Made available in DSpace on 2016-04-04T18:27:50Z (GMT). No. of bitstreams: 1 Lucas Cortelletti Uchoa.pdf: 572412 bytes, checksum: 16c2dd3bff2398cdaeb595bd4df46321 (MD5) Previous issue date: 2010-02-10 / Pontif?cia Universidade Cat?lica de Campinas / This paper discusses the issue of drug addiction as a problem related to failures in the transitioning phase, as suggested by Winnicott in his article "Transitional objects and transitional phenomena . Whereas the phenomenon of transitioning concerns both the separation and the integration of the subjective world with the world objectively perceived, this paper is to analyze both the environmental failures that may occur during the transitioning that could contribute to the emergence of drug addiction at a time later, as the interpretation that the drug addiction may correspond an attempt to experience this state of unionseparation as a quest for integration of the self. / Este trabalho pretende analisar a quest?o da drogadi??o como problema relacionado a falhas na fase da transicionalidade, tal como sugere Winnicott em seu artigo Objetos Transicionais e Fen?menos Transicionais . Considerando que o fen?meno da transicionalidade diz respeito tanto ? separa??o como ? integra??o do mundo subjetivo com o mundo objetivamente percebido, trata-se de analisar n?o s? as falhas ambientais que podem ocorrer na fase da transicionalidade e que poderiam contribuir para o surgimento da drogadi??o em data mais tardia, mas tamb?m a interpreta??o de que a drogadi??o pode corresponder a uma tentativa de experienciar este estado de uni?o-separa??o como uma busca de integra??o de si mesmo.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-10-20T14:03:57Z No. of bitstreams: 1 Wojciech Mittelstaedt.pdf: 1167076 bytes, checksum: 560d9e5198cc41dc8ef7204f477e04b8 (MD5) / Made available in DSpace on 2017-10-20T14:03:58Z (GMT). No. of bitstreams: 1 Wojciech Mittelstaedt.pdf: 1167076 bytes, checksum: 560d9e5198cc41dc8ef7204f477e04b8 (MD5) Previous issue date: 2017-09-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Fundação São Paulo - FUNDASP / This research seeks to illustrate the specificities in the process of recovery from chemical dependency in the therapeutic community of religious nature, where the religiosity is encouraged and lived becomes the primary tool in the fight against the addiction. This study wants to contribute to the recovery methods of the chemical dependents, showing that the religiosity as a method of therapy. As the hypothesis was considered the religiosity as a source of existential sense and psychological forces, with which the chemical dependent has got a greater possibility to abandon the addiction and to protect himself better from a relapse. Through the reports of the psychological care of four clinical cases during the addiction treatment, the changes occurred during the time of treatment were analysed in the religious and existential sense, through the methods of confrontation and life satisfaction. To realise this purpose have introduced: the complexity of the problem of dependence on psychoactive substances and those aspects of religiosity, which provide the existential meaning and greater resilience. The transformations were examined in the light of the concepts of religious experience, existential sense, conversion and theories of religious and moral development. The character of the bond formed with God was evaluated by the attachment theory. The particularities of a religious explication were considered according to the theory of attribution. Those methods of confrontation to bring meaning, control, spiritual comfort and closeness with others, were analysed by the coping religious theory of Pargament. The elements of well-being and life satisfaction, such as positive emotions, forces of character and positive relationships, were contemplated in the light of the concepts of positive psychology. It has been verified that the religiosity transformations take to a significant change of direction and develop positive psychological forces. In this way, this research has verified the positive influence of religiosity in the recovery process, increasing the resilience of dependent and supplying many protective elements / A presente pesquisa procura ilustrar as especificidades do processo de recuperação da