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Ocitocina (OT) é um nonapeptídeo neurosecretório sintetizado nas células hipotalâmicas que se projetam para a neurohipófise e para locais extensamente distribuídos no sistema nervoso central. As microinjeções centrais de OT induzem uma variedade de comportamentos em animais no âmbito cognitivo, sexual, reprodutivo, de autolimpeza e afiliativo. O transtorno obsessivo-compulsivo (TOC) inclui uma escala dos sintomas cognitivos e comportamentais que tem alguma relação com dimensões de comportamento associadas com a OT. A administração de OT no núcleo central da amígdala (CeA) induz autolimpeza exacerbada, considerada um sintoma de TOC. Neste trabalho, nós estudamos os substratos neuroanatômicos e celulares deste comportamento. Nossos dados sugerem uma ligação entre o CeA e a “área hipotalâmica de grooming" (HGA). A HGA inclui parte do núcleo paraventricular do hipotálamo e a área hipotalâmica dorsal. Nossos dados mostrando co-localização de OT (imunohistoquímica para peptídeo), receptor para OT (ensaio de binding) e marcação de células retrogradamente depois da injeção de Fluoro-Gold no CeA sugerem que o CeA e conexões são substratos importantes nos circuitos subjacentes de comportamento normal e de quadro patológico tal como o TOC dependente de OT descrito neste trabalho. / Oxytocin (OT) is a neurosecretory nonapeptide synthesized in hypothalamic cells that project to the neurohypophysis as well as to widely distributed sites in the central nervous system. Central OT microinjections induce a variety of cognitive, sexual, reproductive, grooming and affiliative behaviors in animals. Obsessive-compulsive disorder (OCD) includes a range of cognitive and behavioral symptoms that bear some relationship to dimensions of behavior associated with OT. The administration of OT into central nucleus of amygdala (CeA) induces hypergrooming, considered a symptom of OCD. Here, we study the neuroanatomical and cellular substrates of this behavior. Our data suggest a link between the CeA and the “hypothalamic grooming area" (HGA). The HGA includes parts of the paraventricular hypothalamic nucleus and the dorsal hypothalamic area. Our data on co-localization of OT (immunohistochemistry for peptide), OT receptor (binding assay) and retrogradely labeled cells after Fluoro Gold injection in CeA suggest that CeA and connections are an important substrate of the circuit underlying this OCD-like OT-dependent behavior.

Ocitocina (OT) é um nonapeptídeo neurosecretório sintetizado nas células hipotalâmicas que se projetam para a neurohipófise e para locais extensamente distribuídos no sistema nervoso central. As microinjeções centrais de OT induzem uma variedade de comportamentos em animais no âmbito cognitivo, sexual, reprodutivo, de autolimpeza e afiliativo. O transtorno obsessivo-compulsivo (TOC) inclui uma escala dos sintomas cognitivos e comportamentais que tem alguma relação com dimensões de comportamento associadas com a OT. A administração de OT no núcleo central da amígdala (CeA) induz autolimpeza exacerbada, considerada um sintoma de TOC. Neste trabalho, nós estudamos os substratos neuroanatômicos e celulares deste comportamento. Nossos dados sugerem uma ligação entre o CeA e a “área hipotalâmica de grooming” (HGA). A HGA inclui parte do núcleo paraventricular do hipotálamo e a área hipotalâmica dorsal. Nossos dados mostrando co-localização de OT (imunohistoquímica para peptídeo), receptor para OT (ensaio de binding) e marcação de células retrogradamente depois da injeção de Fluoro-Gold no CeA sugerem que o CeA e conexões são substratos importantes nos circuitos subjacentes de comportamento normal e de quadro patológico tal como o TOC dependente de OT descrito neste trabalho. / Oxytocin (OT) is a neurosecretory nonapeptide synthesized in hypothalamic cells that project to the neurohypophysis as well as to widely distributed sites in the central nervous system. Central OT microinjections induce a variety of cognitive, sexual, reproductive, grooming and affiliative behaviors in animals. Obsessive-compulsive disorder (OCD) includes a range of cognitive and behavioral symptoms that bear some relationship to dimensions of behavior associated with OT. The administration of OT into central nucleus of amygdala (CeA) induces hypergrooming, considered a symptom of OCD. Here, we study the neuroanatomical and cellular substrates of this behavior. Our data suggest a link between the CeA and the “hypothalamic grooming area” (HGA). The HGA includes parts of the paraventricular hypothalamic nucleus and the dorsal hypothalamic area. Our data on co-localization of OT (immunohistochemistry for peptide), OT receptor (binding assay) and retrogradely labeled cells after Fluoro Gold injection in CeA suggest that CeA and connections are an important substrate of the circuit underlying this OCD-like OT-dependent behavior.

