This study investigated how therapists working with children and youth victims of interpersonal trauma (e.g. sexual abuse) are impacted by the resilience processes of their clients. Qualitative multiple case study design and thematic analysis were used to explore the research question. Four counselors working in an organization providing services to victims of trauma were interviewed and asked about how the act of bearing witness to the resilience of their clients affected their personal lives and clinical practice. The findings showed that for the participants there was an increased sense of hope and optimism, and an intense sense of being inspired by the strengths of clients as result of working with this population. To reflect about the challenges faced by clients allowed counselors to put their own challenges and strengths into perspective. In addition, they reported positive changes in their personal relationships. Further research is suggested, including further investigation about the relationship between optimism, hope and vicarious resilience processes as well as between the counseling approach adopted and the development of vicarious resilience responses. / Graduate / 0621 / 0622 / 0347 / fabianesilveira@gmail.com

Rheumatoid arthritis (RA) is a chronic, deteriorative disease, which leads to psychological distress. &lsquo / Conservation of Resources theory (COR)&rsquo / is a relatively recent stress model, developed by Hobfoll (1988, 1989). This resource-oriented theory is based on the assumption that psychological stress is a reaction to a threat of loss of resources, loss of resources and/or lack of resource gain after investment in resources. Religiousness, coping abilities, coping self-efficacy and social support are very important personal resources, which have been found to protect individuals against psychological distress. The aim of the present study was to examine the predictive values of socio-demographic and illness related variables, religiousness, perceived social support, ways of coping, resource loss and arthritis self efficacy for both psychological distress (anxiety and depression) and posttraumatic growth (PTG) of RA patient. In addition, the COR theory was tested for a chronic debilitating illness. Data were collected by administering eight scales to one hundred and seventeen RA patients in the Rheumatology and Physical Medicine and Rehabilitation Clinics of Ankara Numune Hospital. As a result of the regression analysis, it was found that being female, fatigue, resource loss, helplessness coping and perceived social support were significant predictors of anxiety. Impact of illness on daily activities, resource loss, problem solving coping and arthritis self-efficacy were significant predictors of depression. Gender, perceived severity of the illness, perceived social support and problem solving coping were significant predictors of PTG. Perceived social support was not related to depression and total psychological distress whereas it was related to anxiety and PTG. Religiousness was not related to psychological distress and PTG. The results of the study were discussed within the relevant literature, shortcomings of the current study, clinical implications and suggestions for future research were proposed.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O presente trabalho investiga os diferentes processos sociais relacionados ao surgimento do transtorno de estresse pós-traumático (TEPT) no contexto brasileiro. Categoria diagnóstica norte-americana instituída na década de 1980 pela terceira edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (Diagnostic and Statistical Manual of Mental Disorders DSM-III) uma publicação da Associação Americana de Psiquiatria (American Psychiatric Association APA) o TEPT tornou-se, desde a sua aparição, uma das categorias nosológicas mais difundidas, estudadas e diagnosticadas da psiquiatria contemporânea. A partir do cotidiano de um laboratório de pesquisa e tratamento do TEPT, de análises conversacionais dos atendimentos médicos, de um estudo das diferentes escalas psiquiátricas utilizadas no acompanhamento dos pacientes e de pesquisas sobre a mídia relacionada às experiências traumáticas buscou-se entender os entrelaçamentos entre os processos de difusão e a construção da legitimidade da categoria diagnóstica do TEPT. A abordagem aqui proposta pretende ir além do aparente dilema entre uma concepção medicalizada que assumem a existência o TEPT como um fenômeno natural e as abordagens sócio-antropológicas que veem o TEPT como uma experiência culturalmente construída. Por fim, pretendo mostrar, pela investigação dos alicerces políticos e culturais dos denominados transtornos mentais, que o estatuto social dos diagnósticos e dos tratamentos da moderna psiquiatria só pode ser compreendido tendo como referência as dinâmicas de longo prazo nas sociedades contemporâneas. / This dissertation examines the social processes related to the reception of the Post Traumatic Stress Disorder (PTSD) in Brazil. Originating in the United States during the 1980, this diagnostic category first appeared in the Diagnostic and Statistical Manual of Mental Disorders DSM-III, a publication of the American Psychiatric Association APA. It soon became one of the most studied and diagnosed syndrome of contemporary psychiatry. In order to map out the interrelated processes of diffusion and construction of PTSD I resorted to the analysis of a gamut sources: the daily operation of a research and treatment psychiatric institution, the verbal exchanges between psychiatrists and patients during medical appointments, psychiatric manuals and diagnostic tables and questionnaires, and mass media articles on PTSD. The approach adopted here intends to go beyond the apparent dilemma between a medicalized conception of PTSD as a natural phenomenon and an anthropological approach that sees PTSD as a culturally construed social experience. Finally, I also intend to show that the political and cultural underpinnings of the so called mental disorders cannot be correctly understood without taking into consideration the longue dureé dynamics of contemporary societies.

