Na Psicossomática, dentro do modelo biopsicossocial, entende-se que respostas psicológicas a condições de vida podem interagir com fatores somáticos existentes, alterando a susceptibilidade e manifestação da doença, o que se mostra evidente nas somatizações, como na Síndrome do Intestino Irritável (SII), onde há alteração da motilidade intestinal e no formato das fezes, acompanhada de dores abdominais. O funcionamento mental associado às somatizações, no qual a pessoa apresenta dificuldade em relacionar o adoecimento com seu universo psicológico, é que a capacidade de simbolização, ou seja, a construção de representações mentais para o alívio do estado emocional, é afetada, cronificando as alterações fisiológicas correspondentes. O objetivo da pesquisa foi verificar se o atendimento clínico psicológico, baseado na técnica da Psicoterapia Breve Operacionalizada (PBO), com ênfase na promoção da capacidade de simbolização em relação a determinadas questões significativas, pode contribuir para a melhora dos sintomas no quadro clínico de pacientes com SII. O método utilizado na pesquisa foi o clínico-qualitativo, a partir do estudo de caso de duas pacientes adultas, com o diagnóstico principal de transtorno neurovegetativo somatoforme, portadoras de SII. A intervenção psicológica foi estruturada em três fases: 1) psicodiagnóstico, composto por entrevista semi-dirigida, Sistema Diagnóstico Adaptativo Operacionalizado (SISDAO) e Teste de Apercepção Temática (TAT), questionário de avaliação clínica da SII; 2) psicoterapia breve, em doze sessões; 3) reavaliação após seis meses. A capacidade de simbolização da primeira participante era comprometida fundamentalmente relacionada à sua dificuldade em lidar com a perda da mãe quando criança, num luto não elaborado. Apresentava dores abdominais forte, a cada dois ou três dias, evacuando uma vez ao dia e quando em crise, duas ou três vezes por dia. A segunda participante apresentou uma capacidade de simbolização que passava a ser comprometida quando o conflito entre o desejo de ser aceita por sua família, em especial sua mãe, e o de rompimento tornava-se insuportável. Apresentava dores moderada, a cada cinco dias, evacuando quatro vezes ao dia e, quando em crise, seis vezes ao dia. A intervenção clinico psicológica em pacientes com SII, baseada na técnica da PBO, com elaboração da demanda psicológica e das questões significativas que comprometiam a capacidade de simbolização, possibilitou a elaboração psicológica dos estados emocionais que estariam influenciando os sintomas da SII, de forma que contribuiu para a melhora do quadro clínico das participantes. Após seis meses da psicoterapia, a primeira participante apresentou dores fracas a cada cinco dias, frequência única de evacuação por dia, não apresentou crises. A segunda participante estava evacuando uma a duas vezes por dia, dores fracas a cada cinco dias e crises ocorriam em menor frequência. O modelo de intervenção mostrou-se vantajoso para as participantes da pesquisa, de forma que seu uso no tratamento clinico psicológica para pacientes com SII, levando em consideração as especificidades do funcionamento mental associado às somatizações, apresenta-se promissor / In Psychosomatics, within the biopsychosocial model, it is understood that psychological responses to living conditions may interact with existing somatic factors, altering the susceptibility and manifestations of diseases, which is evidenced in somatizations, such as the case of Irritable Bowel Syndrome (IBS), where there is altered intestinal motility and stool format, accompanied by abdominal pain. The mental functioning associated with somatizations, in which a person presents difficulties in associating the illness to their psychological universe, that is, the capacity of symbolization, i.e. the construction of mental representations for the relief of the emotional state is affected, cronifying the physiological changes. The research objective was to determine whether psychological clinical care, based on the technique of Operationalized Brief Psychotherapy (OBP), with emphasises on promoting symbolization capacity regarding certain significant issues, can contribute to the improvement of symptoms in clinical condition of patients with IBS. The method used in the study was the clinical-qualitative, from the case study of two female adult patients