. 551-590). San Diego, CA: Academic Press.
Cannon, W. B. (1932 ). The wisdom of the body. The American Journal of the Medical Sciences, 184, 864. doi:http://dx.doi.org/10.1097/00000441- 193212000-00028
Castonguay, L. G. Muran, J. C. (2015). Fostering collaboration between researchers and clinicians through building practice-oriented research: an introduction. Psychother Res, 25(1), 1-5. doi:10.1080/10503307.2014.966348
Cristea, I. A., Gentili, C., Cotet, C. D., Palomba, D., Barbui, C. y Cuijpers, P. (2017). Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis. JAMA Psychiatry, 74(4), 319-328. doi:10.1001/jamapsychiatry.2016.4287
Cuijpers, P., Karyotaki, E., Reijnders, M. Ebert, D. D. (2018). Was Eysenck right after all? A reassessment of the effects of psychotherapy for adult depression. Epidemiol Psychiatr Sci, 1-10. doi:10.1017/S2045796018000057
Díaz-García, A., González-Robles, A., Fernández-Álvarez, J., García-Palacios, A., Baños, R. M. y Botella, C. (2017). Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: Study protocol for a randomized controlled trial. Bmc Psychiatry, 17, 145. doi:10.1186/s12888-017-1297-z
Dixon-Gordon, K. L., Bernecker, S. L. y Christensen, K. (2015). Recent innovations in the field of interpersonal emotion regulation. Curr Opin Psychol, 3, 36-42. doi:10.1016/j.copsyc.2015.02.001
Extremera, N. y Rey, L. (2015). The moderator role of emotion regulation ability in the link between stress and well-being. Front Psychol, 6, 1632. doi:10.3389/fpsyg.2015.01632
Fernández-Álvarez, J., Fernández-Álvarez, H. y Castonguay, L. (2018). Summarizing novel efforts to integrate practice and research from a practice oriented research perspective. Revista Argentina de Clínica Psicológica, 27(2), 363-372.
Gaggioli, A., Pallavicini, F., Morganti, L., Serino, S., Scaratti, C., Briguglio, M., Crifaci, G., Vetrano, N., Giulintano, A., Bernava, G., Cipresso, P., Vigna, C., Grassi, A., Baruffi, M., Wiederhold, B. y Riva, G. (2014). Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial. J Med Internet Res, 16(7), e167. doi:10.2196/jmir.3235
González-Blanch, C. s., Umaran-Alfagemea, O., Cordero-Andrés, P., Muñoz-Navarro, R., Ruiz-Rodríguez, P., Medrano, L. A., Ruiz-Toress, M., Collado, E. D. y Cano-Vindel, A. (2018). Tratamiento psicológico de los trastornos emocionales en Atención Primaria: el manual de tratamiento transdiagnóstico del estudio PsicAP. Ansiedad y Estrés, 24(1), 1-11. doi:10.1016/j.anyes.2017.10.005
González-Robles, A., García-Palacios, A., Baños, M. R., Riera, A., Llorca, G., Traver, F., Haro, G., Palop, V., Lera, G., Romeu, J. E. y Botella, C. (2015). Effectiveness of a transdiagnostic internet- based protocol for the treatment of emotional disorders versus treatment as usual in specialized care: study protocol for a randomized controlled trial. Trials, 16. doi:10.1186/s13063-015-1024-3
Gratz, K. L. y Roemer, L. (2004). Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, Vol. 26(1), 41-54.
Grill, S. S., Castañeiras, C. y Fasciglione, M. P. (2017). Aplicación grupal del Protocolo Unificado para el tratamiento transdiagnóstico de los trastornos emocionales en población argentina. Revista de Psicopatología y Psicología Clínica, 22(3), 171-181. doi:10.5944/rppc.vol.22.num.3.2017.18122
Gross, J. J. (1998). The Emerging Field of Emotion Regulation: An Integrative Review. Review of General Psychology, 2(3), 271-299.
Gross, J. J. (2015a). Emotion Regulation: Current Status and Future Prospects. Psychological Inquiry, 26(1), 1-26. doi:10.1080/1047840X.2014.940781
Gross, J. J. (2015b). Handbook of Emotion Regulation (Second Edition). Nueva York, NY: The Guilford Press.
Guillén, V., García-Palacios, A. y Baños, R. (2018). Terapia dialéctica comportamental para un paciente con trastorno bipolar I: un estudio de caso con seguimiento a los dos años. Revista Argentina de Clínica Psicológica, 27(1), 14-35. doi:10.24205/03276716.2018.1045
Gyani, A., Shafran, R., Myles, P. y Rose, S. (2014). The gap between science and practice: how therapists make their clinical decisions. Behav Ther, 45(2), 199-211. doi:10.1016/j.beth.2013.10.004
Harvey, A. G., Watkins, E., Mansell, W. y Shafran, R. (2004). Cognitive Behavioural Processes Across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment. Oxford, Reino Unido: Oxford University Press.
