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La mastocytose se définit par une accumulation excessive de mastocytes dans un ou plusieurs organes ou tissus. Si dans la plupart des cas la maladie ne diminue pas l’espérance de vie, elle reste néanmoins associée à un handicap souvent mal connu et mal compris. Malgré l’importance des manifestations neuropsychiatriques accompagnant la mastocytose, les efforts concentrés sur leur compréhenson et celle de leurs liens avec la maladie ont été longtemps mis au second plan. L’objectif de cette thèse était de mieux connaître ces troubles neuropsychologiques, notamment la dépression et les troubles de l’attention/ mémoire, d’investiguer les liens entre ces troubles et des aspects biologiques et émotionnels comme l’effet d’un inhibiteur de tyrosine kinase bloquant les mastocytes sur la dépression ; les liens entre le stress perçu, la dépression et la longueur des télomères ; et les liens entre dépression et compétences de régulation émotionnelle. Nos résultats montrent que la dépression est un symptôme fréquent dans la mastocytose, ainsi que les troubles de la mémoire. Ces derniers ne semblent pas liés à la dépression. Par ailleurs, la dépression est améliorée par un traitement visant les mastocytes ; le stress perçu chez ces patients est lié à la longueur des télomères et le métaolisme du tryptophane, en particulier l’activité de l’IDO est associée aux troubles neuropsychologiques chez ces patiens. Ces résultats ouvrent des nouvelles perspectives dans la compréhension des symptômes psychologiques associés à la mastocytose. / Mastocytosis is defined as an excessive accumulation of mast cells in one or more organs or tissues. While in most cases the disease does not reduce life expectancy, it is associated with a disability often poorly known and poorly understood relate to the symptoms due to the release of mast cell mediators. Despite the importance of these neuropsychiatric manifestations, efforts focused on their understanding and their relationship to the disease has been put into the background. The aim of this thesis was to better know these neuropsychological disorders present in mastocytosis, including depression and attention deficit disorder and to investigate the relationship between these disorders and biological and emotional aspects as effect of an inhibitor of tyrosine kinase locking mast cells, the relationship between perceived stress, depression, and telomere length, and the links between depression and emotional regulation skills. Our results show that depression and memory disorders are common symptoms in mastocytosis. Attention impairment do not seem related to depression. Furthermore, depression is improved by masitinib treatment. Perceived stress in these patients is related to telomere length and tryptophan metabolism; in particular the activity of IDO is associated with neuropsychological disorders. These results open new perspectives in understanding the psychological symptoms associated with mastocytosis.

Die vorliegende Arbeit untersucht Zusammenhänge zwischen verschiedenen Vulnerabilitätsfaktoren der Depression und deren Einflüsse auf den Krankheitsverlauf bei stationär behandelten, depressiven Patienten.

Ce travail de thèse étudie l'impact du théâtre thérapeutique utilisant à la fois des exercices d’improvisation et des jeux théâtraux structurés auprès de patients obèses. Ainsi, 44 sujets bénéficient-ils de 5 séances avec cette modélisation dans le cadre d'un programme d'éducation thérapeutique au cours d’une hospitalisation standardisée de 3 semaines. Un groupe de 50 sujets bénéficient du même programme de soin mais sans de théâtre thérapeutique ; ils forment le groupe contrôle. Tous ont été explorés en procédure test/retest au niveau de l’alexithymie (TAS-20), l’estime de soi (ETES), les troubles du comportement alimentaires (EDI-2), et les stratégies de coping (Brief COPE). Par ailleurs, les représentations et le vécu du groupe expérimental a été recueilli en post hospitalisation (questionnaires ECTM). Les résultats indiquent une augmentation significative des scores de l'estime de soi émotionnelle, une diminution de pensée orientée vers l’extérieur et les scores d'utilisation des stratégies de coping tournées vers le soutien social augmentent. De même, leur investissement dans ses activités parait s’inscrire durablement comme processus de changement et contribue à leur inscription socioculturelle. Cette étude permet d'avancer la pertinence d'utiliser une technique de théâtre thérapeutique structurée et manuélisée auprès de patients obèses. / The work of this thesis studies the impact of drama therapy using improvisation exercises as well as structured theatre games with obese patients. In this context 44 individuals received 5 sessions using this model of therapy in the context of a therapeutic education program during a standardized 3-week hospitalization. A group of 50 individuals received the same program of care but which did not include drama therapy; they formed the control group. All were estimated, in test/retest procedure, at the level of the alexithymia (TAS-20), self-esteem (ETES), the eating disorder, and strategies of coping (Brief COPE). Furthermore the representations and experiences of the experimental group were collected post-hospitalization (ECTM questionnaires). The results indicate a significant increase in scores of emotional self-esteem, a decrease in outward-oriented thinking and an increase in the scores of coping strategies geared towards social support. This study suggests the appropriateness of using structured and codified drama therapy techniques with obese patients. Similarly, the participation in those activities seems to indicate a sustainable process of change and to contribute to their socio-cultural assimilation.

