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Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2016-08-01T12:24:32Z No. of bitstreams: 1 amanda reyesvolume final - 23-07-15.pdf: 348695 bytes, checksum: 2ee5f76444cb295f170acae0bec93565 (MD5) / Made available in DSpace on 2016-08-01T12:24:32Z (GMT). No. of bitstreams: 1 amanda reyesvolume final - 23-07-15.pdf: 348695 bytes, checksum: 2ee5f76444cb295f170acae0bec93565 (MD5) Previous issue date: 2014-11-25 / . / Objetivo Geral • Comparar o desempenho cognitivo e o funcionamento global entre adultos jovens com e sem o diagnóstico de Transtorno Bipolar, bem como correlacionar estas medidas nos sujeitos com Transtorno Bipolar. 2.2 Objetivos Específicos • Comparar o funcionamento global de adultos jovens com e sem diagnóstico de TB; • Comparar o desempenho cognitivo de adultos jovens com e sem diagnóstico de TB; • Correlacionar o desempenho cognitivo e o funcionamento em uma amostra populacional de adultos jovens; • Correlacionar o desempenho cognitivo e o funcionamento nos adultos jovens com Transtorno Bipolar; • Correlacionar a severidade dos sintomas maníacos e depressivos com o desempenho cognitivo e o funcionamento dos jovens com TB.

Objective: The nature of interpersonal relationships, whether supportive or critical, may affect the association between health status and mental health outcomes. We examined the potential moderating effects of social support, as a buffer, and family criticism, as an exacerbating factor, on the association between illness burden, functional impairment and depressive symptoms. Methods: Our sample of 735 older adults, 65 years and older, was recruited from internal and family medicine primary care offices. Trained interviewers administered the Hamilton Rating Scale for Depression, Duke Social Support Inventory, and Family Emotional Involvement and Criticism Scale. Physician-rated assessments of health, including the Karnofsky Performance Status Scale and Cumulative Illness Rating Scale, were also completed. Results: Linear multivariable hierarchical regression results indicate that social interaction was a significant buffer, weakening the association between illness burden and depressive symptoms, whereas perceived social support buffered the relationship between functional impairment and depressive symptoms. Family criticism and instrumental social support were not significant moderators. Conclusions: Type of medical dysfunction, whether illness or impairment, may require different therapeutic and supportive approaches. Enhancement of perceived social support, for those who are impaired, and encouragement of social interactions, for those who are ill, may be important intervention targets for treatment of depressive symptoms in older adult primary care patients.

“A child has been born unto us”, is the most beautiful expression of humankind’s ability to cherish hope and trust for the world, writes Hanna Arendt. She describes how every child’s birth is the beginning of something new, something that the title is intended to emphasise. “Us” in the title also indicates that the child with a functional impairment becomes a public child in a special way. The purpose of this study is to describe the experience of becoming a parent when the child has a functional impairment. The study is based on a relational perspective. The theoreticians whose ideas have been used are, aside from Arendt, also Buber, Stern and Winnicott. In the analysis of the parental narratives, inspiration was taken from Ricoeur in a hermeneutic phenomenological approach. Encounters are the themes in this thesis, and have been formulated as encounters with the child, the environment and the professionals. 30 parents (19 mothers and 11 fathers) were interviewed about their experiences of parenthood. The diagnosis of the child’s functional impairment was a chaotic and upsetting situation for the parents. Many strong, different feelings came into play. The parents could feel that they had been “thrown out into space”, and that their future was suddenly taken away from them. The future was what worried them most, and the question that was singled out was “How can we live this life?” Many professionals became involved in the child’s life, which could be both advantageous and disadvantageous for the family. The professionals’ attitudes and advices had a profound influence on the parents. Even though the child became in a sense a public child, the parents also had a feeling of having to carry on a struggle for their child in society, a” struggle of love” demanding the consideration of the child’s potential. Another “struggle of love” initially involved the parents’ own attempts to establish a relationship to the child. Thus there were two “struggles of love”. In their new, hesitant parenthood they had to “find their place in the world” and a way to exist. In their interaction with the child they had two competing figures of mind during the first period, “to be” and “to act”. The grief the parents had felt for the diagnosis could after a while be separated from the child, and it was the child who helped the parents to handle the grief. In the thesis the parents’ experiences are discussed, based on questions confronting them. How playing and training are interrelated is also discussed, as well as the significance of narration and the responsibility of the professionals. These results can be expected to have consequences for special educational work in this field.

The purpose of this essay is to examine the Swedish governments discourse on integration of immigrants and thereby examine what social reality it constructs. The aim is to examine how integration and immigrants are constructed within the discourse. The method and theory being used in this essay is discourse theory. As a methodological instrument we use the policy on functional impairment as a comparison. The material being analyzed in this essay is political documents on the strategy on integration policy and the strategy on the policy of functional impairment. The main conclusions of the study are that immigrants are constructed as a homogenous group and immigrants are being discursively separated from the majority society. Social exclusion serves as an identity within the discourse. Another main conclusion is that integration is connected to labour and firstly constructed as labour market policy within the discourse. Integration is also related to social exclusion. The government often uses the term social exclusion instead of the term integration. The comparison with the policy on functional impairment serves as a possible alterative way of understanding integration and identity.

