El efecto de la técnica “K” sobre la ansiedad y los niveles de cortisol salivales en adolescentes

Autores/as

DOI:

https://doi.org/10.15448/1980-8623.2023.2.42920

Palabras clave:

Ansiedad, Aprendizaje, Cognición

Resumen

Esta investigación presenta argumentos teóricos para un nuevo enfoque denominado Técnica “K”, con el objetivo de reducir la ansiedad de los estudiantes frente a un desafío cognitivo. A través de un ensayo clínico aleatorizado y controlado, evaluamos el Inventario de Ansiedad de Beck y el cortisol salival. Comparamos los resultados de los estudiantes, que se enfrentaban a pruebas escolares, antes y después de la aplicación de la técnica “K” (grupo de intervención) y placebo (grupo control). Los análisis estadísticos consistieron en utilizar la prueba de Chi-cuadrado, Spearman y Wilcoxon. El análisis de componentes principales observado en el grupo de casos, -10,50 (-18,25; -4,75), fue estadísticamente superior al grupo control, -6,00 (-8,75; -1,25). No es posible identificar significación estadística (p = 0,462) en la variación de la concentración de cortisol salival. Los resultados sugieren la efectividad de la técnica “K” en el manejo de la ansiedad en estudiantes de secundaria. Sin embargo, se necesitan futuras investigaciones para ampliar los datos preliminares obtenidos en este estudio.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

André Michael Kolb, Universidad Federal de Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil

Licenciatura en Psicología por la Pontificia Universidad Católica de Minas Gerais (2015), intercambio en Psicología - Ruprecht-Karls-Universität Heidelberg (2013) y maestría en Salud del Niño y del Adolescente por la Universidad Federal de Rio Grande do Sul (2018). Especialización en Terapia Cognitivo Conductual por Wainer (2019). Terapeuta de esquemas de ISST/NY (2021) con certificación avanzada (2022). Supervisor por ISST/NY (2023). Actualmente se desempeña como psicólogo clínico, supervisor, investigador invitado y profesor especializado en Terapia Cognitivo Conductual y Terapia de Esquemas.

André Luiz Moreno, Universidad Federal de Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil.

Psicóloga (USP), maestría en Psicología (UFRGS), doctora en Salud Mental (USP). Especialista en Terapia Cognitivo-Conductual (IWP), con formación adicional en Terapia de Esquemas (Wainer – ISST). Profesor y supervisor de cursos de Especialización en Terapia Cognitivo-Conductual y Terapia de Esquemas. Consultor de Salud Mental.

Alberto Scofano Mainieri, Universidad Federal de Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil.

Licenciado en Medicina (1984); especializaciones en Pediatría (1987), Medicina del Adolescente (1988) y Atención Clínica Psicológica con énfasis en terapia de pareja y familia (2010); maestría en Medicina: Ciencias Médicas (1996); Doctorado en Ciencias Médicas: Endocrinología (2000). Actualmente es Profesor Asociado II de la Universidad Federal de Rio Grande do Sul. Tiene mayor experiencia en el área de medicina del adolescente, con énfasis en el crecimiento y desarrollo puberal y en las cuestiones emocionales y sexuales de esta etapa.

Rudimar dos Santos Riesgo, Moreno Psicología, Uberaba, MG, Brasil.

Neuropediatra y especialista en Epilepsia y EEG pediátrico. Tiene maestría y doctorado en Pediatría (UFRGS). Completó una beca de formación en EEG y epilepsia en el Miami Childrens Hospital (FL/EE.UU.). Miembro de la Asociación Internacional de Neurología Infantil, la Sociedad Internacional para la Investigación del Autismo y la Academia Iberoamericana de Neuropediatría. Profesor Titular de Medicina del Departamento de Pediatría de la UFRGS. Profesor del Programa de Posgrado en Salud del Niño y del Adolescente (UFRGS). Líder del Grupo de Investigación en Neuropediatría (HCPA-UFRGS-CNPq). Es jefe de la Unidad de Neuropediatría del Hospital de Clínicas de Porto Alegre.

