Os transtornos de ansiedade (TAs) estão entre os principais problemas que acometem crianças e adolescentes, podendo atingir uma prevalência de até 24,9% ao longo da vida. A eficácia do tratamento de TAs na infância e na adolescência tem sido demonstrada em estudos de curto prazo de terapia cognitivo-comportamental (TCC), mas ainda são poucos os estudos que avaliam a eficácia da terapia de longo prazo. Portanto, a presente pesquisa tem por objetivo realizar uma revisão sistemática de estudos de seguimento sobre TCC com crianças e adolescentes com TAs (artigo 1) e verificar a resposta a longo prazo da terapia cognitivocomportamental em grupo (TCCG) em relação à intensidade dos sintomas de ansiedade e depressão e à qualidade de vida (artigo 2). Para a realização do primeiro artigo (revisão sistemática), foram consultadas as bases de dados Pubmed e Isi Web of Science. Foram considerados como critérios de inclusão: estudos de coorte após TCC para TAs na infância e na adolescência. Foram excluídos os estudos com período de seguimento inferior a um ano. Para a apresentação dos achados dos estudos, foram considerados os resultados significativos (p<0,05). Em relação ao método utilizado na elaboração do segundo artigo (seguimento não controlado), a pesquisa envolveu 20 adolescentes que realizaram 14 sessões de TCCG para TAs e foram reavaliados após 2 anos do término da intervenção. Para avaliar os desfechos, utilizaram-se os instrumentos antes da TCCG, no final (4 meses) e após 2 anos: Autorrelato para Transtornos Relacionados à Ansiedade na Infância (SCARED-C); Inventário de Depressão Infantil (CDI); Impressão Clínica Global (CGI); Escala de Funcionamento Global (CGAS) e Qualidade de Vida de Jovens (YQOL). O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital de Clínicas de Porto Alegra (nº 110181). Os adolescentes e seus responsáveis assinaram o termo de consentimento livre e esclarecido (TCLE). Como resultado da revisão sistemática, obteve-se um total de 10 artigos que preencheram os critérios de inclusão. O período de seguimento variou entre 12 meses a 13 anos e, em geral, os resultados indicaram a manutenção dos ganhos com a TCC de curto prazo. No entanto, os estudos apresentaram limitações, principalmente em relação ao método, como ausência de grupo controle e perdas de seguimento. No estudo de seguimento, um total de 19 (95%) adolescentes com média de idade de 12,3 (DP=1,0) anos foi avaliado. Houve redução significativa (p<0,001) da gravidade dos sintomas (CGI) e melhora do funcionamento global (CGAS) em comparação com a avaliação inicial. A qualidade de vida geral no seguimento melhorou significativamente (p=0,041) em comparação com a avaliação inicial e final da 7 TCCG. Os sintomas específicos de ansiedade e depressão não apresentaram mudanças significativas (p=0,071 e p=0,206, respectivamente). Os resultados do trabalho sugerem a manutenção dos benefícios da TCC de longo prazo e encorajam a sua utilização entre adolescentes com TAs. / Anxiety disorders (ADs) are among the most prevalent conditions affecting children and adolescents with a lifetime prevalence of up to 24.9%. The efficacy of treatment for ADs in childhood and adolescence has been demonstrated in short-term studies of cognitivebehavioral therapy (CBT), but few studies have investigated the long-term effects of this treatment. Therefore, the present study aimed to systematically review follow-up studies of CBT in children and adolescents with ADs (article 1) and explore the long-term effects of group cognitive-behavioral therapy (GCBT) on quality of life and symptoms of anxiety and depression (article 2). The systematic review was based on a search of the PubMed and ISI Web of Science databases. Articles reporting cohort studies of CBT for ADs in childhood and adolescence were included in the review. Studies with follow-up periods of less than one year were excluded. Results were considered significant at p < 0.05. The second article consisted of an uncontrolled follow-up study involving 20 adolescents who underwent 14 sessions of GCBT for ADs and were assessed at three time points (before and after treatment, and two years after the end of treatment) with the following instruments: Screen for Child Anxiety Related Emotional Disorders, child (SCARED-C); Children's Depression Inventory (CDI); Clinical Global Impression (CGI); Children’s Global Assessment Scale (CGAS) and Youth Quality of Life (YQOL). The study was approved by the Hospital de Clínicas de Porto Alegre Research Ethics Committee (protocol number 110181). Participants and guardians provided written informed consent prior to participation. Ten articles were included in the systematic review. Follow-up periods ranged from 12 months to 13 years, with most studies indicating that the effects of short-term CBT remained stable over time. However, the studies presented a series of methodological limitations, such as lack of control groups and follow-up losses. In the present follow-up study, a total of 19 (95%) adolescents with mean age 12.3 (SD=1.0) years were assessed. There were significant reductions (p<0.001) in symptom severity (CGI) and improvements in global functioning (CGAS) over the course of the study. General quality of life improved significantly at follow-up (p=0.041) as compared to assessments immediately before and after GCBT. There were no significant differences in anxiety and depression symptoms (p=0.071 and p=0.206, respectively). Results of the present studies indicate that the benefits of CBT are maintained over time, and that this method is suitable for the treatment of ADs in adolescents.