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O impacto dos sintomas depressivos na remissão dos sintomas depressivos em psicoterapias breves para depressão: follow-up de seis mesesCardoso, Taiane de Azevedo 17 January 2013 (has links)
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Previous issue date: 2013-01-17 / Introduction: The literature indicates high occurrence of anxiety symptoms in people who have depression, this index simultaneously suggests the importance of studying the impact of anxiety symptoms in treatment for depression.
Objective: To evaluate the impact of anxiety symptoms in remission of depressive symptoms in brief psychotherapies for depression at follow-up six months.
Methods: Randomized clinical trial with youth of 18 to 29 years old who met diagnostic criteria for depression assessed by the Structured Clinical Interview for DSM (SCID). Depressive symptoms were assessed using the Hamilton Depression Scale (HAM-D), while the anxiety symptoms were assessed using the Hamilton Anxiety Scale (HAM-A). The protocols of psychotherapy used were: Cognitive Narrative Psychotherapy (CNP) and Cognitive Behavioral Psychotherapy (CBP), both with seven sessions. At the end of treatment and at follow-up six months an evaluation was made with the HAM-D and HAM-A.
Results: The sample included 97 patients divided evenly between the protocols of psychotherapy. There was a significant positive moderate correlation between the severity of anxiety symptoms at baseline and remission of depressive symptoms at post-intervention (r = 0.444 p <0.001), while at follow-up six months not there was a significant correlation (r = 0.181 p = 0.164). There was remission of anxiety symptoms (8.69 ± 7.93) and depressive symptoms (6.38 ± 5.4o) after the brief psychotherapies. The remission of anxiety symptoms remained at follow-up of six months (7.59 ± 8.31, p = 0,228) and the same was true for the remission if depressive symptoms (6.48 ± 5.04, p = 0,879).
Conclusion: The severity of anxiety symptoms contributed to greater remission of depressive symptoms after brief psychotherapies in the short term. However, in long
term, the severity of the anxiety symptoms has no impact on the remission of the depressive symptoms. The brief psychotherapies for depression demonstrate efficacy in the remission of depressive and anxious symptoms / Introdução: A literatura aponta alta ocorrência de sintomas ansiosos em indivíduos que apresentam depressão, este índice simultâneo sugere a importância de se estudar o impacto dos sintomas ansiosos no tratamento para depressão.
Objetivo: Avaliar o impacto dos sintomas ansiosos na remissão de sintomas depressivos em psicoterapias breves para depressão no follow-up de seis meses. Método: Ensaio clínico randomizado com jovens de 18 à 29 anos que preencheram critério diagnóstico de depressão avaliado através da Structured Clinical Interview for DSM (SCID). Os sintomas depressivos foram avaliados através da Hamilton Depression Scale (HAM-D), enquanto os sintomas ansiosos foram avaliados através da Hamilton Anxiety Scale (HAM-A). Os protocolos de psicoterapia utilizados foram: Psicoterapia Cognitiva Narrativa (PCN) e Psicoterapia Cognitivo Comportamental (PCC), ambos com sete sessões. Ao fim do tratamento, bem como, no follow-up de seis meses foi realizada uma avaliação com as escalas HAM-D e HAM-A.
Resultados: A amostra total contou com 97 pacientes distribuídos homogeneamente entre os protocolos de psicoterapia. Houve uma correlação moderada positiva significativa entre a severidade dos sintomas ansiosos no baseline e a remissão de sintomas depressivos no pós-intervenção (r=0,444 p<0,001), no entanto, no follow-up de seis meses a correlação não foi estatisticamente significativa (r=0,181 p=0,164). Houve remissão de sintomas ansiosos (8,69±7,93) e de sintomas depressivos (6,38±5,40) após as psicoterapias breves. A remissão dos sintomas ansiosos manteve-se no follow-up de seis meses (7,59±8,31; p=0,228) e o mesmo ocorreu para a remissão se sintomas depressivos (6,48±5,04; p=0,879).