with primary diagnosis of somatoform autonomic disorder, suffering from IBS. Psychological intervention was structured in three phases: 1) psychodiagnosis, composed of semi-directed interview, Operationalized Adaptive Diagnostic System (OADS) and Thematic Apperception Test (TAT), questionnaire of clinical evaluation of IBS; 2) brief psychotherapy split in twelve sessions; 3) re-evaluation after six months. The symbolization capacity of the first participant was compromised primarily because of her difficulty dealing with the loss of her mother when a child, in a non-elaborated mourning. The patient presented strong abdominal pains, every two or three days, evacuating once a day and when in crisis, two or three times a day. The second participant presented a symbolization capacity that began to be compromised when the conflict between the desire to be accepted by her family, especially her mother, and the disruption became unbearable. She felt moderate pain, every five days, evacuating four times a day, and when in crisis, six times a day. Psychological clinical intervention in patients with IBS, based on the technique of OADS, with development of psychological demand and significant issues that compromised the capacity of symbolization, allowed the psychological development of emotional states that would influence the symptoms of IBS, so it contributed to the improvement of the clinical condition of the participants. After six months of psychotherapy, the first participant presented weak pains every five days, single daily stool frequency, no crisis. The second participant was evacuating once or twice a day, felt weak pains every five days and crisis occurred less frequently. The intervention model was advantageous to the participants, so that its use in clinical psychological treatment for IBS patients presents promising, taking into account the specifics of mental functioning associated with somatization

Estudos anteriores demonstram que fatores psicológicos intervêm nos resultados de um transplante cardíaco. Diferem, em seus achados, em função dos paradigmas a que estão vinculados, que incluem ou não o campo intersubjetivo nos quais os fenômenos emergem. Nesta investigação objetivamos descrever o funcionamento mental de pacientes candidatos ao transplante, a partir de suas relações objetais inconscientes, delimitando uma vivência emocional comum nesta situação, bem como, buscamos averiguar se existem diferenças entre os pacientes, em função da realização ou não da cirurgia. Utilizou-se, como procedimento, o Teste de Relações Objetais de H. Phillipson (TRO), aplicado em 63 cardiopatas com indicação ao procedimento. O material clínico proveniente do acompanhamento psicológico destes pacientes também é utilizado para completarmos as observações. Os resultados apontam a presença de indicadores psicopatológicos, de acordo com a classificação de Grassano (1996) para depressão clínica em 60 casos. Em dois casos observaram-se indicadores para psicopatia e um caso para funcionamento psicótico, com repercussões negativas sobre o vínculo com o tratamento. Constataram-se diferenças estatisticamente significantes na performance dos pacientes frente às lâminas BG e C2, mas não podemos afirmar que as dificuldades de ajuste perceptual nestas lâminas, mais freqüentes entre aqueles que não fazem a cirurgia, seja fator de obstáculo ao procedimento. Sugerimos, como hipótese teórica deste trabalho, a presença de refúgios psíquicos, de acordo com Steiner (1997) como estratégia de sobrevivência psíquica, nesta situação, tendo em vista o predomínio, regressivo, de relações de objeto persecutórias, em virtude da extrema ansiedade depressiva. Assim, neste refúgio (ninho da Fênix), o paciente abriga-se da dor da perda (luto pela vida, pelo coração a ser retirado) e da aniquilação (devastação da doença, risco cirúrgico e da imunossupressão), conseguindo enfrentar o processo de transplante cardíaco. Caso contrário, o paciente sucumbe ao quadro depressivo. / Prior studies have shown that psychological factors influence the results not a hearth transplant. The findings are different in function of the paradigm linked to them that may include or not the inter-subjective field from which the phenomena emerge. The purpose of this research was to describe the mental functioning of patients who are candidate to a heart transplant, starting