• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 93
  • 60
  • 11
  • 9
  • 9
  • 8
  • 4
  • 3
  • 2
  • 2
  • 2
  • 2
  • 2
  • 2
  • 2
  • Tagged with
  • 240
  • 240
  • 61
  • 56
  • 44
  • 43
  • 41
  • 41
  • 39
  • 35
  • 35
  • 32
  • 28
  • 27
  • 25
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
61

Sex differences in anxiety during adolescence : evidence from rodents and humans

Lynn, Debra A. January 2012 (has links)
Anxiety disorders commonly emerge during adolescence, and girls are diagnosed with these disorders more frequently than boys. Understanding why anxiety disorders emerge and why non-clinical anxiety symptoms increase during adolescence is important for understanding this sex difference and how to treat adolescent sufferers. Potential mechanisms, such as puberty or cognitive biases, can be investigated both in humans and in rodent models of anxiety. This thesis aimed to characterise sex differences and changes in anxiety-like behaviour across adolescence and into adulthood in the rat, and to examine anxiety and interpretive bias in adolescent humans. In rats, we examined performance on common tests of anxiety-like behaviour: the emergence test, open field and elevated plus-maze. Exploration on these tests increased from mid-adolescence into adulthood, and greater exploration by females was apparent from late adolescence. While the behaviours themselves remain interesting, caution on interpreting these behaviours as anxiety-related warranted and is discussed throughout the thesis. Potential effects of the ovarian cycle and testing order on EPM performance were also examined. In humans, 12-14 year old adolescents complete visual and written interpretive bias tasks, this bias being considered to be a cognitive vulnerability for anxiety. The results showed that, when imagining themselves in ambiguous scenarios, girls were more negative in their interpretations than boys. Additionally, both sexes also interpreted social scenarios more negatively than non-social scenarios. As puberty is thought to be important to the emergence of disorder during adolescence, interpretive bias could potentially mediate the puberty-anxiety relationship. While more interpretive bias work is needed in both species, the recent development of interpretive bias tasks for rodents provides an opportunity to move away from difficult to interpret tests of anxiety-like behaviour in rodents, and should allow for greater convergence of the human and rodent anxiety research.
62

Affective-related endophenotypes in serotonin transporter over-expressing mice

Dawson, Neil January 2008 (has links)
The affective disorders (anxiety and depression) are common psychiatric disorders that primarily involve disturbances in mood and represent the second leading source of disease burden world-wide. A wide base of evidence supports a significant genetic contribution to these disorders. Polymorphic variation in the promoter region (5-HTTLPR) of the human serotonin transporter (hSERT) gene, which leads to a life-long alteration in serotonin transporter (SERT) expression and functioning, has been implicated in the aetiology of both anxiety and depression. Despite the strong evidence implicating a role for this polymorphism in affective psychopathology the underlying mechanism by which genetically determined SERT bioavailability influences affective functioning are not understood. In these studies I attempt to elucidate the alterations in cerebral, serotonin (5-HT) system and hypothalamo-pituitary-adrenal (HPA) axis functioning which may relate to the effect of the 5-HTTLPR on affective functioning by characterising these parameters in an animal model of genetically increased SERT expression (hSERT over-expressing mice; hSERT OVR). Furthermore, as gender influences both the likelihood of developing affective disorders and the impact of the 5-HTTLPR on affective functioning, with a greater effect being observed in females than in males, we characterise these parameters in mice of both genders. The data presented in this thesis demonstrate that the life-long increase in SERT bioavailability present in hSERT OVR mice produces profound alterations in cerebral, serotonin system and HPA axis functioning. Furthermore, the influence of increased SERT expression upon cerebral and serotonin system functioning is greater in females than in males. Additionally, a number of sexually dimorphic variations in serotonin system functioning were identified. Thus this thesis extends the currently available information regarding the underlying mechanisms by which gender and a life-long alteration in SERT expression may influence the risk of affective psychopathology.
63

Emotional Testimonies: An Ethnographic Study of Emotional Suffering Related to Migration from Mexico to Arizona