dependência química na comunidade terapêutica de cunho religioso, onde a religiosidade incentivada e vivenciada se torna a ferramenta principal na luta contra a dependência. Essa tese quer contribuir na prática do trabalho de recuperação dos dependentes químicos, mostrando a religiosidade como método de terapia. Como hipótese foi considerada a religiosidade como fonte de sentido existencial e das forças psíquicas, com as quais o dependente químico tem maior possibilidade de abandonar o vício e proteger-se melhor da recaída. Através de relatos dos atendimentos psicológicos dos quatro casos clínicos, foram analisadas as mudanças ocorridas durante a internação, no sentido religioso e existencial, nos métodos de enfrentamento e na satisfação de vida. Para realizar esse propósito foram apresentadas: a complexidade do problema da dependência das substancias psicoativas e os aspectos da religiosidade, que fornecem o significado existencial e maior resiliência. As transformações foram examinadas a luz dos conceitos de experiência religiosa, sentido existencial, conversão e teorias de desenvolvimento religioso e moral. O caráter do vínculo formado com Deus foi avaliado pela teoria de apego. As particularidades da explicação religiosa foram ponderadas conforme da teoria de atribuição. Os métodos de enfrentamento para buscar significado, controle, conforto espiritual e proximidade com outros, foram analisados pela teoria de coping religioso de Pargament. Os elementos do bem-estar e satisfação de vida, tais como emoções positivas, forças de caráter e relacionamentos positivos, foram contemplados em luz dos conceitos da psicologia positiva. Foi constatado, que as transformações de religiosidade levam uma mudança significativa de sentido e aumentam as forças psíquicas positivas. Nesse modo, a pesquisa verificou a influência positiva da religiosidade no processo de recuperação, aumentando a resiliência do dependente e fornecendo vários elementos protetores

This dissertation examines Puerto Rican therapeutic communities – resource-poor mutual-aid collectives that have flourished over the past five decades, despite being heavily criticized by human rights groups for using unwaged labor as a method to treat addiction. The persistence of these communities, which are spreading rapidly across Latin America, is widely ascribed in international media to state neglect. I conducted a year of ethnographic research in Puerto Rico to understand why labor therapies thrive, and what these approaches are intended to achieve among those who practice them. Challenging the argument that labor therapies are the simple result of the state failing to provide alternatives, my research shows that during the last half century therapeutic communities have been successively recruited to serve a variety of distinct and sometimes competing interests. My examination of the multiple, contested, and sometimes-converging projects that inhere within this therapeutic regime shows that these organizations have variously served as entrepreneurial projects of informal enterprise, existential projects of redemption, state projects of containment, and shunt-valves for relieving burdens of dependency from straining kinship systems. Their endurance, therefore, not only reflects their capacity to patch the cracks of multiple faltering systems (including employment, corrections, family), but it also reflects their protean vulnerability to appropriation: that is, the ease with which they are co-opted by other actors for alternative utilities. Based on eight months of intensive participant observation in one therapeutic community, La Casita, where I explored the cultural logics and meanings of labor therapies, I argue that “drug treatment” here is not centrally geared towards “treating addiction.” Instead, La Casita’s therapeutic practices of labor therapy, time-discipline, prayer, and internal work are more instructively read as social technologies through which men who are excluded from the labor market and estranged from kinship ties seek to cultivate an alternative masculinity that restores their sense of worth. The “socially useful” masculinity under construction here, based on a performance of work, responsibility, and duty, offers unemployed men an alternative way to claim the dignity and social membership of work.