Citas

American Psychiatric Association. (2014). DSM-5: Manual Diagnóstico e Estatístico de Transtornos Mentais (5a ed.). Porto Alegre: Artmed. Retrieved from https://www.institutopebioetica.com.br/documentos/manual-diagnostico-e-estatistico-de-transtornos-mentais-dsm-5.pdf

Barch, D. M., Harms, M. P., Tillman, R., Hawkey, E., & Luby, J. L. (2019). Early childhood depression, emotion regulation, episodic memory, and hippocampal development. Journal of Abnormal Psychology, 128(1), 81–95. https://doi.org/10.1037/abn0000392

Barker, H., Munro, J., Orlov, N., Morgenroth, E., Moser, J., Eysenck, M. W., & Allen, P. (2018). Worry is associated with inefficient functional activity and connectivity in prefrontal and cingulate cortices during emotional interference. Brain and Behavior, 8(12), e01137. https://doi.org/10.1002/brb3.1137

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006X.56.6.893

Blackwell, S. E. (2021). Mental Imagery in the Science and Practice of Cognitive Behaviour Therapy: Past, Present, and Future Perspectives. International Journal of Cognitive Therapy, 14(1), 160–181. https://doi.org/10.1007/s41811-021-00102-0

Burckhardt, R., Manicavasagar, V., Batterham, P. J., & Hadzi-Pavlovic, D. (2016). A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology. Journal of School Psychology, 57, 41–52. https://doi.org/10.1016/j.jsp.2016.05.008

Caldwell, D. M., Davies, S. R., Hetrick, S. E., Palmer, J. C., Caro, P., López-López, J. A., … Welton, N. J. (2019). School-based interventions to prevent anxiety and depression in children and young people: a systematic review and network meta-analysis. The Lancet. Psychiatry, 6(12), 1011–1020. https://doi.org/10.1016/S2215-0366(19)30403-1

Caldwell, D. M., Davies, S. R., Thorn, J. C., Palmer, J. C., Caro, P., Hetrick, S. E., … Welton, N. J. (2021). School-based interventions to prevent anxiety, depression and conduct disorder in children and young people: a systematic review and network meta-analysis. Southampton: NIHR Journals Library. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK572522/

Chojnowska, S., Ptaszyńska-Sarosiek, I., Kępka, A., Knaś, M., & Waszkiewicz, N. (2021). Salivary Biomarkers of Stress, Anxiety and Depression. Journal of Clinical Medicine, 10(3), 517. https://doi.org/10.3390/jcm10030517

Cunha, J. A. (2001). Manual da Versão em Português das Escalas Beck. São Paulo: Casa do Psicólogo.

Daros, A. R., Haefner, S. A., Asadi, S., Kazi, S., Rodak, T., & Quilty, L. C. (2021). A meta-analysis of emotional regulation outcomes in psychological interventions for youth with depression and anxiety. Nature Human Behaviour, 5(10), 1443–1457. https://doi.org/10.1038/s41562-021-01191-9

David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in Psychiatry, 9(4), 1–3. https://doi.org/10.3389/fpsyt.2018.00004

de Hullu, E., Sportel, B. E., Nauta, M. H., & de Jong, P. J. (2017). Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety: Two-year follow-up of a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 55, 81–89. https://doi.org/10.1016/j.jbtep.2016.11.011

DeSousa, D. A., Moreno, A. L., Gauer, G., Manfro, G. G., & Koller, S. H. (2013). Revisão sistemática de instrumentos para avaliação de ansiedade na população brasileira. Avaliação Psicológica, 12(3), 397–410. Retrieved from http://pepsic.bvsalud.org/pdf/avp/v12n3/v12n3a15.pdf

Dhama, K., Latheef, S. K., Dadar, M., Samad, H. A., Munjal, A., Khandia, R., ... Joshi, S. K. (2019). Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values. Frontiers in Molecular Biosciences, 6, 1–50. https://doi.org/10.3389/fmolb.2019.00091