Crocker, Rebecca 13 July 2015 (has links)
UA Open Access Publishing Fund / It is increasingly argued that social and economic inequities poorly affect overall health. One of the means through which these inequities are translated to the body is via negative emotions, which carry known psychological and physiological responses. This paper examines migration-related psychosocial stressors impacting first-generation Mexican immigrants in southern Arizona, and reports on the primary emotional experiences immigrants associate with these stressors. Data were drawn from a qualitative, ethnographic study conducted over the course of 14 months during 2013–2014 with first-generation Mexican immigrants (N = 40) residing in Tucson Arizona and service providers working directly in the immigrant community (N = 32). Results indicate that the primary structural vulnerabilities that cause emotional hardship among immigrants are pre-migration stressors and adversity, dangerous border crossings, detention and deportation, undocumented citizenship status, family separation, and extreme poverty. Many of these factors have intensified over the past decade due to increased border security and state level anti-immigrant legislation in Arizona. Immigrants connected these hardships to the emotions of trauma (50%), fear (65%), depression (75%), loneliness (75%), sadness (80%), and stress (85%), and most respondents reported suffering from three or more of these emotions. Given the heavy emotional toll of migration and the direct impact that regional legislation and border security had on well-being, this paper argues that emotion be considered an important mechanism for health declines in the immigrant community. In order to stem the frequency and intensity of emotional stress in the Mexican immigrant community in Tucson, it is imperative to support organizations and policies that promote community building and support networks and also expand access to and availability of mental health services for immigrants regardless of documentation status.
64

A Multimodal Investigation of Renewal of Human Avoidance, Perceived Threat, and Emotion

Ludlum, Madonna L. 05 1900 (has links)
Many people who receive exposure-based treatments for anxiety disorders exhibit a return of fear and avoidance which is often referred to as renewal or relapse. Human and nonhuman research on fear conditioning and renewal has been instrumental in helping understand relapse in anxiety disorders. The purpose of this investigation was to examine renewal of human avoidance and assess whether avoidance may aid in sustaining renewal of fear responses. We adopted a multimodal measurement approach consisting of an approach-avoidance task along with ratings of perceived threat and fear and measures of skin-conductance, a widely used physiological measure of fear. A traditional, single-subject research design was used with six healthy adults. All tasks employed a discrete trial procedure. Experimental conditions included Pavlovian fear conditioning in which increased probability of money loss was paired with a “threat” meter in Context A and later followed extinction in Context B. Fear and avoidance increased to higher threat levels in Context A but not Context B. Renewal testing involved presenting the threat meter on a return to Context A to determine if it evoked fear and avoidance (i.e., relapse). As predicted, renewal testing in Context A showed that increased threat was associated with increased avoidance, ratings of perceived threat and fear, and higher skin-conductance. Moreover, results showed that renewal maintained over six blocks of trials. This is the first investigation of renewal of threat and avoidance in humans that highlights avoidance as a mechanism that may contribute to maintaining fear in anxiety pathology.
65

The relative efficacy of homoeopathic Simillimum treatment as compared to psychological counseling (cognitive therapy and behavioral therapy) in the management of Generalized Anxiety Disorder

Ngobese, Jabulile Cresancia January 2006 (has links)
This double-blind placebo-controlled study investigated the relative efficacy of Homoeopathic similimum treatment as compared to psychological counselling (Cognitive therapy combined with Behavioural therapy), in the management of Generalized Anxiety Disorder (GAD). / Mini dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban Institute of Technology, 2006.
66

Aspectos neuropsicológicos dos transtornos de ansiedade na infância e adolescência: um estudo comparativo entre as fases pré e pós-tratamento medicamentoso / Neuropsychological aspects of anxiety disorders in children and adolescents: a comparative study between the pre and postpharmacological treatment

