Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

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

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Feb. 12, 2009). Includes bibliographical references (p. 35-43).

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 70-78).

Thesis (Ph. D.)--University of Kentucky, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Kentucky, 1997. / Includes bibliographical references.

abstract: ABSTRACT Post-Traumatic Stress Disorder (PTSD), depression, and insomnia are prevalent among United States (US) military veterans. This study investigates whether Brain Boosters, a new cognitive enhancement group therapy, improves symptoms of PTSD, depression, and insomnia among veterans completing the groups. The study population includes 64 US military veterans treated in the setting of the Veterans Affairs (VA) Health Care System in Phoenix, AZ. Group members were US military veterans, age 22 to 87 (mean age=53.47), who had served in or after World War II (WWII), who sought mental health care at the Phoenix VA from 2007 through 2011. Participants were treated with Brain Boosters therapy. They completed measures of mental-health related symptoms before and after this therapy. Participants were assessed pre and post group with the PTSD Checklist for military personnel (PCL-M), the Patient Health Questionnaire (PHQ-9; a measure of depression symptoms), and the Insomnia Severity Index (ISI). Statistical analyses were done with paired samples t-tests and McNemar's tests, using SPSS. The hypotheses were that symptoms of PTSD, depression, and insomnia would show statistically significant improvement with Brain Boosters therapy. Results supported the hypotheses that symptoms of PTSD and depression would improve significantly. Insomnia did not show significant improvement. The results showed the mean PCL-M score was 54.84 before Brain Boosters therapy and 51.35 after (p= 0.008). The mean PHQ-9 score was 15.21 before Brain Boosters therapy and 13.05 after (p= 0.002). The mean ISI score was 15.98 before Brain Boosters Therapy and 14.46 after (p= 0.056). Although this is a nonrandom, uncontrolled trial, findings nevertheless suggest that Brain Boosters may be an effective therapy to reduce PTSD symptom severity and depression symptom severity. This may be especially important for veterans seeking alternatives to pharmacological intervention or traditional therapeutic interventions. / Dissertation/Thesis / M.S. Psychology 2012

