Departament de Psicologia

The purpose of this study is to determine if the DHI model (DHI for its acronym in Spanish: "Desarrollo Humano Integral") affects the development of motivational quality, considering that the nature of the DHI model is integrative, as it connects the intellectual and the emotional aspects of the human being, inner disposition and external behavior, the intrapersonal and the interpersonal, and the short and the long term. Considering the above, the hypothesis of this work is that the integrative nature of the DHI model increases the probability of successfully facing the process of forming habits, and reduces the risks of abandonment, typical of an emotional, no-effort society. In the broad context of healthy lifestyle development programs, this article highlights the Integral Human Development model due to its richness and novelty. First, we describe four of the challenges that the DHI methodology faces. Second, we present the results of the assessment performed over its effectiveness, its implementation, and its four pedagogical components: motivation, reflection, perseverance in Specific, Attainable, and Measurable goals (CAM goals for its acronym in Spanish: "Concretas, Accesibles, Medibles"), and good environment. This assessment consisted of a quantitative and a qualitative analysis of the results on the application of a tool developed for this study (with proven reliability and construct validity) to a sample of 66 teachers from 5 schools where the DHI model had been implemented for more than one year through the Integrated Training Operating System (SOFI, for its acronym in Spanish: "Sistema Operativo de Formación Integrado"). The pedagogical component good environment is relevant in the DHI methodology; therefore, we examine such methodology with the perspective of a new concept called motivational quality. This concept is now presented and refers to the proportion of intrinsic, extrinsic, and transcendent motivation that motivates a behavior. The conclusion is that a greater proportion of transcendental motivation contributes in a particularly effective way to the permanence of habit and, therefore, to the development of healthy lifestyles. The civil association Desarrollo Humano Integral A.C. (DHI) has created a model for the formation of healthy habits. The DHI model is not an educational program methodology, but a methodological structure (know-how) of multiple programs aimed at specific population sectors. In the school sector, DHI has implemented the Integrated Training Operating System (SOFI) and a 26-book collection for teachers and students named Be happy building values ("Para ser feliz forjando valores" in Spanish) throughout 13 grades of primary education: 4 grades of preschool, 6 grades of elementary school, and 3 grades of middle school. In the social sphere, in companies and civil society organizations, DHI A.C. has developed the "Health Values and Physical Education program" and its predecessor, "Healthy Habits".

Given the development of artificial intelligence (AI) and the conditions of vulnerability of large sectors of the population, the question emerges: what are the ethical limits of technologies in patient care? This paper examines this question in the light of the “language of nature” and of Aristotelian causal analysis, in particular the concept of means and ends. Thus, it is possible to point out the root of the distinction between the identity of the person and the entity of any technology. Nature indicates that the person is always an end in itself. Technology, on the contrary, should only be a means to serve the person. The diversity of their respective natures also explains why their respective agencies enjoy diverse scopes. Technological operations (artificial agency, artificial intelligence) find their meaning in the results obtained through them (poiesis). Moreover, the person is capable of actions whose purpose is precisely the action itself (praxis), in which personal agency and, ultimately, the person themselves, is irreplaceable. Forgetting the distinction between what, by nature, is an end and what can only be a means is equivalent to losing sight of the instrumental nature of AI and, therefore, its specific meaning: the greatest good of the patient. It is concluded that the language of nature serves as a filter that supports the effective subordination of the use of AI to its specific purpose, the human good. The greatest contribution of this work is to draw attention to the nature of the person and technology, and about their respective agencies. In other words: listening to the language of nature, and attending to the diverse nature of the person and technology, personal agency, and artificial agency.

Far from being transparent and neutral, the reception of Ovid’s corpus eroticum in the Libro de Buen Amor reveals, on the one hand, resistance to the Latin text as a result of the different literary systems in which both authors are set and the vicissitudes of the transmission of Ovid, not only as a text but as a convention and an authority and, on the other, that this same reception seems to be an appropriation of the Ovidian tradition by Juan Ruiz, Archpriest of Hita, who uses and incorporates it into his own literary and aesthetic project. To reflect on such discrepancies, we need to demonstrate a fundamental aspect of comparative literature: the conditions of production and enunciation of the literary discourse. In other words, the relationship between a text and the literary and cultural system which provides the codes and literary conventions that make an influence or specific trace meaningful. Accordingly, this article presents the reception of Ovid also as a form of resistance to Ovid.