It is well established that methadone maintenance (MM) reduces but does not eliminate the self-administration of other illicit drugs. For those on MM, there is considerable variation in consumption patterns, route of heroin administration, additional non-opioid substances routinely administered and the clinical disorders associated with these patterns of use. While there is a large literature base documenting these phenomena, studies have been almost exclusively descriptive in nature, with little attempt to develop a theoretical model in which to understand such use. In the following thesis, a model proposed by Gray was tested, the Reinforcement Sensitivity Theory (RST). This biopsychosocial model broadly describes two action tendencies; approach (Behavioural Activation System) and avoidance or withdrawal (Flight Fight Freeze System and the Behavioural Inhibition System). The model proposes that a heightened sensitivity to punishment underlies anxiety disorders. Conversely, a heightened sensitivity to rewarding stimuli may predispose some individuals to engage in highly rewarding behaviour and is associated with conduct disorder and antisocial personality disorder. According to the Joint Subsystems Hypothesis, these personality styles are mutually dependent, whereby BIS and BAS interact to influence reward mediated and punishment mediated behaviours. Based on Gray's model, this thesis tests whether opiate dependent individuals with heightened sensitivity to punishment are more likely to use anxiolytic drugs (such as benzodiazepines), and individuals with heightened reward sensitivity will show a preference for substances that have high reward potential (such as stimulants). At time one, the participant sample (N= 120) comprised 71 males (59%) and 49 females who were opioid dependent and recruitment took place over an eight-month period in two city opioid replacement clinics. A range of measures was administered to assess substance use, mood, anxiety and the personality dimensions of reward sensitivity and punishment sensitivity, with substance use again measured at three months. Results of the first study suggested that a large proportion of the variance was accounted for by personality within the models. A total of 98 participants (81%) participated in the 12-week follow-up study. Sensitivity to punishment and reward significantly predicted drug preference. Although psychopathology symptoms were not able to moderate the relationship between personality and drug use, anxiety symptoms negatively mediated the relationship between punishment sensitivity and anxiolytic use, whereby the relationship became non-significant. In contrast, sensitivity to reward remained the strongest predictor of amphetamine use over antisocial characteristics. Individual differences were not able to predict treatment retention nor susceptibility to relapse during a 12-week initiation to a MM programme.

<p>Syftet med studien var att genomföra en deskriptiv undersökning för att få kunskap om i vilken omfattning föräldrar med missbruksproblematik har deltagit i generella föräldrastödjande insatser och hur de uppfattat detta stöd. Ett delsyfte var att söka kunskap om huruvida dessa föräldrar har fått s.k. riktade föräldrastödjande insatser. Studien har genomförts med kvalitativa intervjuer, sju respondentintervjuer och åtta informantintervjuer. Studiens resultat påvisar att föräldrar med missbruksproblematik i mycket liten utsträckning utnyttjat de generella former av föräldrastöd som kommuner och landsting erbjuder. Enligt studiens resultat beror detta till stor del dels på att föräldrarna inte upplever att barnmorskorna och sköterskorna tagit deras situation på allvar och intresserat sig för den, dels att föräldrarna känt ett utanförskap i förhållande till andra föräldrar. När det gäller riktade stödinsatser, visar resultatet att föräldrarna inte erbjudits stöd i föräldrarollen riktat till dem som personer. Dessutom kan utrönas genom informantintervjuerna att det inte förekommer riktade stödinsatser till denna grupp av föräldrar.</p> / <p>The aim of this study was to do a descriptive study in order to receive knowledge about to what extent parents with a drug addiction have participated in general parental support programs and how they have experienced the support. A part of the purpose of the study was to seek knowledge about whether these parents have been offered special support. The study has been done with qualitative interviews, seven respondent interviews and eight informant interviews. The result of the study shows that parents with a drug addiction in a very low extent have participated in the general parental support programs offered by the local authorities and the county council. According to the results of this study, this is due partly to the fact that the parents feel that the midwives and nurses have not been interested in their situation or taken it seriously, partly also because they feel outside in relation to other parents. When it comes to special support, the result shows that the parents have not been offered parental support directed to them as persons. The informant interviews also show that there is no special support directed to this group of parents.</p>

