Made available in DSpace on 2015-07-22T20:50:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-07-28 / Objetivo: Verificar a prevalência de alterações vocais em adolescentes de 16 anos, estudantes da rede pública estadual da cidade de Recife-PE, com características de bulimia nervosa. Método: Para este estudo foram avaliados 216 adolescentes sendo 80 do gênero masculino e 136 do gênero feminino para identificar os que apresentavam características de bulimia nervosa foi utilizado o Teste de Investigação Bulímica (BITE) e a identificação dos sinais e sintomas vocais foi por meio de análises vocais subjetivas (Escala de GRBASI e Escala Analógica Visual- Escala Numérica EAV-EN) e objetiva (Voxmetria). Resultados: A prevalência de características de bulimia nervosa entre a população estudada foi de 70 indivíduos (32,4%), tendo percentual maior para o gênero feminino 52(74,3%) e menor para o masculino 18(25,7%). Quanto à análise vocal destes indivíduos com características de bulimia nervosa, na escala de GRBASI 19(27,1%) apresentaram vozes normais enquanto que 51(73,9%) mostraram alterações na voz (p<0,001); na EAV-EN 31(44,3%) apresentaram vozes no padrão normal e 39(56,5%) tinham alterações vocais (p<0,001), para o Voxmetria 37(53,6%) possuíam vozes normais e 33(47,1%) tinham algum tipo de alteração (p=0,381). Conclusão: Este estudo apresentou uma alta prevalência de adolescentes com características de bulimia nervosa das escolas públicas da cidade de Recife, com 16 anos de idade, além de encontrar neste grupo um alto percentual de sinais na voz, com isso se conclui a necessidade de que haja uma maior atenção aos riscos causados pelos transtornos alimentares nas vozes dos adolescentes. / Objective: To verify the prevalence of voice disorders in teenagers of 16 years old, students from public schools in the city of Recife-PE, with characteristics of bulimia nervosa. Method: For this study, 216 teenagers were rated with 80 males and 136 females to identify those that had characteristics of bulimia nervosa was used Bulimic Investigatory Test (BITE) and the identification of signs and symptoms vocal was by analysis subjective voice (Scale GRBASI and Visual Analog Scale-Scale Numerical- EN VAS) and objective (Voxmetria). Results: The prevalence of features of bulimia nervosa among the study population was 70 individuals (32.4%) and higher percentage for females 52 (74.3%) and lower for males 18 (25.7%). As for vocal analysis of these individuals with characteristics of bulimia nervosa, scale GRBASI 19 (27.1%) had normal voices while 51 (73.9%) showed changes in voice (p <0.001) in VAS-EN 31 (44.3%) had voices in the normal pattern and 39 (56.5%) had vocal changes (p <0.001) for Voxmetria 37 (53.6%) had normal voices and 33 (47.1%) had some type of change (p = 0.381). Conclusion: This study showed a high prevalence of teenagers with bulimia nervosa characteristics of public schools in the city of Recife, with 16 years of age, and find this group a high percentage of sings in her voice, it concludes with the need that there is greater attention to the risks posed by eating disorders in the voices of adolescents. / TEDE / BV UNIFESP: Teses e dissertações