Made available in DSpace on 2016-04-04T18:27:34Z (GMT). No. of bitstreams: 1 Ana Paula FPregnolatto.pdf: 230365 bytes, checksum: f0f9540c03031709a2d9741c1eaeeda4 (MD5) Previous issue date: 2005-02-11 / The chronic renal failure is a disease that evolves slowly, gradually and irreversibly causing physical and emotional damage. Studies on the emotional aspects of patients undergoing hemodialysis procedures emphasize that they are a special group among chronic disease patients, because the procedure itself and the individual s dependence on the equipment involved assume great importance on the individual s life. These stressful aspects can, therefore, cause special effects on the emotions and behavior of these patients, overloading the depressive symptoms caused by uremia itself. Among the pathologies and conditions related to emotions, alexithymia stands out. The term been applied to an individual s difficulty to express emotions and affection. Alexithymia and its psychopathological symptoms are considered to have influence on diagnosis, prognosis, and the way a patient can cope with the different forms of treating renal failure. That being so, the evaluation and identification of these aspects can provide a better understanding of them in order to identify and offer to these patients more adequate psychological treatment and a program of prevention and mental health involving patients and the health team. For this study the sample include 48 patients who have been receiving hemodialysis at the hospital of the University School of Medicine in the state of S?o Paulo, Brazil. The sample was stratified according to the type of renal disease presented. The tools used were Identification Form, The Toronto Alexithyimia Scale (TAS) and the Symptoms Evaluation Scale (EAS-40). The sample was distributed like the following: men (60,4%); age between 40 and 59 years of age (58,3%); basic education (50%); retired or on sick leave (47,9%). High blood pressure (41,6%); diabetes mellitus (31,3%); chronic glomerule nephritis (27,1%). Regarding alexithymia 52% of the patients presented scores equal or superior to 74, and 4,2% presented scores equal or inferior to 62. 43,8% of the subjects are on the range between 63 and 73 points. The average score of the sample was 74 and DP 7,52. The results show that patients undergoing hemodialysis present high scores on TAS, regardless of sex, level of education, marital status, occupation, age or diagnosis, and the differences between these variables were not significant. Concerning the psychopathological symptoms, the average score was 0,63 and DP 0,37 , and there were no significant differences between the social and demographic variables. Regarding the association between alexithymia and psychopathological symptoms the results show significant relation between the total scores of TAS and EAS-40; and also between the total score of TAS and Factors 1, 2 and 3 of EAS-40, which fulfill the theoretical expectations. Although further research is needs to identify how these aspects believe in other groups, our finding confirm that alexithymia