Engen, H. G., & Anderson, M. C. (2018). Memory Control: A Fundamental Mechanism of Emotion Regulation. Trends in Cognitive Sciences, 22(11), 982–995. https://doi.org/10.1016/j.tics.2018.07.015

Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion), 7(2), 336–353. https://doi.org/10.1037/1528-3542.7.2.336

Eysenck, M. W., & Derakshan, N. (2011). New perspectives in attentional control theory. Personality and Individual Differences, 50(7), 955–960. http://dx.doi.org/10.1016/j.paid.2010.08.019

Feder, A., Fred-Torres, S., Southwick, S. M., & Charney, D. S. (2019). The Biology of Human Resilience: Opportunities for Enhancing Resilience Across the Life Span. Biological psychiatry, 86(6), 443–453. https://doi.org/10.1016/j.biopsych.2019.07.012

Feiss, R., Dolinger, S. B., Merritt, M., Reiche, E., Martin, K., Yanes, J. A., … Pangelinan, M. (2019). A Systematic Review and Meta-Analysis of School-Based Stress, Anxiety, and Depression Prevention Programs for Adolescents. Journal of Youth and Adolescence, 48(9), 1668–1685. https://doi.org/10.1007/s10964-019-01085-0

Garay, C. J., Korman, G. P., & Keegan, E. G. (2015). Terapia Cognitiva basada en Atención Plena (mindfulness) y la «tercera ola» en Terapias Cognitivo-Conductuales. Vertex, 26(119), 49–56. Retrieved from https://www.researchgate.net/publication/281519109_Mindfulness-Based_Cognitive_Therapy_MBCT_and_the_’Third_Wave’_of_Cognitive-Bahavioral_Therapies_CBT

Garnefski, N., & Kraaij, V. (2018). Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety. Cognition & Emotion, 32(7), 1401–1408. https://doi.org/10.1080/02699931.2016.1232698

Gee, B., Reynolds, S., Carroll, B., Orchard, F., Clarke, T., Martin, D., … Pass, L. (2020). Practitioner Review: Effectiveness of indicated school-based interventions for adolescent depression and anxiety - a meta-analytic review. Journal of Child Psychology and Psychiatry, 61(7), 739–756. https://doi.org/10.1111/jcpp.13209

Grist, R., Croker, A., Denne, M., & Stallard, P. (2019). Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis. Clinical Child and Family Psychology Review, 22(2), 147–171. https://doi.org/10.1007/s10567-018-0271-8

Haugland, B. S. M., Haaland, Å. T., Baste, V., Bjaastad, J. F., Hoffart, A., Rapee, R. M., … Wergeland, G. J. (2020). Effectiveness of Brief and Standard School-Based Cognitive-Behavioral Interventions for Adolescents With Anxiety: A Randomized Noninferiority Study. Journal of the American Academy of Child & Adolescent Psychiatry, 59(4), 552–564. https://doi.org/10.1016/j.jaac.2019.12.003

Hayes, S. C., & Hofmann, S. G. (2021). “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry. World Psychiatry, 20(3), 363–375. https://doi.org/10.1002/wps.20884

Hoffmann, J. D., Brackett, M. A., Bailey, C. S., & Willner, C. J. (2020). Teaching emotion regulation in schools: Translating research into practice with the RULER approach to social and emotional learning. Emotion, 20(1), 105–109. https://doi.org/10.1037/emo0000649

Holmes, E. A., Arntz, A., & Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: Images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 297–305. https://doi.org/10.1016/j.jbtep.2007.10.007

Hood, A., Pulvers, K., Spady, T. J., Kliebenstein, A., & Bachand, J. (2015). Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: a moderated mediation analysis. Anxiety, Stress & Coping, 28(5), 545–562. https://doi.org/10.1080/10615806.2014.1000880

Hulley, S. B., Cummings, S. R., Browner, W. S., Grady, D. G., & Newman, T. B. (2015). Delineando a pesquisa clínica (4a ed.). Porto Alegre: Artmed. Retrieved from https:// www.biosanas.com.br/uploads/outros/artigos_cientificos/143/c4fd11a995cc235510d275cf8298427d.pdf