from their unconscious object relations that delimit a shared emotional existence upon that situation, and we also verified if there were differences between patients as to the accomplishment or not of the surgery. The procedure used was the Object Relation Test (ORT) applied over 63 cardiac patients who had indication for that procedure. The clinical material arose from the psychological follow-up performed with those patients was used to complete the observations as well. The results indicate the presence of psychopathological markers, following the Grassano's classification (1996) to the clinical depression in 60 cases. The markers for psychopathy were observed in two cases, and in one case it was observed the marker for psychotic functioning with negative repercussions on the link to the treatment. It was verified statistically significant differences in the patients' performance on the analysis of the BG and C2 plates, but it was impossible to assert that the difficulties in the perceptual adjustment in those plates which were more frequently found plates in patients who were not submitted to the surgery is an obstacle factor to the procedure. The theoretical hypothesis we have suggested in this paper is the presence of psychic refuges, according to Steiner (1997) as strategy for psychic survival to face such situation, having in mind the regressive predominance of the relationships of persecutory object upon an extremely depressive anxiety. Thus, in such refuge (the Phoenix's nest), the patient has a shelter against the pain caused by the loss (mourning the life because one's heart has to be withdrawn), and the annihilation (devastation caused by the disease, surgical risk, and due to the immunosuppression), in order to face the heart transplant process. Otherwise, the patient succumbs to the depressive situation.

O presente trabalho consiste em um estudo teórico que busca relacionar os princípios que norteiam as técnicas corporais fundamentadas na filosofia taoísta com alguns conceitos da psicologia analítica, tomando como eixo o processo de desenvolvimento da personalidade. Como método de trabalho, foi feita uma revisão bibliográfica, procurando sistematizar o assunto por meio da análise de alguns tópicos. A pesquisa começa com a apresentação da técnica corporal terapêutica taoísta chamada qigong (chi kun), situando-a em seus aspectos históricos, depois parte para as pesquisas clínicas que buscam validar seus efeitos terapêuticos, principalmente, explorando alguns conceitos filosóficos que fundamentam sua prática. Em seguida, foi destacada a perspectiva psicossomática como referencial de abordagem aos processos de saúde e doença, e, apresentadas algumas técnicas corporais da psicologia, destacando as técnicas de relaxamento. A partir desses elementos foram identificados nos estudos de C. G. Jung sobre as práticas corporais e meditativas taoístas, relações entre elas e o processo de individuação. O corpo, tomado como um instrumento de intervenção, por meio dos exercícios de relaxamento, alongamento, respiração e meditação, pode explicar as técnicas corporais taoístas no que diz respeito aos seus benefícios terapêuticos, concebidos nestes métodos como a busca da harmonização da energia, chamada de qi, e de seus aspectos yin e yang, o que culminaria tanto na saúde do corpo, quanto na harmonia psíquica resultante da experiência de identificação com um aspecto superior da consciência, nesta filosofia denominado Tao. Por outro lado a psicologia analítica dá mais atenção às manifestações corporais como expressões simbólicas, já que o trabalho corporal nessa abordagem busca facilitar o diálogo entre os aspectos conscientes e inconscientes da personalidade, tendo em vista uma integração maior entre os mesmos, o que corresponde a essência do processo de individuação. Assim foi observado que existe a possibilidade de convergência entre as duas propostas no que diz respeito ao cuidado com corpo e o desenvolvimento psíquico, desde que respeitando a especificidade de cada abordagem. Não existe somente um paralelismo, mas sobretudo uma complementaridade entre o conceito de processo de individuação descrito na psicologia analítica, e os objetivos e os métodos de desenvolvimento propostos pelos filósofos taoístas. A dissertação aponta ainda para a necessidade de futuros estudos que identifiquem com mais precisão