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-25T12:42:31Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) tese_tatiana_bertulino.pdf: 10443220 bytes, checksum: 79c9bf743bf865c2a6d7ee7c679ecadb (MD5) / Made available in DSpace on 2017-07-25T12:42:32Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) tese_tatiana_bertulino.pdf: 10443220 bytes, checksum: 79c9bf743bf865c2a6d7ee7c679ecadb (MD5) Previous issue date: 2016-06-17 / Os adolescentes aprendem em nossa sociedade que uma das características do sucesso é o corpo magro. Esta pressão social pela magreza está mais presente nas adolescentes, criando o aumento da insatisfação corporal nesta população. A insatisfação com a própria imagem corporal é o cerne dos transtornos alimentares. Entre os transtornos alimentares destaca-se a bulimia nervosa, caracterizada pelos comportamentos de compulsão alimentar associado à purgação. O tratamento clínico recomendável para a bulimia nervosa é a terapia cognitivo-comportamental, realizado por um especialista em transtornos alimentares. Outras formas de intervenção nos pacientes com transtornos alimentares também são utilizadas, entre elas a psicoeducação. O objetivo deste estudo foi de avaliar as possíveis diferenças entre a intervenção psicoterápica do tipo cognitivocomportamental e a intervenção psicoeducativa em adolescentes diagnosticadas com bulimia nervosa. Foi realizado um ensaio clínico, constituído de 11 adolescentes do sexo feminino entre 13 a 19 anos com diagnóstico de bulimia nervosa. Para o diagnóstico utilizou-se a entrevista clínica diagnóstica: Levantamento sobre o Desenvolvimento e Bem – Estar de Crianças e Adolescentes (DAWBA). As adolescentes foram divididas em dois grupos: controle e experimental. No grupo controle, constituído de cinco adolescentes, o tratamento utilizado foi a terapia cognitivo-comportamental em grupo durante 13 encontros em 12 semanas. No grupo experimental, constituído de seis adolescentes, o tratamento utilizado foi a psicoeducação em grupo, em 13 encontros semanais. As medidas primárias de eficácia no estudo foram: diminuição dos sintomas de bulimia nervosa, diminuição dos sintomas de compulsão alimentar e diminuição da insatisfação corporal. Houve diminuição de sintomas de bulimia nervosa nos dois grupos, porém não se comprovou diferença significativa entre os grupos. Em relação a compulsão alimentar não houve modificação nos sintomas em nenhum dos grupos. A insatisfação corporal foi a variável que demonstrou melhora significativa quando os grupos foram analisados em conjunto, porém não houve diferença significativa entre os grupos. Na terapia cognitivocomportamental é aceitável que após o tratamento da bulimia nervosa, os pacientes ainda apresentem sintomas de transtorno alimentar, como a compulsão alimentar, pois o principal objetivo é que o sistema de manutenção das crenças que mantem a bulimia nervosa seja interrompido. A psicoeducação possui como foco o aumento da satisfação com a imagem corporal, o que de fato ocorreu no estudo. A psicoeducação não foca especificamente na melhora da bulimia nervosa e de seus sintomas, como a compulsão alimentar. Apesar de estudos anteriores terem encontrado melhora na relação alimentar dos participantes de psicoeducação, além da melhora nos sintomas da insatisfação corporal. Os dois tratamentos realizados na pesquisa demonstraram diminuição de sintomas, porém essa diminuição não foi significativa em nenhum dos grupos quando avaliados individualmente. É necessária a continuação da pesquisa, com o aumento da amostra e se possível com a análise qualitativa dos dados. A pesquisa demonstrou a possibilidade da utilização da psicoeducação, em um primeiro momento, em populações não crônicas. / Teenagers learn in our society that one of the characteristics of success is a thin body. This social pressure for thinness is more prevalent among the girls, causing increased body dissatisfaction in their group. Dissatisfaction with their own body image is the core of eating disorders. Among the eating disorders, bulimia nervosa stands out, characterized by binge eating behaviors associated with purging. The recommended medical treatment for bulimia nervosa is cognitive-behavioral therapy with a specialist in eating disorders. Other forms of intervention in patients with eating disorders are also used, including psychoeducation. The goal of this study was to evaluate possible differences between the psychotherapeutic intervention of cognitive-behavioral type and the psychoeducational intervention in female teenagers diagnosed with bulimia nervosa. A clinical trial was performed, consisting of 11 female teenagers between 13 and 19 years old, all of whom were diagnosed with bulimia nervosa. The clinical interview Development and Well-Being Assessment (DAWBA) was used for the diagnosis. The teenagers were split into two groups: control and experimental. In the control group, consisting of five teenagers, the treatment used was cognitive-behavioral group therapy for 13 meetings in 12 weeks. In the experimental group, consisting of six teenagers, the treatment used was group psychoeducation, in 13 weekly meetings. The primary effectiveness measures in the study were: reduction of the symptoms of bulimia nervosa, decreased symptoms of binge eating, and decreased body dissatisfaction. There was a reduction of the symptoms of bulimia nervosa in both groups; however, no significant difference was proved between them. Regarding binge eating, there was no change in symptoms in either group. Body dissatisfaction was the variable that showed most significant improvement when the groups were analyzed together, but once again there was no significant difference between groups. In cognitive-behavioral therapy, it is acceptable that after the treatment of bulimia nervosa, patients still present symptoms of eating disorders such as binge eating, because the main goal is that the system of beliefs which sustains bulimia nervosa is interrupted. Psychoeducation, on the other hand, focuses on increasing body image satisfaction, which actually happened in the study; psychoeducation does not focus specifically on the improvement of bulimia nervosa and its symptoms, though previous studies have found an improvement in the participants' relationship with food, besides an improvement in the symptoms of body dissatisfaction. Both treatments carried out in the research showed decreased symptoms, but this decrease was not significant in either group when assessed individually. Continued research, with a larger sample and qualitative data analysis, if possible, is required. The study has shown the possibility of using psychoeducation, at first, in nonchronic populations.

Abstract: The present study was designed to answer the following questions: (a) What is the level of awareness patients with Bulimia Nervosa (BN) and the professionals who work with them regarding the vocal health risks associated with self-induced vomiting? (b) Is the bulimic population at risk for under-referral for assessment and treatment of vocal pathology? (c) How do patients and professionals perceive the role of the Speech-Language Pathologist (SLP) in the treatment of eating disorder-related vocal pathology? Three original surveys were developed to address the research questions. There was one survey for individuals with a history of BN, one for SLPs, and one for other health care professionals involved in the care of bulimic individuals. There were 89 total participants in the present study. Thirty were respondents to the Health Care Providers Survey, 28 were respondents to the SLP Survey, and 31 were respondents to the Patient Survey. Results indicate a general lack of awareness concerning these risks and treatment options to address them on the part of patients and health care professionals and a lack of specific knowledge of how to recognize and treat individuals with BN on the part of SLPs. Results from all three groups supported the notion that the bulimic population is at risk for under-referral for treatment for voice disorders. Finally, results suggest that SLPs do in fact provide services to persons with BN, but that at present, patients and other health care professionals do not seem to perceive the SLP as having a role in management of care of this population. / text

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The role of dieting in the etiology and maintenance of bulimia nervosa remains unclear, and current treatments, which primarily aim to eliminate dieting behaviors, demonstrate limited efficacy. The purpose of this study was to conduct a randomized treatment trial to test whether healthy dieting maintains bulimic symptoms or effectively reduces this eating disturbance. Female participants (N=85) with full and subthreshold bulimia nervosa were randomly assigned to a 6-session healthy dieting intervention or waitlist condition and assessed through 3-month follow-up. Relative to control participants, intervention participants showed modest weight loss during treatment and demonstrated significant improvements in bulimic symptoms that persisted through follow-up. These preliminary results suggest that this intervention shows potential for the treatment for bulimia nervosa and may be worthy of future refinement and evaluation. Results also provide experimental evidence that dieting behaviors do not maintain bulimia nervosa, suggesting the need to reconsider maintenance models for this eating disorder. / text

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