Rodrigues, Camila Luisi 02 September 2011 (has links)
O alto nível de ansiedade pode interferir no desempenho de diversas funções cognitivas. Nesse sentido, pessoas portadoras de transtorno de ansiedade são mais vulneráveis à presença de déficits cognitivos. Por meio de testagens neuropsicológicas, é possível mensurar o desempenho e, por conseguinte, descrever potenciais alterações de funções cognitivas. Estudos mostram déficits nos processos de atenção, memória e funções executivas. Uma vez que não existem dados suficientes na literatura sobre o funcionamento cognitivo de jovens com transtornos de ansiedade, objetivou-se com este estudo avaliar o funcionamento cognitivo em crianças e adolescentes com transtorno de ansiedade, pré e pós-tratamento medicamentoso. Para isso, foram estudados sujeitos (7 a 17 anos) diagnosticados com transtorno de ansiedade generalizada, transtorno de ansiedade de separação e/ou fobia social. Incluíram-se 30 portadores de ao menos um transtorno de ansiedade, avaliados antes do início do tratamento farmacológico, e 34 controles saudáveis. Dezoito sujeitos com transtornos de ansiedade foram reavaliados após terem sido aleatoriamente divididos (por meio de tabela de números aleatórios) em três grupos [clomipramina (n=5), fluoxetina (n=5) e placebo (n=8)] e submetidos a tratamento por um período de seis meses. Da mesma maneira, dez sujeitos do grupo controle foram reavaliados após o mesmo intervalo de tempo. Os instrumentos utilizados nas avaliações neuropsicológicas foram: \"Wechsler Abbreviated Sacale of Intelligence\", \"Trail Making Test\", \"Stroop Card Test\", \"Matching Familiar Figures Test-20\", testes de fluência verbal para letras (\"FAS\") e para categoria (\"animais\"), \"Wisconsin Card Sorting Test\", \"Torre de Hanói\", \"Wide Range Assessment of Memory and Learning-2\", \"Figura Complexa de Rey\". Para a avaliação de sintomas ansiosos, utilizou-se a \"Escala Multidimensional de Ansiedade para Crianças\". A partir dos dados obtidos, realizaram-se comparações estatísticas em dois momentos distintos: antes e depois do tratamento dos sujeitos diagnosticados com transtornos de ansiedade. Os resultados da avaliação pré-tratamento sugerem desempenho significativamente inferior nas atividades que medem atenção, memória visual, memória verbal e funções executivas entre sujeitos do grupo com transtorno de ansiedade em comparação ao do grupo controle. Em relação à sintomatologia ansiosa, conforme medida pela \"Escala Multidimensional de Ansiedade para Crianças\", o grupo com transtornos de ansiedade apresentou escores significativamente mais elevados que os observados entre os controles. Os resultados da avaliação pós-tratamento sugerem que, a partir de qualquer das intervenções realizadas (através de medicações ou placebo), o desempenho nos processos atencionais, mnésticos e executivos das crianças do grupo com transtorno de ansiedade melhora. Conclui-se, assim, que sintomas ansiosos nas crianças e adolescentes com transtorno de ansiedade interferem no desempenho das funções cognitivas / The high level of anxiety may interfere with the performance of various cognitive functions. Thus, people with anxiety disorders are more vulnerable to the presence of cognitive deficits. Through neuropsychological testings, it is possible to measure performance and, therefore, to describe potential changes in cognitive functions. Studies have pointed to deficits in attentional processes, memory and executive functions. Since there are insufficient data in the literature on the cognitive functioning of young people with anxiety disorders, the aim of this study is to evaluate cognitive functioning in children and adolescents with anxiety disorders, before and after pharmacological treatment. The sample consisted of subjects (7-17 years) diagnosed with generalized anxiety disorder, separation anxiety disorder and / or social phobia. Thirty subjects with at least one anxiety disorder, assessed before the beginning of pharmacological treatment, and 34 healthy controls. Eighteen subjects with anxiety disorders were reassessed after they have been randomly assigned (by table of random numbers) into three groups [clomipramine (n = 5), fluoxetine (n = 5) and placebo (n = 8)] and submitted to treatment for a period of six months. Likewise, ten subjects in the control group were evaluated after the same interval of time. The instruments used in the neuropsychological tests were \"Wechsler Abbreviated Sacal of Intelligence,\" \"Trail Making Test,\" \"Card Stroop Test, Matching Familiar Figures Test-20\", tests of verbal fluency for letters (FAS) and category (animals), \"Wisconsin Card Sorting Test\", \"Tower of Hanoi\", \"Wide Range Assessment of Memory and Learning-2\", \"Rey Complex Figure\". For the assessment of anxiety symptoms, the \"Multidimensional Anxiety Scale for Children\" was utilized. From the data observed, statistical comparisons were performed at two different times: before and after treatment of subjects with diagnoses of anxiety disorders. Results from the pre-treatment evaluation suggest that subjects from the anxiety disorder group when compared to the control group showed significantly lower performance in activities that measure attention, visual memory, verbal memory and executive function. In relation to anxiety symptoms, as measured by the \"Multidimensional Anxiety Scale for Children\", the group with anxiety disorders had significantly higher scores than those observed among controls. Results from the post-treatment evaluation suggest that, no matter which interventions have been used (either medications or placebo), performance on attentional, memory and executives processes of the group of children with anxiety disorder improved. We, therefore, conclude that anxious symptomatology in children and adolescents with anxiety disorder interferes with the performance of cognitive functions
67

