Palabras clave
Caribbean veterans
cultural adaptation
emotion regulation
interpersonal functioning
post-traumatic stress disorder
Cómo citar
Resumen
El Departamento de Asuntos de Veteranos de EE.UU. ha avalado la terapia de Entrenamiento de Destrezas en Afecto y Regulación Interpersonal (EDARI) como una intervención eficaz para reducir los síntomas de TEPT, mejorar la autorregulación y la eficacia interpersonal. Sin embargo, los veteranos hispanohablantes del Sistema de Salud de veteranos del Caribe no contaban con manuales en su idioma. Este estudio abordó esta carencia traduciendo y adaptando culturalmente el manual, utilizando el Modelo de Validez Ecológica (EVM). Posteriormente, se probaron los materiales en una intervención aleatorizada con seis veteranos hispanohablantes del Caribe, entre 23 y 62 años, diagnosticados con TEPT y que recibían servicios de salud mental en el nivel de Atención Primaria. Se utilizaron pruebas no paramétricas para evaluar la progresión de los síntomas y análisis de contenido para entrevistas semiestructuradas. No hubo cambios estadísticamente significativos en los grupos en cuanto a TEPT, regulación emocional o problemas interpersonales. Sin embargo, los participantes del grupo de intervención informaron de cambios clínicamente significativos en la sintomatología. Las entrevistas con terapeutas y participantes destacaron mejoras en la participación social y los límites interpersonales. La intervención se consideró viable y aceptable. La versión en español culturalmente adaptada del manual demostró ser efectiva, sugiriendo que EDARI podría ser una estrategia viable para reducir los síntomas de TEPT y mejorar las estrategias de regulación interpersonal y autorregulación entre los veteranos hispanohablantes en entornos de atención primaria. Se recomienda un ensayo controlado aleatorizado para explorar mejor su eficacia.
Citas
Akyunus, M., & Gencoz, T. (2016). Psychometric properties of the inventory of interpersonal problems-circumplex scales short form: A reliability and validity study. Dusunen Adam, 29(1), 36-48. https://doi.org/10.5350/DAJPN2016290104
Bernal, G., Bonilla, J., & Bellido, C. (1995). Ecological validity and cultural sensitivity for outcome research: issues for the cultural adaptation and development of psychosocial treatments with Hispanics. Journal of Abnormal Child Psychology, 23(1), 67–82. https://doi.org/10.1007/BF01447045
Bird, H. R., Canino, G., Stipec, M. R., & Shrout, P. (1987). Use of the Mini-mental State Examination in a probability sample of a Hispanic population. The Journal of Nervous and Mental Disease, 175(12), 731–737. https://doi.org/10.1097/00005053-198712000-00005
Cloitre, M., Jackson, C., & Schmidt, J. A. (2016). Case Reports: STAIR for strengthening social support and relationships among veterans with military sexual trauma and PTSD. Military Medicine, 181(2), e183–e187. https://doi.org/10.7205/MILMED-D-15-00209
Cloitre, M., Cohen, L. R., Ortigo, K. M., Jackson, C., & Koenen, K. C. (2020). Treating survivors of childhood abuse and interpersonal trauma, STAIR narrative therapy. Guilford Publications.
Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., Gan, W., & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: a randomized controlled trial. The American journal of psychiatry, 167(8), 915–924. https://doi.org/10.1176/appi.ajp.2010.09081247
Colón, P. (2018). La relación entre experiencias traumáticas, síntomas por estrés posttraumático, depresión y cambios en religiosidad [Doctoral Dissertation]. Carlos Albizu University.
Domenech Rodríguez, M., & Bernal, G. (2012). The gap between research and practice in a multicultural world. In G. Bernal & M. Domenech Rodríguez (Eds.). Cultural adaptations: Tools for evidence-based practice with diverse populations (pp. 265-87). American Psychological Association.
Fowler, J. C., Charak, R., Elhai, J. D., Allen, J. G., Frueh, B. C., & Oldham, J. M. (2014). Construct validity and factor structure of the difficulties in emotion regulation scale among adults with severe mental illness. Journal of Psychiatric Research, 58, 175–180. https://doi.org/10.1016/j.jpsychires.2014.07.029
Hall-Clark, B. N., Kaczkurkin, A. N., Asnaani, A., Zhong, J., Peterson, A. L., Yarvis, J. S., Borah, E. V., Dondanville, K. A., Hembree, E. A., Litz, B. T., Mintz, J., Young-McCaughan, S., & Foa, E. B. (2017). Ethnoracial differences in PTSD symptoms and trauma-related cognitions in treatment-seeking active duty military personnel for PTSD. Psychological Trauma: Theory, Research, Practice and Policy, 9(6), 741–745. https://doi.org/10.1037/tra0000242
Jackson, C., Weiss, B. J., & Cloitre, M. (2019). STAIR group treatment for veterans with PTSD: Efficacy and impact of gender on outcome. Military Medicine, 184(1-2), e143–e147. https://doi.org/10.1093/milmed/usy164
Jain, S., Ortigo, K., Gimeno, J., Baldor, D. A., Weiss, B. J., & Cloitre, M. (2020). A randomized controlled trial of brief skills training in affective and interpersonal regulation (STAIR) for veterans in primary care. Journal of Traumatic Stress, 33(4), 401–409. https://doi.org/10.1002/jts.22523
Kneebone I. I. (2016). Stepped psychological care after stroke. Disability and Rehabilitation, 38(18), 1836–1843. https://doi.org/10.3109/09638288.2015.1107764
Novas, H. (2008). Everything you need to know about Latino history. Penguin Group.