9 Summary This thesis deals with obsessive-compulsive disorder in connection with the practice of social work. It draws attention to numerous problems of anxiety disorders in society, risk factors for the development of anxiety disorders and risks in the social sphere. It also analyzes in detail obsessions, compulsions, manifestations and diagnosing of OCD and, last but not least, the practice of social work with the obsessive-compulsive disorder. Social work with people suffering from obsessive-compulsive disorder may be more challenging overall, requiring increased patience, knowledge of social workers, and the ability to use some important methods. The same importance is dedicated to managing clients to refer to follow-up professional help. People with OCD deserve support from experts and acceptance by the public, which is also a reason why it is so important to have knowledge of obsessive-compulsive disorder and do not underestimate this issue..

Made available in DSpace on 2016-04-25T20:22:56Z (GMT). No. of bitstreams: 1 Leandro Alberto de Paiva Siqueira.pdf: 3521197 bytes, checksum: 69a587110b1ceae987343d261e25189e (MD5) Previous issue date: 2009-10-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Beginning in the 1990s, diverse habits, conducts, and daily-life behaviors, when practised in excess, in an uncontrolled or repetitive manner began to be biologized by psychiatry and progressively included in diagnostic manuals of mental disorders. Generically known by the term compulsions, these "new mental disorders" group together thoughts and desires that provoke discomfort, fear, and anxiety the activities whose engagement brings pleasure such as playing, eating, buying, doing physical exercise, working, sex, surfing the internet, using substances that alter perception, relationships, and religion. The emergency of compulsions as a new "epidemic" to be combatted against occurred at the same that psychiatry went through a reformulating process of its practices and knowledge thanks to new computo-informational technologies, the development of modern psychopharmaceuticals, and the incorporation of the contents regarding the mental and human behavior produced by the neurosciences. This research aims to trace a genealogy of compulsions in order to problematize dispositifs of power that operate subjects at the moment when disciplinary societies, analyzed by Michel Foucault, come to be overlapped by control societies, as pointed out by Gilles Deleuze. In this change, the asylum no longer is the principal economy of power in the formatation of subjectivities, in order to be substituted by technologies that operate in open air and result in normalizations of the normal. They are technologies that combine subjections and machinic servitudes, promoting processes of (in)dividuation, and take place on an environment by means of flows of mental health that convokes the policing of "disfunctions", the auto-vigilance of behaviors and conducts, and the formation of organized groupings of carriers of disorders. Understood as unfoldings of neoliberal governamentality, compulsions are configured as one more dispositif of an "era of moderation and moderates" and of the proliferation of the sensations of liberty / A partir dos anos 1990, diversos hábitos, condutas e comportamentos da vida cotidiana, quando praticados em excesso, de maneira descontrolada ou repetitiva passaram a ser biologizados pela psiquiatria e progressivamente incluídos em manuais de diagnósticos de transtornos mentais. Conhecidos genericamente pelo termo compulsões, estes novos transtornos mentais reúnem desde pensamentos e desejos que provocam desconforto, medo e ansiedade a atividades cujo engajamento traz prazer como jogar, comer, comprar, fazer exercícios físicos, trabalhar, sexo, navegar na Internet, usar substâncias que alterem a percepção, relacionamentos e religião. A emergência das compulsões como nova epidemia a ser combatida ocorreu simultaneamente à psiquiatria passar por um processo de reformulação de suas práticas e conhecimentos graças às novas tecnologias computoinformacionais, ao desenvolvimento de modernos psicofármacos e à incorporação de conteúdos sobre o mental e o comportamento humano produzidos pelas neurociências. Esta pesquisa visa traçar uma genealogia das compulsões a fim de problematizar dispositivos de poder que operam assujeitamentos no momento em que as sociedades disciplinares, analisadas por Michel Foucault, passam a ser sobrepostas pelas sociedades de controle, como apontou Gilles Deleuze. Neste deslocamento, o manicômio deixa de ser a principal economia de poder na formatação de subjetividades, para ser substituído por tecnologias que operam a céu aberto e procedem a normalizações do normal. São tecnologias que combinam sujeições e servidões maquínicas, promovendo processos de (in)dividuação, e incidem sobre o ambiente por meio de fluxos da saúde mental que convocam ao policiamento de disfunções , à autovigilância de comportamentos e condutas e à formação de agrupamentos organizados de portadores de transtornos. Entendidas como desdobramentos da governamentalidade neoliberal, as compulsões configuram-se como mais um dispositivo de uma era da moderação e dos moderados em meio à proliferação de sensações de liberdade