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Conclusão: A severidade dos sintomas ansiosos contribuiu para maior remissão de sintomas depressivos após psicoterapias breves em curto prazo. Contudo, a longo prazo, a severidade dos sintomas ansiosos não apresenta impacto sobre a remissão dos sintomas depressivos. As psicoterapias breves para depressão demonstram eficácia na remissão de sintomas ansiosos e depressivos
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Terapia analítico-comportamental: sistematização da definição com base em introduções de textos empíricos / Behavioral-analytic therapy: systematization of the definition based on the introductions of empirical textsSantos, Gabriela Alves Rodrigues dos 20 June 2018 (has links)
A Análise do Comportamento Clínica nasceu da transposição do modelo experimental do laboratório para a aplicação com humanos, logo, mostra-se comprometida com a ciência desde sua concepção. No Brasil, a Análise do Comportamento Clínica tem uma história particular, ela foi gradualmente construída pelos primeiros estudantes de Análise do Comportamento do país e atualmente é denominada como Terapia Analítico-Comportamental (TAC). Apesar da TAC ser comprometida com a ciência desde sua concepção, uma recente revisão integrativa da produção científica da área foi realizada com o objetivo de aproximar a TAC de uma Prática Baseada em Evidências em Psicologia. Os dados demonstraram que ela carece de evidências empíricas que comprovem sua eficácia, tanto pela quantidade quanto pela qualidade dos trabalhos. Uma vez que o ponto principal de qualquer esforço para definir uma prática como baseada em evidências é começar com uma definição rigorosa da prática, o presente trabalho buscou examinar as definições da TAC descritas por autores de pesquisas empíricas. Para isso foram realizados os seguintes passos: (1) atualização da revisão integrativa da literatura de pesquisas empíricas em TAC realizada por Jan Leonardi em 2016; (2) leitura e levantamento das definições à TAC dada pelos autores nas introduções da literatura empírica levantada; (3) categorização das definições em termos de pressupostos, processos, procedimentos e resultados; e (4) análise crítica das definições dadas pelos autores. Na busca foram selecionadas 24 introduções de textos empíricos e extraídos 141 trechos referentes à definição de TAC, totalizando 265 categorizações. Os dados encontrados mostraram que as definições de TAC utilizadas nas introduções contemplam descrições em termos de procedimento, processo, resultado e pressupostos, mas apenas uma pequena parte das definições abrangeu todas essas categorias. A maior parte das descrições encontradas estão relacionadas a procedimento e, em sua maioria, respostas inespecíficas do terapeuta. A categoria de respostas inespecíficas do terapeuta consiste em descrições de ações do terapeuta de forma que não permite que um leitor bem treinado as reproduza. Os dados mostraram uma descrição pouco precisa da TAC nas introduções e, a partir deles, são discutidas as implicações para o ensino, pesquisa e prática clínica. Por fim, sugere-se possíveis diretrizes para descrições de TAC em introduções de futuras publicações, a saber: (a) apresentar os pressupostos filosóficos e teóricos que embasam a TAC fazendo uma relação direta entre estes e as implicações na compreensão, análise do caso e a prática do terapeuta; (b) descrever os fenômenos, o máximo quanto possível, em termos de processos comportamentais; (c) ao descrever procedimentos padronizados, utilizar nomenclaturas já descritas na literatura e evitar nomenclaturas novas, a não ser que esteja propondo um procedimento inédito; (d) ao descrever respostas do terapeuta, especificar quais respostas devem ser emitidas pelos terapeutas diante de quais antecedentes, e quais as consequências esperadas. Essas diretrizes visam promover uma descrição mais precisa a fim de favorecer avanços na área e viabilizar pesquisas que avaliem a eficácia da TAC / Clinical Behavior Analysis was born from the transposition of the laboratorys experimental model to the application with humans, therefore, it has been committed with science from the beginning. In Brazil, Clinical Behavior Analysis has a particular history, it was gradually constructed by the countrys first students of Behavior Analysis and is currently denominated as Behavioral-Analytic Therapy (TAC). Although TAC has been committed to science since its inception, a recent integrative