Disminución del cortisol y mejora del estado de ánimo tras un programa psicoeducativo en cuidadores informales de personas con trastorno de la conducta alimentaria (TCA)un estudio preliminar

  1. Patricia Sariñana-González 1
  2. Nicolás Ruiz-Robledillo 1
  3. Vanesa Pla 2
  4. Eugenia Moreno 2
  5. Luis Moya-Albiol 1
  1. 1 Universitat de València
    info

    Universitat de València

    Valencia, España

    ROR https://ror.org/043nxc105

  2. 2 Clínica Trastornos Alimentarios (CTA), Valencia
Revista:
Informació psicològica

ISSN: 0214-347X

Año de publicación: 2015

Número: 110

Páginas: 77-91

Tipo: Artículo

DOI: 10.14635/IPSIC.2015.110.7 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Informació psicològica

Resumen

El cuidado de un familiar con un trastorno de la conducta alimentaria (TCA) repercute negativamente en el cuidador, aumentando su percepción de estrés y deteriorando su calidad de vida. Los cuidadores informales de personas con TCA presentan mayores índices de ansiedad y depresión, y un peor estado de salud general. Se analizó la efectividad de un programa de intervención psicoeducativo en esta población, formado por 12 sesiones repartidas en 6 meses, y orientado a la reducción del estrés, la ansiedad y el estado de ánimo negativo. Se evaluaron los niveles de cortisol vespertino como marcador biológico de percepción de estrés, y la ansiedad y el estado de ánimo, antes y después de 3 sesiones del programa de intervención (pre-intervención, intermedia y post-intervención). Los resultados indicaron una mejora significativa del estado de ánimo y la ansiedad al finalizar el programa. Además, hubo una reducción de los niveles de cortisol vespertino en cada una de las sesiones evaluadas. En conclusión, el programa psicoeducativo utilizado fue efectivo para la mejora del estado de ánimo y la percepción de estrés. Futuros estudios deberían replicar estos resultados aumentando el tamaño muestral, incluyendo un grupo control e investigando los efectos positivos en los pacientes de TCA.

