Background: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. Methods: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. Discussion: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. Trial registration: ClinicalTrial.gov: NCT05225701. Registered February 4, 2022.

Background: The COVID-19 pandemic has become a public health emergency of international concern; it has not only threatened people's physical health but has also affected their mental health and psychological well-being. It is necessary to develop and offer strategies to reduce the psychological impact of the outbreak and promote adaptive coping.Objective: This study protocol aims to describe a self-administered web-based intervention (Mental Health COVID-19) based on the principles of positive psychology supported by elements of cognitive behavioral therapy and behavioral activation therapy to reduce the symptoms of anxiety and depression and increase positive emotions and sleep quality during and after the COVID-19 outbreak through a telepsychology system.Methods: A randomized controlled clinical superiority trial with two independent groups will be performed, with intrasubject measures at four evaluation periods: pretest, posttest, 3-month follow-up, and 6-month follow-up. Participants will be randomly assigned to one of two groups: self-administered intervention with assistance via chat or self-administered intervention without assistance via chat. The total required sample size will be 166 participants (83 per group).Results: The clinical trial is ongoing. This protocol was approved by the Research Ethics Board of the Free School of Psychology-University of Behavioral Sciences (Escuela libre de Psicología-Universidad de Ciencias del Comportamiento). The aim is to publish the preliminary results in December 2020. A conservative approach will be adopted, and the size effect will be estimated using the Cohen d index with a significance level (α) of .05 (95% reliability) and a conventional 80% power statistic.Conclusions: The central mechanism of action will be to investigate the effectiveness of an intervention based on positive psychology through a web platform that can be delivered through computers and tablets, with content that has been rigorously contextualized to the Mexican culture to provide functional strategies to help the target users cope with the COVID-19 pandemic.Trial Registration: ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/ct2/show/NCT04468893International Registered Report Identifier (IRRID): DERR1-10.2196/23117

This study aimed to evaluate the effect of time on suicidal behavior, associated risk factors, and protective factors in early Mexican adolescents. Method: With a two-year longitudinal design, which included 18 of 34 adolescents who had previously participated in a DBT skills training program (DBT-PAHSE). The study evaluated ideation, suicide attempt, depression, emotional dysregulation, and psychological resources. Results: We observed differentiating significant differences over time in emotional dysregulation (F = 2.36 p = 0.04, η²= 0.12, β = 0.72), affective resources (F = 3.94, p = 0.01, η² = 0.18, β = 0.82), and suicidal ideation. (F = 2.55, p = 0.03, η²= 0.13, β = 0.77). In conclusion, the DBT-PAHSE program prevented deaths by suicide. It showed a reduction in emotional dysregulation up to two years after the end of treatment and maintained an increase in emotional and social resources. However, improvements are required to reduce depression over time and strengthen psychological resources.

Background: The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic. Objective: This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants’ symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants’ satisfaction and acceptability. Methods: A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change. Results: A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects. Conclusions: Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention’s usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users’ perceived utility of the intervention, among other issues identified in the study. Trial Registration: ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results International Registered Report Identifier (IRRID): RR2-10.2196/23117

