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Exploring perceived changes in family functioning after the imprisonment of a family member / Catharina Magdalena DavelDavel, Catharina Magdalena January 2014 (has links)
Research regarding the imprisonment of a family member has mainly focused on the effects of parental imprisonment on the children in that family. Literature indicates that the child of an imprisoned parent has to deal with numerous challenges, including stigma and shame related to their parent‟s arrest and imprisonment. Other common feelings these children might experience include anger, confusion and sadness. Furthermore these children often experience pressure related to keeping the imprisonment a secret from those close to them. These children might also face multiple separations from the imprisoned parent, experience changes with regards to residence, school and friendships, adoption of adult roles and responsibilities, financial distress, lack of supervision and more. When compared to literature regarding parental imprisonment relatively few studies have been done on the effects of imprisonment on the family as a whole, especially in the South African context. The available research indicates there are numerous implications for the family as a whole. Some of these implications include stigma, financial stress, role changes within the family, relational problems between family members (including extended family), challenges in dealing with the criminal justice system and emotional distress (feelings of loneliness, anxiety, isolation and worry). The aim of this study was to explore and describe the changes that take place in family functioning when a member of that family is imprisoned as they are perceived by the members of the nuclear family. A qualitative description (descriptive) research approach was used in this study. Purposive sampling was used to recruit participants. Six voluntary participants (all family members of imprisoned individuals) from four families were recruited. Participants were aged between 15 and 75, consisted of one male and five females. Semi-structured interviews were used to collect data. These interviews were audio recorded and then transcribed. Initial questions for the semi-structured interviews were obtained using the McMaster Model of Family Functioning as a guiding framework. Therefore, first deductive (directed) content analysis was used, after which thematic analysis was then done on the transcribed data. From the analysis two main themes and nine subthemes emerged. It was found that participants relied more on their family members for problem solving, were generally more open-hearted and honest with their communication towards each other while limiting potentially distressing communication and they experienced changes in the roles and responsibilities within the family. Participants also reported experiencing new emotions (positive and negative) and experienced increased support, understanding and involvement from their family members. They furthermore experienced changes in behaviour control and household rules ranging from rigid to laissez-faire and often fluctuating between these. Some participants reported experiencing more support from outside the family. Participants furthermore reported feeling stigmatised and isolated within their communities. They also experienced gaining resilience and inner strength and found strength through their religious beliefs. The findings of this study can‟t be generalized due to the limited demographic variability and small sample size. Limited research is available regarding the changes in family functioning after the imprisonment of a family member in the family as a whole, especially in the South African context. The identification of religion and resilience (as subthemes identified from the data) as they relate to coping is probably the most important contribution of this study as it is not discussed in any of the models of family functioning mentioned in this study, including the McMaster Model of Family Functioning. It is recommended that further research focus on both resilience and religion as they relate to coping and possibly contribute to family functioning after the imprisonment of a family member. It is furthermore suggested that specific intervention programs be developed to help families function effectively after the imprisonment of a family member. These intervention programs might include group work with different families or working with individual families either with skills development, psycho-education or therapeutically. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2015
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Exploring perceived changes in family functioning after the imprisonment of a family member / Catharina Magdalena DavelDavel, Catharina Magdalena January 2014 (has links)