review of the areas scientific production was carried out with the aim of bringing TAC closer to Evidence Based Practice in Psychology. The data demonstrated that it lacks empirical evidence to prove its efficacy, both regarding the quantity and the quality of the work. Since the main point of any effort to define an evidence-based practice is to begin with a rigorous definition of practice, the present work sought to examine the definitions of TAC described by empirical research authors. In order to do that, the following steps were taken: (1) update the integrative review of the empirical research literature on TAC performed by Jan Leonardi on 2016; (2) read and retrieve the definitions of TAC given by the authors in the introductions of the empirical literature; (3) categorize the definitions in terms of assumptions, processes, procedures and results; and (4) critically analyze the definitions given by the authors. In the review, 24 introductions of empirical texts were selected and 141 excerpts referring to the definition of TAC were extracted, totaling 265 categorizations. The data showed that the definitions of TAC used in the introductions include descriptions in terms of procedures, processes, outcomes and assumptions, but only a small part of the definitions covered all of these categories. Most of the descriptions found are related to procedure and, for the most part, nonspecific responses of the therapist. The category of nonspecific responses of the therapist consists of descriptions of the therapist\'s actions in a way that it does not allow for a well-trained reader to reproduce them. The data showed a description of TAC in the introductions with low precision and, from them, the implications for teaching, research and clinical practice are discussed. Finally, it is suggested possible guidelines for descriptions of TAC in introductions of future publications, namely: (a) to present the philosophical and theoretical assumptions that underpin TAC, establishing a direct relation between them and the implications for the understanding, case analysis and the practice of the therapist; (b) describe the phenomena as much as possible in terms of behavioral processes; (c) to use nomenclatures already described in the literature and avoid new nomenclatures when describing standardized procedures, unless it is proposing an unpublished procedure; (d) when describing the therapist\'s responses, specify which responses should be emitted in relation to what antecedents, and what are the expected consequences. These guidelines aim to promote a more precise description in order to promote advances in the area and to enable researches that evaluate the effectiveness of TAC
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Kognitiv funktion vid insomni, depression samt komorbid insomni och depression : skiljer grupperna sig åt och spelar det någon roll för behandlingsutfall? / Cognitive functioning in insomnia, depression and comorbid insomnia and depression : do the groups differ and does it matter for treatment outcome?Häggqvist, Jenni, von Salomé, Hanna January 2014 (has links)
Insomni och depression är psykiatriska åkommor som idag drabbar många människor. Forskning har visat att det råder en stor samsjuklighet mellan diagnoserna där många drabbade lider av samtidig insomni och depression vilket utgör en stor belastning för den enskilde individen. Patienter rapporterar ofta en negativ påverkan på kognitiva funktioner, bland annat minnessvårigheter och problem med koncentration och uppmärksamhet. Inom forskningen råder det i dagsläget en osäkerhet kring vilka kognitiva nedsättningar som karakteriserar personer med dessa diagnoser och på vilka sätt de skiljer sig åt. Det finns också ett behov av att undersöka vilken roll kognitiv förmåga spelar för människors möjlighet att tillgodogöra sig psykologisk behandling. I föreliggande studie var syftet att undersöka dessa båda områden. Resultaten visade inte på några signifikanta skillnader mellan personer med insomni, personer med depression och personer med det komorbida tillståndet avseende kognitiva funktioner, när det mättes genom test av uppmärksamhet, arbetsminne och exekutiva funktioner. Däremot framkom vissa samband mellan arbetsminne och förbättring av upplevda sömnbesvär, liksom mellan förmåga till bibehållen uppmärksamhet och förbättring av depressionssymtom. Vidare forskning med större och jämnare urvalsgrupper behövs för att undersöka stabiliteten i dessa fynd.