O'Connor, T. M., Perez, O., Beltran, A., Colón García, I., Arredondo, E., Parra Cardona, R., Cabrera, N., Thompson, D., Baranowski, T., & Morgan, P. J. (2020). Cultural adaptation of 'Healthy dads, healthy kids' for Hispanic families: Applying the ecological validity model. The International Journal of Behavioral Nutrition and Physical Activity, 17(52), 1-18. https://doi.org/10.1186/s12966-020-00949-0
Oprel, D. A. C., Hoeboer, C. M., Schoorl, M., de Kleine, R. A., Cloitre, M., Wigard, I. G., van Minnen, A., & van der Does, W. (2021). Effect of Prolonged Exposure intensified Prolonged Exposure and STAIR+Prolonged Exposure in patients with PTSD related to childhood abuse: A randomized controlled trial. European Journal of Psychotraumatology, 12(1), 1851511. https://doi.org/10.1080/20008198.2020.1851511
Oprel, D., Hoeboer, C. M., Schoorl, M., De Kleine, R. A., Wigard, I. G., Cloitre, M., Van Minnen, A., & Van der Does, W. (2018). Improving treatment for patients with childhood abuse related posttraumatic stress disorder (IMPACT study): Protocol for a multicenter randomized trial comparing prolonged exposure with intensified prolonged exposure and phase-based treatment. BMC Psychiatry, 18(385), 1-10. https://doi.org/10.1186/s12888-018-1967-5
Perera, C., Salamanca-Sanabria, A., Caballero-Bernal, J., Feldman, L., Hansen, M., Bird, M., Hansen, P., Dinesen, C., Wiedemann, N., & Vallières, F. (2020). No implementation without cultural adaptation: a process for culturally adapting low-intensity psychological interventions in humanitarian settings. Conflict and health, 14, 46. https://doi.org/10.1186/s13031-020-00290-0
Pérez-Pedrogo, C., Planas-García, B. Y., Rivera-Suazo, S., Ortega-Guzmán, J., & Albizu-García, C. E. (2022). Viabilidad preliminar y aceptabilidad de una adaptación cultural de la terapia de aceptación y compromiso para Latinxs con VIH y trastornos por uso de drogas en Puerto Rico. Revista Puertorriqueña de Psicología, 33(2), 232–243. https://doi.org/10.55611/reps.3302.03
Pittman J. O. (2014). Latino Veterans with PTSD: A Systematic Review. Behavioral Sciences, 4(3), 320–340. https://doi.org/10.3390/bs4030320
Ritschel, L. A., Tone, E. B., Schoemann, A. M., & Lim, N. E. (2015). Psychometric properties of the difficulties in emotion regulation scale across demographic groups. Psychological Assessment, 27(3), 944–954. https://doi.org/10.1037/pas0000099
Rivera-Rivera, N., Pérez-Pedrogo, C., Calaf, M., & Sánchez-Cardona, I. (2021). Translation, cultural adaptation, and psychometric properties of the Spanish version of the Combat Exposure Scale (CES-S) with U.S. military Spanish speaking Latino veterans living in the Caribbean: A cross-sectional preliminary data study. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0001099
Schnyder, U., Ehlers, A., Elbert, T., Foa, E. B., Gersons, B. P., Resick, P. A., Shapiro, F., & Cloitre, M. (2015). Psychotherapies for PTSD: What do they have in common?. European Journal of Psychotraumatology, 6, 28186. https://doi.org/10.3402/ejpt.v6.28186
Sit, H. F., Ling, R., Lam, A. I. F., Chen, W., Latkin, C. A., & Hall, B. J. (2020). The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults. Frontiers in psychiatry, 11, 650. https://doi.org/10.3389/fpsyt.2020.00650
Tombaugh, T. N., & McIntyre, N. J. (1992). The mini-mental state examination: A comprehensive review. Journal of the American Geriatrics Society, 40(9), 922–935. https://doi.org/10.1111/j.1532-5415.1992.tb01992.x
Trappler, B., & Newville, H. (2007). Trauma healing via cognitive behavior therapy in chronically hospitalized patients. The Psychiatric quarterly, 78(4), 317–325. https://doi.org/10.1007/s11126-007-9049-8
Vera, M., Juarbe, D., Hernández, N., Obén, A., Pérez-Pedrogo, C., & Chaplin, W. F. (2012). Probable posttraumatic stress disorder and psychiatric co-morbidity among Latino primary care patients in Puerto Rico. Journal of Depression & Anxiety, 1(5), 124. https://doi.org/10.4172/2167-1044.1000124
Weiss, B. J., Azevedo, K., Webb, K., Gimeno, J., & Cloitre, M. (2018). Telemental health delivery of skills training in affective and interpersonal regulation (STAIR) for rural women veterans who have experienced military sexual trauma. Journal of Traumatic Stress, 31(4), 620–625. https://doi.org/10.1002/jts.22305
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Derechos de autor 2024 Naiomi Rivera-Rivera, Myralys Calaf, Coralee Pérez-Pedrogo, Israel Sánchez-Cardona, Yelitza Villegas-Adorno