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-04-27T13:36:16Z No. of bitstreams: 1 biancaaparecidaribeirosingulane.pdf: 1026859 bytes, checksum: 6891320e0ee0d08d8facc3e7176b9dc9 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-05-02T00:59:28Z (GMT) No. of bitstreams: 1 biancaaparecidaribeirosingulane.pdf: 1026859 bytes, checksum: 6891320e0ee0d08d8facc3e7176b9dc9 (MD5) / Made available in DSpace on 2016-05-02T00:59:28Z (GMT). No. of bitstreams: 1 biancaaparecidaribeirosingulane.pdf: 1026859 bytes, checksum: 6891320e0ee0d08d8facc3e7176b9dc9 (MD5) Previous issue date: 2016-02-22 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introdução: O consumo de álcool salienta-se como um grave problema de saúde pública no Brasil e no mundo. Porém, o número de usuários que procuram ajuda ou que conseguem tratamento ainda é reduzido. As terapias por computador (e-terapias) têm sido apontadas como alternativas de tratamento para diversos transtornos mentais, dentre eles o uso problemático de álcool e outras drogas. Uma preocupação importante relacionada a esta modalidade de atendimento refere-se à aliança terapêutica e a satisfação com o tratamento, condições básicas para que haja um atendimento psicoterapêutico de qualidade. Objetivo: O presente trabalho contempla objetivos de dois estudos: o primeiro pretendeu avaliar a literatura sobre aliança terapêutica nas Terapias cognitivo-comportamentais realizadas por videoconferência para diferentes transtornos mentais; e o segundo almejou avaliar a aliança terapêutica e a satisfação com o tratamento em uma psicoterapia por videoconferência para dependentes de álcool. Metodologia: No primeiro estudo foi realizada uma revisão sistemática de literatura, incluindo artigos empíricos dos últimos 11 anos, escritos nas línguas inglesa, portuguesa ou espanhola, que avaliavam a aliança terapêutica na TCC realizada por videoconferência. No segundo estudo, foi realizado um estudo de casos múltiplos, retirados de uma amostra que participou da TCC por videoconferência para dependentes de álcool. Os resultados foram analisados por meio de uma triangulação de dados, trabalhados de forma qualitativa e quantitativa. Resultados: No artigo 1 observou-se que a maioria dos estudos indicou que a aliança foi alta no decorrer das sessões de TCC por videoconferência, podendo ser comparada com a formada na psicoterapia presencial. Já os resultados do estudo 2 mostraram que, na TCC por videoconferência, houve formação de uma aliança terapêutica de qualidade e que os clientes ficaram satisfeitos com tratamento. Discussão: Apesar das limitações destes estudos, podemos inferir que há indícios tanto na revisão de literatura, quanto no estudo empírico, de que a aliança terapêutica e a satisfação com o tratamento na TCC por videoconferência pode ser comparável com os resultados encontrados na psicoterapia presencial. Assim, ela pode ser uma alternativa viável de tratamento para indivíduos com dependência de álcool. / Introduction: Alcohol consumption stands out as a serious public health problem in Brazil and worldwide. However, the number of users seeking help or who fail treatment is still low. The computer therapies (e-therapies) have been identified as alternative treatment for various mental disorders, including the abuse of alcohol and other drugs. A major concern related to this type of service refers to the therapeutic alliance and treatment satisfaction, basic conditions so that there is a psychotherapeutic care quality. Objective: This study includes two study objectives: the first aimed to evaluate the literature on therapeutic alliance in cognitive-behavioral therapies conducted by videoconference for different mental disorders; and the second craved evaluate the therapeutic alliance and treatment satisfaction in psychotherapy by videoconference to alcoholics. Methodology: In the first study was carried out a systematic review of the literature, including empirical articles from the past 11 years, written in English, Portuguese or Spanish that evaluated the therapeutic alliance in CBT held by videoconference. In the second study, we conducted a study of multiple cases, drawn from a sample of CBT participated by videoconference for alcoholics. The results were analyzed by means of a data triangulation worked qualitative and quantitative manner. Results: In Article 1 it was observed that most studies indicated that the alliance was high during the CBT sessions by videoconference and can be compared to that formed in the presence psychotherapy. Already the second study results showed that, in CBT by video conference, there is formation of a therapeutic alliance of quality and that clients were satisfied with treatment. Discussion: Despite the limitations of these studies, we can infer that there is evidence of the therapeutic alliance and treatment satisfaction in CBT by videoconference can be comparable with the results found in face psychotherapy. Thus, it can be a viable alternative treatment for patients with alcohol dependence.