O exercício físico como terapia de exposição no tratamento do transtorno de pânico / Physical exercise as exposure therapy in the treatment of panic disorder

Muotri, Ricardo William 26 June 2018 (has links)
Introdução: O Transtorno de Pânico é um transtorno de ansiedade que se caracteriza pela recorrência de ataques de pânico: crises súbitas de mal-estar e sensação de perigo ou morte iminente, acompanhadas de diversos sintomas físicos e cognitivos. Os indivíduos com Transtorno de Pânico apresentam, caracteristicamente, preocupações acerca das implicações ou consequências dos ataques de pânico. É uma condição clínica complexa que envolve diferentes modalidades ou conglomerados de sintomas. Assim, o foco nas sensações físicas erroneamente interpretadas no transtorno de pânico e na hipocondria, centraliza-se basicamente nas manifestações autonômicas, como taquicardia e dispneia. Há poucos estudos sobre atividade física e transtorno de pânico. Objetivo: O estudo visa verificar a influência do exercício como terapia de exposição nesta população, em comparação a atividades de relaxamento para pacientes com transtorno de pânico isentos de tratamento medicamentoso. Método: Foram incluídos neste estudo 72 pacientes, de ambos os gêneros com idades entre 18 e 55 anos, diagnosticados com TP com ou sem agorafobia. Foram submetidos a diferentes questionários e a uma ergoespirometria para avaliação inicial do transtorno de ansiedade e identificação de risco cardiovascular. Após adequar aos critérios de inclusão os pacientes foram dispostos aleatoriamente em dois grupos para realização dos protocolos. A ideia foi comparar os grupos e avaliar a eficiência do exercício (grupo ETE) e do relaxamento (grupo R) na amenização dos ataques de pânico e consequente aumento da qualidade de vida dos pacientes, através de diferentes testes e questionários. Resultados: Ambos os grupos apresentaram resultados significativos na redução dos sintomas de pânico, aumento da qualidade de vida e diminuição do número de ataques por dia e na intensidade dos ataques, porém o grupo ETE, que utilizou o exercício como terapia de exposição apresentou melhores resultados, comparado ao grupo R e maior eficácia de manutenção. Conclusão: a pesquisa destaca o potencial do exercício como um suporte autônomo ou intervenção complementar para tratamento de transtornos de ansiedade, e se tratando de TP, o exercício também pode ser considerado como uma exposição terapêutica / Introduction: The panic disorder is an anxiety disorder that is characterized by recurrent attacks of panic: sudden crises of malaise and sense of danger or imminent death, accompanied by various physical and cognitive symptoms. Individuals with panic disorder have, characteristically, concerns about the implications or consequences of the attacks of panic. A complex clinical condition involves different modalities or clusters of symptoms. Thus, the focus on physical sensations erroneously interpreted as a panic disorder and hypochondria, is basically centered in the autonomic manifestations such as tachycardia and dyspnea. There are few studies on physical activity and panic disorder. Purpose: The study is to investigate the influence of exercise as interoceptive exposure therapy in this population, compared to the relaxation activities for patients with panic disorder-free drug treatment. Method: We included 72 patients, of both genders aged between 18 and 55 years, diagnosed with PD with or without agoraphobia. They were submitted to different questionnaires and an ergospirometry for initial evaluation of anxiety disorder and cardiovascular risk identification. After adjusting for the inclusion criteria, the patients were randomly placed into two groups for the protocols. The idea was to compare the groups and to evaluate the efficiency of exercise (ETE group) and relaxation (R group) in the mitigation of panic attacks and consequent increase in patients\' quality of life through different tests and questionnaires. Results: Both groups presented significant results in reducing panic symptoms, increased quality of life and a reduction in the number of attacks per day and in the intensity of the attacks, but the TEE group, which used exercise as exposure therapy, presented better results, compared to the R group and greater maintenance effectiveness. Conclusion: the research highlights the potential of exercise as an autonomous support or complementary intervention for the treatment of anxiety disorders, and if it is a question of PD, exercise can also be considered as a therapeutic exposition
68