até que ponto o trabalho teórico de Jung sofreu contribuição do pensamento oriental, particularmente da filosofia taoísta e, por outro lado, o quanto algumas interpretações ocidentais da filosofia taoísta, sofreram influência do pensamento de Jung. / The present research consists of a theoretical study that intends to relate the principles which guide the body techniques based on taoist philosophy to some concepts of the analytical psychology. As a main point, it is centered on the process of the personality development. In order to systematize the subject through the analysis of some topics, a bibliographic review has been made. It begins with the taoist therapeutic body technique qigong (chi kun) being historically situated. Then, it approaches the clinical researches that intend to validate its therapeutic effects and, mainly, with the exploration of some philosophical concepts in which it is based. After that, the psychosomatic perspective is focused as a reference to the healthiness and illness processes, and some psychological body techniques, such as the relaxation, are emphasized. Beginning with those elements, relations between taoist body and meditative techniques and the individuation process have been identified in C.G. Jung´s studies. The body, considered as an intervention instrument, through the exercises of relaxation, stretching, breathing and meditation can explain the taoist body techniques regarding its therapeutic benefits as a way to pursuit the energy harmony, called qi, as well as the yin and yang aspects, which would culminate not only in the body health but also in the psychic harmony gained by the identification with a major consciousness called Tao in that philosophy. On the other hand, analytical psychology gives more attention to the body manifestations as symbolic expressions, since the body work in this approach intends to facilitate the dialogue between the conscious and the unconscious aspects of personality, aiming at increasing the integration between them, what meets the essence of the individuation process. Thus, it has been observed that, regarding body and psychic development, both approaches may converge, provided that their peculiarities are respected. There is not only a parallel, but also a complementarity between the individuation process concept described in the analytical psychology and the aims and methods of development proposed by taoist philosophers. Moreover, this research indicates the need for further studies which are able to identify more precisely the contribution of Eastern thoughts, mainly of the taoist philosophy, to Jung´s theorical work, as well as the influence of Jung´s thoughts in the Western interpretation of taoist philosophy.

O presente trabalho é uma avaliação do efeito da administração de ocitocina nasal sobre o perfil de ativação do sistema nervoso autônomo e níveis salivares de cortisol, buscando compreender a relação entre esses vetores dentro da perspectiva da teoria polivagal e da concepção da ocitocina como um peptídeo de ação pró-social. A hipótese testada foi se o sistema pró-social, mediado pela ocitocina, exerce um efeito de ativação no ramo parassimpático, diminuindo o nível salivar de cortisol, comprovando o efeito anti-stress dessa molécula, ao desligar o sistema de alarme, reação filogenética para a preparação fisiológica para a interação social (relaxamento e tranquilidade). Para tanto, utilizou-se do Trial Social Stress Test, cuja tarefa é falar em público, situação em que parâmetros autonômicos foram medidos em sujeitos humanos, assim como o nível de cortisol salivar avaliado, em dois grupos: um experimental (com administração de ocitocina) e um controle (com administração de placebo) e em dois momentos (pré e pós stress social), relacionando-os a dados de personalidade (teste Bateria Fatorial da Personalidade). Os achados foram indicativos que a ocitocina exerce um efeito inibitório notável sobre os níveis de cortisol, não encontrando dados conclusivos sobre o vinculo ou não da atividade parassimpática relacionada com a presença da ocitocina e baixo nível de cortisol, embora se tenha encontrado forte influência da presença da ocitocina na atividade cardíaca (mediada pelo sistema nervoso autônomo). O fator de personalidade se mostrou bastante relevante nos resultados de cortisol e efeitos de ocitocina, correlacionados