Hershenberg, R. y Goldfried, M. R. (2015). Implications of RDoC for the Research and Practice of Psychotherapy. Behavior Therapy, 46, 156-165.
Hofmann, S. G. (2014). Interpersonal Emotion Regulation Model of Mood and Anxiety Disorders. Cognit Ther Res, 38(5), 483-492. doi:10.1007/s10608-014-9620-1
Hofmann, S. G. y Asmundson, G. J. (2008). Acceptance and mindfulness-based therapy: new wave or old hat? Clin Psychol Rev, 28(1), 1-16. doi:10.1016/j.cpr.2007.09.003
Hofmann, S. G. y Hayes, S. C. (2018). The Future of Intervention Science: Process-Based Therapy. Clinical Psychological Science, 2167702618772296. doi:10.1177/2167702618772296
Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sqanislow, C. y Wang, P. (2010). Research Domain Criteria (RDoC): Toward a New Classication Framework for Research on Mental Disorders. American Journal of Psychiatry, 167(7), 748-751.
Kanfer, F. H. y Hagerman, S. (1987). A Model of Self-Regulation. Berlin, Alemania: Heidelberg.
Kirwan, M., Pickett, S. M. y Jarrett, N. L. (2017). Emotion regulation as a moderator between anxiety symptoms and insomnia symptom severity. Psychiatry Res, 254, 40-47. doi:10.1016/j.psychres.2017.04.028
Koole, S. L. y Veenstra, L. (2015). Does Emotion Regulation Occur Only Inside People's Heads? Toward a Situated Cognition Analysis of Emotion-Regulatory Dynamics. Psychological Inquiry, 26(1), 61-68. doi:10.1080/1047840X.2015.964657
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., Brown, T. A., Carpenter, W. T., Caspi, A., Clark, L. A., Eaton, N. R., Forbes, M. K., Forbush, K. T., Goldberg, D., Hasi, D., Hyman, S. E., Ivanova, M. Y., Lynam, D. R., Markon, K., Miller, J. D., Moffitt, T. E., Morey, L. C., Mullins-Sweatt, S. N., Ormel, J., Patrick, C. J., Regier, D. A., Rescorta, L., Ruggero, C. J., Samuel, D. B., Sellbom, M., Simms, L. J., Skodol, A. E., Slade, T., South, S. C., Tackett, J. L., Waldman, I. D., Waszczuk M. A., Widiger, T. A., Wright, A. G. C. y Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. J Abnorm Psychol, 126(4), 454-477. doi:10.1037/abn0000258
Krueger, R. F. y Markon, K. E. (2006). Reinterpreting Comorbidity: A Model-Based Approach to Understanding and Classifying Psychopathology. Annual Review of Clinical Psychology, 2, 111-133.
LeDoux, J. E. y Hofmann, S. G. (2017). The subjective experience of emotion: a fearful view. Current Opinion in Behavioral Sciences, 19, 67-72. doi:10.1016/j.cobeha.2017.09.011
Loo Gee, B., Griffiths, K. M. y Gulliver, A. (2016). Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: a systematic review. J Am Med Inform Assoc, 23(1), 221-229. doi:10.1093/jamia/ocv043
Mahaffey, B. L., Watson, D., Clark, L. A. y Kotov, R. (2016). Clinical and personality traits in emotional disorders: Evidence of a common framework. J Abnorm Psychol, 125(6), 758-767. doi:10.1037/abn0000187
Malik, S., Wells, A. y Wittkowski, A. (2015). Emotion regulation as a mediator in the relationship between attachment and depressive symptomatology: A systematic review. J Affect Disord, 172, 428-444. doi:10.1016/j.jad.2014.10.007
Mansell, W. y Marken, R. S. (2015). The Origins and Future of Control Theory in Psychology. Review of General Psychology, 19(4), 425-430. doi:10.1037/gpr0000057
Miller, G. (2012). The Smartphone Psychology Manifesto. Perspectives on Psychological Science, 7(3), 221-237.
Neacsiu, A. D., Bohus, M. y Linehan, M. (2014). Dialectical behavior therapy: An intervention for emotion dysregulation. En J. J. Gross (Ed.), Handbook of emotion regulation (pp. 491-507). Nueva York, NY: Guilford Press.