Comparação entre clomipramina e fluoxetina para o tratamento de transtornos de ansiedade em crianças e adolescentes / Comparison between clomipramine and fluoxetine for the treatment of anxiety disorders in children and adolescents

Costa, Carolina Zadrozny Gouvêa da 12 March 2010 (has links)
Os transtornos de ansiedade são os quadros psiquiátricos mais comuns em jovens. Seu tratamento precoce pode evitar repercussões negativas na vida atual da criança e, possivelmente, na vida adulta. A associação da terapia cognitivo-comportamental à farmacoterapia é tida como o tratamento de escolha para a maioria dos jovens com transtornos ansiosos. Dentre os medicamentos, destacam-se os inibidores seletivos de recaptura da serotonina e os antidepressivos tricíclicos. A literatura demonstra que aqueles fármacos são eficazes e seguros para o tratamento agudo da ansiedade em jovens. Em relação aos antidepressivos tricíclicos, há uma escassez de estudos, possivelmente, pelos efeitos colaterais e pela necessidade de controles laboratoriais. Revisões apontam para a necessidade de novos estudos controlados com medicamentos. Objetivouse com este estudo: testar a eficácia da fluoxetina e da clomipramina, controlados por placebo; comparar a ação desses compostos em crianças e adolescentes com transtornos ansiosos. Foram estudados sujeitos (7 a 17 anos) com: transtorno de ansiedade generalizada e/ou transtorno de ansiedade de separação e/ou fobia social (incluídos os três diagnósticos, em razão de sua alta taxa de comorbidade). Incluíram-se 30 indivíduos, divididos aleatoriamente em três grupos: fluoxetina (n=10), clomipramina (n=9) ou placebo (n=11), acompanhados por 12 semanas. Os instrumentos usados foram: Schedule for Affective Disorders and Schizophrenia; Escala Multidimensional de Ansiedade para Crianças; Inventário para Depressão em Crianças; Impressão Clínica Global; Escala de Avaliação Global. Na avaliação inicial, os grupos mostraram-se semelhantes em relação a sintomas ansiosos e nas avaliações globais. Na análise exploratória, os três grupos apresentaram uma melhora significativa. As taxas de resposta ao tratamento foram de 87,5% (n=7) no grupo clomipramina, 100% (n=8) no grupo fluoxetina e 77,7% (n=7) no grupo placebo. As taxas de remissão foram de 75% (n=6) no grupo clomipramina, 100% (n=8) no grupo fluoxetina e 44,4% (n=4) no grupo placebo, com uma diferença significativa entre o grupo fluoxetina e placebo na medida de remissão. O grupo que recebeu fluoxetina teve uma redução mais acentuada dos sintomas ansiosos em relação ao grupo placebo nas subescalas ansiedade social e índice de transtorno de ansiedade da Escala Multidimensional de Ansiedade. Não foram observadas diferenças significativas entre o grupo clomipramina e placebo ou entre o grupo fluoxetina e clomipramina. Na análise regressiva, observou-se um efeito significativo do tempo em todas as variáveis. Em relação ao efeito dos grupos de tratamento (grupo placebo como referência), não houve diferença significativa. Notou-se a interferência significativa do grupo fluoxetina na ação do tempo nas variáveis: Escala Multidimensional de Ansiedade para Crianças total (p=0,029), ansiedade social (p=0,007), ansiedade de separação (p=0,008) e Impressão Clínica Global (p=0,003). O presente estudo sugere que a fluoxetina seja eficaz e segura para o tratamento dos transtornos ansiosos na infância e adolescência, e seu efeito, em relação ao placebo, parece ser superior quanto maior a gravidade dos sintomas. A clomipramina parece não trazer