Research regarding the imprisonment of a family member has mainly focused on the effects of parental imprisonment on the children in that family. Literature indicates that the child of an imprisoned parent has to deal with numerous challenges, including stigma and shame related to their parent‟s arrest and imprisonment. Other common feelings these children might experience include anger, confusion and sadness. Furthermore these children often experience pressure related to keeping the imprisonment a secret from those close to them. These children might also face multiple separations from the imprisoned parent, experience changes with regards to residence, school and friendships, adoption of adult roles and responsibilities, financial distress, lack of supervision and more. When compared to literature regarding parental imprisonment relatively few studies have been done on the effects of imprisonment on the family as a whole, especially in the South African context. The available research indicates there are numerous implications for the family as a whole. Some of these implications include stigma, financial stress, role changes within the family, relational problems between family members (including extended family), challenges in dealing with the criminal justice system and emotional distress (feelings of loneliness, anxiety, isolation and worry). The aim of this study was to explore and describe the changes that take place in family functioning when a member of that family is imprisoned as they are perceived by the members of the nuclear family. A qualitative description (descriptive) research approach was used in this study. Purposive sampling was used to recruit participants. Six voluntary participants (all family members of imprisoned individuals) from four families were recruited. Participants were aged between 15 and 75, consisted of one male and five females. Semi-structured interviews were used to collect data. These interviews were audio recorded and then transcribed. Initial questions for the semi-structured interviews were obtained using the McMaster Model of Family Functioning as a guiding framework. Therefore, first deductive (directed) content analysis was used, after which thematic analysis was then done on the transcribed data. From the analysis two main themes and nine subthemes emerged. It was found that participants relied more on their family members for problem solving, were generally more open-hearted and honest with their communication towards each other while limiting potentially distressing communication and they experienced changes in the roles and responsibilities within the family. Participants also reported experiencing new emotions (positive and negative) and experienced increased support, understanding and involvement from their family members. They furthermore experienced changes in behaviour control and household rules ranging from rigid to laissez-faire and often fluctuating between these. Some participants reported experiencing more support from outside the family. Participants furthermore reported feeling stigmatised and isolated within their communities. They also experienced gaining resilience and inner strength and found strength through their religious beliefs. The findings of this study can‟t be generalized due to the limited demographic variability and small sample size. Limited research is available regarding the changes in family functioning after the imprisonment of a family member in the family as a whole, especially in the South African context. The identification of religion and resilience (as subthemes identified from the data) as they relate to coping is probably the most important contribution of this study as it is not discussed in any of the models of family functioning mentioned in this study, including the McMaster Model of Family Functioning. It is recommended that further research focus on both resilience and religion as they relate to coping and possibly contribute to family functioning after the imprisonment of a family member. It is furthermore suggested that specific intervention programs be developed to help families function effectively after the imprisonment of a family member. These intervention programs might include group work with different families or working with individual families either with skills development, psycho-education or therapeutically. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2015
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Cognitive and emotional functioning in BEDKittel, Rebekka, Brauhardt, Anne, Hilbert, Anja 21 June 2016 (has links) (PDF)
Objective: Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating and is associated with eating disorder and general psychopathology and overweight/obesity. Deficits in cognitive and emotional functioning for eating disorders or obesity have been reported. However, a systematic review on cognitive and emotional functioning for individuals with BED is lacking.
Method: A systematic literature search was conducted across three databases (Medline, PubMed, and PsycINFO). Overall, n = 57 studies were included in the present review.
Results: Regarding cognitive functioning, individuals with BED consistently demonstrated higher information processing biases compared to obese and normal-weight controls in the context of disorder-related stimuli (i.e., food and body cues), whereas cognitive functioning in the context of neutral stimuli appeared to be less affected. Thus, results suggest disorder-related rather than general difficulties in cognitive functioning in BED. With respect to emotional functioning, individuals with BED reported difficulties similar to individuals with other eating disorders, with a tendency to show less severe difficulties in some domains. In addition, individuals with BED reported greater emotional deficits when compared to obese and normal-weight controls. Findings suggest general difficulties in emotional functioning in BED. Thus far, however, investigations of emotional functioning in disorder-relevant situations are lacking.
Discussion: Overall, the cross-sectional findings indicate BED to be associated with difficulties in cognitive and emotional functioning. Future research should determine the nature of these difficulties, in regards to general and disorder-related stimuli, and consider interactions of both domains to foster the development and improvement of appropriate interventions in BED.