is related to psychopathological symptoms. / A insufici?ncia renal cr?nica (IRC) ? a uma doen?a de instala??o lenta, gradativa e irrevers?vel das fun??es renais, levando o indiv?duo a ter altera??es f?sicas e emocionais. Estudos sobre os aspectos emocionais de pacientes em hemodi?lise enfatizam que estes comp?em um grupo especial entre os portadores de doen?a cr?nica, pois o tratamento, e a depend?ncia dos equipamentos utilizados assume grande import?ncia na vida da pessoa. Assim, estes aspectos podem acentuar caracter?sticas especiais na sua afetividade e no seu comportamento, salientando que a pr?pria uremia pode produzir sintomas depressivos. Dentre as altera??es e patologias relacionadas ?s emo??es destaca-se a alexitimia, que designa a dificuldade de expressar afetos ou emo??es. Considera-se que a alexitimia e os sintomas psicopatol?gicos podem influenciar no diagn?stico, no progn?stico e na forma de rea??o do sujeito ? modalidade de tratar a insufici?ncia renal. Desta maneira a avalia??o e identifica??o destes aspectos possibilitam uma melhor compreens?o destes visando um tratamento psicol?gico mais adequado a esta popula??o e um trabalho de preven??o e promo??o da sa?de mental com estes pacientes e tamb?m com a equipe. Para este estudo a amostra ? composta de 48 pacientes em hemodi?lise de um hospital escola no interior de S?o Paulo. Esta foi estratificada em fun??o da doen?a renal apresentada. Os materiais utilizados foram ficha de Identifica??o, a Escala de Alexitimia de Toronto (TAS) e a Escala de Avalia??o de Sintomas (EAS-40). Amostra ficou distribu?da com um predom?nio de: pacientes do sexo masculino (60,4%), casados (50%), na faixa et?ria entre 40 e 59 anos de idade (58,3%), com ensino b?sico (50%), aposentados ou afastados do trabalho (47,9%). Quanto ao diagn?stico, 41,6% t?m hipertens?o arterial sang??nea, 31,3% diabetes mellitus e 27,1%, glomerunefrite cr?nica. Quanto ? alexitimia, observou-se que 52% dos participantes apresentaram pontua??o igual ou maior que 74 e que 4,2% obtiveram escore igual ou inferior a 62. E, 43,8% dos sujeitos encontram-se na faixa de 63 a 73 pontos. J? a m?dia geral da amostra foi 74 e DP 7,52. Verificou-se que pacientes submetidos a hemodi?lise apresentam altos escores na TAS, independentemente do sexo, n?vel de escolaridade, estado civil, atividade profissional, idade e hip?tese diagn?stica e que n?o houve diferen?as significantes entre estas vari?veis.Em rela??o aos sintomas psicopatol?gicos a pontua??o m?dia foi de 0,63 e DP 0,37 e tamb?m n?o houve diferen?as significantes nas categorias segundo as vari?veis s?cio-demogr?ficas. Em rela??o ? associa??o entre alexitimia e sintomas psicopatol?gicos averiguou-se correla??o significantes entre os escores totais da TAS e EAS_40 e entre o escore total da TAS e os fatores 1, 2 e 3 da EAS-40, que correspondem a expectativa te?rica. Logo, os resultados deste trabalho confirmam que para esta popula??o a alexitimia se associa com os sintomas psicopatol?gico e a necessidade de futuras pesquisas para conhecermos como estes aspectos se comportam em outras popula??es.