Osbeck, L. M. (2009). Transformations in Cognitive Science: Implications and Issues Posed. Journal of Theoretical and Philosophical Psychology, 29(1), 16-33. doi:10.1037/a0015454
Osma, J., Suso-Ribera, C., Garcia-Palacios, A., Crespo-Delgado, E., Robert-Flor, C., Sanchez-Guerrero, A., Ferreres-Galan, V., Pérez-Ayerra, L., Malea-Fernández, A. y Torres-Alfosea, M. A. (2018). Efficacy of the unified protocol for the treatment of emotional disorders in the Spanish public mental health system using a group format: study protocol for a multicenter, randomized, non-inferiority controlled trial. Health Qual Life Outcomes, 16(1), 46. doi:10.1186/s12955-018-0866-2
Patten, S. B., Williams, J. V. A., Lavorato, D. H., Bulloch, A. G. M., Wiens, K. y Wang, J. (2016). Why is major depression prevalence not changing? J Affect Disord, 190, 93-97. doi:10.1016/j.jad.2015.09.002
Perna, G., Grassi, M., Caldirola, D. y Nemeroff, C. B. (2018). The revolution of personalized psychiatry: will technology make it happen sooner? Psychol Med, 48(5), 705-713. doi:10.1017/S0033291717002859
Porges, S. W. (2007). The Polyvagal Perspective. Biological Psychology, 74(2), 116-143.
Riva, G., Raspelli, S., Algeri, D., Pallavicini, F., Gorini, A., Wiederhold, B. K. y Gaggioli, A. (2010). Interreality in Practice: Bridging Virtual and Real Worlds in the treatment of Posttraumatic Stress Disorders . Cyberpsychology, Behavior & Social Networking, 13 (1), 55-65. doi:10.1089/cyber.2009.0320
Sandín, B., Chorot, P. y Valiente, R. M. (2012). Transdiagnóstico: nueva frontera en psicología clínica Revista de Psicopatología y Psicología Clínica, 17(1), 185-203.
Shapero, B. G., Abramson, L. Y. y Alloy, L. B. (2016). Emotional Reactivity and Internalizing Symptoms: Moderating Role of Emotion Regulation. Cognit Ther Res, 40(30), 328-340. doi:10.1007/s10608-015-9722-4
Sloan, E., Halla, K., Mouldinga, R., Brycec, S., Mildreda, H. y Staigerb, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. 57, 141-163. doi:10.1016/j.cpr.2017.09.002
Stanton, K., Rozek, D. C., Stasik-O'Brien, S. M., Ellickson-Larew, S. y Watson, D. (2016). A transdiagnostic approach to examining the incremental predictive power of emotion regulation and basic personality dimensions. J Abnorm Psychol, 125(7), 960-975. doi:10.1037/abn0000208
Strauss, G. P., Ossenfort, K. L. y Whearty, K. M. (2016). Reappraisal and Distraction Emotion Regulation Strategies Are Associated with Distinct Patterns of Visual Attention and Differing Levels of Cognitive Demand. Plos One, 11(11), e0162290. doi:10.1371/journal.pone.0162290
Thayer, J. F. y Lane, R. D. (2009). Claude Bernard and the heart-brain connection: further elaboration of a model of neurovisceral integration. Neurosci Biobehav Rev, 33(2), 81-88. doi:10.1016/j.neubiorev.2008.08.004
Tull, M. T., Bardeen, J. R., DiLillo, D., Messman-Moore, T. y Gratz, K. L. (2015). A prospective investigation of emotion dysregulation as a moderator of the relation between posttraumatic stress symptoms and substance use severity. J Anxiety Disord, 29, 52-60. doi:10.1016/j.janxdis.2014.11.003
Tyron, W. W. (2018). Mediators and Mechanisms. Clinical Psychological Science. doi:10.1177/2167702618765791
Vohs, K. D. y Baumeister, R. F. (2016). Handbook of Self-Regulation: Research, Theory, and Applications. Nueva York, NY: Guilford Press.
Von Bertalanffy, L. (1967). General theory of systems : Application to psychology. Information (International Social Science Council), 6(6), 125-136. doi:10.1177/053901846700600610
Webb, T. L., Miles, E. y Sheeran, P. (2012). Dealing with feeling: a meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychol Bull, 138(4), 775-808. doi:10.1037/a0027600
WHO. (2017). Depression and Other Common Mental Disorders Global Health Estimates.
Williams, J. M. G. (2007). The mindful way through depression: Freeing yourself from chronic unhappiness. New York, NY: Guilford Press.
Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B. y Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: a meta-analysis. Clin Psychol Rev, 28(6), 1021-1037. doi:10.1016/j.cpr.2008.02.007
Zaki, J. y Williams, W. C. (2013). Interpersonal emotion regulation. Emotion, 13(5), 803-810. doi:10.1037/a0033839