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Vers une compréhension fonctionnelle des dépérissements forestiers : étude du cas du hêtre (Fagus sylvatica L.) en forêt de Fontainebleau / Towards a functional understanding of forest decline : a case study on beech (Fagus sylvatica L.) in the Fontainebleau forestDelaporte, Alice 22 September 2015 (has links)
Les dépérissements forestiers rapportés dans la littérature ont fortement augmenté durant la dernière décennie. Si cette augmentation semble attribuable au moins en partie aux changements globaux, les mécanismes écophysiologiques sous jacents restent encore mal connus. La littérature sur ce sujet a initialement permis de dégager deux principales hypothèses sur les mécanismes fonctionnels à l’œuvre lors d’un dépérissement : un manque de réserves carbonées et un dysfonctionnement du système hydraulique. Ces deux hypothèses ne sont pas mutuellement exclusives, ni exhaustives : les fonctionnements carboné et hydraulique interagissent à de multiples niveaux, et une implication du cycle interne de l’azote n’est pas à exclure. L’objectif principal de cette thèse est de documenter les mécanismes écophysiologiques à l’œuvre dans un dépérissement de hêtres (Fagus sylvatica L.) matures en forêt de Fontainebleau, lié principalement à des sécheresses répétées. Le dépérissement a ici été étudié en dehors de fortes contraintes climatiques. Ce sont donc majoritairement des arrières-effets de stress passés qui ont été renseignés. Au cours de ce travail, une approche intégrant des aspects hydraulique, carboné et azoté du fonctionnement du système arbre-sol a été adoptée afin de développer une vision intégrée de l’impact du dépérissement sur les grandes fonctions de l’arbre. Le transfert de composés de l’arbre vers le sol via la rhizodéposition a également été pris en compte. En dehors de périodes de stress, le fonctionnement des arbres sains et dépérissants à l’échelle de l’organe est similaire, à l’exception d’une diminution de la croissance radiale du tronc chez les arbres dépérissants. Au niveau du tronc, la croissance radiale apparait donc comme la variable d’ajustement des arbres dépérissants à une assimilation de carbone diminuée du fait de la détérioration de l’état de santé du houppier. Suite à une contrainte hydrique modérée, les arbres dépérissants présentent un déficit en réserves carbonées par rapport aux arbres sains dans certains organes. Ce déficit se trouve compensé après une année favorable. Une forte résilience des concentrations en réserves carbonées pourrait expliquer la capacité des arbres dépérissants à survivre de nombreuses années avec un houppier très endommagé. Des différences de proportion et de structure des rayons ligneux détectées entre les arbres sains et dépérissants laissent entrevoir l’intérêt qu’aurait dans le futur l’étude de caractéristiques anatomiques fonctionnelles dans le xylème. De plus, une approche rétrospective grâce aux cernes permettrait d’affiner notre compréhension de la mise en place du dépérissement à long terme. Par ailleurs, une étude actuellement en cours sur la structure des communautés microbiennes de la rhizosphère devrait permettre de compléter notre connaissance de l’impact du dépérissement sur les relations arbre-sol. / The cases of forest decline reported in the literature have strongly increased during the last decade. This increase seems at least in part attributable to global change. However, the ecophysiological mechanisms underlying tree declines remain poorly understood. Two main hypotheses initially emerged from the recent literature: a deficit of carbon reserve compounds, or a failure of the hydraulic system of the tree. These hypotheses are not mutually exclusive, nor exhaustive: multiple couplings exist between the carbon and hydraulic functionings, and the internal nitrogen cycle of the trees could also be involved in tree decline. The main objective of this work was to document the ecophysiological mechanisms underlying a case of mature beech (Fagus sylvatica L.) drought-related decline in the Fontainebleau state forest. The decline was studied under non extreme climatic conditions. Therefore, we documented maily after-effects of past stresses. In this thesis, we developed an approach integrating the hydraulic, carbon and nitrogen aspects of functioning of the tree-soil system. The transfer of carbon compounds from tree roots to soil via the rhizodeposition process was also taken into account. Under non-stressful conditions, the functioning of healthy and declining trees is similar at the organ level, apart from a decreased stem radial growth in declining trees. In the trunk, radial growth thus appears to be the “adjustment variable” of declining trees in response to a lower whole-tree carbon assimilation due to their severely thinned crowns. Our results show that after a moderate hydric constraint, declining trees show a carbon reserve deficit in some organs compared to healthy trees. This deficit is compensated after a favourable year. A high resilience of carbon reserve concentrations could explain the ability of declining trees to survive for several years with a strongly reduced whole-tree leaf area. Healthy and declining trees presented different parenchyma ray proportions and structures in the stem xylem. Therefore, it could be interesting to study functional anatomical features in the future. Besides, tree rings characteristics could offer an insightful retrospective view of the history of this decline. Furthermore, an ongoing study on the structure of the microbial communities in the rhizosphere of healthy and declining trees will improve our knowledge about the impact of tree decline on the tree-soil interactions.