Referencias bibliográficas

  • Aguinaga, M., Fernández, L. J., & Varo, J. R. (2000). Trastornos de la conducta alimentaria. Revisión y actualización. Anales del sistema sanitario de Navarra, 23(2), 279-292.
  • Barrera-Ortiz, L., Pinto-Afanador, N., & Sánchez-Herrera, B. (2006). Evaluación de un programa para fortalecer a los cuidadores familiares de enfermos crónicos. Revista Salud Pública, 8(2), 141- 152.
  • Contreras, R. S., & González Romo, Z. F. (2010). Estudio y análisis de los trastornos del comportamiento a través de las revistas científicas. Revisión bibliográfica de 2004 a 2008. Revista Electrónica de Psicología Iztacala, 13(1).
  • Coomber, K., & King, R. M. (2012). Coping strategies and social support as predictors and mediators of eating disorder carer burden and psychological distress. Social psychiatry and psychiatric epidemiology, 47(5), 789-796.
  • Coomber, K., & King, R. M. (2013). A longitudinal examination of burden and psychological distress in carers of people with an eating disorder. Social psychiatry and psychiatric epidemiology, 48(1), 163-171.
  • Davis, L. L., Weaver, M., Zamrini, E., Stevens, A., Kang, D. H., & Parker, C. R. (2004). Biopsychological markers of distress in informal caregivers. Biological Research for Nursing, 6(2), 90-99.
  • Dare, C., & Eisler, I. (2000). A multi-family group day treatment programme for adolescent eating disorder. European Eating Disorders Review, 8(1), 4-18.
  • De Andrés-García, S., Moya-Albiol, L., & González-Bono, E. (2012). Salivary cortisol and immunoglobulin A: Responses to stress as predictors of health complaints reported by caregivers of offspring with autistic spectrum disorder.Hormones and behavior, 62(4), 464-474.
  • De Andrés-García, S., Sariñana-González, P., Romero-Martínez, A., Moya-Albiol, L., & Gonzalez-Bono, E. (2013). Cortisol response to stress in caregivers of offspring with autism spectrum disorder is associated with care recipient characteristics. Stress, 16(5), 510-519.
  • Eisler, I., Dare, C., Hodes, M., Russell, G., Dodge, E., & Le Grange, D. (2000). Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. Journal of Child Psychology and Psychiatry, 41(06), 727-736.
  • Fuentes, I., Balaguer, I., Meliá, J.L., & García-Merita, M. (1995). Forma abreviada del Perfil de Estado de Ánimo (POMS). En E. Cantón (Comp.). V Congreso Nacional de Psicología de la Actividad Física y el Deporte, pp. 19-26. Valencia: Universitat de València.
  • Goddard, E., Macdonald, P., & Treasure, J. (2011). An examination of the impact of the Maudsley Collaborative Care skills training workshops on patients with anorexia nervosa: A qualitative study. European eating disorders review, 19(2), 150-161.
  • Gonzalez-Bono, E., de Andrés-Garcia, S., & Moya-Albiol, L. (2011). The cortisol awakening response in caregivers of schizophrenic offspring shows sensitivity to patient status. Anxiety, Stress & Coping, 24(1), 107-120.
  • González, N., Padierna, A., Martín, J., Aguirre, U., & Quintana, J. M. (2012). Predictors of change in perceived burden among caregivers of patients with eating disorders. Journal of affective disorders, 139(3), 273-282.
  • Grover, M., Williams, C., Eisler, I., Fairbairn, P., McCloskey, C., Smith, G., ... & Schmidt, U. (2011). An off-line pilot evaluation of a web based systemic cognitive behavioral intervention for carers of people with anorexia nervosa. International Journal of Eating Disorders, 44(8), 708-715.
  • Gutiérrez, E., Sepulveda, A. R., Anastasiadou, D., & Medina-Pradas, C. (2014). Programa de psicoeducación familiar para los trastornos del comportamiento alimentario. Behavioral Psychology / Psicología Conductual, 22(1), 131-147.
  • Jevning, R., Wilson, A. F., & Smith, W. R. (1978). Adrenocortical activity during meditation. Hormones and Behavior, 10(1), 54-60.
  • Kyriacou, O., Treasure, J., & Schmidt, U. (2008). Expressed emotion in eating disorders assessed via self-report: An examination of factors associated with expressed emotion in carers of people with anorexia nervosa in comparison to control families. International Journal of Eating Disorders, 41(1), 37-46.