Orientador: Cláudio Eduardo Muller Banzato / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T23:16:44Z (GMT). No. of bitstreams: 1 Araujo_LuisFernandoSilvaCastrode_M.pdf: 17028426 bytes, checksum: 19c4738a0813da9cb9bc34f3ae98874d (MD5) Previous issue date: 2013 / Resumo: A noção de causa é de grande importância na medicina e o uso de um vocabulário causal é praticamente inevitável. Afinal, intervenções como a prevenção e o tratamento dependem do conhecimento sobre as causas das doenças. Contudo, na literatura médica científica, frequentemente não se explicita quais são as noções de causa e os modelos causais empregados. Há ainda uma expectativa da descoberta de causas fortes, isto é, que seja necessário e suficiente o que nem sempre é o que constatamos na prática. No caso da psiquiatria, que nos interessa em particular, na maioria das vezes temos muitos fatores com influência causal fraca, cuja determinação é, na melhor das hipóteses, probabilística. Entender como se dá a cadeia causal dos transtornos mentais é um grande desafio. E a equação fica ainda mais complicada se incluirmos no raciocínio causal eventos que não se repetem, como, por exemplo, circunstâncias biográficas. OBJETIVO: O objetivo deste trabalho é analisar de forma filosoficamente informada às noções de causalidade presentes explícita ou implicitamente na literatura científica atual e estabelecer quais os modelos filosóficos de causalidade que predominam nestes textos. Abordo o modelo de causalidade do filósofo John L. Mackie como alternativa para a aplicação de modelos exclusivamente estatísticos de causalidade, como aparecem na literatura científica desde os trabalhos de Bradford- Hill (1964). MÉTODO E RESULTADOS: Realizei uma revisão da literatura filosófica e médica através das bases de dados relevantes (Philosophy Index e PubMed) e analisei os conceitos de causa utilizados, seja implícita ou explicitamente nos artigos. Também fiz uma busca ativa por livros de filósofos que tenham abordado o tema causalidade, bem como busquei artigos através das referências do material coletado. Há consequências da aplicação de certas ideias de causalidade sobre os dados empíricos, por exemplo, se devemos assumir ou não uma visão indeterminística de mundo é uma delas (distinção que aparece implicitamente entre os trabalhos de Koch e de Bradford- Hill, por exemplo). Outra consequência é a de que modelos estatísticos e de regularidade se aplicam com dificuldade em casos que não se repetem como acontece particularmente na psiquiatria. Além disto, a forma de investigação científica que escolhemos tem como consequência o acúmulo de informações com pouco poder explicativo sobre os eventos mentais. Exatamente por estas características da psiquiatria que utilizo o modelo do filósofo John L. Mackie de condição INUS, por ser capaz de lidar tanto com casos singulares quanto com relações estatísticas, assim como também é capaz de organizar de forma explicativa os dados científicos. Mackie propõe que nossa noção de causa inclui como causalmente relevantes elementos periféricos; causalidade é, para ele, "necessidade nas circunstâncias". Através desta idéia, define uma condição INUS como sendo um elemento necessário para um conjunto de circunstâncias que por sua vez é suficiente para o efeito em estudo. Detalho este modelo causal no decorrer do texto e, a título de exemplo, o aplico na Esquizofrenia e no Transtorno de Estresse Pós-traumático / Abstract: Causality is of great importance in medicine and the use of causal vocabulary is perhaps inevitable. After all, interventions such as prevention and treatment depend, to a large extent, upon the knowledge about the causes of diseases. However, medical scientific literature is seldom explicit about the notions of cause and causal models employed. There seems to be high expectations of finding strong causes for the diseases, i.e., causes that are necessary and sufficient, which are rarely seen in daily practice. In psychiatry, our main concern here, there are many weak causal factors whose determination is, at best, probabilistic. Understanding the causal chain of mental disorders is, therefore, a major challenge, and this equation becomes even more complex if we include in it singular events, such as biographical circumstances. OBJECTIVE: This work aims to analyze, in a philosophically-informed way, the explicit or implicit notions of causality in the current medical scientific literature and to find out which philosophical models of causality prevail in these texts. I also suggest that the causality model of the philosopher John L. Mackie is as an alternative to the exclusive use of statistical models in scientific papers, tendency observed since the seminal work of Bradford-Hill (1964). METHODS AND RESULTS: I reviewed medical and philosophical literature through the relevant databases (PubMed and Philosophy Index, respectively) and analyzed the concepts of cause used either implicitly or explicitly in the articles. I also made an active search through the references of the articles reviewed and considered as well books of philosophers who have addressed causality. There are important consequences of applying certain ideas of causality on empirical data, such as, for instance, deciding whether or not we should adopt an indeterministic stance of the world (distinction that implicitly appears in the contrast between the works of Koch and Bradford-Hill, for example). Another key consequence is that statistical models (which are based on regularity) face some difficulties when dealing with events that do not repeat, common occurrence in psychiatry. Moreover, the mainstream scientific research in psychiatry is leading to a growing set of empirical data with limited explanatory power about the causality of mental disorders. In that regard, the model of the philosopher John L. Mackie, called INUS condition, appear to be very helpful for rearranging the causal elements within a causal field. Mackie suggests that our notion of cause usually takes peripheral elements to be causally relevant; for him, causality is "necessity in the circumstances." Thus, he defines the notion of INUS condition as a necessary element within a set of conditions, set that is, at its turn, sufficient (though not necessary) for the effect. I explored the notion of INUS condition throughout the text and, to exemplify its feasibility and to stress its advantages, applied it to the hypothetical causal conceptualization of Schizophrenia and Post-Traumatic Stress Disorder / Mestrado / Saude Mental / Mestre em Ciências Médicas

The purpose of this study was to identify health and emotional-related issues of service members after a deployment to Iraq. Secondary data analysis and a cross-sectional descriptive design, were used to analyze data from the Department of Defense Post Deployment Health Assessment (PDHA) database. The cognitive appraisal model of stress and coping (Lazarus and Folkman, 1984) guided this study. Several statistical techniques were used including: frequency distributions cross tab evaluations, factor analysis, reliability calculations, regression analysis and tests for mediation. The study sample included 510, 352 service members (49,998 females, 460,349 males) with a mean age of 29 years. The sample represented all components and branches of the military. Of the total sample, 51.9% (n=264,777) saw wounded, killed or dead individuals and 22.1% (n=112,620) discharged their weapon in combat. Environmental exposures were an important source of stress. Exposures to sand and dust were the largest complaint (89.8% of the sample). Multiple physical symptoms were identified and 40% of the sample reported four or more symptoms (e.g. diarrhea, back pain, headache, fatigue). PTSD symptoms were identified in 11.8% (n = 60,200) and depressive symptoms in 26.5%, (n=123,808) of participants. Results of the study indicated that age, gender, rank, race/ethnicity, military component and branch were important predictors of emotional and health-related concerns in this sample. Appraisal variables (danger of being killed and exposure concerns) mediated the relationship between immediate (physical and depressive symptoms) and long term outcomes (health perception, PTSD symptoms) for the majority of the analyses; supporting the study hypothesis. However, length of deployment did not have a significant impact on stress-related outcomes in this study. Implications for practice, policy and future research are discussed.