com o índice de Neuroticismo e se encontrou indicativos de que outros fatores de personalidade podem também ser importantes / The present work is an evaluation of nasal administration effect of oxytocin over the activation profile of the autonomic nervous system and salivary levels of cortisol, seeking to understand the relationship between these vectors within the perspective of the polyvagal theory and the conception of oxytocin as a pro social peptide. The hypothesis tested was whether the pro-social system, mediated by oxytocin, exerted an activation effect over the parasympathetic branch, reducing the salivary level of cortisol, proving the anti-stress effect of this molecule, when the alarm system was turned off, phylogenetic reaction to the physiological preparation for social interaction (relaxation and tranquillity). For this purpose, the Trial Social Stress Test was used, whose task is to speak in public, in which its autonomic parameters were measured, as well as the level of salivary cortisol evaluated, in two groups: one experimental (with oxytocin administration) and one control (with placebo administration) and at two moments (pre and post social stress), relating these results with personality data (Personality Factor Battery test). The findings were indicative that oxytocin exerts a remarkable inhibitory effect on cortisol levels, and we did not find conclusive data about the relationship or not of the parasympathetic activity related to the presence of oxytocin and low cortisol level, although strong oxytocin influence was found over the cardiac activity (mediated by the autonomic nervous system). The personality factor was shown to be very relevant in the cortisol and oxytocin effects correlated with the Neuroticism Index and it was found that other personality factors may also be important

Cette étude se propose d’introduire auprès du lectorat français, dans la mesure de nos moyens et de notre axe problématique, l’œuvre encore méconnue de Viktor von Weizsäcker (1886-1957), susceptible pourtant de figurer dans la lignée des penseurs et praticiens inspirés par la phénoménologie, au même titre que Ludwig Binswanger dans le domaine de la psychiatrie. En effet, si les concepts forgés par l’auteur dépaysent et déroutent parfois le lecteur – mais aussi le surprennent et l’enhardissent –, ce dernier ne sera toutefois pas sans remarquer la présence, profondément inscrite dans la trame du texte, d’un fil rouge, celui de la démarche phénoménologique même : à savoir la tâche de remettre en lumière inlassablement le sujet, sans cesse occulté par le monde des objets. À rebours de toute réification, la médecine psychosomatique de Weizsäcker découvre que chaque maladie est chargée de sens, et en tire les conséquences théoriques sur la nature du corps humain, et par extension de la matière toute entière. Nous voulons déterminer si la pensée de Weizsäcker peut nous permettre de fonder en raison la thèse de la conscience corporelle, c’est-à-dire de la nature conscience du corps, et par extension, de la matière. Cette idée serait porteuse d’une nouvelle lecture du monde, réconciliatrice et bienfaisante. / This study intends to introduce the French lectors to the opus of Viktor von Weizsäcker (1186-1957), in the limit of our capacities and of our own problematical axis. While still largely unknown, he is yet one of the thinker and practitioner who has been inspired by phenomenology, like for instance Ludwig Binswanger in the psychiatrical aera. Indeed, if the concepts forged by the author can surprise the lector - as well as they can stimulate him - one can note however the presence of a common thread, deeply inscribed in the text itself, that is, the very phenomenological way of thinking or the unremitting task of questionning the subject by freeing it from the world of objects. Against any reification, the psychosomatical medicine of Viktor von Weizsäcker reveals that each disease is full of meanings, and concludes from there to the real nature of human body, as well as to the real nature of matter itself. We would like to etablish whether the thinking of Weizsäcker can allow us to ground the thesis of the bodily consciousness – namely, of the conscious nature of the body, and then, of the conscious nature of matter. This idea would bear a new lecture of the world, bringing reconciliation and goodness.