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Zur Wirksamkeit psychoanalytisch-interaktioneller Gruppentherapie in der stationären Allgemeinpsychiatrie / On the Effectiveness of Psychoanalytic-Interactional Group Therapy in Inpatient General PsychiatryValkyser, Anke 03 December 2013 (has links)
Gruppentherapie ist in der stationären Allgemeinpsychiatrie weit verbreitet, ihre Wirksamkeit im Rahmen der allgemeinpsychiatrischen Pflicht- und Regelversorgung ist hingegen wenig untersucht. Die vorliegende Arbeit geht in einer naturalistischen Studie der Frage nach, ob psychoanalytisch-interaktionelle Gruppentherapie, eine psychoanalytische Behandlungsmethode, die speziell für die Arbeit mit schwerer beeinträchtigten Patienten entwickelt wurde, in einem solchen Setting wirksam ist. Hierzu wurden zwischen 2007 und 2009 42 Patienten bezüglich ihrer Symptomverbesserung untersucht, die in der Klinik für Psychiatrie und Psychotherapie der Katholischen Krankenhaus GmbH Hagen stationär mit psychoanalytisch-interaktioneller Gruppentherapie, ergänzt durch Elemente der Dialektisch-Behavioralen Therapie, behandelt wurden. Als Kontrollgruppe dienten 40 Patienten, die auf einer psychotherapeutischen Station des Asklepios Fachklinikums Tiefenbrunn mit Dialektisch-Behavioraler Therapie allein behandelt wurden. Die Ergebnisse zeigten signifikante Verbesserungen in beiden Patientengruppen bezüglich Symptombelastung, Lebenszufriedenheit und Beeinträchtigungsschwere von mittlerer bis hoher Effektstärke. Nur in der Hagener Gruppe zeigte sich auch eine signifikante Verbesserung interpersoneller Probleme. Die Hagener Patienten wiesen im Zwischengruppenvergleich signifikant bessere Ergebnisse in Bezug auf Beeinträchtigungsschwere und interpersonelle Probleme auf. Die Ergebnisse können ein Hinweis darauf sein, dass psychoanalytisch-interaktionelle Gruppentherapie in einer allgemeinpsychiatrischen Klinik wirksam ist und eine spezifische Beeinflussung interpersoneller Schwierigkeiten bewirkt. Methodische Einschränkungen werden diskutiert.
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Depression Does Not Affect the Treatment Outcome of CBT for Panic and Agoraphobia: Results from a Multicenter Randomized TrialEmmrich, Angela, Beesdo-Baum, Katja, Gloster, Andrew T., Knappe, Susanne, Höfler, Michael, Arolt, Volker, Deckert, Jürgen, Gerlach, Alexander L., Hamm, Alfons, Kircher, Tilo, Lang, Thomas, Richter, Jan, Ströhle, Andreas, Zwanzger, Peter, Wittchen, Hans-Ulrich 13 February 2014 (has links) (PDF)
Background: Controversy surrounds the questions whether co-occurring depression has negative effects on cognitivebehavioral therapy (CBT) outcomes in patients with panic disorder (PD) and agoraphobia (AG) and whether treatment for PD and AG (PD/AG) also reduces depressive symptomatology.
Methods: Post-hoc analyses of randomized clinical trial data of 369 outpatients with primary PD/AG (DSM-IV-TR criteria) treated with a 12-session manualized CBT (n = 301) and a waitlist control group (n = 68). Patients with comorbid depression (DSM-IV-TR major depression, dysthymia, or both: 43.2% CBT, 42.7% controls) were compared to patients without depression regarding anxiety and depression outcomes (Clinical Global Impression Scale [CGI], Hamilton Anxiety Rating Scale [HAM-A], number of panic attacks, Mobility Inventory [MI], Panic and Agoraphobia Scale, Beck Depression Inventory) at post-treatment and follow-up (categorical). Further, the role of severity of depressive symptoms on anxiety/depression outcome measures was examined (dimensional).
Results: Comorbid depression did not have a significant overall effect on anxiety outcomes at post-treatment and follow-up, except for slightly diminished post-treatment effect sizes for clinician-rated CGI (p = 0.03) and HAM-A (p = 0.008) when adjusting for baseline anxiety severity. In the dimensional model, higher baseline depression scores were associated with lower effect sizes at post-treatment (except for MI), but not at follow-up (except for HAM-A). Depressive symptoms improved irrespective of the presence of depression.