The stress response that is triggered in an organism when facing a stressor is crucial to maintain stability and health. However, exposure to a severe or a chronic stressor can be maladaptive and cause several impairments in the body, such as cardiovascular diseases, atrophy of the brain, and psychopathologies mainly characterized by anxiety and depression. Resilience or vulnerability to stress is mediated through different biopsychosocial factors, one of which is the use of coping strategies. Different types of coping strategies have been linked to either adaptive or maladaptive outcomes, and are an important factor to consider regarding stress resilience. Cultural differences in symptoms of stress, anxiety, depression, and coping strategies were assessed through self-report measurements in the form of two questionnaires. 75 Swedes and 67 Sri Lankans between the age of 18-50 took part in the study. The most significant findings of this study suggest that 1) Sri Lankans experience more symptoms of stress, anxiety, and depression compared to Swedes, 2) dysfunctional coping is correlated with higher levels of stress, anxiety, and depression in both Sweden and Sri Lanka, 3) higher levels of stress predicts higher levels of anxiety and depression in both Sweden and Sri Lanka, and 4) both countries tend to favor problem-focused coping over emotion-focused and dysfunctional coping. A discussion regarding the current findings, including limitations of the study is provided, as well as directions for future research.

This dissertation focuses on the field of psychosocial counselling intended for the people involved in traffic accidents. Traffic accidents often result in considerable whole-society damages and significant reduction in the life quality of affected individuals or their relatives. Traffic accidents may often represent nerve-racking, traumatic events which significantly go beyond the scope of common human experience. People involved in traffic accidents may suffer from mental problems which might impair an area of their social functioning. As a result, traffic accidents have significant impact not only to the lives of persons directly involved, but also to their relatives. Victims´ self-help may fail and, without the expert intervention, may lead to the whole-life misery. One of possible ways of how to help the people involved in the traffic accident is the psychosocial counselling which is the subject of this dissertation. This thesis, among others, aims to analyse the offer of psychosocial consulting services intended for traffic accident participants in the town of České Budějovice. To this end, the combination of qualitative and quantitative data collection techniques, questionnaire survey of experts and organizations and semi-standardized interviews with experts operating in České Budějovice were carried out. Other goals of the thesis included mapping of public awareness concerning the possible utilization of psychosocial counselling for traffic accident participants in České Budějovice, as well as, mapping the interest in using such services on the public{\crq}s part in this town. A public questionnaire survey was performed to reach these objectives. The findings revealed that there is a public demand for services of an organization providing the people involved in traffic accidents with psychosocial counselling. The public awareness of the possibility of using psychosocial counselling in this area, however, proved to be low in České Budějovice. The survey has also shown that the offer of psychosocial counselling focused on traffic accident participants does exist in this town. The dissertation may contribute to higher awareness of not only the professional employees who provide the assistance (psychologists, social workers, non-profit organization employees, physicians, police officers, fire fighters), students of humanities and volunteers involved in giving psychosocial assistance to the victims of disasters, but also of those people involved in traffic accidents whom anyone of us may become.

No description available.

