Analysis of brief Cognitive Behavioral Therapy for panic discorder
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El objetivo del presente estudio era determinar si una modificación hecha a los tratamientos tradicionales para el trastorno de pánico (TP) resultaba efectiva al ajustarse a las características culturales y económicas de pacientes en la región andina sur colombiana. Se empleó un modelo cuasi experimental, con mediciones antes y después del tratamiento, con seguimiento tras 1 y 2 años; la muestra fue constituida por 82 personas (47 mujeres y 35 hombres, con edades promedio de 34 y 29 años respectivamente). Los resultados mostraron una reducción de síntomas clínica del TP después del tratamiento (d> 0.8), la significancia en todos los casos fue p <... Ver más
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Analysis of brief Cognitive Behavioral Therapy for panic discorder Analysis of brief Cognitive Behavioral Therapy for panic discorder El objetivo del presente estudio era determinar si una modificación hecha a los tratamientos tradicionales para el trastorno de pánico (TP) resultaba efectiva al ajustarse a las características culturales y económicas de pacientes en la región andina sur colombiana. Se empleó un modelo cuasi experimental, con mediciones antes y después del tratamiento, con seguimiento tras 1 y 2 años; la muestra fue constituida por 82 personas (47 mujeres y 35 hombres, con edades promedio de 34 y 29 años respectivamente). Los resultados mostraron una reducción de síntomas clínica del TP después del tratamiento (d> 0.8), la significancia en todos los casos fue p < 0.001 y los cambios se mantuvieron durante el periodo de seguimiento. En conclusión, es posible acercar el tratamiento a las características socio culturales de los pacientes a quienes está dirigido y fue posible reducir el número de sesiones manteniendo la efectividad del tratamiento. The aim of this study was to determine if a modification made to the traditional treatments for panic disorder (PD) proved to be effective in adjusting to the cultural and economic characteristics of patients in the southern Andean Region of Colombia. A quasi-experimental model was used, measurements were taken before and after treatment and follow-ups took place after 1 and 2 years; the sample was made up of 82 people (47 women and 35 men, with an average age of 34 and 29 years respectively). Results showed a reduction of PD clinical symptoms after the treatment (d>0.8), the significance in all cases was p <0.001 and changes maintained throughout the follow up period. In conclusion, it is posible to draw the treatment closer to the socio-cultural characteristics of patients to whom it is directed and the number of sessions could be reduced maintaining the effectiveness of the treatment. Chicaiza, Nelson Arturo panic disorder brief treatment cultural adaptation quasi-experimental Tearapia Cognitivo Conductual trastorno de pánico tratamiento abreviado adaptación cultural cuasi experimento desordem anica tratamento breve adaptação cultural quase experimental 11 2 Núm. 2 , Año 2018 : Revista Iberoamericana de Psicología Artículo de revista Journal article 2018-12-31T00:00:00Z 2018-12-31T00:00:00Z 2019-12-31 application/pdf Bogotá: Corporación Universitaria Iberoamericana Revista Iberoamericana de Psicología 2027-1786 2500-6517 https://reviberopsicologia.ibero.edu.co/article/view/rip.11206 10.33881/2027-1786.rip.11206 https://doi.org/10.33881/2027-1786.rip.11206 eng https://creativecommons.org/licenses/by-nc-sa/4.0/ 51 60 Allen, L., White, K., Barlow, D., Shear, M., Gorman, J. & Woods, S. (2010). Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome. Journal of Psychopathology and Behavioral Assessment. 32(2), 185–192. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20421906 American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Retrieved from: https://www.appi.org/DSM-5_Classification Amor, P., Echeburúa, E., de Corral, P., Zubizarreta, I. & Sarasua, B. (2002). Repercusiones psicopatológicas de la violencia doméstica en la mujer en función de las circunstancias del maltrato. Revista Internacional de Psicología Clínica y de la Salud, Vol. 2, Nº 2, 227-246. Retrieved from: http://www.aepc.es/ijchp/articulos_pdf/ijchp-38.pdf Angelosante, A., Pincus, D., Whitton, S., Cheron, D. & Pian, J. (2009). Implementation of an Intensive Treatment Protocol for Adolescents With Panic Disorder and Agoraphobia. Cognitive and Behavioral Practice, 16 (3), 345-357. Retrieved from: https://www.researchgate.net/publication/223209089_Implementation_of_an_Intensive_Treatment_Protocol_for_Adolescents_With_Panic_Disorder_and_Agoraphobia Atun, R., de Andrade, L., Almeida, G., Cotlear, D., Dmytraczenko, T., Frenz, P., Garcia, P., Gómez-Dantés, O., Knaul, F., Muntaner, C., de Paula, J., Rígoli, F., Serrate, P. & Wagstaff, A. (2015). Health-system reform and universal health coverage in Latin America. The Lancet, 385(9974), pp.1230-1247. Doi: 10.1016/s0140-6736(14)61646-9 Beck, A., Epstein, N., Brown, G., & Steer, R.A. (1988). An Inventory for measuring Clinical Anxiety: Psychometric properties. Journal of consulting and clinical psychology, 56, 893 – 897. Retrieved from: https://pdfs.semanticscholar.org/1a3e/334f16b6888843a8150ddf7e4f46b2b28fd5.pdf Bergström, J., Andersson, G., Ljótsson, B., Rück, C., Andréewitch, S., Karlsson, A., Carlbring, P., Andersson, E. & Lindefors, N. (2010). Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial. BMC Psychiatry, 10:54. Doi: 10.1186/1471-244X-10-54. Bologna, E. (2015). Estimación por intervalo del tamaño del efecto expresado como proporción de varianza explicada. Revista Evaluar, 14, 43-66. Retrieved from: https://revistas.unc.edu.ar/index.php/revaluar/article/viewFile/11521/11960 Boswell, J., Gallagher, M., Sauer-Zavala, S., Bullis, J., Gorman, J., Shear, M., Woods, S. & Barlow, D. (2013). Patient characteristics and variability in adherence and competence in cognitive-behavioral therapy for panic disorder. Journal of Consulting and Clinical Psychology, 81(3), pp.443-454. Doi: 10.1037/a0031437. Botella, C. & Ballester, R. (1997). Trastorno de Pánico: Evaluacion y Tratamiento. Barcelona: Martinez-Roca. Retrieved from: https://www.casadellibro.com/libro-trastorno-de-panico-evaluacion-y-tratamiento/9788427022461/572628 Chambless, D., Caputo, G., Bright, P. & Gallagher, R. (1984). Asssessment of fear in agoraphobics: The body sensations Questionnaire and the Agoraphobic Cognitions Cuestionnaire. Journar of Consulting and Clinical Psychology, 52, 1090 – 1097. Retrieved from: http://psycnet.apa.org/record/1985-13540-001 Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P. & Saxena, S. (2016). Scaling-up treatment of depression and anxiety: a global return on investment analysis. The Lancet Psychiatry, 3(5), pp.415-424. DOI: 10.1016/ S2215-0366(16)30024-4. Chowdhary, N., Jotheeswaran, A., Nadkarni, A., Hollon, S., King, M., Jordans, M. & Patel, V. (2014). The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review. Psychological medicine, 44(6), 1131-1146. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23866176 Comeche. M., Díaz, M. & Vallejo, M. (1995). Cuestionarios, Inventarios y Escalas – Ansiedad, Depresión y Habilidades Sociales. Fundación Universidad- Empresa: Madrid. Retrieved from:https://www.agapea.com/libros/Cuestionario-inventarios-y-escalas-ansiedad-depresion-y-habilidades-sociales-9788478421220-i.htm Commission for Latin America and the Caribbean (ECELAC). (2016). La población de América Latina alcanzará 625 millones de personas en 2016. Retrieved from http://www.cepal.org/es/noticias/la-poblacion-america-latina-alcanzara-625-millones-personas-2016-segun-estimaciones-la. Cotlear, D., Gómez-Dantés, O., Knaul, F., Atun, R., Barreto, I., Cetrángolo, O., Cueto, M., Francke, P., Frenz, P., Guerrero, R., Lozano, R., Marten, R. & Sáenz, R. (2015). Overcoming social segregation in health care in Latin America. The Lancet, 385(9974), pp.1248-1259. Doi: 10.1016/s0140-6736(14)61647-0. Craske, M. & Barlow, D. (2007). Mastery of Your Anxiety and Panic: Therapist Guide. New York: Oxford University Press. Retrieved from: https://www.amazon.es/Mastery-Your-Anxiety-Panic-Treatments/dp/0195311353 Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A., & Reynolds, C. (2013). The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry, 12: 137–148. doi:10.1002/wps.20038 Dow, M., Kenardy J., Johnston, D., Newman, M., Taylor, C. & Thomson, A. (2007). Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome. Psychological Medicine, 37, 1503-1509. Retrieved from: https://www.cambridge.org/core/journals/psychological-medicine/article/prognostic-indices-with-brief-and-standard-cbt-for-panic-disorder-ii-moderators-of-outcome/60D79BC6FA88715C73D8339BA9AA50E5 Emmrich, A., Beesdo-Baum K., Gloster A., Knappe S., Höfler M., Arolt, V., Deckert, J., Gerlach, A., Hamm, A., Kircher, T., Lang, T., Richter, J., Ströhle, A., Zwanzger, P & Wittchen, H. (2012). Depression Does Not Affect the Treatment Outcome of CBT for Panic and Agoraphobia: Results from a Multicenter Randomized Trial. Psychotherapy Psychosomatic. 81,161-172. doi: 10.1159/000335246 Forshaw, M.; Upton, D. & Jones, S. (2014). Psychology Express: Research Methods in Psychology. New York: Prentice Hall. Retrieved from: https://www.amazon.co.uk/Psychology-Express-Research-Methods/dp/0273737252 Gallo, K. P., Cooper-Vince, C. E., Hardway, C. L., Pincus, D. B., & Comer, J. S. (2014). Trajectories of change across outcomes in intensive treatment for adolescent panic disorder and agoraphobia. Journal of Clinical Child & Adolescent Psychology, 43(5), 742-750. Retrieved from: https://www.researchgate.net/publication/236917069_Trajectories_of_Change_Across_Outcomes_in_Intensive_Treatment_for_Adolescent_Panic_Disorder_and_Agoraphobia Gallo, K., Chan, P., Buzzella, B., Whitton, S. & Pincus, D. (2012). The Impact of an 8-Day Intensive Treatment for Adolescent Panic Disorder and Agoraphobia on Comorbid Diagnoses. Behavior Therapy, 43(1), 153-159. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/22304887 Gallego, M.; Gerardus, P.; Van der Kooij, M. & Mees, H. (2011). The effects of a Dutch version of an Internetbased treatment program for fear of public speaking: A controlled study. International journal of clinic and health Psychology, 11 (3), 459-472. Retrieved from: http://www.redalyc.org/articulo.oa?id=33719289003 González, L., Peñaloza, R., Matallana, M., Gil, F., Gómez-Restrepo, C., & Landaeta, A. (2016). Factores que determinan el acceso a servicios de salud mental de la población adulta en Colombia. Revista Colombiana de Psiquiatría, 45, 89-95. Doi:10.1016/j.rcp.2016.10.004 Gray, R. (2013). Anxiety disorders cost £10 billion a year.cTelegraph.co.uk. Retrieved from: http://www.telegraph.co.uk/news/health/news/10200562/Anxiety-disorders-cost-10-billion-a-year.html Hofmann, S., Asnaani, A., Vonk, I., Sawyer, A. and Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy & Research, 36(5), pp.427-440. Doi: 10.1007/s10608-012-9476-1. Iraurgi, I. (2009). Evaluación de resultados clínicos (II): Las medidas de la significación clínica o los tamaños del efecto. Norte de Salud Mental, 34, 94–110. Retrieved from: https://dialnet.unirioja.es/descarga/articulo/4830218.pdf Kenardy, J., Johnston, D., Thomson, A., Dow, M., Newman, M., & Barr Taylor, C. (2003). A comparision of delivery methods of cognitive – behavioval therapy for panic Disorder: An international multicenter Trial. Journal of consulting and clinical psychology, 71, 1068 – 1075. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/14622082 Leyfer, O., Ruberg, J. and Woodruff-Borden, J. (2006). Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders. Journal of Anxiety Disorders, 20(4), pp.444-458. Doi: 10.1016/j.janxdis.2005.05.004. Manfro, G. G., Heldt, E., Cordioli, A. V., & Otto, M. W. (2008). Cognitive-behavioral therapy in panic disorder. Revista Brasileira de Psiquiatria, 30, s81-s87. Retrieved from: http://www.scielo.br/scielo.php?pid=s1516- 44462008000600005&script=sci_arttext&tlng=en Marchand, A., Roberge, P., Primiano, S. & Germain, V. (2009). A randomized, controlled clinical trial of standard, group and brief cognitive-behavioral therapy for panic disorder with agoraphobia: A two-year follow-up. Journal of Anxiety Disorders, 23(8), 1139-1147 Retrieved from: http://psycnet.apa.org/record/2009-15372-001 Marks, I. & Mathews, A. (1979). Brief standard self – rating for phobic patients. Behaviour Research and Therapy, 17, 263 – 267. Retrieved from: https://www.sciencedirect.com/science/article/pii/000579677990041X Ministerio de Salud y Protección Social. (2015). Encuesta Nacional de Salud Mental. Recuperado desde: http://www.visiondiweb.com/insight/lecturas/Encuesta_Nacional_de_Salud_Mental_Tomo_I.pdf Morales, P. (2012). El tamaño del efecto (effect size): análisis complementarios al contraste de medias. Universidad Pontificia Comillas, Madrid. Disponible en http://www.upcomillas.es/personal/peter/investigacion/Tama%F1oDelEfecto.pdf Nas, T. (2016). Cost-benefit analysis: Theory and application. Lexington Books. National Institute of Mental Health (NIMH), (2014). Panic disorder. Recuperado desde http://www.nlm.nih.gov/medlineplus/ency/article/000924.htm Ovsanna T. Leyfer, Joshua L. Ruberg, Janet Woodruff-Borden. (2006). Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders. Journal of Anxiety Disorders. 20(4), 444-458. Retrieved from: doi:10.1016/j.janxdis.2005.05.004 Panamerican Health Organización (PAHO). (2013). Informe Regional sobre los Sistemas de Salud Mental en América Latina y el Caribe. Washington. Retrieved from: http://www.paho.org/per/images/stories/FtPage/2013/WHO-AIMS.pdf . Pompoli, A., Furukawa, T., Imai, H., Tajika, A., Efthimiou, O., & Salanti, G. (2016). Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database of Systematic Reviews. Doi: 10.1002/14651858.CD011004.pub2 Posada, José A. (2013). La salud mental en Colombia. Biomédica, 33(4), 497-498. Retrieved from: http://www.redalyc.org/pdf/843/84329152001.pdf. Rodriguez, J. (2014). Trastorno de pánico y agorafobia. Madrid: Síntesis. https://www.casadellibro.com/libro-trastorno-de-panico-y-agorafobia/9788499588407/2266033 Salvador-Cruz, J., Cuetos-Vega, F., & Aguillón, C. (2016). Adaptación cultural y datos normativos del test de lectura PROLEC-R en niños mexicanos de 9 A 12 años. Cuadernos de Neuropsicología/Panamerican Journal of Neuropsychology, 10(2). Retrieved from: http://www.cnps.cl/index.php/cnps/article/view/234 Sánchez, J., Alcázar, A., Marín, F., & Gómez, A. (2010). Psychological treatment of panic disorder with or without agoraphobia: A meta-analysis. Clinical Psychology Review, 30 (1), 37-50, doi:10.1016/j.cpr.2009.08.011. Sánchez-Arribas, C., Chorot, P., Valiente, R. & Sandín, B. (2015). Evaluación de factores cognitivos positivos y negativos relacionadas con el trastorno de pánico: Validación del CATP. Revista de Psicopatología y Psicología Clínica, 20(2), p.85. Doi: 10.5944/rppc.vol.20.num.2.2015.15164 Shear, M., Brown, T., Barlow, D., Money, R., Sholomskas, D., Woods, S., Gorman, J. & Papp, L. (1997). Multicenter collaborative panic disorder severity scale. American journal of psychiatry, 154, 1571 – 1575. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/9356566 Spielberger, C. & Díaz-Guerrero, R. (1975). Inventario de Ansiedad: Rasgo-Estado (IDARE). México: Editorial El Manual Moderno. Retrieved from: https://psicometriamar.com/adultos/inventario-de-ansiedad-rasgo-estado-idare Teng, E. J., Barrera, T. L., Hiatt, E. L., Chaison, A. D., Dunn, N. J., Petersen, N. J., & Stanley, M. A. (2015). Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study. Journal of anxiety disorders, 33, 1-7. Retrieved from: http://isiarticles.com/bundles/Article/pre/pdf/60284.pdf Titov, N., Dear, B., Johnston, L., Lorian, C., Zou, J., Wootton, B., Spence, J., McEvoy, P. & Rapee, R. (2013). Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: Randomised Controlled Trial. PLoS ONE, 8(7), p.e62873. doi: 10.1371/journal.pone.0062873. Varkeviser, C., Pathmanathan, I. & Brownlee, A. (2011). Diseño y realización de proyectos de investigación sobre sistemas de salud. Volumen II. Elaboración: propuesta de investigación y trabajo de campo. Bogotá: Mayo l. Retrieved from: http://webcache.googleusercontent.com/search?q=cache:84OtI17fr6gJ:iris.paho.org/xmlui/bitstream/handle/123456789/3088/Disenio%2520y%2520realizacion%2520de%2520proyectos%2520de%2520investigacion%2520sobre%2520sistemas%2520de%2520salud%2520(2),%25201.pdf%3F White, K., Payne, L., Gorman, J., Shear, M., Woods, S., Saksa, J. & Barlow, D. (2013). Does maintenance CBT contribute to long-term treatment response of panic disorder with or without agoraphobia? A randomized controlled clinical trial. Journal of Consulting and Clinical Psychology, 81(1), pp.47-57. Doi: 10.1037/a0030666. https://reviberopsicologia.ibero.edu.co/article/download/rip.11206/pdf info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 http://purl.org/redcol/resource_type/ARTREF info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Publication |
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Revista Iberoamericana de Psicología |
title |
Analysis of brief Cognitive Behavioral Therapy for panic discorder |
spellingShingle |
Analysis of brief Cognitive Behavioral Therapy for panic discorder Chicaiza, Nelson Arturo panic disorder brief treatment cultural adaptation quasi-experimental Tearapia Cognitivo Conductual trastorno de pánico tratamiento abreviado adaptación cultural cuasi experimento desordem anica tratamento breve adaptação cultural quase experimental |
title_short |
Analysis of brief Cognitive Behavioral Therapy for panic discorder |
title_full |
Analysis of brief Cognitive Behavioral Therapy for panic discorder |
title_fullStr |
Analysis of brief Cognitive Behavioral Therapy for panic discorder |
title_full_unstemmed |
Analysis of brief Cognitive Behavioral Therapy for panic discorder |
title_sort |
analysis of brief cognitive behavioral therapy for panic discorder |
title_eng |
Analysis of brief Cognitive Behavioral Therapy for panic discorder |
description |
El objetivo del presente estudio era determinar si una modificación hecha a los tratamientos tradicionales para el trastorno de pánico (TP) resultaba efectiva al ajustarse a las características culturales y económicas de pacientes en la región andina sur colombiana. Se empleó un modelo cuasi experimental, con mediciones antes y después del tratamiento, con seguimiento tras 1 y 2 años; la muestra fue constituida por 82 personas (47 mujeres y 35 hombres, con edades promedio de 34 y 29 años respectivamente). Los resultados mostraron una reducción de síntomas clínica del TP después del tratamiento (d> 0.8), la significancia en todos los casos fue p < 0.001 y los cambios se mantuvieron durante el periodo de seguimiento. En conclusión, es posible acercar el tratamiento a las características socio culturales de los pacientes a quienes está dirigido y fue posible reducir el número de sesiones manteniendo la efectividad del tratamiento.