benefícios superiores ao placebo, embora não tenha havido diferença significativa entre os grupos fluoxetina e clomipramina. Ressalta-se que este estudo encontra-se em andamento e esta foi uma análise preliminar dos resultados. / Anxiety disorders are the most common psychiatric disorders in youngsters. Early treatment can avoid negative repercussions in the childs current life and, possibly, in adult life. The association of cognitive-behavioral therapy with pharmacotherapy is regarded as the treatment of choice for most youths with anxiety disorders. Among the medications, selective serotonin reuptake inhibitors and tricyclic antidepressants stand out. The literature shows that those drugs are efficacious and safe for acute treatment of anxiety in youths. As regards tricyclic antidepressants, there is a lack of studies, possibly due to side effects and need for laboratory controls. Reviews indicate the need for new pharmacological controlled studies. This study aims: to test the efficacy of fluoxetine and clomipramine, controlled by a placebo; to compare the action of these compounds in children and adolescents with anxiety disorders. Subjects (7 thru 17 years) with: generalized anxiety disorder and/or separation anxiety disorder and/or social phobia (the three diagnoses were included due to their high rate of comorbidity) were studied. Thirty individuals were included, randomly divided into three groups: fluoxetine (n=10), clomipramine (n=9) or placebo (n=11), followed for 12 weeks. The following instruments were used: Schedule for Affective Disorders and Schizophrenia; Multidimensional Anxiety Scale for Children; Children\'s Depression Inventory; Clinical Global Impression; Children\'s Global Assessment Scale. In start evaluation, groups were similar concerning anxiety symptoms and global evaluations. In the exploratory analysis, the three groups had a significant improvement. The treatment response rates were 87.5% (n=7) in clomipramine group, 100% (n=8) in fluoxetine group and 77.7% (n=7) in placebo group. Remission rates were 75% (n=6) in clomipramine group, 100% (n=8) in fluoxetine group and 44.4% (n=4) in placebo group, with a significant difference between fluoxetine and placebo groups in the remission measure. The group which received fluoxetine had a more marked reduction of anxiety symptoms than placebo group in the social anxiety and anxiety disorder index sub-scales of the Multidimensional Anxiety Scale. No significant differences were observed between clomipramine and placebo groups or between fluoxetine and clomipramine groups. In regressive analysis, a significant time effect was observed in all the variables. As regards the effect of treatment groups (placebo group as reference), a significant difference was not found. A significant interference of fluoxetine group was observed in the action of time noted in the variables: Multidimensional Anxiety Scale for Children (p=0.029), social anxiety (p=0.007), separation anxiety (p=0.008) and Clinical Global Impression (p=0.003). The present study suggests that fluoxetine is efficacious and safe for the treatment of anxiety disorders in infancy and adolescence. Its effect, compared to placebo, appears to be greater, the more severe the symptoms are. Clomipramine does not seem to bring greater benefits than placebo, although any significant difference was observed between fluoxetine and clomipramine groups. It should be pointed out that this study is in progress, and that this is a preliminary analysis of the results.
69