In Mexico, although 86% of individuals with mental disorders seek professional assistance, only 22% receive adequate treatment. The COVID-19 pandemic accelerated the demand for telepsychology, which emerged as a critical alternative with reported use surpassing 95%, underscoring the urgent need for structured training and supervision of mental health professionals. Adequate preparation is essential to strengthen competencies, reinforce therapists’ self-efficacy, and improve treatment outcomes. However, its rapid expansion exposed gaps in professional training, raising ethical concerns and potentially undermining clinical competence. This study aimed to evaluate the acceptability and changes in clinical skills, performance, and competence among psychologists following a self-directed online training course based on a transdiagnostic framework in telepsychology. A pre-experimental single-group design was employed with three evaluation points: pre-training, post-training, and six-month follow-up. The final sample consisted of 28 professionals (92.9% women, mean age 42.5 years, SD = 11.9); 24 held bachelor’s degrees and 4 master’s degrees. All participants reported prior experience in cognitive behavioral therapy. The 45-hour training, delivered through Moodle, was organized into five modules covering the transdiagnostic model, emotional disorders, Unified Protocol interventions, online clinical skills, and ethical and human rights considerations. Clinical skills, performance, and competence were assessed through simulated sessions using the Cognitive Therapy Scale (CTS), a 0–6 performance rating, and a novice-to-expert competence framework. Analyses included Friedman and Wilcoxon tests with Bonferroni correction, as well as Kruskal-Wallis and Mann-Whitney tests for subgroup comparisons. The Friedman test revealed significant changes across time points for average clinical skills (χ² = 11.8, p = .003, Kendall’s W = 0.211) and performance (χ² = 6.59, p = .037, W = 0.118), although no effect significant effect was found for competence (χ² = 2.93, p = .231). Post-hoc analyses indicate that clinical skills improved significantly from pre- to post-training (p = .001) and declined at follow-up (post–follow-up p = .008), with no significant difference between pre-training and follow-up (p = .319). Performance exhibited only temporary improvement (post–follow-up p = .005), while competence remained unchanged. Subscale analyses revealed immediate post-training gains in personal effectiveness, collaboration, guided discovery, cognitive behavioral techniques, and task management, of which only task management was maintained at follow-up. Finally, subgroup analyses yielded no significant differences by age, sex, or clinical experience, although participants holding master’s degrees demonstrated higher baseline competence. The self-directed online program yielded immediate improvements in clinical skills and performance, demonstrating its potential as an accessible training tool. However, gains were not fully sustained at six months, and competence in a complex construct requiring continuous practice did not improve significantly. Taken together, the findings underscore the need for reinforcement strategies, such as ongoing supervision, booster sessions, or blended learning models, to ensure long-term professional development in telepsychology.

Background: The coronavirus 2019 disease (COVID-19) illness pandemic is one of the highest challenges in modern history, with nearly four million deaths confirmed, generating with this a serious psychological impact on the loved ones of the deceased. So far, the evidence regarding the impact of the COVID-19 pandemic on the grievers is scarce, and urgent evidence needs to be developed, especially for developing countries, such as Mexico, where the deaths caused by the COVID-19 are high.Methods: A cross-sectional study was conducted through the Duelo (Grief) COVID platform, a self-applied online treatment. The response of 5,224 participants, which was fully completed, included measurements of anxiety, depression, sleep quality, activation, PTSD related factors (avoidance and activation), and drugs consumed. Independent sample t tests, Cohen´s d, Chi-Square and ANOVA tests were conducted along with multinomial logistic regression.Outcomes: The results indicated that 90·4% of the participants showed a clinical symptomatology of depression, anxiety, and sleep affectations, 513 individuals informed they consumed substances. Antidepressants and Anxiolytics were the most common drugs reported. The most affected participants were young unemployed women, that consumed medicines, had a recent suicide attempt in the last 3 months, and lost someone due to COVID-19, or for some other reason in less than one month prior (all p<0·0001).Interpretation: Due to these results, an urgently implementation of broad psychological treatments on the general population is suggested in order to reduce the impact on mental health.Clinical Trial Registration Details: Registered in Clinical trials (NCT04638842).Funding Information: This study was funded by the Autonomous University of Ciudad Juárez (UACJ).Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, provided the approval for this study. Reference code: CEI-2020-2-226. Before proceeding to answer the questionnaires, the participants needed to read the informed consent that is also available on the register study in Clinical Trials (NCT04638842). In order to receive the intervention, the participants needed to read and accept the informed consent. Only adults aged 18 or older were allowed to register, and their data will be protected, such as their email. No sensible data was required by the participants such as their name, telephone, address, socioeconomic status or location. Any modification of the trial protocol will be communicated to the Research Ethics Committee of the Autonomous University of Ciudad Juárez and Clinical Trials.