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Model za donošenje odluka u procesima prepoznavanja tipa funkcije pouzdanosti brodskih postrojenja / The Model for Decision Making in Recognition Process of Reliabilitu Funcition Type in Ship FacilitiesTomašević Marko 03 July 2007 (has links)
<p style="text-align: justify">Doktorska disertacija se bavi aktuelnom problematikom donošenja odluka u procesu prepoznavanja tipa funkcije pouzdanosti brodskih postrojenja. U uvodnom delu doktorata objašnjeni su motivi za rad na doktorskoj disertaciji. Motivacija je proizašla iz nastojanja da se unapredi teorija i praksa donošenja odluka u prepoznavanju tipa funkcije pouzdanosti brodskih postrojenja, koja se zasniva na analitič kim i matematič ko-statistič ikim metodama. Pristup za rešavanje tog problema, koji je predložen u doktoratu, svodi se na teorijsku analizu radova i tehnologija, kao i na primenu sistemske dinamike i simulacione tehnologije u eksploatacionom istraž ivanju, a koje se bave problematikom klasifikacije signala sa pragom za donošenje odluka o pouzdanosti brodskih postrojenja. To je uzrokovalo da se autor ove disertacije bavi istraživanjem novih metoda koje se mogu primeniti u oblasti pouzdanosti brodskih postrojenja. U doktoratu su razvijeni matematički i verbalni modeli ponašanja sistema pomoću signala na izlazu sistema za nekoliko slučajeva. U zaključku disertacije sistematično se interpretiraju rezultati istraživanja, potvrđuju hipoteze i komentarišu teorijska i praktična rešenja, daje se pregled mogućnosti daljih istraživanja rešenja koja su predložena disertacijom. Na primeru merenih i separiranih signala eksperimentalno, pomoću simulacione metodologije i sistemske dinamike, verifikovana je hipoteza statistič ke nezavisnosti izvornih signala. Sintezom teorijskih i analitičkih saznanja i numerički potkrepljenim praktič nim rezultatima (simulacijama), težilo se osmišljavanju preporuka za usklađivanje procesa donošenja odluka na bazi prepoznavanja oblika pouzdanosti sa ukupnom sigurnošću brodskih postrojenja, na način kako se do sada nije činilo.</p> / <p>This doctoral thesis deals with up-to-date problems related to decision making in the<br />process of recognizing forms of reliability of marine plants. Marine propulsion plant is very<br />complex and includes a set of interrelated and dependent subsystems with a large number of<br />components. The reliability and availability of such complex system depends on reliability of its<br />all components.<br />In the introductory part motives for work on this thesis are explained. Motivation has<br />come out of intention to develop the theory and practice of decision making in recognizing forms<br />of reliability of marine plants based on analytical and mathematical-statistical methods. The<br />approach to solving the problem, that is proposed in the thesis, corresponds to the theoretical<br />analysis of works and technologies as well as to the application of system dynamics and<br />simulation technology in exploitation research that again deal with the problems of classification<br />of signals with the level of decision making on the reliability of marine plants. The above<br />mentioned has lead the author to devote himself to researching new methods that can be applied<br />in the field of reliability of marine plants. The thesis presents developed mathematical and verbal<br />models of system behaviour with the use of signals observed at the system output for several<br />cases. In the conclusion of the thesis results of the research are systematically interpreted,<br />hypotheses are proved and theoretical and practical solutions commented on. Furthermore, a<br />range of possibilities for further research of solutions proposed in the thesis are presented. On the<br />example of measured and separated signals the hypothesis of statistical independence of original<br />signals has been verified experimentally using simulation methodology and system dynamics.<br />Synthesis of theoretical and analytical newly gained knowledge and numerically supported<br />practical results (simulations) have been used with the aim to reach reccomendations for<br />matching the process of decision making based on recognizing forms of reliability with total<br />safety of marine plants in a manner not used so far.</p>
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Comparison of physical activity questionnaires for the elderly with the International Classification of Functioning, Disability and Health (ICF)Eckert, Katharina G., Lange, Martin A. 14 March 2015 (has links) (PDF)
Background: Physical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels. Most PAQ are derived from an energy expenditure-based perspective and assess activities with a certain intensity level. Activities with a moderate or vigorous intensity level are predominantly used to determine a person’s
PA level in terms of quantity. Studies show that the time spent engaging in moderate and vigorous intensity PA does not appropriately reflect the actual PA behavior of older people because they perform more functional, everyday activities. Those functional activities are more likely to be considered low-intense and represent an important qualitative health-promoting activity. For the elderly, functional, light intensity activities are of special interest but are assessed
differently in terms of quantity and quality. The aim was to analyze the content of PAQ for the elderly.
