An overview of the existing body of knowledge on the most widely researched areas of childhood leukaemia was presented and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This conceptual shift encompassed an ecosystemic approach. This study was conducted within a holistic systemic epistemology. A qualitative approach employing a case study method to provide rich descriptions of the context in which two leukaemia sufferer's symptoms were embedded. / Psychology / M.A. (Psyhcoloy)

An overview of the existing body of knowledge on the most widely researched areas of childhood leukaemia was presented and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This conceptual shift encompassed an ecosystemic approach. This study was conducted within a holistic systemic epistemology. A qualitative approach employing a case study method to provide rich descriptions of the context in which two leukaemia sufferer's symptoms were embedded. / Psychology / M.A. (Psyhcoloy)

by Wong Chi-ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1994. / Includes bibliographical references (leaves 62-69 (2nd gp.)). / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.iii / TABLE OF CONTENTS --- p.iv / LIST OF TABLES --- p.vi / LIST OF FIGURES --- p.viii / LIST OF APPENDICES --- p.ix / Chapter CHAPTER I - --- INTRODUCTION --- p.1 / Definition of Somatization --- p.2 / A Model of Somatization --- p.5 / Somatization in the Correctional Setting --- p.8 / The Study --- p.12 / Chapter CHAPTER II- --- METHOD --- p.14 / Subjects --- p.14 / Measures --- p.15 / Pilot Study --- p.21 / Main Study --- p.21 / Chapter CHAPTER III - --- RESULTS --- p.23 / Validity of Protocols --- p.23 / Descriptive Statistics and the Sociodemographic and Custodial Profile of the Subjects --- p.23 / Reliability of Scales Used in this Study --- p.26 / Data Transformation --- p.26 / Principal Components Analyses of Variables on Psychological Distress and Somatization --- p.28 / Predictors of Somatization --- p.30 / Differences among Subjects with Different Levels of Somatization and Psychological Distress --- p.35 / Differences among Somatizers Who Attribute Differently --- p.47 / Chapter CHAPTER IV - --- DISCUSSION --- p.51 / Somatization and Psychological Distress Among Prisoners --- p.51 / Other Correlates of Somatization among Prisoners --- p.51 / Patterns of Somatization under Different Levels of Psychological Distress --- p.55 / "Comparison between ""True"", ""Facultative"", and ""Initial"" Somatizers" --- p.56 / Management Implications --- p.58 / Chapter CHAPTER V - --- CONCLUSION AND LIMITATION --- p.60 / REFERENCES --- p.62 / APPENDICES --- p.70

O presente trabalho tem o objetivo de descrever e discutir os conceitos de Transtornos Somatoformes (TS) na perspectiva psiquiátrica e psicanalítica. A pesquisa pauta-se no estudo do estado da arte relativo aos TS, mediante revisão bibliográfica semi-dirigida, tendo como meta mapear e discutir a temática historicamente e em diferentes campos de conhecimento. Pretende-se compreender, descrever e analisar o conceito de TS nos manuais de psiquiatria, a saber, no Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM) e na Classificação Internacional de Doenças (CID-10). O estudo explora o conceito de histeria na obra freudiana, buscando investigar que proximidade haveria entre o conceito psiquiátrico de TS e o de Histeria em Freud. Além dos manuais e da obra freudiana, foram utilizados textos psiquiátricos e psicanalíticos que contribuíram para o entendimento das questões. A partir da reconstrução histórica observa-se que, nas primeiras edições dos manuais psiquiátricos, os TS remetiam ao que a ciência psiquiátrica até aquele momento tinha dificuldade em classificar. Reconhecia-se também a influência dos conflitos psíquicos na manifestação dos sintomas, e o conceito de histeria estava atrelado a esta categoria diagnóstica. Após 1980 a categoria diagnóstica de histeria foi retirada do DSM. Tais aspectos explicitam a necessidade de uma maior compreensão acerca do processo histórico e da interlocução entre o campo da Psiquiatria e da Psicanálise, levando-se em conta o modo como é feito o diagnóstico deste transtorno, que ocorre, na maior parte das vezes por exclusões. Ressalta-se que a alteração da nomenclatura de TS produziu uma significativa mudança no entendimento deste tipo de sofrimento mental. Conclui-se que o conceito de histeria e o diagnóstico de TS se aproximam no que se refere ao aspecto fenomenológico e descritivo, mas se distanciam no que se refere à construção da compreensão clínica e ao tratamento tal como se processa atualmente / The present work aims to describe and discuss the concepts of Somatoform Disorders (SD) in the psychiatric and psychoanalytic perspective. The research presents a study on the state of the art related to SD, through a semi-directed literature review, with the target to map and discuss the topic historically and across different fields of knowledge. It is intended to comprehend, describe and analyse the concept of SD in the psychiatric manuals, namely: Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD-10). This study explores the concept of hysteria in the Freudian works, seeking to investigate the proximity between the psychiatric concept of SD and that of hysteria in Freud. In addition to the manuals and the Freudian works, the research refers to other psychiatric and psychoanalytical texts that contributed to the understanding of these issues. From the historical reconstruction is observed that, in the first editions of psychiatric manuals, the SD remitted to what the psychiatric science had difficult to classify. It was also recognized the influence of psychic conflict in the manifestation of the symptoms, and the concept of hysteria was linked to this diagnostic category. After 1980s, the diagnostic category of hysteria was removed from DSM. These aspects make explicit the need for greater understanding of the historical process and the dialogue between the fields of psychiatry and psychoanalysis, taking into account how this disorder is diagnosed, which occurs in most cases by exclusions. It is noteworthy that the change in the nomenclature of SD produced a significant shift in the understanding of this type of mental suffering. It follows that the term hysteria approaches SD diagnostic with regard to phenomenological aspects and description, but it differs from this disorder with respect to the construction of clinical understanding and treatment as it is currently handled