Background: This study examined the contribution of various aspects of obsessive-compulsive disorder (OCD) on quality of life (QoL) in 102 adults with a principal diagnosis of OCD from an archival database. Method: Participants were assessed for DSM-IV diagnoses by trained clinicians using the Anxiety Disorders Interview Schedule, 4th Edition (ADIS-IV), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and an unstructured interview. Further information was attained using the Beck Depression Inventory II (BDI-II), the Obsessive Compulsive Inventory Revised (OCI-R) and the Medical Outcome Study-36 (MOS-36). Results: Results indicated that obsessive-compulsive symptom severity was positively correlated with diminished emotional health, social functioning and general health QoL, but not physical health QoL. Main effects were found for depression severity, the presence or absence of comorbid major depressive disorder and obsessive-compulsive symptom severity and QoL. Mediational analyses indicated that interference of obsessive-compulsive symptoms on the Y-BOCS mediated the relationship between obsessive-compulsive symptom severity and social functioning, emotional health and general health QoL. Mediational analyses further revealed that resistance to obsessive-compulsive symptoms on the Y-BOCS was a mediator between obsessive-compulsive symptom severity and social functioning QoL. Further analyses explained the role of each mediator in the relationship between obsessive-compulsive symptom severity and social functioning QoL. Across symptom dimensions, persons with OCD had a largely impacted QoL within multiple domains. Conclusions: Diminished QoL is common in persons with OCD and is essential in understanding the complete clinical picture of OCD. Results are discussed in terms of implications for assessment, treatment and future research.

This study aimed to model the trajectories of life satisfaction as influenced by functional impairment and family satisfaction over a five-year period following spinal cord injury, severe burns, and lower-extremity fractures. Marital status and injury type were included to estimate predicted life satisfaction over the five-year period post-injury. Measures: Six-hundred sixty-two participants completed the Functional Independence Measure, Family Satisfaction Scale, and Life Satisfaction Inventory at 12, 24, 48, and 60 months post-injury. Results: Family satisfaction was a consistent predictor of life satisfaction across models. Consistent with past research (Resch et al., 2009), functional impairment was significantly predictive of life satisfaction. Conclusions: Individuals predicted to be most at risk were those individuals with severe burns, who were divorced or separated, with low family satisfaction, and/or high functional impairment.

The purpose of this qualitative, exploratory study was to develop a deeper understanding of educational and other social experiences and relationships of post-secondary students who were clinically diagnosed with primary obsessive-compulsive disorder (OCD). The researcher also investigated their strengths, weaknesses, coping strategies, and quality of life through mental and physical health. The majority of people with OCD have obsessions and compulsions that last greater than an hour each day or severely impact daily life. Obsessions are irritating feelings or mental pictures that individuals try to block or mitigate with irrational physical or mental compulsions, often appearing as excessive hand washing in reaction to a contamination obsession. Participants comprised seven university students who completed three self-report questionnaires and two semi-structured interviews with the researcher. Five participants submitted self-report journals. These data were examined using interpretative phenomenological analysis (IPA).The present study advanced previous research as it documented extensive lifelong characteristics, experiences, and relationships from these students. It yielded salient findings related to their OCD functional impairment and quality of life. Further, it showed that as students, their intellectual integration seemed to play a greater role in academic persistence than did their social integration. In addition, participants’ university policy and practice recommendations were congruent with a similar study from about a decade ago indicating that perhaps few or none of the past recommendations were implemented for the benefit of such students. Present recommendations should be implemented accordingly.

Social support and family criticism variables were examined as potential moderators of the association between illness burden and depression and between functional impairment and depression in a secondary data analysis. Participants (n=735) were older adults aged 65 and older from internal medicine and family medicine primary care offices. It was hypothesized that both illness burden and functional impairment would be associated with increased depressive symptoms and a diagnosis of depression. In addition, it was hypothesized that higher levels of social support and lower levels of family criticism would moderate this relationship. Both linear and logistic multivariate hierarchical regression analyses were used to examine these variables as potential moderators. Hypotheses concerning perceived social support and social interaction as moderators were supported. Hypotheses involving family criticism and instrumental social support were not supported. Enhancement of perceived social support and encouragement of social interactions may be important intervention targets for treatment of depressive symptoms in older adults with illness or impairment who are seen in primary care settings.

Pediatric chronic pain is a common developmental health problem with negative effects that can influence youth throughout their lives. Cognitive behavioral therapy is an efficacious treatment for pain management; however, treatment compliance among adolescents is a major problem. Emerging research suggests that some family-level factors play a role in treatment engagement and outcomes. Moreover, adolescents with greater coping and resilience strategies are more likely to benefit from treatment. However, it is not clear to what extent (a) other family factors predict short-term (3-month) and long-term (6-month) treatment compliance among adolescents with chronic pain, (b) adolescent-level factors predict treatment compliance, and (c) family-level factors interact with adolescent-level factors to predict treatment compliance (i.e., through moderating pathways). In addition, the association of family-level risk factors and adolescent-level resilience factors with functional impairment needs to be further investigated. To address these gaps, the current study explored factors that may predict treatment compliance and functional impairment within a multidisciplinary pediatric pain management program. Sixty-four adolescents (M = 15.00 ± 1.69 years; 85.9% female; 84.4% Caucasian, 6.3% African American/Black, 1.6% Hispanic/Latino, 1.6% Asian, 4.7% Mixed Race, 1.6% “Other”) diagnosed with chronic pain and their primary caregivers were assessed at three time points: their initial intake in the program (N=64), 3-months post-intake (n=62), and 6-months post-intake (n=61). Most family-level and adolescent-level factors, as well as the interaction of these factors, did not predict improved treatment compliance. However, consistent with prior research, several family-level and adolescent-level factors were associated with increased functional impairment among this sample. Study limitations and statistical concerns warrant that these findings be interpreted with caution. Results contribute to our understanding of the importance of family-level factors within the developmental context of adolescence, while also highlighting the need for investigating other relevant influences towards treatment compliance and functional impairment. Delineating such characteristics can inform assessment, as well as tailor treatment targets, recommendations, and outcomes among adolescents with chronic pain within a multidisciplinary treatment setting. / Psychology