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Subjective Cognitive Complaints in the Working Population : The Influence of Objective Cognitive Functioning and Working ConditionsStenfors, Cecilia U. D. January 2013 (has links)
Cognitive functioning is important for managing work and life in general. However, subjective cognitive complaints (SCC), involving self-perceived difficulties with concentration, memory, decision making, and clear thinking are common in the general and in the working population and can be coupled with both lowered well-being and work ability. The present thesis investigated the extent to which SCC among people in the work force can be explained by objective cognitive functioning (study I & II) and working conditions (study III), utilizing samples from the working population. The potential roles of other common psychological problems which often co-occur with SCC were also investigated in studies I-III. In Study I, high levels of SCC were associated with significantly poorer episodic memory performance during high executive demands and a trend was found towards poorer episodic memory, while not being associated with semantic memory. In Study II, high levels of SCC were associated with significantly poorer executive cognitive performance on all three executive cognitive tests used. Symptoms of depression, chronic stress and sleeping problems were found to play an important role in the relations between SCC and episodic memory during divided attention in study I and executive cognitive functioning in study II. In Study III, in all cross-sectional data analyses, high quantitative demands, information and communication technology (ICT) demands, underqualification in the work situation and inter-personal conflicts were positively associated with SCC, whereas social support, good resources at work and overqualification in the work situation were negatively associated with SCC. In all prospective data analyses, quantitative job demands, ICT demands and underqualification were positively associated with future SCC, including when adjusted for baseline cognitive complaints. The findings may guide prevention of and interventions for SCC among people in the work force. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Submitted. Paper 2: Accepted.</p>
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Avaliação da funcionalidade em pacientes adultos com transtornos alimentaresMoser, Carolina Meira January 2011 (has links)
Introdução: O uso de questionários auto-aplicáveis para avaliar o prejuízo da funcionalidade em indivíduos com Transtornos Alimentares (TAs) apresenta importantes limitações devido à natureza egossintônica dos sintomas, particularmente na anorexia nervosa (AN) do subtipo restritivo. A Functioning Assessment Short Test (FAST) pode ser um instrumento útil para a avaliação dessa população, uma vez que é pontuada pelo entrevistador e abrange diversos aspectos da funcionalidade em pacientes psiquiátricos. Objetivo: O objetivo do presente estudo foi comparar a funcionalidade de pacientes com TA de subtipos restritivo e purgativo através da escala FAST. Também analisamos as propriedades psicométricas da FAST nesta população específica. Método: Uma amostra consecutiva de 36 mulheres com diagnóstico de anorexia nervosa, bulimia nervosa ou síndromes parciais, de acordo com critérios do DSM-IVTR, e 29 controles saudáveis foram incluídas. As pacientes foram agrupadas, de acordo com presença de sintomas purgativos, em grupo restritivo (RP) e grupo purgativo (PP) de TA. A funcionalidade foi avaliada