  • Macdonald, P., Murray, J., Goddard, E., & Treasure, J. (2011). Carer’s experience and perceived effects of a skills based training programme for families of people with eating disorders: A qualitative study. European Eating Disorders Review, 19(6), 475-486.
  • Macdonald, P., Hibbs, R., Corfield, F., & Treasure, J. (2012). The use of motivational interviewing in eating disorders: A systematic review. Psychiatry research, 200(1), 1-11.
  • Martín, J., Padierna, A., Aguirre, U., Quintana, J.M., Las Hayas, C. & Muñoz, P. (2011). Quality of life among caregivers of patients with eating disorders. Quality of life research, 20(9), 1359- 1369.
  • Martín, J., Padierna, A., Aguirre, U., González, N., Muñoz, P., & Quintana, J. M. (2013). Predictors of quality of life and caregiver burden among maternal and paternal caregivers of patients with eating disorders. Psychiatry research, 210(3), 1107-1115.
  • Matousek, R., 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.
  • McEwen, B. S., (2003). Interacting mediators of allostasis and allostatic load: towards an understanding of resilience in aging. Metabolism, 52(10), 10–16.
  • McNair, D. M., Lorr, M., & Droppleman, L. F. (1992). Manual for the Profile of Mood States. San Diego, California: EdITS/Educational and Industrial Testing Services. (Edición revisada).
  • Padierna, A., Martín, J., Aguirre, U., González, N., Muñoz, P., & Quintana, J. M. (2013). Burden of caregiving amongst family caregivers of patients with eating disorders. Social psychiatry and psychiatric epidemiology, 48(1), 151-161.
  • Peláez-Fernández, M. A., LabradorEncinas, F. J. & Raich-Escursell, R. M. (2005). Prevalencia de los trastornos de la conducta alimentaria: consideraciones metodológicas. International Journal of Psychology and Psychological Therapy, 5(2), 135-148.
  • Peláez-Fernández, M. A., Raich-Escursell, R. M., & LabradorEncinas, F. J. (2010). Trastornos de la conducta alimentaria en España: Revisión de estudios epidemiológicos. Revista mexicana de trastornos alimentarios, 1(1), 62-75.
  • Pérez-Pareja, B., Quiles, Y., Romero, C., Pamies-Aubalat, L., & Quiles, M. J. (2014). Malestar psicológico y emoción expresada en cuidadores de pacientes con un trastorno de la conducta alimentaria. Anales de psicología, 30(1), 37-45.
  • Pla, V., Moreno, E., Fuentes Durá, I., & Dasí, C. (2013). Evaluación de un programa psicoterapéutico para cuidadores de pacientes con TCA: Estudio piloto. Informació Psicològica, 106, 28-40.
  • Ruíz-Robledillo, N. & Moya-Albiol, L. (2012). El cuidado informal: una visión actual. Revista de Motivación y Emoción, 1, 22-30.
  • Ruiz-Robledillo, N., & Moya-Albiol, L. (2013). Self-reported health and cortisol awakening response in parents of people with asperger syndrome: The role of trait anger and anxiety, coping and burden. Psychology & health, 28(11), 1246-1264.
  • Ruiz-Robledillo, N., de Andrés-García, S., Pérez-Blasco, J., González-Bono, E., & Moya-Albiol, L. (2014). Highly resilient coping entails better perceived health, high social support and low morning cortisol levels in parents of children with autism spectrum disorder. Research in developmental disabilities, 35(3), 686-695.
  • Ruiz-Robledillo, N., Sariñana-González, P., Pérez-Blasco, J., González-Bono, E., & Moya-Albiol, L. (2014). A Mindfulness-Based Program Improves Health in Caregivers of People with Autism Spectrum Disorder: a Pilot Study. Mindfulness, 6(4), 767-777.
  • Salorio, P., Ruiz, M.E., Torres, A., Sanchis, F. & Navarro, L. (1999). Psicoeducación familiar en grupo en los trastornos de la alimentación. Aplicación de un programa. Psiquiatria.com, 3(1).
  • Scholz, M. & Asen, E. (2001). Multiple family therapy with eating disorders adolescents: Concepts and preliminary results. European Eating Disorders Review, 9(1), 33-42.
  • Seisdedos, N. (1988). Cuestionario de ansiedad estado-rasgo. Adaptación española. Madrid: TEA Ediciones.
  • Sepulveda, A. R., Lopez, C., Todd, G., Whitaker, W., & Treasure, J. (2008). An examination of the impact of “the Maudsley eating disorder collaborative care skills workshops” on the well being of carers. Social Psychiatry and Psychiatric Epidemiology, 43(7), 584-591.