Objectif. L’enquête Santé mentale en Population Générale a été réalisée, en 2003, par le centre collaborateur de l’OMS (CCOMS-Lille) en partenariat avec l’hôpital psychiatrique Mahfoud Boucebci (EHS-Alger). Les données portant sur le risque suicidaire sont exploitées dans le présent travail. Son objectif principal est d’étudier la relation entre le trouble de stress post-traumatique et le risque suicidaire. Méthode. Huit cent quatre-vingt-dix-neuf sujets vivant en Algérie (n=899) ont participé à cette enquête. Le Mini International Neuropsychiatric Interview (MINI) a été utilisé afin de recueillir des données relatives aux troubles mentaux. Résultats. 61 % de la population (n=548) a été exposée à des événements potentiellement « traumatisants ». La prévalence du PTSD est estimée à 13,5 % (n=121) dans l’échantillon global. 13,6 % des sujets (n=122) présentent un risque suicidaire. Aucune relation directe entre le PTSD et le risque suicidaire n’a été observée. Toutefois, le PTSD augmente significativement le risque suicidaire chez les non-pratiquants (OR=5.81 ; IC [1.948-17.328] ; p=0.001) en comparaison avec les sujets pratiquants. Le risque suicidaire est 10 fois plus élevé chez les sujets pratiquants souffrant de problème d’alcool (OR =10.26 ; IC [3.133-33.609] ; p<=0.0001). Conclusion. Cette première étude en population générale souligne la prévalence relativement élevée du risque suicidaire et de PTSD. La pratique religieuse est un élément protecteur contre les conduites suicidaires. Les résultats qui en découlent pourraient être exploités dans le but de fonder une démarche de prévention du risque suicidaire. / Objective. The Mental Health Survey on General Population was conducted in 2003 by the WHO collaborating centres in Lille (WHOCC-Lille) in partnership with the Mahfoud Boucebci psychiatric hospital (EHS-Alger). Data regarding suicidal risk are exploited in the present study. The main objective aims at studying the relationship between post traumatic stress disorder and suicidal risk.Method. Eight hundred ninety-nine subjects living in Algeria (n=899) took part in this survey. Mini International Neuropsychiatric Interview (MINI) was used to collect data related to mental disorders and suicidal behaviors. Results. 61% of the population (n=548) were exposed to « traumatic » events. PTSD prevalence is estimated to be 13.5% (n = 121) in the overall sample. 13.6% of the subjects (n = 122) present a suicidal risk. There is no direct relationship between PTSD and suicidal risk.However, PTSD significantly increases the suicidal risk in non-practising subjects (OR = 5.81, CI [1.948-17.328], p = 0.001) compared to practising subjects. Suicidal risk is 10 times higher in practising subjects suffering from alcohol problems (OR = 10.26, IC [3.133-33.609], p <= 0.0001). Conclusion. This first study in the general population highlights the relatively high prevalence of suicidal risk and PTSD. Religious practice is a protective element against suicidal behavior. These results could be exploited so that a preventive approach to suicidal risk can be put in place.

Made available in DSpace on 2015-07-22T20:49:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-11-24. Added 1 bitstream(s) on 2015-08-11T03:26:29Z : No. of bitstreams: 1 Publico-346.pdf: 373324 bytes, checksum: b15251f6022f133299360a274f5cbd73 (MD5) / Objetivo: Avaliar eficácia da Psicoterapia Interpessoal no formato de grupo (TIP-G) adaptada para o Transtorno de Estresse Pós-Traumático (TEPT) como um tratamento adjunto para pacientes refratários a medicação. Método: Foram incluídos na pesquisa 40 pacientes do Programa de Atendimento e Pesquisa em Violência (Prove) do departamento de psiquiatria da Universidade Federal de São Paulo (Unifesp). Eles receberam tratamento farmacológico convencional por pelo menos 12 semanas e não obtiveram uma resposta clínica significativa. Após a assinatura do termo de consentimento livre e esclarecido (TCLE), o diagnóstico de TEPT era confirmado através da aplicação da entrevista diagnóstica semi-estruturada (SCID-I) segundo os critérios do DSM-IV. Ao início e no final da intervenção (TIP-G TEPT) foi aplicada a Clinician Administered PTSD Scale (CAPS) para avaliar a gravidade dos sintomas, a Beck Depression Inventory (BDI) depressão, a Beck Anxiety Inventory (BAI) ansiedade, a Social Adjustment Scale (SAS) para avaliar o ajustamento social, a MOS 36-Item Short-Form Health Survey (SF-36) para avaliar a qualidade de vida, e os resultados comparados. Resultados: Dos 40 pacientes incluídos no estudo 33 completaram a intervenção e apresentaram melhora significativa em todas as mensurações, com "effect size" elevado. Os escores da CAPS [72,3 (4,4) vs 35,5(5,4) ES=1,169 p<0,0001], do BDI [26,2 (1,8) vs 13,3 (1,56) ES=1,291 p<0,0001], do BAI [31,97(2,01) vs 17,03(2,14) ES=1,201 p<0,0001, da SAS [2,6(0,12) vs 2,17(0,11) ES=0,633 p=0,0007, e da SF-36 [ 80,16(3,2) vs 104,4(4,18) ES=1,04 p<0,0001. Conclusão: A adaptação da TIP-G para o TEPT se mostrou eficaz como tratamento adjuntivo e com ótima tolerabilidade para os pacientes que não responderam ao tratamento medicamentoso, não só na diminuição dos sintomas do TEPT, mas também na diminuição dos sintomas de depressão e ansiedade. Assim como uma melhora significante no ajustamento social e qualidade de vida. Novos estudos randomizados e controlados devem ser feitos para a confirmação desses resultados. / Background: Posttraumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the “gold standard” therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT-G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of São Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, previously approved by the UNIFESP Ethics Review Board, they received a semistructured diagnostic interview (SCID-I), administered by a trained mental health worker, to confirm the presence of a-PTSD diagnosis according DSM-IV criteria. Other instruments were administered, and patients completed out selfreport instruments at baseline, and endpoint to evaluate clinical outcomes.Results: Thirty-three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT-G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. / TEDE / BV UNIFESP: Teses e dissertações