através da FAST e da Global Assessment of Functioning Scale (GAF). Os sintomas específicos de TA foram aferidos com as escalas Eating Attitudes Test (EAT), Bulimic Investigatory Test of Edinburgh (BITE) e Body Shape Questionnaire (BSQ). Também foram aplicadas a Symptom Checklist-90 (SCL- 90) e a Hamilton Depression Rating Scale (17-HDRS). Resultados: A média dos escores totais da FAST na população de pacientes em estudo foi significativamente maior (41.62± 13.94) que a encontrada em indivíduos do grupo controle (8.14± 5.02) em todos os domínios (p<0.001), mesmo após controle para variáveis de confusão com modelo de regressão linear múltipla. Não houve diferença nos escores totais da FAST, nem em suas subescalas, entre as pacientes de subtipo restritivo (39.70 ± 15.96) e subtipo purgativo de TA (43.54 ± 11.92) (p= 0.44). No entanto, na área de finanças, o grupo RP não foi diferente dos controles. O alfa de Cronbach da FAST na amostra foi de 0.865 e a correlação entre a FAST e a GAF foi forte (r = -0.92, p <0.01). Conclusão: A avaliação da funcionalidade em pacientes com TA requer cautela. A FAST parece ser um instrumento útil para isto, uma vez que avalia domínios específicos do funcionamento, identifica o nível de prejuízo em cada área e não é autoaplicável. Com esta avaliação objetiva, o grupo de TA de subtipo restritivo apresentou prejuízo no funcionamento global semelhante ao encontrado no subtipo purgativo. / Introduction: The use of self-report questionnaires in people with eating disorders (EDs) has limitations derived from egosyntonic nature of symptoms, particularly in restrictive type of anorexia nervosa (AN). In this context, the Functioning Assessment Short Test (FAST) is an interviewer scored scale that covers several aspects of functionality in psychiatric patients, and therefore could be a useful instrument for evaluation of individuals with EDs. Objective: To examine functionality of restrictive and purgative subtypes of eating disorders’ (ED) patients with Functioning Assessment Short Test (FAST) and its psychometric properties in this population. Method: A consecutive sample of 36 adult female patients with diagnosis of ED, according to DSM-IV-TR, and 29 healthy controls were included. Patients were divided into restrictive (RP) and purgative (PP) groups according to presence of purgative symptoms. Functioning was assessed by the FAST and the Global Assessment of Functioning Scale (GAF) instruments. ED’s symptoms were evaluated with Eating Attitudes Test (EAT), Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ). We also used Symptom Checklist-90 (SCL-90) and Hamilton Depression Rating Scale (17-HDRS). Results: The mean scores of FAST show that purgative and restrictive groups of ED patients together scored significantly higher (41.62± 13.94) than controls (8.14± 5.02) on all domains (p<0.001), even after controlling for possible confounding factors with multiple linear regression model. No differences were found on total and subscales scores of FAST between restrictive (39.70 ± 15.96) and purgative (43.54 ± 11.92) groups (p= 0.44). However RP group did not differ from controls in finances domain. The Cronbach’s alpha of FAST for the total sample was 0.865 and correlation between FAST and GAF (r = -0.92, p <0.01) was strong. Conclusion: FAST scale appears to be a useful instrument that assesses specific domains of functioning, identifies level of disability in each area and is not self-reported. With this objective evaluation restrictive and purgative subtypes of ED presented similar global impairment.