Conclusions: Exposure-based CBT for primary PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbid depression or depressive symptomatology. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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The Social Phobia Psychotherapy Research NetworkLeichsenring, Falk, Hoyer, Jürgen, Beutel, Manfred, Herpertz, Sabine, Hiller, Wolfgang, Irle, Eva, Joraschky, Peter, König, Hans-Helmut, de Liz, Therese Marie, Nolting, Björn, Pöhlmann, Karin, Salzer, Simone, Schauenburg, Henning, Stangier, Ulrich, Strauss, Bernhard, Subic-Wrana, Claudia, Vormfelde, Stefan, Weniger, Godehard, Willutzki, Ulrike, Wiltink, Jörg, Leibing, Eric 13 February 2014 (has links) (PDF)
This paper presents the Social Phobia Psychotherapy Research Network. The research program encompasses a coordinated group of studies adopting a standard protocol and an agreed-on set of standardized measures for the assessment and treatment of social phobia (SP). In the central project (study A), a multicenter randomized controlled trial, refined models of manualized cognitive-behavioral therapy and manualized short-term psychodynamic psychotherapy are compared in the treatment of SP. A sample of 512 outpatients will be randomized to either cognitive-behavioral therapy, short-term psychodynamic psychotherapy or waiting list. Assessments will be made at baseline, at the end of treatment and 6 and 12 months after the end of treatment. For quality assurance and treatment integrity, a specific project using highly elaborated measures has been established (project Q). Study A is complemented by 4 interrelated add-on projects focusing on attachment style (study B1), on cost-effectiveness (study B2), on variation in the serotonin transporter gene in SP (study C1) and on structural and functional deviations of the hippocampus and amygdala (study C2). Thus, the Social Phobia Psychotherapy Research Network program enables a highly interdisciplinary research into SP. The unique sample size achieved by the multicenter approach allows for studies of subgroups (e.g. comorbid disorders, isolated vs. generalized SP), of responders and nonresponders of each treatment approach, for generalization of results and for a sufficient power to detect differences between treatments. Psychological and biological parameters will be related to treatment outcome, and variables for differential treatment indication will be gained. Thus, the results provided by the network may have an important impact on the treatment of SP and on the development of treatment guidelines for SP. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Fungerar begränsningar i sovtid för patienter som genomgår kognitiv beteendeterapi mot insomni som exponering mot oro att sova för lite? : En kvantitativ studie på patienter som genomgår internetbehandling mot insomni.Larsson, Philip, Landbris, Peter January 2018 (has links)
Sömnsvårigheter inklusive insomni är ett utbrett problem för stora delar av befolkningen. Personer med insomni tenderar att oroa sig över sin sömn och har dysfunktionella antaganden kring sömnbristens konsekvenser. Studiens huvudsakliga syfte var att undersöka om skillnader i utfall mellan två behandlingsmetoder för insomni kunde tillräknas en exponeringseffekt. Studiens hypoteser var: 1a) Patienter som deltar i sömnrestriktion kommer få en större reducering av oro över sin sömn. 1b) Det finns ett samband mellan hög följsamhet till behandlingsmetoden och minskad oro över sömnen. 2) En kraftigare exponering medför lägre följsamhet till behandlingsmetoden. 3) Det finns ett samband mellan minskad oro över sömnen och minskade insomnisymptom. Data användes där 185 deltagare randomiserats till någon av KBT-behandlingarna för insomni sömnkomprimering (n=93) och sömnrestriktion (n=92). Oron hade minskat för studiedeltagarna fem veckor efter behandlingsstart men inga signifikanta skillnader påträffades mellan grupperna. Ett signifikant samband observerades mellan minskning av insomnisymptom och oro över sömnbrist. Slutsatser från uppsatsen är det redan etablerade sambandet mellan oro och insomni bekräftas. Studien kunde inte bekräfta hypotesen att exponering leder till minskad oro. Vidare forskning rekommenderas för att avgöra hur exponering kan användas för patienter med insomni för att möjliggöra effektivare behandlingsmetoder. / Sleep impairments including insomnia is a widespread problem affecting a large quantity of the population. Insomnia patients tend to worry about their sleep and having dysfunctional beliefs about sleep deficit consequences. The main purpose of this study was to examine if differences in results between two treatment methods could be attributed to effects of exposure. The hypotheses in the study were: 1a) Patients who participate in sleep restriction will have a greater reduction of sleep-related worry. 1b) There is a correlation between high compliance to the treatment methods and reduced sleep-related worry. 