ADAPTAÇÃO DA ESCALA AUSTRALIANA CHILDHOOD CONCERNS SURVEY (CCS) NUM CONTEXTO BRASILEIRO

Silva, Wildson Vieira da 22 December 2003 (has links)
Made available in DSpace on 2016-03-22T17:27:43Z (GMT). No. of bitstreams: 1 Wildson.pdf: 615673 bytes, checksum: f76785a39c7bddef5788cf7c58944c34 (MD5) Previous issue date: 2003-12-22 / Objective: To translate and to adapt the Childhood Concerns Survey (CCS), an Australian scale that evaluates anxiety disorders among preschoolers based on their parent s answers, with the intention of using it in the Brazilian children. Method: Two bilingual professionals translated two Portuguese versions of the scale, which were retro-translated by other tree bilingual professionals. The differences were harmonized and pre-tested in a pilot study. The final Portuguese version was applied by 420 parents of boys and girls between 2,5 to 6 years old from Pelotas. The CCS s psychometrical properties were tested. The Contend Validity was verified by the Theoretical Items Analysis and the Items Analysis by the Classic Tests Theory. For the extern criterion validity the ANOVA was utilized, considering age and sex. The Construct Validation study was made by the Exploratory Factor Analysis and Cronbach s alpha coefficient was used as reliability. Results: The Exploratory Factor Analysis indicated the presence of 4 factors reflecting Obsessive Compulsive Disorder, Fear of physical injury and Social Phobia and Generalized Anxiety Disorder. The ANOVA method revealed relevant differences p<0,05 between gender and age, demonstrating that girls had higher scores than boys. Conclusion: It was found necessary to reformulate the written composition of some items. The final version of the proposed scale to evaluate 4 anxiety disorders has 26 items and presents acceptable psychometric characteristics / Objetivo: Traduzir e adaptar o "Childhood Concerns Survey" (CCS), escala australiana que avalia transtornos de ansiedade em pré-escolares com base nas respostas dos pais, com a intenção de utilizá-la em crianças brasileiras. Método: Dois profissionais bilíngües traduziram duas versões da escala para o português, as quais foram retro-traduzidas por outros três profissionais bilíngües. As diferenças foram harmonizadas e pré-testadas em um estudo piloto. A versão final em português foi aplicada em 420 pais de crianças de ambos os sexos entre 2,5 a 6 anos da cidade de Pelotas-RS. Foram testadas as propriedades psicométricas do CCS. A validade de conteúdo por meio da análise teórica dos Itens e a capacidade discriminativa dos itens segundo a análise da correlação item/ total. Para a validade de critério externa utilizou-se a análise de variância (ANOVA) fatorial, considerando idade e sexo. A validade de construto foi realizada por meio da análise fatorial exploratória e utilizou-se como o coeficiente de fidedignidade o alfa de Cronbach. Resultados: A análise fatorial exploratória indicou a presença de 4 fatores refletindo transtorno obsessivo compulsivo, medo de lesão física, fobia social e transtorno de ansiedade generalizada. O método da ANOVA revelou diferenças significativas p<0,05 entre os sexos e idades, demonstrando que as meninas tiveram escores maiores que os meninos. Conclusão: Identificou-se a necessidade de reformular a redação de alguns itens. A versão final da escala proposta para avaliar 4 transtornos de ansiedade consta de 26 itens e apresenta características psicométricas aceitáveis
70

Transtorno de ansiedade: investigação da adesão à terapêutica medicamentosa / Anxiety disorders: an investigation of drug treatment adherence