Auf der Grundlage der Basisuntersuchung einer epidemiologischen prospektiven Verlaufsstudie (1995–1999) an 3021 Personen im Alter zwischen 14 und 24 Jahren werden epidemiologische Befunde zur Häufigkeit von somatoformen Beschwerden und somatoformen Syndromen/Störungen bei Jugendlichen und jungen Erwachsenen berichtet. Die Jugendlichen und jungen Erwachsenen wurden mit Hilfe des M-CIDI, einem standardisierten Interview zur Erfassung psychischer Symptome, Syndrome und Störungen nach dem DSM-IV, befragt. Die Ergebnisse der ersten Untersuchung zeigen, daß 50% der Jugendlichen einmal in ihrem bisherigen Leben unter einem somatoformen Symptom litten. Junge Frauen berichten häufiger von somatoformen Beschwerden als junge Männer (61 vs. 40%). Die im DSM-IV operationalisierten Kriterien einer somatoformen Störung werden nur von wenigen Jugendlichen und jungen Erwachsenen (2,7%) erfüllt. Die Prävalenz erhöht sich jedoch, wenn man nicht ausschließlich voll ausgeprägte somatoforme Störungen, sondern zusätzlich unterschwellige Syndrome in die Betrachtung einschließt: Hier berichten etwa 11% der Jugendlichen von somatoformen Syndromen. Somatoforme Störungen/Syndrome zeigen sich häufig im Verbund mit anderen psychischen Störungen, wobei die Komorbidität mit dem Alter zunimmt. Wie unsere Analysen ergaben, berichten Jugendliche und junge Erwachsene mit somatoformen Störungen, aber auch solche mit unterschwelligen Syndromen, vermehrt Beeinträchtigungen in verschiedenen sozialen Rollenbereichen und der Arbeitsproduktivität. / As part of a longitudinal study, prevalence findings of somatoform symptoms, syndromes and disorders are presented for a random sample of 3021 respondents aged 14 to 24 years. The response rate was 71%. Assessment was made using the computer- assisted Munich-Composite International Interview (M-CIDI). Findings of the first part of the study revealed that 50% (men: 40%; women: 61%) of the sample once had a somatoform symptom in their life. Threshold somatoform disorders were rare with 2.7%. However, when including subthreshold somatoform syndromes (11%), the lifetime prevalence of any somatoform disorder/syndrome was 13%. Somatoform disorders and syndromes are often comorbid with other mental disorders, and comorbidity rises with age. Further, they are associated with disabilities and impairments in social and work domains.

Objective. Although somatoform disorders are assumed to be chronic clinical conditions, epidemiological knowledge on their natural course based on representative samples is not available. Method. Data come from a prospective epidemiologic study of adolescents and young adults in Munich, Germany. Respondents’ diagnoses (N = 2548) at baseline and follow-up on average 42 months later are considered. The follow-up incidence, stability as well as selected baseline risk factors (sociodemographics, psychopathology, trauma exposure) for the incidence and stability of somatoform disorders and syndromes are prospectively examined. Diagnostic information was assessed by using the standardized Munich-Composite International Diagnostic Interview (M-CIDI). Results. Over the follow-up period, incidence rate for any of the covered somatoform diagnoses was 25.7%. Stability for the overall group of any somatoform disorder/syndrome was 48%. Female gender, lower social class, the experience of any substance use, anxiety and affective disorder as well as the experience of traumatic sexual and physical threat events predicted new onsets of somatoform conditions, while stability was predicted by being female, prior existing substance use, affective and eating disorders as well as the experience of a serious accident. Conclusions. At least for a substantial proportion of individuals, the overall picture of somatization seems to be relatively stable, but with fluctuation in the symptom picture over time. Being female, the experience of substance use as well as anxiety disorder seem to constitute risk factors for the onset of new somatoform conditions as well as for a stable course over time.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 4 uppsatser.