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Avaliação da funcionalidade em pacientes adultos com transtornos alimentaresMoser, Carolina Meira January 2011 (has links)
Introdução: O uso de questionários auto-aplicáveis para avaliar o prejuízo da funcionalidade em indivíduos com Transtornos Alimentares (TAs) apresenta importantes limitações devido à natureza egossintônica dos sintomas, particularmente na anorexia nervosa (AN) do subtipo restritivo. A Functioning Assessment Short Test (FAST) pode ser um instrumento útil para a avaliação dessa população, uma vez que é pontuada pelo entrevistador e abrange diversos aspectos da funcionalidade em pacientes psiquiátricos. Objetivo: O objetivo do presente estudo foi comparar a funcionalidade de pacientes com TA de subtipos restritivo e purgativo através da escala FAST. Também analisamos as propriedades psicométricas da FAST nesta população específica. Método: Uma amostra consecutiva de 36 mulheres com diagnóstico de anorexia nervosa, bulimia nervosa ou síndromes parciais, de acordo com critérios do DSM-IVTR, e 29 controles saudáveis foram incluídas. As pacientes foram agrupadas, de acordo com presença de sintomas purgativos, em grupo restritivo (RP) e grupo purgativo (PP) de TA. A funcionalidade foi avaliada através da FAST e da Global Assessment of Functioning Scale (GAF). Os sintomas específicos de TA foram aferidos com as escalas Eating Attitudes Test (EAT), Bulimic Investigatory Test of Edinburgh (BITE) e Body Shape Questionnaire (BSQ). Também foram aplicadas a Symptom Checklist-90 (SCL- 90) e a Hamilton Depression Rating Scale (17-HDRS). Resultados: A média dos escores totais da FAST na população de pacientes em estudo foi significativamente maior (41.62± 13.94) que a encontrada em indivíduos do grupo controle (8.14± 5.02) em todos os domínios (p<0.001), mesmo após controle para variáveis de confusão com modelo de regressão linear múltipla. Não houve diferença nos escores totais da FAST, nem em suas subescalas, entre as pacientes de subtipo restritivo (39.70 ± 15.96) e subtipo purgativo de TA (43.54 ± 11.92) (p= 0.44). No entanto, na área de finanças, o grupo RP não foi diferente dos controles. O alfa de Cronbach da FAST na amostra foi de 0.865 e a correlação entre a FAST e a GAF foi forte (r = -0.92, p <0.01). Conclusão: A avaliação da funcionalidade em pacientes com TA requer cautela. A FAST parece ser um instrumento útil para isto, uma vez que avalia domínios específicos do funcionamento, identifica o nível de prejuízo em cada área e não é autoaplicável. Com esta avaliação objetiva, o grupo de TA de subtipo restritivo apresentou prejuízo no funcionamento global semelhante ao encontrado no subtipo purgativo. / Introduction: The use of self-report questionnaires in people with eating disorders (EDs) has limitations derived from egosyntonic nature of symptoms, particularly in restrictive type of anorexia nervosa (AN). In this context, the Functioning Assessment Short Test (FAST) is an interviewer scored scale that covers several aspects of functionality in psychiatric patients, and therefore could be a useful instrument for evaluation of individuals with EDs. Objective: To examine functionality of restrictive and purgative subtypes of eating disorders’ (ED) patients with Functioning Assessment Short Test (FAST) and its psychometric properties in this population. Method: A consecutive sample of 36 adult female patients with diagnosis of ED, according to DSM-IV-TR, and 29 healthy controls were included. Patients were divided into restrictive (RP) and purgative (PP) groups according to presence of purgative symptoms. Functioning was assessed by the FAST and the Global Assessment of Functioning Scale (GAF) instruments. ED’s symptoms were evaluated with Eating Attitudes Test (EAT), Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ). We also used Symptom Checklist-90 (SCL-90) and Hamilton Depression Rating Scale (17-HDRS). Results: The mean scores of FAST show that purgative and restrictive groups of ED patients together scored significantly higher (41.62± 13.94) than controls (8.14± 5.02) on all domains (p<0.001), even after controlling for possible confounding factors with multiple linear regression model. No differences were found on total and subscales scores of FAST between restrictive (39.70 ± 15.96) and purgative (43.54 ± 11.92) groups (p= 0.44). However RP group did not differ from controls in finances domain. The Cronbach’s alpha of FAST for the total sample was 0.865 and correlation between FAST and GAF (r = -0.92, p <0.01) was strong. Conclusion: FAST scale appears to be a useful instrument that assesses specific domains of functioning, identifies level of disability in each area and is not self-reported. With this objective evaluation restrictive and purgative subtypes of ED presented similar global impairment.