Researchers within the criminal justice field have examined recidivism to discover effective methods to deter criminals from re-offending. Typically, incarceration provided specific deterrence for offenders but recidivism after release proved problematic. Using secondary data analysis, the present study evaluates a cognitive behavioral therapy [CBT] program, Reasoning and Rehabilitation, which the state of Colorado implemented in 1995 among juveniles on intensive probation. The original research team collected the data through pre- and post-questionnaires and interviews with probation officers. The pre- and post-test data are utilized to specifically analyze certain variables including self-control, empathy and problemsolving abilities. The focus of the present study is to determine the level of change in these particular variables as an outcome of completing the CBT program. This analysis also explores the value of CBT programs and examines how the programs alter an offender's level of selfcontrol, empathy and problem-solving abilities thus reducing recidivism after completion.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2015-12-17T19:00:41Z No. of bitstreams: 1 andressabianchigumier.pdf: 994615 bytes, checksum: 8eba0a39853c01d532f6c4a336fb9340 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T15:09:40Z (GMT) No. of bitstreams: 1 andressabianchigumier.pdf: 994615 bytes, checksum: 8eba0a39853c01d532f6c4a336fb9340 (MD5) / Made available in DSpace on 2016-01-25T15:09:40Z (GMT). No. of bitstreams: 1 andressabianchigumier.pdf: 994615 bytes, checksum: 8eba0a39853c01d532f6c4a336fb9340 (MD5) Previous issue date: 2015-02-10 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Diante do crescente envolvimento dos indivíduos com álcool e da falta de ofertas de tratamento em relação à demanda, tem aumentado na literatura estudos avaliando a eficácia e a efetividade de intervenções realizadas por internet. A partir de uma revisão de literatura sobre o tema, verificou-se que, no país, ainda não foi realizado nenhum estudo com esses propósitos. Porém, anterior à realização de um ensaio clínico randomizado desta natureza, faz-se primordial o estabelecimento de um protocolo de intervenção terapêutica padronizado que possa auxiliar e orientar os clínicos e pesquisadores no desenvolvimento de uma terapia realizada por internet. A criação de um protocolo de pesquisa clínica contribui para uma melhor compreensão do estudo e possibilita um melhor julgamento da confiabilidade, da repetibilidade e da reproducibilidade dos seus resultados. O presente trabalho tem como objetivo geral desenvolver um protocolo de pesquisa e intervenção para a realização de um ensaio clínico randomizado para avaliar a efetividade de uma terapia realizada por internet com a presença de um terapeuta para dependentes de álcool baseada na Terapia Cognitivo-Comportamental, na Prevenção de Recaída e em princípios da Entrevista Motivacional. / Given the increasing involvement of individuals with alcohol and the lack of treatment offers over demand, studies to evaluate the efficacy and effectiveness of interventions through the internet have increased in the literature. From a literature review on the topic, it was found that, in Brazil, no studies for these purposes were done. However, prior to carrying out a randomized clinical trial of this nature, it is essential to establish a standard therapeutic intervention protocol that can assist and guide clinicians and researchers in the development of a therapy performed through the internet. The creation of a clinical research protocol contributes to a better understanding of the study and provides a better judgment of the reliability, repeatability and reproducibility of their results. The main objective of this essay is develop a protocol for research and intervention for conducting a randomized clinical trial to evaluate the effectiveness of a therapy performed through the internet with the presence of a therapist for alcoholics based on Cognitive-Behavioral Therapy, in Relapse Prevention and principles of Motivational Interviewing.