2) A greater exposure induces lower compliance to the treatment methods. 3a) There is a correlation between reduction of sleep-related worry and reduction of insomnia symptoms. Data consisted of 185 participants who was randomised into the CBT-treatments for insomnia sleep compression (n=93) or sleep restriction (n=92). A hypothesis was that sleep restriction implicate more exposure than sleep compression. Worry had decreased among participants after five weeks of treatment but no significant differences occurred between the groups. A significant correlation occurred between reduction of insomnia symptoms and reduction of worries regarding sleep deficit. Conclusions is that the already established correlation between worry and insomnia is confirmed. This study failed to confirm that exposure leads to reduced worry. Further research is advised to determine how exposure can be used for insomnia patients to enable more efficient treatment methods. / ClinicalTrials.gov Identifier: NCT02743338, CompRest - a Comparison Between Sleep Compression and Sleep Restriction for Treating Insomnia
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RELAXAMENTO PSICOFÍSICO EM CRIANÇASFernandes, Elaine Ferrão 08 March 2005 (has links)
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Previous issue date: 2005-03-08 / Research of bibliographical and monographical nature, this paper investigates the psychophysics relaxation in the health area, of children in a period of eight years, between January 1997 and November 2004. Initially, based in neuropsychological literature, it describes the relaxation role in homeostasis and the conscious body health, emphasizing the pleasure and painful behavior. Next, it describes and analyses several relaxation techniques, Jacobson Progressive Relaxation, Schulz Autogenos and Michaux Relaxation. To develop this research it was used 27 databases, due to the lack of production of this theme, per base. As result, it shows the total of 500 articles about relaxation, 200 of them related to children. They are national and international articles, most of them in English. Following this, it classifies these group in production by year, showing a significant increasing, although it is not systematic in number, from 14 articles in 1997 to 39 in 2004. As for the thematic, the data reveals first, the interest in pain, second in breathing problems and third in anxiety. The articles about pain, as they are in more quantity, have more detailed analysis, with discrimination by year, situation type, relaxation usage and pathology characterized by painful behavior. Finally, it is made a classification of the articles due to the usage of relaxation in clinical problems mainly the physical ones, those of affectionate-emotional psychic background, those with no usage of drugs and those with psychic background with the aid of drugs and psychiatric treatment. To discuss the results, several articles researched are also mentioned. Due to the richness of data, showing up the increasing of professionals in this health area, it is suggested further reading. / Trabalho de natureza monográfica bibliográfica investiga o relaxamento psicofísico na área da saúde, em crianças, por um intervalo de oito anos, entre janeiro de 1997 e novembro de 2004. Inicialmente, com base em literatura neuropsicológica, descreve o papel do relaxamento na busca da homeostase e da consciência corporal saudável, enfocando comportamentos de prazer e dor. A seguir, descreve e analisa diversas técnicas de relaxamento, Relaxamento Progressivo de Jacobson, Autógeno de Schultz e Relaxamento de Michaux. A fim de desenvolver sua pesquisa utiliza-se de 27 bases de dados, devido a pouca produção encontrada sobre o tema, por base. Como resultados, levanta ao todo 500 artigos sobre relaxamento, sendo 200 em crianças. São artigos nacionais e internacionais, com predomínio do idioma inglês. A seguir, classifica esses artigos por ano de produção, constatando um crescimento significativo, porém não sistemático em seu número, de 14 artigos em 1997, para 39, em 2004. Quanto à temática, os dados revelam em primeiro lugar, um interesse em dor, em segundo em problemas respiratórios, e, em terceiro lugar, em ansiedade. Os artigos sobre dor, por serem os mais numerosos levantados, sofrem análise mais detalhada, com discriminação da quantidade de artigos por ano e dos tipos de situação e de patologia caracterizados por quadro álgico. Finalmente é feita uma classificação dos artigos segundo a utilização do relaxamento junto à problemática clínica predominantemente física, a de fundo psíquico afetivo-emocional, sem utilização de fármacos e, a de fundo psíquico, com intervenção psiquiátrica farmacológica. Na discussão dos resultados, vários artigos pesquisados são também comentados. Dada a riqueza dos dados, evidenciando interesse crescente de profissionais da área da Saúde na literatura levantada, sugere-se pesquisa complementar.