Made available in DSpace on 2016-04-26T14:57:49Z (GMT). No. of bitstreams: 1 Leandro Alberto de Paiva Siqueira.pdf: 3521197 bytes, checksum: 69a587110b1ceae987343d261e25189e (MD5) Previous issue date: 2009-10-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Beginning in the 1990s, diverse habits, conducts, and daily-life behaviors, when practised in excess, in an uncontrolled or repetitive manner began to be biologized by psychiatry and progressively included in diagnostic manuals of mental disorders. Generically known by the term compulsions, these "new mental disorders" group together thoughts and desires that provoke discomfort, fear, and anxiety the activities whose engagement brings pleasure such as playing, eating, buying, doing physical exercise, working, sex, surfing the internet, using substances that alter perception, relationships, and religion. The emergency of compulsions as a new "epidemic" to be combatted against occurred at the same that psychiatry went through a reformulating process of its practices and knowledge thanks to new computo-informational technologies, the development of modern psychopharmaceuticals, and the incorporation of the contents regarding the mental and human behavior produced by the neurosciences. This research aims to trace a genealogy of compulsions in order to problematize dispositifs of power that operate subjects at the moment when disciplinary societies, analyzed by Michel Foucault, come to be overlapped by control societies, as pointed out by Gilles Deleuze. In this change, the asylum no longer is the principal economy of power in the formatation of subjectivities, in order to be substituted by technologies that operate in open air and result in normalizations of the normal. They are technologies that combine subjections and machinic servitudes, promoting processes of (in)dividuation, and take place on an environment by means of flows of mental health that convokes the policing of "disfunctions", the auto-vigilance of behaviors and conducts, and the formation of organized groupings of carriers of disorders. Understood as unfoldings of neoliberal governamentality, compulsions are configured as one more dispositif of an "era of moderation and moderates" and of the proliferation of the sensations of liberty / A partir dos anos 1990, diversos hábitos, condutas e comportamentos da vida cotidiana, quando praticados em excesso, de maneira descontrolada ou repetitiva passaram a ser biologizados pela psiquiatria e progressivamente incluídos em manuais de diagnósticos de transtornos mentais. Conhecidos genericamente pelo termo compulsões, estes novos transtornos mentais reúnem desde pensamentos e desejos que provocam desconforto, medo e ansiedade a atividades cujo engajamento traz prazer como jogar, comer, comprar, fazer exercícios físicos, trabalhar, sexo, navegar na Internet, usar substâncias que alterem a percepção, relacionamentos e religião. A emergência das compulsões como nova epidemia a ser combatida ocorreu simultaneamente à psiquiatria passar por um processo de reformulação de suas práticas e conhecimentos graças às novas tecnologias computoinformacionais, ao desenvolvimento de modernos psicofármacos e à incorporação de conteúdos sobre o mental e o comportamento humano produzidos pelas neurociências. Esta pesquisa visa traçar uma genealogia das compulsões a fim de problematizar dispositivos de poder que operam assujeitamentos no momento em que as sociedades disciplinares, analisadas por Michel Foucault, passam a ser sobrepostas pelas sociedades de controle, como apontou Gilles Deleuze. Neste deslocamento, o manicômio deixa de ser a principal economia de poder na formatação de subjetividades, para ser substituído por tecnologias que operam a céu aberto e procedem a normalizações do normal. São tecnologias que combinam sujeições e servidões maquínicas, promovendo processos de (in)dividuação, e incidem sobre o ambiente por meio de fluxos da saúde mental que convocam ao policiamento de disfunções , à autovigilância de comportamentos e condutas e à formação de agrupamentos organizados de portadores de transtornos. Entendidas como desdobramentos da governamentalidade neoliberal, as compulsões configuram-se como mais um dispositivo de uma era da moderação e dos moderados em meio à proliferação de sensações de liberdade