The striatum represents the main input nucleus of the basal ganglia, a system of subcortical nuclei critically involved into motor control and motivational processes and altered in several conditions such as Parkinson’s diseases or drug addiction. The projection neurons of the striatum are GABAergic (γ-aminobutyric acid) medium-sized spiny neurons (MSNs), and account for the large majority of striatal neurons, while interneurons represent about 10% of striatal cells. The MSNs are subdivided into two subpopulations that form two main efferent pathways: the striatonigral and striatopallidal neurons. The striatonigral MSNs project to the entopeduncular nucleus (EP) and substancia nigra pars reticulata (SNr) (direct pathway) and co-express dopamine D1 receptors (D1R) and substance P neuropeptide (SP). On the other hand, striatopallidal MSNs project to the lateral globus pallidus (LGP) (indirect pathway) and co-express dopamine D2 receptor (D2R), adenosine A2A receptor (A2AR) and enkephalin (Enk). The D1R striatonigral and D2R striatopallidal MSNs are equal in number and shape and are mosaically distributed through all the striatum. The dorsal striatum is mainly involved in motor control and learning while the ventral striatum is crucial for motivational processes. In view of the still debating respective functions of projection D2R-striatopallidal and D1R-striatonigral neurons and striatal interneurons, both in motor control and learning of skills and habits but also in more cognitive processes such as motivation, we were interested in the development of models allowing the removal of selective striatum neuronal populations in adult animal brain. Because of the mosaical organisation of the striatum, a targeting of specific neuronal type, with techniques such as chemical lesions or surgery, is still impossible. Taking advantage of new transgenic approaches, the goal of the present work was to generate and/or to initiate the characterization of genetic models in which a selective subtype of striatal neuron can be ablated in an inducible way. We used a transgenic approach in which mice express a monkey diphtheria toxin (DT) receptor (DTR) in D2R-striatopallidal or D1R-striatonigral neurons. Local stereotactic injections of DT can then induce selective neuronal ablation in functionally different striatal areas. We first investigated functions of D2R-striatopallidal neurons in motor control and drug reinforcement by their selective ablation in the entire striatum or restricted to the ventral striatum. This DTR strategy produced selective D2R striatopallidal MSN ablation with integrity of the other striatal neurons as well as the striatal dopaminergic function. D2R MSN ablation in the entire striatum induced permanent hyperlocomotion while ventral striatum-restricted ablation increased amphetamine place preference. We next compared respective roles of D2R-striatopallidal and D1R-striatonigral neurons in motor control and skill learning in functionally different striatum subregions. Finally, to target nitrergic interneurons of the striatum, we developed a bacterial artificial chromosome genetic strain in which the cre-recombinase expression is under the control of the neuronal nitric oxide gene promoter. Altogether, those results show that DTR expression and DT local injections is an efficient and flexible strategy to ablate selective striatum neuronal types with spatial resolution. We provide the first direct experimental evidences that D2R striatopallidal neurons inhibit both locomotor and drug-reinforcement processes and that D2R and D1R MSNs in different striatum subregions have distinct functions in motor control and motor skill learning. Those results strongly support a cell-type and topographic functional organization of the striatum and underscore the need for characterization of the specific cellular and molecular modifications that are induced in D2R and D1R MSNs during drug-reinforcement or procedural learning.

Syftet med studien var att genomföra en deskriptiv undersökning för att få kunskap om i vilken omfattning föräldrar med missbruksproblematik har deltagit i generella föräldrastödjande insatser och hur de uppfattat detta stöd. Ett delsyfte var att söka kunskap om huruvida dessa föräldrar har fått s.k. riktade föräldrastödjande insatser. Studien har genomförts med kvalitativa intervjuer, sju respondentintervjuer och åtta informantintervjuer. Studiens resultat påvisar att föräldrar med missbruksproblematik i mycket liten utsträckning utnyttjat de generella former av föräldrastöd som kommuner och landsting erbjuder. Enligt studiens resultat beror detta till stor del dels på att föräldrarna inte upplever att barnmorskorna och sköterskorna tagit deras situation på allvar och intresserat sig för den, dels att föräldrarna känt ett utanförskap i förhållande till andra föräldrar. När det gäller riktade stödinsatser, visar resultatet att föräldrarna inte erbjudits stöd i föräldrarollen riktat till dem som personer. Dessutom kan utrönas genom informantintervjuerna att det inte förekommer riktade stödinsatser till denna grupp av föräldrar. / The aim of this study was to do a descriptive study in order to receive knowledge about to what extent parents with a drug addiction have participated in general parental support programs and how they have experienced the support. A part of the purpose of the study was to seek knowledge about whether these parents have been offered special support. The study has been done with qualitative interviews, seven respondent interviews and eight informant interviews. The result of the study shows that parents with a drug addiction in a very low extent have participated in the general parental support programs offered by the local authorities and the county council. According to the results of this study, this is due partly to the fact that the parents feel that the midwives and nurses have not been interested in their situation or taken it seriously, partly also because they feel outside in relation to other parents. When it comes to special support, the result shows that the parents have not been offered parental support directed to them as persons. The informant interviews also show that there is no special support directed to this group of parents.