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Efficacy of an Internet-based Intervention Targeted to Adolescents with Subthreshold DepressionMakarushka, Marta Maria, 1969 09 1900 (has links)
xiv, 105 p. ill. (some col.) / Depression during adolescence is highly prevalent with as many as 20% experiencing a major depressive episode by the age of 18. Adolescent depression causes significant impairment across life areas including school functioning, such as poor academic performance and decreased academic achievement. Despite the existence of many evidence-based treatment options, merely 25% of depressed adolescents receive treatment. For this reason, it is essential that easily accessible preventive interventions for adolescent depression be developed and made available. Computerized interventions could broaden the reach of prevention efforts and preliminary results indicate that they have the potential to successfully prevent adolescent depression.
The Coping with Depression course is an empirically validated cognitive-behavioral depression treatment and prevention program that is well-suited for computerized delivery. This dissertation reports on the development and evaluation of a web-based interactive multimedia version of the adolescent Coping with Depression course with students experiencing subclinical levels of depression. The Blues Blaster program includes the following six modules, with five mini-sessions in each: (a) defining depression, (b) mood monitoring, (c) increasing fun activities, (d) increasing positive thinking, (e) recognizing negative thinking, and (f) decreasing negative thinking. Key concepts are presented and reinforced in a variety of engaging ways within each session, including video, animation, comic strips, graphics, interactive exercises, and games.
The Blues Blaster program was evaluated in a randomized controlled trial with 161 adolescents who were randomly assigned to either the Blues Blaster or informationonly control conditions. Participants were assessed at baseline, post-treatment (six weeks after baseline), and six-month follow-up. Results demonstrated greater improvement for the Blues Blaster condition in depression levels, negative thoughts, behavioral activation, knowledge, self-efficacy, and school functioning compared to the information-only control condition. These findings suggest that this targeted prevention program is appropriate for use with middle school students to decrease depression levels and therefore the risk that they will develop major depression in the future. / Committee in charge: Christopher Murray, Chairperson;
Deanne Unruh, Member;
Jeffrey Sprague, Member;
John R. Seeley, Member;
Sara Hodges, Outside Member
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Exploring The Development of Social Responses in Children with Callous and Unemotional Traits: An Examination of The Impact of Hypothesized Reinforcing and Aversive StimuliMaharaj, Andre 28 March 2014 (has links)
Callous and unemotional (CU) traits in children with conduct problems have been indicated as precursors to adult psychopathy. The analysis of the sensitivity to rewards and punishment in this population may be useful in the identification of effective behavior modification programs and particularly the delineation of ineffective punishment procedures. Scores on the Child Psychopathy Scale, Inventory of Callous and Unemotional Traits, Contingency Response Rating Scale and the Sensitivity to Reward Sensitivity to Punishment – Children Revised scale were used to evaluate 20 children, aged 7-13, recruited from FIU’s Center for Children and Families. The sample comprised 14 males and 6 females displaying a range of psychopathic traits measured by the CPS, with scores from 9 to 46 (M = 28.45, SD = 10.73).
Sensitivity to punishment was examined using a behavioral task in which children endured various amounts of either white noise (type I punishment) or time-out from positive reinforcement (type II punishment) in order to gain access to a demonstrated reinforcer. The sample was stratified on the basis of the magnitude of psychopathy scores, and sensitivity to rewards and punishment were evaluated using a Behavioral Activation / Behavioral Inhibition framework by examining task performance: the frequency and duration of punishment conditions selected, electrodermal activity (skin conductance response), and parent-reported measures of child sensitivity to reward and punishment.
Results indicated that the magnitude of CU traits was directly proportional to hyposensitivity to punishment and hypersensitivity to reward. Children with elevated levels of CU traits elected to endure a greater frequency and duration type I punishment in order to maintain continued access to the reinforcer. Significant differences were not found between high- and low-psychopathy children in the selection of type II punishment. The findings indicate that although there may be a hyporeactivity to type I punishment in children with CU traits, the use of a type II punishment by the removal of a positive stimulus has demonstrated treatment efficacy. The difference in sensitivity to rewards and the types of effective punishment in children with CU traits may affect reinforcement based learning, leading to the ineffectiveness of traditional methods informing the development of social responses.
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