  • Sepulveda, A.R., Whitney, J., Hankins, M. & Treasure, J. (2008). Development and validation of an Eating Disorders Symptom Impact Scale (EDSIS) for carers of people with eating disorders. Health and quality of life outcomes, 6, 28-42.
  • Sepulveda, A. R., Todd, G., Whitaker, W., Grover, M., Stahl, D., & Treasure, J. (2010). Expressed emotion in relatives of patients with eating disorders following skills training program. International journal of eating disorders, 43(7), 603-610.
  • Sepulveda, A.R., Graell, M., Berbel, E., Anastasiadou, D., Botella, J., Carrobles, J. & Morande, G. (2012). Factors associated with emocional well-being in primary and secondary caregivers of patients with eating disorders. European eating disorders review, 20(1), 78-84.
  • Spielberger, R., Gorsuch, R., & Lushene, R. (1970). STAI Manual for the State-Trait Anxiety Inventory 1970. Palo Alto, CA: Consulting Psychologists.
  • Tantillo, M. (2003) Eating disorders multifamily therapy group: capitalizing on the healing power of relationship. Eating disorders today, 2, 11-13.
  • Tantillo, M. (2006). A relational approach to eating disorders multifamily therapy group: moving from difference and diconnection to mutual connection. Families, systems & health, 24(1), 82-102.
  • Treasure, J., Sepulveda, A., Macdonald, P., Whitaker, W., Lopez, C., Zabala, M., Kyriacou, O. & Todd, G. (2008a). The assessment of the family of people with eating disorders. European Eating Disorders Review, 16(4), 247-255.
  • Treasure, J., Sepulveda, A.R., MacDonald, P., Whithaker, W., Lopez, C., Zabala, M., Kyriacou, O. & Todd, G. (2008b). Interpersonal manteining factors in eating disorders: Skills sharing interventions for carers. International jounal of child and adolescent health, 1(4), 331-338.
  • Uehara, T., Kawashima, Y., Goto, M., Tasaki, S. I. & Someya, T. (2001). Psychoeducation for the families of patients with eating disorders and changes in expressed emotion: a preliminary study. Comprehensive Psychiatry, 42(2), 132-138.
  • Vandereycken W., Castro, J. & Vanderlinden, J. (1991). Anorexia y Bulimia. La familia en su génesis y tratamiento. Barcelona: Martínez-Roca.
  • Vedhara, K., Cox, N. K., Wilcock, G. K., Perks, P., Hunt, M., Anderson, S., ... & Shanks, N. M. (1999). Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. The Lancet, 353(9153), 627-631.
  • Vedhara, K., McDermott, M. P., Evans, T. G., Treanor, J. J., Plummer, S., Tallon, D., ... & Schifitto, G. (2002). Chronic stress in nonelderly caregivers: psychological, endocrine and immune implications. Journal of psychosomatic research, 53(6), 1153-1161.
  • Vitaliano, P. P., Young, H. M., & Zhang, J. (2004). Is caregiving a risk factor for illness?. Current Directions in Psychological Science, 13(1), 13-16.
  • Whitney, J., & Eisler, I. (2005). Theoretical and empirical models around caring for someone with an eating disorder: The reorganization of family life and inter-personal maintenance factors. Journal of mental Health, 14(6), 575-585.
  • Whitney, J., Haigh, R., Weinman, J., & Treasure, J. (2007). Caring for people with eating disorders: Factors associated with psychological distress and negative caregiving appraisals in carers of people with eating disorders. British Journal of Clinical Psychology, 46(4), 413-428.
  • Winn, S., Perkins, S., Walwyn, R., Schmidt, U., Eisler, I., Treasure, J., ... & Yi, I. (2007). Predictors of mental health problems and negative caregiving experiences in carers of adolescents with bulimia nervosa. International Journal of Eating Disorders, 40(2), 171-178.
  • Yates, M. E., Tennstedt, S., & Chang, B. H. (1999). Contributors to and mediators of psychological wellbeing for informal caregivers. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 54(1), 12-22.
  • Yee, J. L., & Schulz, R. (2000). Gender differences in psychiatric morbidity among family caregivers a review and analysis. The Gerontologist, 40(2), 147-164.
  • Zabala, M. J., Macdonald, P., & Treasure, J. (2009). Appraisal of caregiving burden, expressed emotion and psychological distress in families of people with eating disorders: A systematic review. European Eating Disorders Review,17(5), 338-349.