Johnstone, J. M., Roake, C., Sheikh, I., Mole, A., Nigg, J. T., & Oken, B. (2016). School-based mindfulness intervention for stress reduction in adolescents: Design and methodology of an open-label, parallel group, randomized controlled trial. Contemporary Clinical Trials Communications, 4(15), 99–104. https://doi.org/10.1016/j.conctc.2016.07.001

Jones J. M., Watkins, C. A., Hand, J. S., Warren, J. J., & Cowen, H. J. (2000). Comparison of three salivary flow rate assessment methods in an elderly population. Community Dentistry and Oral Epidemiology, 28(2), 177– 184. https://doi.org/10.1034/j.1600-0528.2000.280303.x

Jones, S. M., McGarrah, M. W., & Kahn, J. (2019). Social and Emotional Learning: A Principled Science of Human Development in Context. Educational Psychologist, 54(3), 129–143. https://doi.org/10.1080/00461520.20 19.1625776

Joseph, N. T., Jiang, Y., & Zilioli, S. (2021). Momentary emotions and salivary cortisol: A systematic review and meta-analysis of ecological momentary assessment studies. Neuroscience and Biobehavioral Reviews, 125, 365–379. https://doi.org/10.1016/j.neubiorev.2021.02.042

Kauer-Sant’anna, M., Britzke, E., & Quevedo, J. (2011). Psiconeuroendocrinologia. In F. Kapczinski, J. Quevedo, & I. Izquierdo (Orgs.), Bases biológicas dos transtornos psiquiátricos: uma abordagem translacional (3a ed., pp. 55–76). Porto Alegre: Artmed. Retrieved from https://edisciplinas.usp.br/pluginfile.php/5799297/mod_resource/-content/1/Bases%20Biologicas%20dos%20Transtornos%20Psiqui%C3%A1tricos.pdf

Koutsimani, P., Montgomery, A., & Georganta, K. (2019). The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Frontiers in Psychology, 10, 284. https://doi.org/10.3389/fpsyg.2019.00284

Lakens, D. (2014). Performing high‐powered studies efficiently with sequential analyses. European Journal of Social Psychology, 44(7), 701–710. https://doi.org/10.1002/ejsp.2023

Likhtik, E., & Johansen, J. P. (2019). Neuromodulation in circuits of aversive emotional learning. Nature Neuroscience, 22, 1586–1597. https://doi.org/10.1038/s41593-019-0503-3

Manigault, A. W., Woody, A., Zoccola, P. M., & Dickerson, S. S. (2018). Trait mindfulness predicts the presence but not the magnitude of cortisol responses to acute stress. Psychoneuroendocrinology, 90, 29–34. https://doi.org/10.1016/j.psyneuen.2018.01.022

Matousek, R. H., Dobkin, P. L., & Pruessner, J. (2010). Cortisol as a marker for improvement in mindfulness- -based stress reduction. Complementary Therapies in Clinical Practice, 16(1), 13–19. https://doi.org/10.1016/j.ctcp.2009.06.004

Moreno, A. L., Ávila-Souza, J., Gomes, W. B., & Gauer, G. (2015). Effects of worry on verbal and visual working memory. Psychology & Neuroscience, 8(3), 341–349. https://doi.org/10.1037/h0101277

Phelps, E. A., & Hofmann, S. G. (2019). Memory editing from science fiction to clinical practice. Nature, 572(7767), 43–50. https://doi.org/10.1038/s41586-019-1433-7

Putwain, D. W., & von der Embse, N. P. (2021). Cognitive-behavioral intervention for test anxiety in adolescent students: do benefits extend to school-related wellbeing and clinical anxiety. Anxiety, Stress & Coping, 34(1), 22–36. https://doi.org/10.1080/10615806.2020.1800656

Roche Diagnóstica Brasil Ltda. (2015). Notificação de Qualidade SWA 37/2015. Roche.