Ce travail étudie les différents mécanismes cognitifs, affectifs et cérébraux de l'anxiété, en distinguant les effets de l'anxiété-trait, l'anxiété-état et les effets de l'alexithymie. L'objectif était notamment de définir les dissociations entre les dimensions trait et état et l'influence de l'alexithymie comme marqueur de difficultés de régulation émotionnelle. Dans cette perspective, nous avons conduit plusieurs travaux dans une approche dimensionnelle (en continuum). Dans les premières études testant les capacités attentionnelles et de contrôle inhibiteur, les résultats ont objectivé différents patterns de distinction entre l'anxiété-trait et état (d'altération ou d'amélioration de la performance) et des effets améliorateurs ou perturbateurs de l'alexithymie sur les performances. En outre, une distinction entre les paradigmes d'émotions dimensionnelles (tâche de Stroop) versus catégorielles (tâche de Simon) sont apparus. La troisième étude en IRMf est venue appuyer les similitudes et distinctions entre d'une part l'anxiété dans ses dimensions trait, état et sociale, et d'autre part l'alexithymie. Enfin la quatrième étude a permis de situer l'anxiété dans un spectre d'affectivité négative (peur et tristesse) distinguée mais en lien avec les affects de colère. Ces deux profils émotionnels ont entretenu des relations opposées avec les facteurs cognitifs de la régulation émotionnelle (basés sur l'alexithymie et l'empathie). L'ensemble des résultats a conduit à une conceptualisation de l'anxiété et de l'alexithymie basée sur les processus de sur-activation et d'inhibition émotionnelle. / This study examines the cognitive, affective and neutral components of anxiety, distinguishing the effects of trait-anxiety, state-anxiety, and the impact of alexithymia. The objective was to define the particular dissociation between trait and state anxiety and the influence of alexithymia as a marker of emotion dysregulation. In this way, we conducted several studies in a dimensional approach (continuum). In the first and second studies testing the attentional abilities and inhibitory control, the results revealed different patterns that supported the distinction between state and trait anxiety (alteration or improvement of the performance) and enhancers or disruptive effects of alexithymia on the cognitive performance. In addition, a distinction between the paradigms constituted by a dimensional approach of emotions (positive versus negative words, Stroop task) versus categorical approach (with facial expressions, Simon task) appeared. The third study using fMRI highlighted the similarities and differences between on the one hand the dimension anxiety (trait, state and social anxiety), and on the other hand alexithymia. Finally, the fourth study permitted to define anxiety in a spectrum of negative affects (profile of fear and sadness). It also permitted to distinguish it from the affects of anger, but underlined a relation between them. These two profiles (negative affects and affects of anger) were differentially related to cognitive factors of emotion regulation (based on alexithymia and empathy). These overall results led to a conceptualization of anxiety and alexithymia based on over-activation and emotional inhibition.

Syftet var att undersöka om exponering inför emotionella röster påverkar muskelanspänning och hjärtats slagfrekvens samt om det finns en samvariation mellan storlek eller längd på muskelanspänning vid aversiv emotionell input och grad av alexitymi. 24 studenter lyssnade på arga, glada och neutrala röster samtidigt som muskelanspänning mättes med EMG och hjärtats slagfrekvens med EKG. Grad av alexitymi mättes med Toronto Alexithymia Scale 20. Resultaten visade att arg eller glad röststimuli gav större muskelanspänningen än neutralröststimuli. Ingen skillnad i muskelanspänning fanns mellan arg eller glad röst. Det fanns inget samband mellan storlek eller längd på muskelanspänning och grad av alexitymi. / The object was to investigate whether exposure to emotionally valid voices, affect muscle tension and heart rate, and if there is a correlation between size or length of muscle tension during aversive emotional input and degree of Alexithymia. 24 students listened to angry, happy and neutral voices while muscle tension was measured by EMG and heart rate by EKG. Degree of Alexithymia was measured by Toronto Alexithymia Scale 20. The results showed that angry or happy voice stimuli caused higher muscle tension than neutral voice stimuli. No difference in muscle tension was shown between angry and happy voice. There was no correlation between size or length of muscle tension and degree of Alexithymia.

This correlational and experimental study examines how people with different levels of alexithymia and emotional intelligence write about their emotional experiences. Because research on expressive writing (writing about important emotional experiences) has found such far-reaching therapeutic benefits, and attributes much of it to expressive writing's linguistic properties, exploring how a person's emotional understanding relates to language matters. Sixty-eight participants engaged in Pennebaker's expressive writing paradigm, and their word usage was measured on a number of categories, as given by the Linguistic Inquiry and Word Count program. Results indicated that different levels of emotional intelligence and alexithymia correlated with certain parameters of word usage. However, few relationships were observed between the two attributes and change in word usage over time.