|
description_eng |
The aim of this study was to determine if a modification made to the traditional treatments for panic disorder (PD) proved to be effective in adjusting to the cultural and economic characteristics of patients in the southern Andean Region of Colombia. A quasi-experimental model was used, measurements were taken before and after treatment and follow-ups took place after 1 and 2 years; the sample was made up of 82 people (47 women and 35 men, with an average age of 34 and 29 years respectively). Results showed a reduction of PD clinical symptoms after the treatment (d>0.8), the significance in all cases was p <0.001 and changes maintained throughout the follow up period. In conclusion, it is posible to draw the treatment closer to the socio-cultural characteristics of patients to whom it is directed and the number of sessions could be reduced maintaining the effectiveness of the treatment.
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author |
Chicaiza, Nelson Arturo |
author_facet |
Chicaiza, Nelson Arturo |
topic |
panic disorder brief treatment cultural adaptation quasi-experimental Tearapia Cognitivo Conductual trastorno de pánico tratamiento abreviado adaptación cultural cuasi experimento desordem anica tratamento breve adaptação cultural quase experimental |
topic_facet |
panic disorder brief treatment cultural adaptation quasi-experimental Tearapia Cognitivo Conductual trastorno de pánico tratamiento abreviado adaptación cultural cuasi experimento desordem anica tratamento breve adaptação cultural quase experimental |
topicspa_str_mv |
trastorno de pánico tratamiento abreviado adaptación cultural cuasi experimento desordem anica tratamento breve adaptação cultural quase experimental |
citationvolume |
11 |
citationissue |
2 |
citationedition |
Núm. 2 , Año 2018 : Revista Iberoamericana de Psicología |
publisher |
Bogotá: Corporación Universitaria Iberoamericana |
ispartofjournal |
Revista Iberoamericana de Psicología |
source |
https://reviberopsicologia.ibero.edu.co/article/view/rip.11206 |
language |
eng |
format |
Article |
rights |
https://creativecommons.org/licenses/by-nc-sa/4.0/ info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 |
references_eng |
Allen, L., White, K., Barlow, D., Shear, M., Gorman, J. & Woods, S. (2010). Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome. Journal of Psychopathology and Behavioral Assessment. 32(2), 185–192. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20421906 American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Retrieved from: https://www.appi.org/DSM-5_Classification Amor, P., Echeburúa, E., de Corral, P., Zubizarreta, I. & Sarasua, B. (2002). Repercusiones psicopatológicas de la violencia doméstica en la mujer en función de las circunstancias del maltrato. Revista Internacional de Psicología Clínica y de la Salud, Vol. 2, Nº 2, 227-246. Retrieved from: http://www.aepc.es/ijchp/articulos_pdf/ijchp-38.pdf Angelosante, A., Pincus, D., Whitton, S., Cheron, D. & Pian, J. (2009). Implementation of an Intensive Treatment Protocol for Adolescents With Panic Disorder and Agoraphobia. Cognitive and Behavioral Practice, 16 (3), 345-357. Retrieved from: https://www.researchgate.net/publication/223209089_Implementation_of_an_Intensive_Treatment_Protocol_for_Adolescents_With_Panic_Disorder_and_Agoraphobia Atun, R., de Andrade, L., Almeida, G., Cotlear, D., Dmytraczenko, T., Frenz, P., Garcia, P., Gómez-Dantés, O., Knaul, F., Muntaner, C., de Paula, J., Rígoli, F., Serrate, P. & Wagstaff, A. (2015). Health-system reform and universal health coverage in Latin America. The Lancet, 385(9974), pp.1230-1247. Doi: 10.1016/s0140-6736(14)61646-9 Beck, A., Epstein, N., Brown, G., & Steer, R.A. (1988). An Inventory for measuring Clinical Anxiety: Psychometric properties. Journal of consulting and clinical psychology, 56, 893 – 897. 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