Aim To comprehensively describe intellectual and executive functioning (EF) in people with dyskinetic cerebral palsy (DCP), by comparing their performance with that of: 1) age- and sex-matched typically developing controls (TDC); and 2) participants with spastic cerebral palsy (SCP) matched for age, sex, term/preterm and gross motor function classification system (GMFCS). Method This cross-sectional study was conducted by the University of Barcelona in collaboration with five institutions. Participants were people with DCP (n = 52; 24 females, median age 20.5 y: 5mo, interquartile range [IQR] = 13.75 y: 7mo; GMFCS I–V). As comparison groups, participants with SCP (n = 20; 10 females, median age = 20.5 y: 5.5mo, IQR = 13.75 y 9mo; GMFCS I–V) and TDC (n = 52; 24 females, median age = 20 y: 4mo, IQR = 12 y 7mo) were included. Intelligence and EF were assessed using common tests in all participants. Results Both CP groups had lower intelligence than TDC and performed poorer in almost all EF tasks. Intelligence was higher in DCP than SCP (z = −2.51, p = 0.01). Participants with DCP also performed significantly better in goal-setting tasks (z = 2.27, p = 0.03) and information processing (z = −2.54, p = 0.01) than those with SCP. Conclusion People with DCP present lower general intellectual functioning and poorer EF across multiple domains than typically developing controls. People with DCP have higher general intellectual functioning and better EF than people with SCP when levels of motor severity are similar.

Purpose: To characterise brain lesions in dyskinetic cerebral palsy (DCP) using the semi-quantitative scale for structural MRI (sqMRI) and to investigate their relationship with motor, communication and cognitive function. Materials and methods: Thirty-nine participants (19 females, median age 21y) with DCP were assessed in terms of motor function, communication and a variety of cognitive domains. Whole-head magnetic resonance imaging (MRI) was per formed including T1-MPRAGE, T2 turbo spin echo (axial plane), and fluid attenuated inversion recovery images (FLAIR). A child neurologist visually assessed images for brain lesions and scored these using the sqMRI. Ordinal, Poisson and binomial negative regression models identified which brain lesions accounted for clinical outcomes. Results: Brain lesions were most frequently located in the ventral posterior lateral thalamus and the frontal lobe. Gross (B = 0.180, p < .001; B = 0.658, p < .001) and fine (B = 0.136, p = .003; B = 0.540, p < .001) motor function were associated with global sqMRI score and parietal involvement. Communication functioning was associated with putamen involvement (B = 0.747, p < .028). Intellectual functioning was associated with global sqMRI score and posterior thalamus involvement (B = −0.018, p < .001; B = −0.192, p < .001). Selective attention was associated with global sqMRI score (B = −0.035, p < .001), parietal (B = −0.063, p = .023), and corpus callosum involvement (B = −0.448, p < .001). Visuospatial and visuoperceptive abil ities were associated with global sqMRI score (B = −0.078, p = .007) and medial dorsal thalamus involvement (B = −0.139, p < .012), respectively. Conclusions: Key clinical outcomes in DCP are associated with specific observable brain lesions as indexed by a simple lesion scoring system that relies only on standard clinical MRI.

Background Cerebral palsy (CP) is a disorder of motor function often accompanied by cognitive impairment. There is a paucity of research focused on cognition in dyskinetic CP and on the potential effect of related factors. Aim To describe the cognitive profile in dyskinetic CP and to assess its relationship with motor function and associated impairments. Method Fifty-two subjects with dyskinetic CP (28 males, mean age 24 y 10 mo, SD 13 y) and 52 typically-developing controls (age- and gender-matched) completed a comprehensive neuropsychological assessment. Gross Motor Function Classification System (GMFCS), Communication Function Classification System (CFCS) and epilepsy were recorded. Cognitive performance was compared between control and CP groups, also according different levels of GMFCS. The relationship between cognition, CFCS and epilepsy was examined through partial correlation coefficients, controlling for GMFCS. Results Dyskinetic CP participants performed worse than controls on all cognitive functions except for verbal memory. Milder cases (GMFCS I) only showed impairment in attention, visuoperception and visual memory. Participants with GMFCS II–III also showed impairment in language-related functions. Severe cases (GMFCS IV–V) showed impairment in intelligence and all specific cognitive functions but verbal memory. CFCS was associated with performance in receptive language functions. Epilepsy was related to performance in intelligence, visuospatial abilities, visual memory, grammar comprehension and learning. Conclusion Cognitive performance in dyskinetic CP varies with the different levels of motor impairment, with more cognitive functions impaired as motor severity increases. This study also demonstrates the relationship between communication and epilepsy and cognitive functioning, even controlling for the effect of motor severity.