O presente trabalho tem o objetivo de descrever e discutir os conceitos de Transtornos Somatoformes (TS) na perspectiva psiquiátrica e psicanalítica. A pesquisa pauta-se no estudo do estado da arte relativo aos TS, mediante revisão bibliográfica semi-dirigida, tendo como meta mapear e discutir a temática historicamente e em diferentes campos de conhecimento. Pretende-se compreender, descrever e analisar o conceito de TS nos manuais de psiquiatria, a saber, no Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM) e na Classificação Internacional de Doenças (CID-10). O estudo explora o conceito de histeria na obra freudiana, buscando investigar que proximidade haveria entre o conceito psiquiátrico de TS e o de Histeria em Freud. Além dos manuais e da obra freudiana, foram utilizados textos psiquiátricos e psicanalíticos que contribuíram para o entendimento das questões. A partir da reconstrução histórica observa-se que, nas primeiras edições dos manuais psiquiátricos, os TS remetiam ao que a ciência psiquiátrica até aquele momento tinha dificuldade em classificar. Reconhecia-se também a influência dos conflitos psíquicos na manifestação dos sintomas, e o conceito de histeria estava atrelado a esta categoria diagnóstica. Após 1980 a categoria diagnóstica de histeria foi retirada do DSM. Tais aspectos explicitam a necessidade de uma maior compreensão acerca do processo histórico e da interlocução entre o campo da Psiquiatria e da Psicanálise, levando-se em conta o modo como é feito o diagnóstico deste transtorno, que ocorre, na maior parte das vezes por exclusões. Ressalta-se que a alteração da nomenclatura de TS produziu uma significativa mudança no entendimento deste tipo de sofrimento mental. Conclui-se que o conceito de histeria e o diagnóstico de TS se aproximam no que se refere ao aspecto fenomenológico e descritivo, mas se distanciam no que se refere à construção da compreensão clínica e ao tratamento tal como se processa atualmente / The present work aims to describe and discuss the concepts of Somatoform Disorders (SD) in the psychiatric and psychoanalytic perspective. The research presents a study on the state of the art related to SD, through a semi-directed literature review, with the target to map and discuss the topic historically and across different fields of knowledge. It is intended to comprehend, describe and analyse the concept of SD in the psychiatric manuals, namely: Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD-10). This study explores the concept of hysteria in the Freudian works, seeking to investigate the proximity between the psychiatric concept of SD and that of hysteria in Freud. In addition to the manuals and the Freudian works, the research refers to other psychiatric and psychoanalytical texts that contributed to the understanding of these issues. From the historical reconstruction is observed that, in the first editions of psychiatric manuals, the SD remitted to what the psychiatric science had difficult to classify. It was also recognized the influence of psychic conflict in the manifestation of the symptoms, and the concept of hysteria was linked to this diagnostic category. After 1980s, the diagnostic category of hysteria was removed from DSM. These aspects make explicit the need for greater understanding of the historical process and the dialogue between the fields of psychiatry and psychoanalysis, taking into account how this disorder is diagnosed, which occurs in most cases by exclusions. It is noteworthy that the change in the nomenclature of SD produced a significant shift in the understanding of this type of mental suffering. It follows that the term hysteria approaches SD diagnostic with regard to phenomenological aspects and description, but it differs from this disorder with respect to the construction of clinical understanding and treatment as it is currently handled