M.A. / The overall objective of the global research project of which the present study is a part, is to create a greater awareness and understanding of the association between physiology and psychology, specifically with regard to IBS. Investigations are being conducted into the contribution of such factors as stress, anxiety, depression, somatization, psychopathology. early sexual abuse and physical abuse to the development and management of IBS. The present study aims to assess the incidence of co-morbid psychopathology in patients with IBS as compared to the general population. 1.3.2 Specific Aims. The aim of the present study is to compare the incidence of concurrent psychopathology in a sample of white, female patients, aged from 25-55 years and diagnosed to have IBS, with the incidence of psychopathology in a sample of white female non-IBS controls aged 25-55 years. Of initial concern will be whether the results of this study confirm the findings of the numerous research projects which attest to the high incidence of comorbid psychopathology in patients with IBS (Chaudhary & Truelove, 1962; Liss et al., 1973; Young et al., 1976), or add support to the limited evidence that disputes these claims (Talley, Kramlinger et al., 1993; Thornton, McIntyre et al., 1990). The study then aims to consider whether the variable of gender has a significant effect on the incidence of co-morbid psychopathology in patients with IBS. As will be discussed in Chapter 3, most of the studies do not differentiate between male and female subjects even though this may well prove to be an important determining factor. As mentioned in section 1.2.1, there is a dearth of research in South Africa into IBS and, more specifically, into the incidence of co-morbid psychopathology and IBS. By restricting participants in this study to those of the white race, the aim of this study is to initiate a process in which the incidence of co-morbid psychopathology in IBS patients of all races will be assessed and compared. In addition, the present study aims to assess whether age and level of education are significant variables in determining the incidence of co-morbid psychopathology in patients with IBS. Inter-group comparisons will be made between three groups of patients with IBS divided first according to age and then according to level of education. Finally, the present study aims to be more methodologically sound than certain of the earlier research projects as reported in the literature. As will become clear in Chapters 2 and 3, a common thread running through much of the literature is the concern that the validity of results may be questionable due to methodological flaws in the design of certain research projects. Small sample size has been a problem in some studies (Liss et al., 1973; Young et al., 1976) whilst in others, the absence of a control group has limited the relevance of data (Liss et al., 1973). Furthermore, a diversity of measuring instruments have been used in the past with little if any standardisation or control of specific variables being assessed. The measuring instrument used in this study, namely the Personality Assessment Inventory (PAI), allows for an accuracy and comprehensiveness of assessment not found in many previous studies (see Chapter 6, section 6.2.1.4). The PAI assesses psychopathological trends in personality functioning. The word "psychopathology" will be used in this study as substitute for the phrase "psychopathological trends in personality functioning".

Submitted by Biblioteca Central (biblioteca@unicap.br) on 2018-08-15T18:51:28Z No. of bitstreams: 2 vanessa_nazario_cordeiro.pdf: 1199389 bytes, checksum: 6ffcb12d46a17e7953d5288681ebf457 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-08-15T18:51:28Z (GMT). No. of bitstreams: 2 vanessa_nazario_cordeiro.pdf: 1199389 bytes, checksum: 6ffcb12d46a17e7953d5288681ebf457 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-07-09 / From centuries past to the present, pain and its symbolic value have not lost their vigor in scientific discussions. Chronic pain, here represented by fibromyalgia, is characterized by the prolongation of painful sensation in the body for more than six months. Fibromyalgia is known for the sensation of pain, without there being an organic substrate to back up its clinical / biomedical diagnosis. In the scientific literature, the tendency to approach fibromyalgia within positivist parameters is perceived in the scientific literature, which, in this case, has as main objective to attenuate the symptom aiming at the control of pain. What are the possible effects of this tendency that supposedly pervades the subject of pain, about what refers to their meanings and their relations? This research aimed to understand the experience of pain, from the perspective of patients in the treatment of fibromyalgia, based on the Systemic Theory reference. Specifically, we sought to understand conceptions and feelings about pain in patients diagnosed and treated with fibromyalgia; to understand the conditions of possibility to the experience with the pain, in the reconstruction of the process of discovery and diagnosis; to identify the perception of the subjects about the ways in which pain has been approached by health professionals; to analyze the ways in which the family is organizing in the face of pain, based on the understanding of family structure and