ContexteAu cours de la maladie de Parkinson, les agonistes dopaminergiques sont associés à la survenue de troubles du contrôle des impulsions (TCI). Leur physiopathologie est supposée liée à une dérégulation du circuit dopaminergique méso-limbique, impliqué dans l’intégration des conséquences d’une action afin d’adapter les comportements ultérieurs. Les agonistes dopaminergiques, par la stimulation tonique qu’ils entrainent, conduiraient à une surestimation des conséquences positives des actions antérieures et la poursuite de comportements aux conséquences néfastes.Nous avons exploré (i) la connectivité fonctionnelle striato-corticale en IRM fonctionnelle de repos, (ii) des marqueurs électro-encéphalographiques (EEG) d’intégration du feedback au cours d’une tache de pari : feedback-related negativity (FRN), feedback-related positivity (FRP) et oscillations dans la bande de fréquence thêta (4-7 Hz) chez 20 patients parkinsoniens avec TCI actif, 19 patients parkinsoniens sans TCI et 19 contrôles sains.IRM fonctionnelle : Le striatum ventral, le noyau caudé dorsal, le putamen antérieur et postérieur étaient segmentés semi-automatiquement. Pour chaque région d’intérêt, une analyse de connectivité fonctionnelle était réalisée sur les données d’IRM fonctionnelle projetées sur la surface corticale.Approche neurophysiologique : les sujets réalisaient une tâche composée de paris répétés, couplée à un enregistrement EEG. Le signal EEG était moyenné pour chaque condition et pour chaque sujet. L’amplitude de la FRP était mesurée en Cz et l’amplitude de la FRN en Fz sur la courbe de différence entre les potentiels évoqués par les pertes et les potentiels évoqués par les gains. Les spectres de puissance ont été calculés en utilisant une transformation en ondelettes sinusoïdales de Morlet et moyennés par condition. La puissance maximale du signal, dans la bande de fréquence thêta, entre 200 et 500 millisecondes après l’affichage du feedback était mesurée.Analyse de la connectivité striato-corticale : Chez les patients parkinsoniens, l’existence d’un TCI était associée à une déconnexion fonctionnelle entre le putamen antérieur gauche et les gyrus cingulaire antérieur et temporal inférieur gauche. Il existait chez ces patients une tendance à une déconnexion fonctionnelle entre (i) le putamen antérieur gauche et le gyrus frontal inférieur, (ii) le putamen postérieur et les gyrus temporal inférieur, frontal supérieur, cingulaire postérieur et frontal médial à gauche, ainsi que les gyrus frontal médial, cingulaire et frontal moyen à droite, (iii), le noyau caudé dorsal et le gyrus rectus, le gyrus frontal moyen et le gyrus temporal inférieur à gauche.Potentiels évoqués : Chez les patients parkinsoniens sans TCI et chez les contrôles, mais pas chez les patients parkinsoniens avec TCI, la FRP était plus ample après les gains qu’après les pertes suite à un choix peu risqué.Analyse temps-fréquence : En Cz, les gains étaient associés à une augmentation plus importante de la puissance thêta que les pertes chez les patients parkinsoniens sans TCI et chez les contrôles, mais pas chez les patients parkinsoniens avec TCI. Il existait une augmentation de la puissance thêta après un résultat ample inattendu (boost), en Fz chez les contrôles et en FCz chez les parkinsoniens avec TCI, mais pas chez les patients parkinsoniens sans TCI.Il existe chez les patients parkinsoniens ayant un TCI une altération de marqueurs EEG d’intégration de la récompense compatible avec une moins bonne discrimination des gains et des pertes et une plus grande sensibilité aux résultats amples, inattendus (boost), supposés entrainer une activation importante des voies dopaminergiques méso-limbiques. Il semble donc bien exister, chez les patients ayant un TCI une dysfonction des mécanismes d’intégration du feedback. Cette dysfonction s’associe, au repos, à une altération de la connectivité striato-corticale qui va au-delà du seul système limbique. / BackgroundIn Parkinson’s disease, dopamine agonists are associated with an increased risk of impulse control disorders (ICD). Their occurrence is supposed to be related with a deregulation of the dopaminergic meso-limbic pathway, involved in the processing of the consequences of previous action to adapt future behaviors. Dopamine agonists, through a tonic stimulation of the dopamine receptors would lead to an overestimation of the positive consequences of actions, and therefore, continuation of a harmful behavior.Method:We investigated (i) the resting-state striato-cortical functional connectivity using functional MRI, and (ii) electro-encephalographic (EEG) markers of feedback processing during a gambling task : the feedback related negativity (FRN), the feedback related positivity, (FRP), and the theta band oscillations (4-7 Hz) in 20 Parkinson’s disease patients with an active ICD, 19 Parkinson’s disease patients without ICD, and 19 healthy subjects.Functional MRI: The