Made available in DSpace on 2016-04-28T20:38:45Z (GMT). No. of bitstreams: 1 Flavia Bello Costa de Souza.pdf: 1163790 bytes, checksum: de1777fe7780efee89ef9a4b712fd308 (MD5) Previous issue date: 2013-10-25 / Violence against women affects thousands of victims, regardless of age, culture and socioeconomic status. It is a public health problem with far-reaching consequences, both physical and psychological, which may be long-lasting. One type of sexual violence is rape. This qualiquantitative research aims at understanding the emotional consequences of a rape episode in a woman s life, as well as investigating the occurrence of post-traumatic stress disorder (PTSD), depression and self-esteem levels, and their correlation with sociodemographic data, specific characteristics of a rape and feelings of shame and guilt. Interviews were conducted with 37 women victims of rape under medical treatment at the Public Health Service in Perola Byington Hospital, São Paulo, Brazil. The instruments used were a semi-structured interview script, the Post-Traumatic Stress Disorder Checklist Civilian Version PCL-C (BERGER et al., 2004), the Beck Depression Inventory BDI (CUNHA, 2011) and the Rosenberg Self-Esteem Scale (DINI et al., 2004). Based on the compiled data, among other factors the study detected a significant statistical correlation between levels of depression and the presence of PTSD. Results indicated that the rape episode had effects such as sleep quality alterations, increased sense of fear of having contracted some disease, concern on being judged by others, difficulties in interpersonal relationships and negative impact on sexual life quality, apart from shame, guilt and negative self-perception of themselves and their bodies. In contrast, familiar, social and religious support and acceptance as well as individual behaviors of resilience proved to be positive and protective factors as regards to the victims / A violência contra a mulher atinge milhares de vítimas, independente de faixa etária, cultura e nível socioeconômico. É um problema de saúde pública com amplas consequências, tanto físicas quanto psicológicas, e que podem ser duradouras. Uma forma de violência sexual é o estupro. Esta pesquisa, de natureza qualiquantitativa, busca compreender as consequências emocionais de um episódio de estupro na vida de uma mulher adulta, bem como investigar a presença do transtorno do estresse pós-traumático (TEPT), depressão e níveis de autoestima, e suas correlações com dados sociodemográficos, características específicas do estupro e sentimentos de vergonha e culpa. Foram entrevistadas 37 mulheres vítimas de estupro sob tratamento médico no Serviço de Saúde Pública do Hospital Pérola Byington, na cidade de São Paulo, Brasil. Os instrumentos utilizados foram um roteiro de entrevista semiaberta, a escala Post-Traumatic Stress Disorder Checklist Civilian Version PCL-C (BERGER et al., 2004), o Inventário de Depressão Beck BDI (CUNHA, 2011) e a Escala de Autoestima de Rosenberg (DINI et al., 2004). Com base nos dados compilados foi observada, entre outros fatores, correlação estatística significativa entre os níveis de depressão e a presença do TEPT. Os resultados indicaram que o episódio de estupro refletiu-se em alterações na qualidade do sono, aumento da sensação de medo de ter contraído alguma doença, medo da reação e julgamento alheios, dificuldade nas relações interpessoais, impacto negativo na qualidade da vida sexual, além de vergonha, culpa e autopercepção negativa sobre si e sobre o próprio corpo. Em contrapartida, o apoio e o acolhimento familiar, social e religioso, assim como comportamentos individuais de resiliência, revelaram-se como fatores positivos e protetores em relação às vítimas

Posttraumatic stress disorder, or PTSD, is associated with enduring and profound impairments affecting emotional stability and the ability to perform fundamental activities. In our VA tinnitus clinic population, more than 35% of the patients carry the diagnosis. Perhaps of greater concern, PTSD is generally acknowledged to be substantially underreported among children (Herman, 1997). Individuals with PTSD experience disruptions to a variety of life functions, intrusive memories, and other powerful symptoms. Functional and emotional consequences of trauma are measured using a variety of handicap scales, and several physiological measures such as EEG and EKG are altered by the effects of trauma. Additionally, fMRI and PET scans reveal enduring changes to neural structures such as the hippocampus following exposure to traumatic events (Bremner, 2002). In this eAudiology Web seminar, we will stress that PTSD should be viewed as a psychological injury; the trauma-provoked physiologic changes that influence not only an individual's to function, but also their ability to obtain benefit from medical care. This presentation will also review the history of the PTSD diagnosis and identify specific elements of the injury that are of significance to audiologists.

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Objective: Individuals with tinnitus and co-occurring psychological conditions typically rate their tinnitus as more disturbing than individuals without such comorbidities. Little is known about how tinnitus self-efficacy, or the confidence that individuals have in their abilities to successfully manage the effects of tinnitus, is influenced by mental or psychological health (PH) status. The purpose of this study was to examine the influence of psychological state on tinnitus perceptions and tinnitus self-efficacy in individuals with chronic tinnitus. Design: Observational study. Three groups (N = 199) were examined and included: (1) those with tinnitus without a concurrent psychological condition (tinnitus-only; n = 103), (2) those with tinnitus and concurrent PH condition other than post-traumatic stress disorder (PTSD; tinnitus + PH; n = 34), and (3) those with tinnitus and PTSD (tinnitus + PTSD; n = 62). The Self-Efficacy for Tinnitus Management Questionnaire (SETMQ) was administered. Responses on the SETMQ were compared among the groups, as well as to other indicators of tinnitus perception such as (1) the percentage of time tinnitus was audible (tinnitus awareness), (2) the percentage of time tinnitus was distressing/bothersome, (3) tinnitus loudness, (4) tinnitus handicap inventory scores, (5) subjective ratings of degree of hearing loss, and (6) subjective ratings of sound tolerance problems. Results: The tinnitus + PTSD group reported significantly poorer tinnitus self-efficacy levels on average than the tinnitus-only group on all SETMQ subscales and poorer self-efficacy levels than the tinnitus + PH group for most subscales (except for routine management and devices). Tinnitus self-efficacy levels were similar between the tinnitus + PH and tinnitus-only groups except for the emotional response subscale in which the tinnitus-only patients reported higher self-efficacy on average than both the other groups. Group differences were not seen for tinnitus loudness ratings nor for the amount of time individuals were aware of their tinnitus. Group differences were observed for the percentage of time tinnitus was distressing/bothersome, self-reported degree of hearing loss, sound tolerance problems ratings, and responses on the tinnitus handicap inventory (THI). In general, the group differences revealed patient ratings for the tinnitus-only group were least severe, followed by the tinnitus + PH group, and the tinnitus + PTSD group rated tinnitus effects as most severe. With all patient responses, the tinnitus + PTSD group was found to be significantly more affected by tinnitus than the tinnitus-only group; in some cases, the responses were similar between the tinnitus + PTSD and tinnitus + PH group and in other cases, responses were similar between the tinnitus + PH group and the tinnitus-only group. Conclusions: Tinnitus self-efficacy, along with other self-assessed tinnitus characteristics, varied across groups distinguished by PH diagnoses. In general, individuals with tinnitus and concurrent PTSD reported significantly poorer tinnitus self-efficacy and more handicapping tinnitus effects when compared to individuals with other psychological conditions or those with tinnitus alone. The group differences highlighted the need to consider tinnitus self-efficacy in intervention strategies, particularly for patients with tinnitus and concurrent PTSD as the results reiterated the unique ability of PTSD to interact in powerful and disturbing ways with the tinnitus experience and with patients’ coping ability.

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Abstract available in Audiofonologia.

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