Roos, A.-L., Goetz, T., Voracek, M., Krannich, M., Bieg, M., Jarrell, A., & Pekrun, R. (2021). Test Anxiety and Physiological Arousal: A Systematic Review and Meta-Analysis. Educational Psychology Review, 33(2), 579–618. https://doi.org/10.1007/s10648-020-09543-z

Rotta, N. T., Ohlweiler, L., & Riesgo, R. S. (Orgs.). (2016). Transtornos da aprendizagem: abordagem neurobiológica e multidisciplinar. Porto Alegre: Artmed.

Saulsman, L. M., Ji, J. L., & McEvoy, P. M. (2019). The essential role of mental imagery in cognitive behaviour therapy: What is old is new again. Australian Psychologist, 54(4), 237–244. https://doi.org/10.1111/ap.12406

Schwarz, S., Grasmann, D., Schreiber, F., & Stangier, U. (2020). Mental imagery and its relevance for psychopathology and psychological treatment in children and adolescents: A systematic review. International Journal of Cognitive Therapy, 13(4), 303–327. https://doi.org/10.1007/s41811-020-00092-5

Shi, R., Sharpe, L., & Abbott, M. (2019). A meta-analysis of the relationship between anxiety and attentional control. Clinical Psychology Review, 72, 101754. https://doi.org/10.1016/j.cpr.2019.101754

Shin, L. M., & Liberzon, I. (2010). The Neurocircuitry of Fear, Stress, and Anxiety Disorders. Neuropsychopharmacology, 35, 169–191. http://doi.org/10.1038/npp.2009.83

Silva, A. L. M. (2018). Heritability in social anxiety disorder and its impact on executive functioning, facial expression recognition, and symptomatic profile. Tese de Doutorado, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto. http://doi.org/10.11606/T.17.2020.tde-27052019-134433.

Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical Psychology Review, 57, 141–163. https://doi.org/10.1016/j.cpr.2017.09.002

Smith, R., Killgore, W. D. S., Alkozei, A., & Lane, R. D. (2018). A neuro-cognitive process model of emotional intelligence. Biological Psychology, 139, 131–151. https://doi.org/10.1016/j.biopsycho.2018.10.012

Syokwaa, K. A., Aloka, P. J. O., & Ndunge, N. F. (2014). The Relationship between Anxiety Levels and Academic Achievement among Students in Selected Secondary Schools in Lang’ata District, Kenya. Journal of Educational and Social Research, 4(3), 403–413. https://doi.org/10.5901/jesr.2014.

Tolgou, T., Rohrmann, S., Stockhausen, C., Krampen, D., Warnecke, I., & Reiss, N. (2018). Physiological and psychological effects of imagery techniques on health anxiety. Psychophysiology, 55(2), 1–12. https://doi.org/10.1111/psyp.12984

Tyng, C. M., Amin, H. U., Saad, M. N. M., & Malik, A. S. (2017). The Influences of Emotion on Learning and Memory. Frontiers in Psychology, 8, 1454. https://doi.org/10.3389/fpsyg.2017.01454

Werner-Seidler, A., Perry, Y., Calear, A. L., Newby, M. J., & Christensen, H. (2017). School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. Clinical Psychology Review, 51, 30–47. https://doi.org/10.1016/j.cpr.2016.10.005

Yusufov, M., Nicoloro-SantaBarbara, J., Grey, N. E., Moyer, A., & Lobel, M. (2019). Meta-analytic evaluation of stress reduction interventions for undergraduate and graduate students. International Journal of Stress Management, 26(2), 132–145. https://doi.org/10.1037/str0000099

Descargas

Publicado

2023-12-22

Cómo citar

Kolb, A. M., Moreno, A. L., Scofano Mainieri, A., & dos Santos Riesgo, R. (2023). El efecto de la técnica “K” sobre la ansiedad y los niveles de cortisol salivales en adolescentes. Psico, 54(2), e42920. https://doi.org/10.15448/1980-8623.2023.2.42920