ventral striatum, dorsal caudate, and anterior and posterior putamen were semi-automatically segmented. For each region of interest, a seed-based connectivity analysis was performed on preprocessed fMRI data mapped on the ipsilateral cortical surface.Neurophysiological approach: The subjects underwent an EEG while performing a gambling task. The EEG was averaged for each condition and each subject. The FRP amplitude was measured in Cz, and the FRN amplitude was measured in Fz on the difference wave between the potential evoked by losses and by gains. The power spectra were computed by using a sinusoidal Morlet wavelet transform and averaged by condition. The maximum power in the theta frequency band was computed for each participant and each condition.Results:Cortico-striatal connectivity analysis: The presence of an ICD in patients with PD was associated with functional disconnection between the left anterior putamen and both the left inferior temporal and anterior cingulate gyrus. ICD patients also displayed a trend toward a functional disconnection between (i) the left anterior putamen and the inferior frontal gyrus, (ii) the posterior putamen and the inferior temporal gyrus, superior frontal gyrus, posterior cingulate, and medial frontal gyrus on the left, as well as the medial frontal gyrus, middle frontal gyrus, and cingulate gyrus on the right, (iii) the dorsal caudate and the gyrus rectus and orbitofrontal cortex, and the middle frontal and inferior temporal gyrus on the left.Evoked potentials: In Parkinson’s disease patients without ICD and healthy controls, the FRP was greater after gains that after losses following a non-risky choice. There was no difference in FRP amplitude after losses and gains in Parkinson’s disease patients with ICD.Time-frequency analysis: At Cz, positive outcomes (gains) were associated with greater theta power than negative outcomes (losses) in Parkinson’s disease patients without ICD and in healthy controls, but not in Parkinson’s disease patients with ICD. There was an increase in theta power after unexpectedly high outcomes, at Fz in healthy controls and in FCz in Parkinson’s disease patients with ICD, whereas theta power was not modulated by the magnitude of the outcome in PD patients without ICDs.Conclusions:Parkinson’s disease patients with ICD have an alteration in EEG markers of reward in line with an altered discrimination of gains and losses and a greater sensitivity to unexpectedly high outcomes, supposed to lead to a significant activation in the dopaminergic meso-limbic pathways. These findings are in line with a dysfunction in reward processing in ICD in Parkinson’s disease. This dysfunction is associated, at rest, with an alteration in striato-cortical connectivity that goes beyond a pure dopaminergic meso-limbic dysfunction.

The study sought to explore the influence of gastrointestinal symptoms in female respondents with emetophobia disorder, panic disorder with agoraphobia and obsessive compulsive disorder. The research assessed a sample of sixty respondents which formed part of three groups which were recruited from clinical and online support groups. The age ranged from twenty to forty-five years. Non-probability quota sampling was employed. A non-experimental research design was implemented in order to make comparisons between these groups’ association of gastrointestinal symptoms and the occurrence of possible vomiting. The differential research strategy determined whether a statistically significant difference existed. The groups were assessed on the Gastrointestinal Symptom Score (2005) and the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (2004). The research aimed to determine whether empirical support exists for the Cognitive Behavioural Model of Emetophobia by Boschen (2007). / Psychology / M.A. (Psychology)

The study sought to explore the influence of gastrointestinal symptoms in female respondents with emetophobia disorder, panic disorder with agoraphobia and obsessive compulsive disorder. The research assessed a sample of sixty respondents which formed part of three groups which were recruited from clinical and online support groups. The age ranged from twenty to forty-five years. Non-probability quota sampling was employed. A non-experimental research design was implemented in order to make comparisons between these groups’ association of gastrointestinal symptoms and the occurrence of possible vomiting. The differential research strategy determined whether a statistically significant difference existed. The groups were assessed on the Gastrointestinal Symptom Score (2005) and the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (2004). The research aimed to determine whether empirical support exists for the Cognitive Behavioural Model of Emetophobia by Boschen (2007). / Psychology / M.A. (Psychology)