its interrelation with pain and treatment. In this qualitative research, five women were diagnosed with fibromyalgia for at least one year. The in-depth interview was used as the main technique, contextualized by field diary, aiming at records of intersubjective aspects arising from interviews. The content analysis of Minayo in its thematic aspect aided in the understanding of the material constructed in the field. In the first theme emotional components related to / influencing the experience of pain were perceived; the presence of traumatic events (with regard to losses, for example) in the first manifestations of pain; adopted behaviors of suppression to the pain, at the same time that occurred movement of resistance to the change and a search to the homeostasis. In the second theme, it was observed the maintenance of beliefs that the disease manifests itself in an exclusively emotional and / or physical instance; medication as the main therapy offered to silence the pain; difficulty in dealing with subjective issues; little demand for space that aims at a treatment beyond physical pain. None of the participants showed interest in a psychotherapeutic space. Finally, in the third theme it was observed that, in general, women occupy a central position in their families; they feel little understood. It was also observed family relations that were negatively feedbacks, facilitating the maintenance of the symptom, the families adopt behaviors that reverberate in a maintenance of dysfunctional homeostasis. This dysfunctional pattern is characterized as a movement of continuous rigidity, with few opportunities for change and consequently few transitions within the systems, leaving the conditions of possibility to the true experience. With this research it is estimated to contribute to an integral assistance, reflecting on the nuances involved in the complexity of the pain experience and family relationships that permeate the context of fibromyalgia and its treatment. / Desde séculos passados até hoje a dor e seu valor simbólico não perderam vigor nas discussões científicas. A dor crônica, aqui representada pela fibromialgia, é caracterizada pelo prolongamento da sensação dolorosa no corpo por mais de seis meses. A fibromialgia é conhecida pela sensação de dor, sem que haja um substrato orgânico para respaldar o seu diagnóstico clínico/biomédico. Percebe-se na literatura científica a tendência em abordar a fibromialgia dentro de parâmetros positivistas que, neste caso, têm como principal objetivo atenuar o sintoma visando ao controle da dor. Quais os possíveis efeitos dessa tendência que supostamente perpassa o sujeito da dor, sobre o que remete aos seus significados e às suas relações? Nesta pesquisa buscou-se compreender a experiência da dor, na perspectiva de pacientes em tratamento de fibromialgia, com base no referencial da Teoria Sistêmica. De forma específica, buscou-se conhecer concepções e sentimentos sobre dor, em pacientes diagnosticados e em tratamento com fibromialgia; compreender as condições de possibilidade à experiência com a dor, na reconstrução do processo de descoberta e diagnóstico; identificar a percepção dos sujeitos sobre os modos como a dor vem sendo abordada pelos profissionais de saúde; analisar os modos como a família vem se organizando perante a dor, com base na compreensão da estrutura familiar e sua inter-relação com a dor e o tratamento. Nesta pesquisa de natureza qualitativa participaram cinco mulheres diagnosticadas com fibromialgia há pelo menos um ano. Utilizou-se a entrevista em profundidade como técnica principal, contextualizada por diário de campo visando registros de aspectos intersubjetivos advindos das entrevistas. A análise de conteúdo de Minayo em sua vertente temática auxiliou na compreensão do material construído em campo. No primeiro tema perceberam-se componentes emocionais relacionados a/influenciando a experiência da dor; a presença de eventos traumáticos (no que concerne a perdas, por exemplo) nas primeiras manifestações de dores; condutas adotadas de supressão à dor, ao mesmo tempo em que ocorria movimento de resistência à mudança e uma busca à homeostase. No segundo tema percebeu-se a manutenção de crenças de que a doença manifesta-se em uma instância exclusivamente emocional e/ou física; a medicação como principal terapêutica ofertada para silenciar a dor; dificuldade de profissionais em lidar com questões de ordem subjetiva; pouca procura por espaço que vise um tratamento para além da dor física. Nenhuma das participantes demonstrou interesse por um espaço psicoterápico. Por fim, no terceiro tema foi observado que, de modo geral, as mulheres ocupam uma posição central em suas famílias; sentem-se pouco compreendidas. Também foi observado relações familiares que se retroalimentavam negativamente, facilitando a manutenção do sintoma, as famílias adotam condutas que repercutem numa manutenção de homeostase disfuncional. Esse padrão disfuncional caracteriza-se como um movimento de rigidez contínuo, com poucas oportunidades de mudança e consequentemente de poucas transições dentro dos sistemas, afastando as condições de possibilidade à verdadeira experiência Com esta pesquisa estima-se contribuir para uma assistência integral, refletindo sobre as nuances envolvidas na complexidade da experiência da dor e as relações com a família que perpassam o contexto da fibromialgia e seu tratamento.