Cruz, Ligiane Paula da 30 September 2014 (has links)
Este estudo teve como objetivo geral investigar a adesão ao tratamento medicamentoso em pessoas com transtorno de ansiedade atendidas em um serviço de saúde mental comunitário, localizado em município do interior paulista. Estudo retrospectivo, transversal e descritivo, com abordagem quantitativa. Dados qualitativos foram utilizados para complementar os resultados. A população foi constituída por 161 pessoas com transtorno de ansiedade que atenderam aos critérios de inclusão do estudo. Para a coleta dos dados quantitativos recorreu- se ao teste de Medida de Adesão ao Tratamento (MAT), ao Inventário de Ansiedade de Beck e à técnica de entrevista estruturada, com aplicação de questionário para obtenção de dados referentes ao perfil demográfico, socioeconômico, clínico e farmacoterapêutico. Para obtenção dos dados qualitativos, referentes às dificuldades de uma parcela dos sujeitos com relação ao seguimento da terapêutica medicamentosa, foi empregada entrevista semiestruturada gravada (N=32). Para análise dos dados quantitativos foi utilizado o programa SAS® 9 e, para os dados qualitativos, a análise de conteúdo, seguindo os passos propostos por Minayo. Os resultados revelaram que a maioria dos participantes era do sexo feminino (77,6%), na faixa etária entre 41-60 anos (50,3%), cor da pele branca (90,6%), com companheiro (62,1%) e renda familiar mensal de até três salários mínimos (50,7%). Os antidepressivos foram os medicamentos mais prescritos (91,3%). Ressalta-se o uso de ansiolítico por 69,5% dos participantes, apesar de terem iniciado o tratamento há mais de seis meses. A maioria dos participantes (85%) foi considerada aderente ao tratamento medicamentoso. Não houve associação estatisticamente significativa entre esta adesão e as variáveis investigadas neste estudo. Identificou-se alta porcentagem de pacientes com sintomas ansiosos moderados ou severos, apesar da adesão. Destaca-se o fato de 34,1% dos participantes desconhecerem a dose dos medicamentos prescritos. Os depoimentos dos sujeitos revelaram que, apesar da alta porcentagem de adesão, há dificuldades por eles vivenciadas na manutenção do tratamento medicamentoso, as quais foram sintetizadas nas seguintes categorias: \"Ter conhecimento insuficiente sobre o diagnóstico e tratamento medicamentoso\", \"Estar insatisfeito(a) com os efeitos do tratamento\", \"Desejar mais do que uma prescrição\", \"Apresentar temores e preocupações relacionadas ao tratamento\" e \"Identificar impedimentos para seguir a prescrição medicamentosa\". Este estudo sinaliza para aspectos, passíveis de intervenção, que interferem na segurança no tratamento farmacológico de pessoas com transtorno de ansiedade e contribuem para a implementação de estratégias nos serviços de saúde que otimizem a adesão ao tratamento medicamentoso / The general objective of this study was to investigate the drug treatment adherence among anxiety disorder patients following treatment at a community mental health center in an upstate São Paulo city. This retrospective, cross-sectional and descriptive study was performed with a quantitative approach. Qualitative data were used to complement the results. The population consisted of 161 people with anxiety disorders who met the inclusion criteria. The quantitative data was collected using the Treatment Adherence Measure (TAM) test, Beck\'s Anxiety Inventory and structured interviews, applying a questionnaire to obtain demographic, socioeconomic, clinical and pharmacotherapeutic data. A recorded semi- structured interview was conducted (N=32) to obtain qualitative data regarding the difficulty that some participants experienced in following the drug treatment. Quantitative data analysis was performed using SAS® 9, whereas content analysis was used for qualitative data, as proposed by Minayo. Results showed that most participants were women (77.6%), aged between 41 and 60 years (50.3%), white skin (90.6%), with a partner (62.1%) and with a monthly family income of three minimum salaries or less (50.7%). Antidepressants were the most commonly prescribed drugs (91.3%). It is noted that 69.5% of participants used anxiolytics, despite having been undergoing treatment for over six months. Most participants (85%) were considered compliant to the drug treatment. No statistically significant association was found between this adherence and the variables investigated in this study. A high percentage of patients with moderate or severe anxiety symptoms was found, despite their adherence. It is highlighted that 34.1% of participants were unaware of the prescribed medication dose. The participants\' reports showed that, despite the high adherence rate, they experience difficulties to maintain the drug treatment, which were summarized into the following categories: \"Having insufficient knowledge regarding the diagnosis and drug treatment\", \"Being dissatisfied with the treatment effects\", \"Wanting more than a prescription\", \"Showing fears and worries related to treatment\" and \"Identify obstacles to following the drug prescription\". This study points at aspects, subject to intervention, that affect the safety of the drug treatment of people with anxiety disorders and contribute with the implementation of strategies at health care services that improve the drug treatment adherence

Page generated in 0.0331 seconds