Dyskinetic cerebral palsy (CP) has long been associated with basal ganglia and thalamus lesions. Recent evidence further points at white matter (WM) damage. This study aims to identify altered WM pathways in dyskinetic CP from a standardized, connectome-based approach, and to assess structure-function relationship in WM pathways for clinical outcomes. Individual connectome maps of 25 subjects with dyskinetic CP and 24 healthy controls were obtained combining a estructural parcellation scheme with whole-brain deterministic tractography. Graph theoretical metrics and the network-based statistic were applied to compare groups and to correlate WM state with motor and cognitive performance. Results showed a widespread reduction of WM volume in CP subjects com pared to controls and a more localized decrease in degree (number of links per node) and fractional anisotropy (FA), comprising parieto-occipital regions and the hippocampus. However, supramarginal gyrus showed a significantly higher degree. At the network level, CP subjects showed a bilateral path way with reduced FA, comprising sensorimotor, intraparietal and fronto-parietal connections. Gross and fine motor functions correlated with FA in a pathway comprising the sensorimotor system, but gross motor also correlated with prefrontal, temporal and occipital connections. Intelligence correlated with FA in a network with fronto-striatal and parieto-frontal connections, and visuoperception was related to right occipital connections. These findings demonstrate a disruption in structural brain connectivity in dyskinetic CP, revealing general involvement of posterior brain regions with relative preservation of pre frontal areas. We identified pathways in which WM integrity is related to clinical features, including but not limited to the sensorimotor system.

Purpose Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP. Methods Fifty subjects diagnosed with dyskinetic CP (mean age 25.96 years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score. Results Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices. Conclusions Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.

Dyskinetic cerebral palsy (CP) is one of the most disabling motor types of CP and has been classically associated with injury to the basal ganglia and thalamus. Although cognitive dysfunction is common in CP, there is a paucity of published quantitative analyses investigating the relationship between white matter (WM) microstructure and cognition in this CP type. Aims This study aims (1) to compare brain WM microstructure between people with dyskinetic CP and healthy controls, (2) to identify brain regions where WM microstructure is related to intelligence and (3) to identify brain regions where WM microstructure is related to executive function in people with dyskinetic CP and (4) to identify brain regions where the correlations are different between controls and people with CP in IQ and executive functions. Patients and methods Thirty-three participants with dyskinetic CP (mean ± SD age: 24.42 ± 12.61, 15 female) were age and sex matched with 33 controls. Participants underwent a comprehensive neuropsychological battery to assess intelligence quotient (IQ) and four executive function domains (attentional control, cognitive flexibility, goal setting and information processing). Diffusion weighted MRI scans were acquired at 3T. Voxel-based whole brain groupwise analyses were used to compare fractional anisotropy (FA) and of the CP group to the matched controls using a general lineal model. Further general linear models were used to identify regions where white matter FA correlated with IQ and each of the executive function domains. Results White matter FA was significantly reduced in the CP group in all cerebral lobes, predominantly in regions connected with the parietal and to a lesser extent the temporal lobes. There was no significant correlation between IQ or any of the four executive function domains and WM microstructure in the control group. In participants with CP, lower IQ was associated with lower FA in all cerebral lobes, predominantly in locations that also showed reduced FA compared to controls. Attentional control, goal setting and information processing did not correlate with WM microstructure in the CP group. Cognitive flexibility was associated with FA in regions known to contain connections with the frontal lobe (such as the superior longitudinal fasciculus and cingulum) as well as regions not known to contain tracts directly connected with the frontal lobe (such as the posterior corona radiata, posterior thalamic radiation, retrolenticular part of internal capsule, tapetum, body and splenium of corpus callosum). Conclusion The widespread loss in the integrity of WM tissue is mainly located in the parietal lobe and related to IQ in dyskinetic CP. Unexpectedly, executive functions are only related with WM microstructure in regions containing fronto-cortical and posterior cortico-subcortical pathways, and not being specifically related to the state of fronto-striatal pathways which might be due to brain reorganization. Further studies of this nature may improve our understanding of the neurobiological bases of cognitive impairments after early brain insult.