Crescimento pós-traumático (CPT) refere-se à mudança positiva em algum aspecto da experiência humana como resultado do enfrentamento de situações adversas (traumáticas ou crises de vida em geral). O objetivo geral do presente trabalho foi investigar em uma amostra brasileira as propriedades psicométricas da Versão Brasileira do Inventário de Crescimento Pós-Traumático (Brazilian Version of the Posttraumatic Growth Inventory – PTGI-B), instrumento que se propõe a mensurar CPT. Para isso, dois estudos distintos foram realizados. O Estudo I buscou investigar a estrutural fatorial do PTGI-B. Participaram dele 321 pessoas que passaram por situações adversas variadas. A estrutura fatorial do PTGI-B foi investigada através do método de análise fatorial confirmatória. Testou-se cinco diferentes modelos de estrutura fatorial. A estrutura convencional de cinco fatores apresentou melhores índices de ajuste quando comparada às demais. Além disso, o modelo de cinco fatores de primeira ordem organizados em torno de um fator geral de segunda ordem também mostrou índices de ajuste adequados. O Estudo II buscou avaliar se as evidências de validade externa da Versão Brasileira do Inventário de Crescimento Pós-Traumático (PTGI-B) são mais consistentes quando se compara os resultados de um subgrupo pontuou alto na Escala de Centralidade de Eventos (ECE) versus os resultados do subgrupo que pontuou baixo na ECE - que avalia em que medida o evento de referência contribuiu na formação da identidade dos indivíduos. Participaram do estudo 317 pessoas que passaram por situações adversas variadas. Investigou-se a relação entre crescimento pós-traumático, suporte social, sentido de vida, satisfação com a vida, religiosidade e desajuste psicológico. As correlações entre CPT e as demais variáveis de interesse mostraram-se maiores e mais coerentes no subgrupo que pontuou alto na ECE do que no subgrupo que pontuou baixo. Os resultados obtidos fortalecem a concepção de que apenas eventos que levam a uma reavaliação das crenças centrais dos indivíduos devem ser incluídos nos estudos de CPT. / Posttraumatic growth (PTG) refers to the positive change in some aspect of the human experience as a result of facing adverse situations (traumatic or general life crisis). The main goal of the present study was to investigate the psychometric properties of the Brazilian Version of the Posttraumatic Growth Inventory (PTGI-B). To address this purpose, two distinct studies were performed. Study I was aimed to investigate the factor structure of the PTGI-B. It involved 321 people who had been through a wide range of adverse situations. The factorial structure of the PTGI was investigated using the method of confirmatory factorial analysis. Five different models of factorial structure were tested. The conventional five factor structure presented better adjustment indices when compared to the others. However, the factorial structure of five first order factors organized around a second order global PTG factor was also adequate. Study II intended to assess whether evidence of the external validity of the Brazilian Version of the Post Traumatic Growth Inventory (PTGI-B) is more consistent when considering the events in which individuals scored high versus individuals who scored low on the Centrality of Events Scale (ECE). The ECE assesses to what extent the reference event contributed to the formation of individuals' identity. A total of 317 people who had been through a variety of adverse events participated in the study. It was investigated the relationship between posttraumatic growth, social support, meaning in life, life satisfaction, religiosity and psychological distress. The correlations between PTGI-B scores and the other variables of interest became larger and more theoretically coherent in the subgroup that scored high in ECE than in the subgroup that scored low. The results obtained strengthen the conception that only events that lead to a reassessment of individuals’ central beliefs should be included in the PTG studies.