The present study sought to determine whether a dietary and multi-element psychological treatment (DMPT) approach in combination with standard medical treatment would offer a more efficacious therapeutic package to irritable bowel syndrome (IBS) patients than would standard medical treatment (SMT) employed alone. The DMPT group (N = 19) received a stress management training package for a 2 week period consisting of relaxation training, imagery, and bowel sound biofeedback training via a stethoscope, in addition to instructions to increase their daily consumption of dietary fiber. They also were to continue the implementation of whatever standard medical treatment they were currently receiving, be it a bulking agent, or anti-anxiety, anti-cholinergic, or anti-depressant medications, etc. The SMT group (N = 19) simply received whatever conventional medical treatment they had been prescribed.

A qualitative, descriptive, explorative, and contextual research design was selected for this study. The purpose was to explore the phenomenon of mass hysteria among the Basotho in Lesotho and to develop guidelines which may facilitate early intervention and better management and control of mass hysteria outbreaks. The study area covered four of the ten districts in Lesotho. Four high schools where recent outbreaks of mass hysteria have been reported were included in the study. Semi-structured individual interviews and focus group interviews were conducted to collect the data. Purposive sampling was used to select young women in high schools who experienced mass hysteria; teachers who were present during mass hysteria episodes; a parent; and traditional healers and religious leaders who were involved in treating the affected.Thirteen individual interviews were held respectively with one victim of mass hysteria from a rural area, four school principals,a parent,five traditional healers, a priest and apastor. Three focus group interviews were conducted with thirty affected young women from three different high schools and two focus group interviews were held with twenty teachers from two different high schools.The data were transcribed verbatim and content analysis was done using open and axial coding. Four themes emerged from the findings, namely: manifestations of mass hysteria among the Basotho; interventions used by the Basotho to alleviate mass hysteria; Basotho’s views about the phenomenon of mass hysteria; and effects of mass hysteria onthe Basotho. The findings show that young women in Lesotho experience both physical and psychological symptoms during mass hysteria episodes and that it has a contagious effect. The interventions used by the Basotho to alleviate mass hysteria include traditional healing, herbal remedies, exorcism and prayer.The Basotho have different views about mass hysteria attributing it to either supernatural forces or natural illness. Episodes of mass hysteria have a negative impact on the victims,their families, and those who witnessed the episodes, causing confusion, fear and anxiety. Guidelines were compiled to assist teachersand health workers to improve the management and control of mass hysteria episodes in Lesotho. / Health Studies / D. Litt. et Phil. (Health Studies)

The workplace is an arena that most individuals spend time at. Work-related stress and psychosomatic complaints are problems for the society. Work-related stress has increased in Sweden over the past decades. The aim was to investigate the difference between men and women in work-related stress and psychosomatic complaints among working adults in the Swedish population, and to see if there is a relationship between work-related stress and psychosomatic complaints. The author posted an online survey on Facebook and Discord and 95 adults answered the survey. The result showed that there is a relationship between work-related stress and psychosomatic complaints. Psychosomatic complaints are more common among those who experience more work-related stress. There were no differences between men and women when it comes to work-related stress and psychosomatic complaints. The model Job demand control support model was used in this study. The model is measured with scales such as workload, time pressure and role conflicts. It can be used to see the relationship between job decision latitude and stress indicators. Psychosomatic complaints are more common among those who experience more stress. There are no differences between men and women when it comes to psychosomatic complaints and work-related stress.