Aleksitimiški žmonės pasižymi silpnu gebėjimu kognityviai apdoroti ir reguliuoti emocijas, dėl to jiems yra sunku emocijas ir jausmus atskirti nuo kūno pojūčių, sunku jomis bendrauti, tokie žmonės pasižymi į išorę orientuotu mąstymu ir silpna vidine introspekcija. Šio tyrimo tikslas - nustatyti vyresnių klasių moksleivių aleksitimiškumo sąsajas su tabako rūkymu, alkoholinių gėrimų vartojimu ir požiūriu į juos bei šias medžiagas vartojančius asmenis. Tyrime dalyvavo 236 dviejų Jurbarko mokyklų vyresnių klasių moksleiviai (16-19 metų amžiaus) iš kurių rūkė 138 (42,30 %) moksleiviai, alkoholinius gėrimus vartojo 196 (60,1 %) moksleiviai. Tyrimo metu moksleiviai pildė savižinos klausimyną, sudarytą iš TAS-20 skalės, skirtos aleksitimiškumui matuoti, klausimų apie tabako rūkymo ir alkoholio vartojimo ypatybes ir skalių, skirtų požiūriui į tabako rūkymą, alkoholio vartojimą ir šias medžiagas vartojančius asmenis nustatyti. Tyrimo rezultatai parodė, kad rūkymas su aleksitimiškumu nesisieja, tačiau dažnesnis ir didesnio kiekio alkoholinių gėrimų vartojimas statistiškai reikšmingai siejasi su labiau išreikštu aleksitimiškumu berniukų tarpe. Taip pat nustatyta, kad anksčiau alkoholinius gėrimus pradedantys vartoti moksleiviai (berniukai iki 13 metų, mergaitės iki 14 metų) pasižymi labiau išreikštu alekstimiškumu ir prastesniu gebėjimu atpažinti emocijas ir jausmus. Aleksitimiškumas su požiūriu nesisiejo. / Alexithimics are described as having poor cognitive emotion processing and regulation. For that reason, alexithimics have difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal, difficulty in communicating emotions, and have external oriented thinking style and weak introspection. The aim of the study was to assess alexithymia associations with tobacco smoking, alcohol consumption and attitudes towards them and towards persons who consume these substances. The subjects of the study were 236 upperclassmen (age 16-19) from two schools in Jurbarkas. 138 (42,30 %) subjects smoked tobacco and 196 (60,1 %) consumed alcohol. Participants filled in a questionnaire composed of TAS-20 scale, questions about tobacco smoking, an evaluation of alcohol consumption, and an attitude scale towards tobacco and alcohol consumption and people who use these materials. The results of the study showed that there is no association between alexithymia and tobacco smoking. However, alcohol consumption has significant associations between alexithymia and frequent and larger quantities of alcohol consumption in the boy's sample. Also found was a significant association between alexithymia and early alcohol drinkers (for boys by 13 years old and for girls by 13 years old). These early alcohol drinkers also showed difficulty identifying feelings. This study showed no associations between alexithymia and the attitudes toward tobacco smoking... [to full text]

This study profiled the mental health needs of youth incarcerated in southern Ontario. The objectives were three-fold. 1) To demonstrate that incarcerated youth endorsed more externalizing than internalizing difficulties on a self-report measure of psychopathology. 2) To demonstrate that incarcerated youth had cognitive vulnerabilities consistent with anxiety and depression, despite their general lack of overt endorsement of internalizing symptoms. 3) To demonstrate that socialization practices in the home and community predicted the endorsement of psychopathology, and to provide a possible explanation for this relationship by considering alexithymia as a mediating variable. The Adolescent Psychopathology Scale – Short Form, Mill Hill Vocabulary Scale, Toronto Alexithymia Scale, Family Expressiveness Questionnaire, Street Codes Questionnaire, Cultural Mistrust Inventory, and a Dot Probe task were administered to 91 adolescents incarcerated in Southern Ontario. Results indicated that incarcerated youth endorsed significantly greater externalizing than internalizing symptoms. Youth demonstrated significant attentional biases toward threatening, but not depressive faces. Negative dominant socialization practices in the home predicted the endorsement of both externalizing and internalizing symptoms, and there was partial support for alexithymia mediating these relationships. Youth who embraced community practices that socialized violence endorsed externalizing but not internalizing difficulties. These results challenge clinicians to consider the internalizing difficulties of incarcerated youth more carefully during assessment.