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Avaliação da funcionalidade em pacientes adultos com transtornos alimentaresMoser, Carolina Meira January 2011 (has links)
Introdução: O uso de questionários auto-aplicáveis para avaliar o prejuízo da funcionalidade em indivíduos com Transtornos Alimentares (TAs) apresenta importantes limitações devido à natureza egossintônica dos sintomas, particularmente na anorexia nervosa (AN) do subtipo restritivo. A Functioning Assessment Short Test (FAST) pode ser um instrumento útil para a avaliação dessa população, uma vez que é pontuada pelo entrevistador e abrange diversos aspectos da funcionalidade em pacientes psiquiátricos. Objetivo: O objetivo do presente estudo foi comparar a funcionalidade de pacientes com TA de subtipos restritivo e purgativo através da escala FAST. Também analisamos as propriedades psicométricas da FAST nesta população específica. Método: Uma amostra consecutiva de 36 mulheres com diagnóstico de anorexia nervosa, bulimia nervosa ou síndromes parciais, de acordo com critérios do DSM-IVTR, e 29 controles saudáveis foram incluídas. As pacientes foram agrupadas, de acordo com presença de sintomas purgativos, em grupo restritivo (RP) e grupo purgativo (PP) de TA. A funcionalidade foi avaliada através da FAST e da Global Assessment of Functioning Scale (GAF). Os sintomas específicos de TA foram aferidos com as escalas Eating Attitudes Test (EAT), Bulimic Investigatory Test of Edinburgh (BITE) e Body Shape Questionnaire (BSQ). Também foram aplicadas a Symptom Checklist-90 (SCL- 90) e a Hamilton Depression Rating Scale (17-HDRS). Resultados: A média dos escores totais da FAST na população de pacientes em estudo foi significativamente maior (41.62± 13.94) que a encontrada em indivíduos do grupo controle (8.14± 5.02) em todos os domínios (p<0.001), mesmo após controle para variáveis de confusão com modelo de regressão linear múltipla. Não houve diferença nos escores totais da FAST, nem em suas subescalas, entre as pacientes de subtipo restritivo (39.70 ± 15.96) e subtipo purgativo de TA (43.54 ± 11.92) (p= 0.44). No entanto, na área de finanças, o grupo RP não foi diferente dos controles. O alfa de Cronbach da FAST na amostra foi de 0.865 e a correlação entre a FAST e a GAF foi forte (r = -0.92, p <0.01). Conclusão: A avaliação da funcionalidade em pacientes com TA requer cautela. A FAST parece ser um instrumento útil para isto, uma vez que avalia domínios específicos do funcionamento, identifica o nível de prejuízo em cada área e não é autoaplicável. Com esta avaliação objetiva, o grupo de TA de subtipo restritivo apresentou prejuízo no funcionamento global semelhante ao encontrado no subtipo purgativo. / Introduction: The use of self-report questionnaires in people with eating disorders (EDs) has limitations derived from egosyntonic nature of symptoms, particularly in restrictive type of anorexia nervosa (AN). In this context, the Functioning Assessment Short Test (FAST) is an interviewer scored scale that covers several aspects of functionality in psychiatric patients, and therefore could be a useful instrument for evaluation of individuals with EDs. Objective: To examine functionality of restrictive and purgative subtypes of eating disorders’ (ED) patients with Functioning Assessment Short Test (FAST) and its psychometric properties in this population. Method: A consecutive sample of 36 adult female patients with diagnosis of ED, according to DSM-IV-TR, and 29 healthy controls were included. Patients were divided into restrictive (RP) and purgative (PP) groups according to presence of purgative symptoms. Functioning was assessed by the FAST and the Global Assessment of Functioning Scale (GAF) instruments. ED’s symptoms were evaluated with Eating Attitudes Test (EAT), Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ). We also used Symptom Checklist-90 (SCL-90) and Hamilton Depression Rating Scale (17-HDRS). Results: The mean scores of FAST show that purgative and restrictive groups of ED patients together scored significantly higher (41.62± 13.94) than controls (8.14± 5.02) on all domains (p<0.001), even after controlling for possible confounding factors with multiple linear regression model. No differences were found on total and subscales scores of FAST between restrictive (39.70 ± 15.96) and purgative (43.54 ± 11.92) groups (p= 0.44). However RP group did not differ from controls in finances domain. The Cronbach’s alpha of FAST for the total sample was 0.865 and correlation between FAST and GAF (r = -0.92, p <0.01) was strong. Conclusion: FAST scale appears to be a useful instrument that assesses specific domains of functioning, identifies level of disability in each area and is not self-reported. With this objective evaluation restrictive and purgative subtypes of ED presented similar global impairment.
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