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Made available in DSpace on 2016-12-12T20:22:54Z (GMT). No. of bitstreams: 1 Helder de Oliveira.pdf: 4130484 bytes, checksum: a157b2baa6aa5cc4b429e16907477afb (MD5) Previous issue date: 2015-12-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Drug addiction is a public health issue that affects millions of people every year. Serious Games (SG) are games that intend to teach/train besides providing entertainment. Persuasive SG, games that aim for behavioral changes, can be applied to fight drug addiction. Involving drug addicts on SG design helps the development of games that are more appropriate to the target audience, besides benefitting the drug addicts during the development process. However, it was observed on a systematic mapping of literature that there are no SG development methodologies that promote the participation of End-Users Apprentices (EUA) during the whole process, although some methodologies promote this kind of participation in the first and last steps of the SG development life cycle, i. c., requirement analysis and final evaluation of the products, respectively. Using the action research method, a decision-making instrument and a preliminary methodology were created and incorporated in a methodology, to promote the participation of EUA on the entire development process. The application of these instruments resulted in the creation of 4 persuasive SG with the participation of drug addicts receiving treatment on therapeutic communities. Results show that these instruments help the participation of EUA and can be incorporated in other methodologies. This research did not investigate the long-term benefits from the usage of the developed SG, nor did it compare the results obtained with the methodology with the results of similar methodologies. It was noted that the participation of drug addicts (EUA) in the development of persuasive SG to fight drug addiction can be a therapeutic activity if there is commitment of the professionals responsible for the treatment of the addicts. However, many logistical and methodological issues highlight the need for proper management. It is concluded that the participation of EUA allows the creation of SG that fulfill the needs of entertainment and learning of these users, and can bring benefits through the participation process. / A dependência química é um problema de saúde pública que afeta milhões de pessoas todos os anos. Jogos Sérios (JS) são jogos cujos objetivos são ensinar/treinar além de prover entretenimento. JS persuasivos, que são jogos voltados para mudanças de comportamento, podem ser aplicados no combate a dependência. Envolver dependentes químicos no design de JS auxilia a desenvolver jogos mais adequados para o público-alvo, além de trazer benefícios para os dependentes durante o processo de desenvolvimento. Entretanto, observou-se em um mapeamento sistemático de literatura que não existem metodologias de desenvolvimento de JS que promovam a participação de Usuários Finais Aprendizes (UFA) durante todo o processo, embora algumas destas metodologias promovam este tipo de participação nas primeiras e últimas etapas do ciclo de vida de desenvolvimento de JS, respectivamente a análise de requisitos e a avaliação final do produto. Utilizando o método de pesquisa-ação, um instrumento de decisão e uma metodologia preliminar foram criados e incorporados em uma metodologia para promover a participação de UFA em todo o processo de desenvolvimento. A aplicação destes instrumentos resultou na criação de 4 JS persuasivos com a participação de dependentes químicos acolhidos em comunidades terapêuticos (ou seja, em tratamento). Resultados apontam que estes instrumentos auxiliam na participação de UFA e podem ser incorporados em outras metodologias. Esta pesquisa não investigou os benefícios a longo prazo do uso dos JS desenvolvidos, nem comparou os resultados a metodologia alterada com os de outras metodologias semelhantes. Percebeu-se que a participação de dependentes químicos (UFA) no desenvolvimento de JS persuasivos para o combate à dependência química pode ser uma atividade terapêutica se houver efetivo comprometimento dos profissionais responsáveis pelo tratamento dos dependentes. Entretanto, existem várias questões logísticas além de metodológicas que acarretam uma necessidade de gerenciamento. Conclui-se que a participação dos UFA permite a criação de JS que atendam às necessidades de entretenimento e de aprendizagem destes usuários, e podem trazer benefícios através do processo de participação.