No description available.

Psychological interventions can improve outcomes and reduce symptom severity for individuals with gambling disorder. This chapter provides an overview of current evidence from moderate- to large-scale randomized controlled trials of psychotherapy interventions for the treatment of gambling problems. Interventions include full-length professionally delivered therapies (behavior therapy, cognitive therapy, and cognitive-behavioral therapy), as well as self-directed workbooks and computer-facilitated programs. Motivational interventions, including motivational interviewing, motivational enhancement therapy, and personalized feedback, are also reviewed. This chapter highlights gambling-related treatment outcomes and comparisons between conditions for randomized trials, with an emphasis on treatment dropout. Attrition rates are generally high across all multi-session intervention modalities and formats. Overall, findings suggest that no specific treatment consistently outperforms other active treatments, but cognitive-behavioral therapy does have the most empirical support for the treatment of gambling disorder. In addition, brief motivational interventions are sufficient for some gamblers to change their behavior, particularly those experiencing only a few adverse symptoms from their gambling involvement. Future research efforts will benefit from further refining existing treatments to improve retention, which in turn may enhance effectiveness.

No description available.

Syfte: Syftet med litteraturöversikten var att utifrån svenska forskningsresultat kartlägga bakomliggande faktorer till tandvårdsrädsla och undersöka vilken effekt kognitiv beteendeterapi (KBT) har på tillståndet. Metod: Sökningen efter svenska vetenskapliga artiklar har gjorts genom Dentistry of Oral Sciences, MEDLINE och CINAHL. Artiklar skrivna under de senaste tio åren har valts. Både kvalitativa och kvantitativa artiklar har använts, samt har kvalitetsgranskats utefter två mallar. Resultat: Underliggande faktorer för utveckling av tandvårdsrädsla inkluderar tidigare negativa tandvårdssituationer, tandvårdsrädsla i familjen, kön, ålder, temperament, allmän ångest och depression, låg socioekonomisk ställning, låg inkomst, rökning, oral smärta, utbildningsnivå och Hyperaktivitetssyndrom (ADHD). KBT-behandling har visat sig vara mycket effektiv när det gäller att behandla tandvårdsrädsla. Slutsats: Det har visats att tandvårdsrädsla utvecklas tidigt i livet och kan vidmakthållas. Det finns flertalet faktorer som bör ses över och om behandling sätts in i sig kan man potentiellt förbättra hälsan hos individen med tandvårdsrädsla. KBT har visat sig vara en mycket framgångsrik behandling för tandvårdsrädsla, då det har en bevisad långvarig effekt. / Aim: The aim of the literature review was to map underlying factors of the development of dental anxiety and investigate the effect cognitive behavioral therapy (CBT)has on the condition, based on Swedish research results. Method: This was a literature review over Swedish studies. The search for scientific articles has been done through the databases Dentistry of Oral Sciences, MEDLINE and CINAHL. Articles written for the past ten years were chosen. Both qualitative and quantitative articles have been used and reviewed with quality templates. Results: Factors for developing dental fear include previous negative dental experiences, dental fear within the family, gender, age, temperament, general anxiety, depression, low socioeconomic standard, low income, smoking, oral pain, education level and for people with attention deficit hyperactivity disorder (ADHD). CBT treatment has shown to be very effective in treating dental anxiety. Conclusion: It has been shown that dental fear develops early in life and can be perpetuated. There are a number of factors that should be considered, and if treatment is initiated the health of the individual with dental fear can potentially be improved. CBT has been proven to be a very successful treatment for dental care, as it has a long-lasting effect.

The purpose of this thesis was to investigate the feasibility of a treatment for hypersexual disorder (HD) by calculating and reporting the results with pre-collected data from a research project at ANOVA/Karolinska Universitetssjukhuset. The treatment was a cognitive behavioral group therapy (CBGT) developed for HD administered in a 7-session group setting with a sample of HD-diagnosed women (n = 16). Feasibility was explored through symptom change of hypersexuality, sexual compulsivity, psychological distress, and depression. Symptom change in relationship to treatment attendance was also explored. In this thesis, the results are considered in a broader context, discussing theoretical issues concerning women’s sexuality in relation to hypersexual problems and medicalization of hypersexual behaviors.   The treatment was shown to be feasible. Significant decrease was found on all measures. Attendance rate significantly correlated with a decrease in depressive symptoms, but not on other measures. Women’s sexuality might differ from men’s, but the treatment, which was first evaluated for men, is still feasible for women. Treatment for hypersexual problems in women and hypersexual problems in women in general have been understudied, which makes this study an important contribution to the research field. Further treatment studies could potentially investigate whether specific alterations based on gender and sexual orientation could be needed for further development of the treatment. There are issues concerning medicalization of hypersexual behaviors which should be considered when addressing the phenomenon, such as the influence of moral and cultural factors on the understanding of hypersexuality. Still, there is need for treatment for hypersexual behaviors experienced as problematic, and having these problems addressed within the medical and scientific field has potential for being beneficial and is preferred to having them left to alternative, unregulated health care providers.

博士(心理学) / Doctor of Philosophy in Psychology / 同志社大学 / Doshisha University