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-07-11T17:24:04Z No. of bitstreams: 1 irmanevestallmannsaar.pdf: 1016050 bytes, checksum: b99796c1d954435d9516f0dff33358cb (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-13T16:35:53Z (GMT) No. of bitstreams: 1 irmanevestallmannsaar.pdf: 1016050 bytes, checksum: b99796c1d954435d9516f0dff33358cb (MD5) / Made available in DSpace on 2016-07-13T16:35:53Z (GMT). No. of bitstreams: 1 irmanevestallmannsaar.pdf: 1016050 bytes, checksum: b99796c1d954435d9516f0dff33358cb (MD5) Previous issue date: 2012-03-02 / O presente trabalho pretendeu investigar, por meio de estudo qualitativo exploratório, utilizando-se da metodologia Estudo de Caso, a presença ou ausência de manifestações psicossomáticas em sujeitos com transtorno mental psicótico. Para o fim proposto, discutiu-se o papel das emoções, em especial do medo e do estresse, potenciais desencadeadores das manifestações psicossomáticas. Contextualizou-se o campo da pesquisa, no qual usuários com transtorno mental têm acesso ao tratamento diferenciado do modelo hospitalocêntrico, respeitados como sujeitos e cidadãos de direito. A pesquisa de campo foi realizada com pessoas de ambos os sexos, maiores de 18 anos, que apresentam transtorno mental psicótico, usuários de um Centro de Atenção Psicossocial (CAPS), situado em Juiz de Fora, selecionadas por meio de amostragem, por variedade de tipos. Verificou-se que, junto à psicose, também se podem evidenciar manifestações orgânicas, de cunho psicossomático. Impossível evidenciar uma relação causa/efeito; contudo, afirma-se a existência de fatos concretos, sentimentos, emoções e reações, que facilitam, direcionam e confluem para o adoecimento do corpo. Confirmou-se que os sujeitos pesquisados sofrem da emoção do medo, do estresse, e que esses fatores podem ser desencadeadores das doenças psicossomáticas. / This work intended to investigate, through exploratory qualitative study, using the methodology Case Study, the presence or absence of somatoform disorders in subjects with psychotic mental disorders. For this purpose, it was discussed the role of the emotions, such as the fear and the stress, as potential trigger of the somatoform disorders. The field of the research was contextualized, in which users with mental disorders have access to the differentiated treatment of the hospital-centered model, in which they are treated as individuals and citizens with rights. The field research was conducted among individuals of both sexes, over 18 years old, who present psychotic mental disorder and users of a Center of Psychosocial Attention situated in Juiz de Fora, selected by sampling by variation in the types. It was verified that with the psychosis we can also evidence organic manifestations with a psychosomatic character. Although impossible to evidence a cause/effect relation, it is stated the existence of facts, feelings, emotions and reactions that facilitate, direct and converge to the illness of the body. It was confirmed that the surveyed subjects suffer the emotion of fear, stress and that these may be triggers of psychosomatic illnesses.

Objective: The perceptual mechanisms underlying the development and maintenance of excessive physical symptom reporting (i.e. 'somatisation') are poorly understood. Research with non-clinical participants suggests that high and low symptom reporters perform differently when detecting somatosensory signals and have different false alarm rates in which the presence of a signal is incorrectly reported when no signal is present. High symptom reporters often incorrectly report the presence of a signal particularly when a stimulus in a different sensory modality is presented. Previous research has shown that it may be possible to reduce false alarm rates by perceptual training using bi-modal visuo-tactile stimuli pairing. The current was designed to test this hypothesis. Methods: Seventy non-clinical participants scoring either high or low on the Patient Health Questionnaire (PHQ-15; a measure of somatisation) completed the Somatic Signal Detection Task (SSDT), a novel perceptual paradigm that purports to measure individual differences in somatosensory distortion. Prior to the SSDT, approximately two thirds of the sample completed either a 'weak' or 'strong' perceptual training protocol in which a suprathreshold tactile and visual stimuli were paired either infrequently (25%) or frequently (75%), with the intention of training participants to discriminate tactile signal from noise more effectively. The remaining participants received no perceptual training. Factors known to be strongly associated with somatisation were controlled for. Negative affectivity was controlled for using the State-Trait Anxiety Inventory Trait Version (STAI-T; Spielberger, Gorsuch & Lushene, 1970), somatosensory amplification was controlled for using the Somatosensory Amplification Scale (SSAS; Barsky, Goodson, Lane & Cleary, 1988), the Patient Health Questionnaire (PHQ-9; Kroenke, Spitzer, & Williams, 2001) was used to control for depression and the Health Anxiety Inventory-Short Version (SHAI; Salkovskis, Rimes, Warwick & Clark, 2002) was used to control for hypochondriacal factors with the Patient Health Questionnaire-Generalised Anxiety Disorder (PHQ-GAD-7; Spitzer, Kroenke, Williams & Löwe, 2006) being used to control for anxiety. Results: The high PHQ-15 group reported significantly more false alarms and had a significantly higher response criterion than the low PHQ-15 group in the no perceptual training conditions. The perceptual training reduced the false alarm rate for the high PHQ-15 group but did not alter response criterion. Although the findings were in the predicted direction, neither of these findings reached significance. The effect size indicated that this was due to low power. Conclusions: The findings were suggestive of the effect of perceptual training reducing false alarm rates; however, low power meant that it was impossible to draw firm conclusions. Further research with a larger sample is required.